The Effects of Goal-Oriented Long-Term Rehabilitation of Persons with Acquired Brain Injury on Quality of Life after Injury
Abstract
Background: After completing primary medical rehabilitation, persons who have suffered a severe brain injury most often need appropriate professional help and counseling as well as inclusion in stimulating environment that enables progress, learning and support in finding new life goals upon returning to their home environment and in finding sense in life after severe acquired brain injury. We are talking about a long-term need for psycho-social and health care or about long-term rehabilitation. This is the kind of service that we provide at Center Naprej Maribor. We are a specialized regional center that provides high intensity services of long-term rehabilitation for persons with acquired brain injury (ABI).
Objectives: The aim of our study was to evaluate whether application of an established and goal-oriented rehabilitation program in persons with acquired brain injury can help in setting life goals, finding meaning in life and improving the quality of life.
Methods: Participants: We included 43 persons with acquired brain injury, of which 32,6 % women and 67,6 % men, average age was 51,86 years. All of the participants are included in long-term rehabilitation program in Center Naprej. The duration of their treatment in Center Naprej is from 1 to 14 years. 39,5 % participants suffered a traumatic brain injury and 60,5 % participants suffered a non-traumatic brain injury. Measurements: Wheel of life - an internal document of Center Naprej, that is a part of individual rehabilitation plan (Center Naprej, 2018), Quality of Life after Brain Injury – QOLIBRI (Von Steinbuechel et al., 2010) and self-evaluation of rehabilitation goal achievement (Center Naprej, 2019).
Results: The results of our research show a significant effect of treatment provided in Center Naprej on different life areas of the participants (evaluated with the measuring instrument Wheel of Life) (p<0,01). The interaction between the duration of treatment and the quality of life after brain injury (QOLIBRI), as well as between the duration of treatment and important areas of life (Wheel of life) can also be seen (p<0,01). There is also a trend towards significance of effect of treatment with the duration of treatment (p=0,06, η2=0,11).
Conclusions: Research evidence supports the significant effects of treatment and the impact of length of treatment on satisfaction with life areas and quality of life of persons with acquired brain injury. The paper summarizes the recommendations and presentation of goal-oriented rehabilitation, which illustrates the usefulness of the proposed theoretical framework in the context of rehabilitation for effective optimization of treatment in setting personal goals and the meaning of rehabilitation of persons with ABI in long-term rehabilitation in the lifelong period after injury.