Long-Term Outcomes and Needs of Military Service Members After Noncombat-Related Traumatic Brain Injury

Abstract

Needs for services following TBI are associated with poor symptomatic and functional outcomes and may persist for years after injury in military service members and veterans. The study suggests service members' needs post TBI for improved cognition, support for emotional issues, and resources for vocational skills. Information about available services should be made accessible to those recovering from TBI to reduce the incidence of long-term unmet needs.

Rehabilitation Needs at 5 Years Post-Traumatic Brain Injury: A VA TBI Model Systems Study

“…Furthermore, 63% of our sample reported having at least 1 rehabilitation need that remained unmet, which is highly consistent with a previous study showing that 65% of veteran participants at various time points post-TBI reported at least 1 unmet rehabilitation need. 20 The most common unmet rehabilitation needs reported in this study were improving memory, controlling physical symptoms, managing emotions/ controlling temper, solving problems, and improving health. This reporting of broad cognitive, physical, and psychological needs is consistent with prior qualitative and quantitative studies that have examined such needs in patients with TBI at various time points postinjury.…”

“…In fact, the only other study that used a veteran population failed to find any differences in demographic or injury characteristics for their 0, 1 to 2, and 3+ unmet needs groups. 20 In addition, while injury severity has been a fairly reliable predictor of rehabilitation needs in the literature, the VA TBIMS enrolls only participants who participated in inpatient rehabilitation at a PRC. Therefore, those who are classified as having a mild TBI likely sustained significant extracranial injuries or were diagnosed with a comorbid mental health condition to qualify them for admission to these inpatient units.…”

“…Other investigations have utilized structured questionnaires to quantify the prevalence of these needs. 9,10,[17][18][19][20] Although the methods of these investigations differed in terms of the time since injury, specific needs queried, and focus on the presence of needs in general versus unmet needs, they universally demonstrated a significant proportion of participants (35%-70%) reporting at least 1 rehabilitation need. Several of these studies also found that demographic and injury-related characteristics are related to greater rehabilitation needs.…”

“…This study included V/SM with any severity of TBI (46% mild) at various times postinjury (2.5-8.2 years) and indicated that 65% of participants reported at least 1 unmet rehabilitation need. 20 The most commonly endorsed unmet needs included receiving information about TBI services (46.1%), improving memory/attention (43.8%), improving mood (32.6%), and learning job skills (29.2%). Demographic and injury characteristics failed to differentiate between those who endorsed different number of unmet needs (ie, 0, 1-2, or 3+).…”

“…Common themes identified include continued need for services related to cognitive symptoms (eg, memory dysfunction), physical symptoms (eg, balance, sleep disturbance), psychological functioning, and social and community reintegration. Other investigations have utilized structured questionnaires to quantify the prevalence of these needs 9,10,17–20. Although the methods of these investigations differed in terms of the time since injury, specific needs queried, and focus on the presence of needs in general versus unmet needs, they universally demonstrated a significant proportion of participants (35%-70%) reporting at least 1 rehabilitation need.…”