Since 1995 the Monash-Epworth Rehabilitation Research Centre (MERRC) has been following a group of individuals with severe Traumatic Brain Injury (TBI), in a project funded by the TAC that aims to paint a comprehensive picture of how TBI affects the lives of patients and their families. This project has since come to be funded by ISCRR and represents a landmark piece of research in this field.
MERRC researchers have interviewed people with traumatic brain injury at one, two, three, five, ten and 20 years after their injury, assessing the following factors:
- neurological functioning (e.g. sight, hearing, epilepsy)
- mobility (ability to move)
- cognitive functioning (e.g. ability to think, learn, understand and control behaviour)
- emotional state (e.g. symptoms of depression, anxiety or post-traumatic stress disorder)
- ability to communicate
- independence in everyday living
- ability to retain employment
- ability to maintain relationships
- ability to participate in leisure activities.
The aim of the project is to assess how individual injury and recovery processes affect these factors. This information can then be used to improve the lives of others with TBI, and to assist the TAC in planning.
Significantly, this research finds that the TBI recovery process is highly influenced by people's personal backgrounds. For example, poorer outcomes are noted in people who are older, have less education, come from culturally and linguistically diverse backgrounds, have pre-injury mental health problems or have poor coping mechanisms.
The research also confirms that the length of post-traumatic amnesia experienced after injury can be used to predict the severity of long-term employment outcomes and costs of care.
Through a collaboration with TIRR Memorial Hermann in the USA, several groupings have been developed, based on the profile of people's symptoms, that help to identify different patterns of outcomes after injury. The findings also highlighted that factors other than injury severity contribute to longer-term outcomes. These include the personal strengths of the individual, including independence and self-esteem and resilience, as well as economic and family supports, the person's level of emotional distress and motivation to recover. If it is possible to identify these groups early it may be possible to tailor appropriate treatments to address issues relevant to each profile with the ultimate aim of improving outcomes.
This group of researchers has produced a significant number of journal articles:
- Costs of care after traumatic brain injury
- Factors contributing to outcome following traumatic brain injury
- Longitudinal follow-up of patients with traumatic brain injury: Outcome at two, five and ten years post-injury
- The experience of challenging behaviours following sever traumatic brain injury: A family perspective