Recovery After mTBI: What Does It Mean and How Do We Measure It?

Abstract

Traumatic brain injuries (TBIs) are proving to be a significant public health issue, with over 36,000 new cases each year in New Zealand. The majority (95%) of these cases are classified as mild (mTBI). Most patients recover within days to weeks after the injury. However, for some patients recovery is not achieved and they still experience symptoms months to years after their injury. One of the issues in determining why some individuals do not recover as quickly as others is that there is no comprehensive patient-reported measure of what it means to be recovered after mTBI. My research consists of three phases. In the first phase I interviewed 14 patients who had experienced at least one mTBI to determine what recovery means to them. Using thematic analysis, I identified three themes that were part of the recovery process: 1) an ability to function without limitations; 2) regaining a sense of self; and 3) symptom resolution. Most participants judged their recovery based on how they were feeling and felt there was a need to have a way of monitoring how they were doing over time. In the second phase I used the participants’ quotes and themes to create a questionnaire designed to measure recovery after mTBI. The initial set of 18 prototype items have been reviewed by five people with personal experience of mTBI and a panel of mTBI experts to refine the language used and ensure all major components of recovery are captured.  In the third phase of my research, I will ask 200 people who have experienced a mTBI to complete the prototype questionnaire so we can establish its validity and reliability to determine its utility to be used as a tool in clinical practice to monitor people’s recovery. In this presentation I will summarise my results from the first and second studies and outline the plans for future research.