Factors influencing community case management and care hours for clients with traumatic brain injury living in the UK

Figures & data

Table I. Care and case management.

Variable	Group 1 (n = 76)	Group 2 (n = 65)
	n (%)	n (%)	p-value
Family Care/support
No family care	12 (16)	26 (40)	0.027
Less than 1 hour per week	6 (7)	4 (6)
Less than 1 hour per day	18 (24)	7 (10)
Over 1 hour per day	40 (53)	28 (43)
Total CM hours
< 50	22 (29)	18 (28)	0.001
51–100	24 (32)	12 (18)
101–150	16 (21)	7 (11)
151–250	9 (12)	6 (9)
> 250	5 (6)	22 (34)
Weekly CS hours	n = 70	n = 58
Mean total care hours	47.8	73.9	< 0.05
Mean day care hours	36.8	57.3	< 0.05
Mean night care hours	10.27	18.2	< 0.05

Table II. Range, median and percentage independent on ABCCS items for Groups 1 and 2.

ABCCS variable	Item range	Group 1 (Median)	Group 1: Percentage independent (no impairment) (n = 76)	Group 2 (Median)	Group 2: Percentage independent (no impairment) (n = 65)	Mann-Whitney U comparing Groups 1 to 2 item scores
Functional items
Continence	0–5	5.00	84%	5.00	79%	0.45
Dressing	0–4	4.00	53%	3.00	48%	0.60
Bathing	0–4	4.00	51%	3.00	48%	0.65
Eating/drinking behaviour	0–3	3.00	72%	3.00	71%	0.66
Indoor mobility	0–6	5.00	73%	5.00	63%	0.85
Meal preparation (complex)	0–3	2.00	11%	2.00	19%	0.71
Street crossing	0–4	3.00	45%	3.00	34%	0.10
Functional-cognition items
Attention	0–3	2.00	8%	2.00	15%	0.39
Appointment keeping	0–3	1.00	7%	0.00	17%	0.38
Insight	0–3	2.00	11%	2.00	26%	0.01**
Impulsivity	0–7	5.00	30%	6.00	34%	0.87
Anxiety	0–5	5.00	54%	5.00	54%	0.55
Consideration of others	0–3	1.00	23%	1.00	22%	0.60
Behaviour items
Response to direction	0–4	2.00	13%	3.00	17%	0.10
Predictability	0–3	2.00	20%	2.00	25%	0.83
Verbal aggression type	0–6	5.00	32%	5.00	28%	0.95
Verbal aggression frequency	0–3	2.00	32%	2.00	23%	0.60
Physical aggression type	0–9	8.00	71%	9.00	72%	0.91
Physical aggressionFrequency	0–3	3.00	73%	3.00	66%	0.47
Frustration tolerance	0–3	1.00	20%	1.00	17%	0.57
Telephone etiquette	0–2	2.00	77%	2.00	74%	0.47
Handicapping social behaviour	0–10	10.00	71%	10.00	72%	0.93
Opportunistic behaviour	0–6	6.00	68%	6.00	66%	0.49
Sexual behaviour	0–6	6.00	76%	6.00	74%	0.53
Miscellaneous disturbed	0–10	10.00	95%	10.00	88%	0.13

** p < 0.01.

High scores on ABCCS items indicate independence and lower scores indicate dependence.

Table III. Demographic and clinical characteristics of case management in Groups 1 and 2.

Variable	Group 1 (n = 76)	Group 2 (n = 65)	p-value
	Mean ± SD	Mean ± SD
Age	33.37 ± 13.3	37.5.9 ± 12.1	0.06, ns
Age when injured	25.8 ± 14.8	25.3 ± 12.3	0.83, ns
Years post-injury	7.7 ± 5.1	12.17 ± 6.2	0.001
Years of CM	3.5 ± 2.9	5.7 ± 4.6	0.001
Not in education or employment	n (%)	n (%)
Pre-injury	8 (10)	7 (10)	0.46, ns
Post-injury	47 (61)	54 (83)	0.01
Gender Male	48 (63)	45 (69)	0.448, ns
GCS score	n = 43	n = 50
3–8	31 (72)	43 (86)	0.21, ns
9–12	5 (12)	4 (8)
13–15	7 (16)	3 (6)
Coma duration	n = 30	n = 37
< hour	0 (0)	2 (5)	0.02
1–24 hours	2 (6)	1 (3)
2–7 days	13 (43)	5 (14)
> 7 days	15 (50)	29 (78)
Duration of PTA	n = 31	n = 42
< hour	1 (3)	0 (0)	0.01
1–24 hours	4 (13)	0 (0)
2–7 days	10 (32)	7 (16)
> 7 days	16 (52)	35 (83)

Table IV. Correlations between CM hours, CS hours and demographic variables in Groups 1 and 2.

Demographic variable	CM Group 1		CM Group 2
	CM hours	CS hours	CM hours	CS hours
Age	–0.18 (n = 76)	0.01 (n = 67)	–0.18 (n = 65)	0.11 (n = 54)
Age at injury	–0.44 (n = 76)	–0.14 (n = 67)	–0.04 (n = 65)	0.11 (n = 54)
Years post-injury	0.05 (n = 76)	0.42*** (n = 67)	–0.41** (n = 65)	–0.73 (n = 54)
GCS score	0.22 (n = 43)	–0.32* (n = 38)	–0.06 (n = 50)	–0.36** (n = 43)
Coma duration	0.11 (n = 30)	0.38* (n = 26)	0.11 (n = 37)	0.422* (n = 29)
PTA duration	0.11 (n = 31)	0.04 (n = 27)	–0.03 (n = 42)	0.288 (n = 35)
Years of case management	0.11 (n = 76)	0.39*** (n = 67)	–0.28* (n = 65)	0.03 (n = 54)
Care total week	0.20 (n = 67)	1.00 (n = 67)	0.43*** (n = 54)	1.00 (n = 54)
Case management	1.00 (n = 76)		1.00 (n = 54)

* p < 0.05; ** p < 0.01; *** p < 0.001.

Table V. Correlations between ABCCS item scores and hours of case management and hours of care in Groups 1 and 2: only variables with at least one significant correlation are shown.

ABCCS variable	Group 1 (n = 76)		Group 2 (n = 65)
	CM hours	CS hours	CM hours	CS hours
Functional items
Continence	ns	–0.31*	ns	–0.36**
Dressing	ns	–0.44**	ns	–0.35**
Bathing	ns	–0.43**	ns	–0.50**
Eating/drinking behaviour	ns	–0.34**	ns	–0.44**
Indoor mobility	ns	–0.25*	ns	ns
Meal preparation	ns	–0.36**	ns	–0.41**
Street crossing	ns	–0.35**	ns	–0.61**
Functional-cognition items
Attention	ns	–0.35**	ns	ns
Appointment keeping	ns	ns	–0.25*	–0.29*
Insight	–0.34**	–0.34**	–0.30*	–0.49**
Impulsivity^a	0.27*	ns	0.25*	ns
Anxiety^a	0.25*	ns	ns	0.30*
Consideration of others	ns	–0.34**	–0.27*	–0.27*
Behaviour items
Response to direction	–0.23*	–0.32*	–0.40**	ns
Predictability	–0.44**	ns	–0.35**	ns
Verbal aggression type	–0.30**	ns	–0.41**	–0.32*
Verbal aggression frequency	–0.36**	–0.29*	–0.40**	ns
Physical aggression type	–0.27**	ns	–0.35**	–0.30*
Physical aggression frequency	ns	ns	–0.40**	–0.27*
Frustration tolerance	–0.39**	ns	–0.40**	ns
Telephone etiquette	–0.27*	ns	–0.31*	–0.39**
Handicapping social behaviour	ns	–0.27*	ns	ns
Opportunistic behaviour	–0.34**	ns	ns	ns
Sexual behaviour	ns	ns	–0.39**	–0.34*
Miscellaneous disturbed	–0.27*	ns	ns	–0.34*

* p < 0.05; ** p < 0.01.

Correlations of interest are predominantly negative with lower ABCCS scores associated with higher levels of CM and CS.

^a Higher scores on the anxiety and impulsivity scales are associated with higher levels of anxiety and impulsivity; therefore, correlations of interest for CM and CS are positive for these scales: greater levels of anxiety/impulsivity are associated with higher CM (group 1) and higher CS (group 2).