Review written by Katherine Smith
Brain Injury Case Manager
The Interrelationship of Funcitonal Skills in Individuals Living in the Community, Following Moderate to Severe Traumatic Brain Injury.
Gordon Muir Giles, Jo Clark-Wilson, Doreen M. Baxter, Ross Tasker, Mark Holloway, and Stephanie Seymour. 2018. Brain Injury 33 (2): 129–36. doi:10.1080/02699052.2018.1539762.
Objective: The Adaptive Behaviour and Community Competency Scale was used to investigate the interrelationship of 22 basic and instrumental activities of daily living (ADL/IADL) in individuals with moderate to severe traumatic brain injury (TBI). The relationship of self-awareness to task performance was also investigated.
This article investigates the interrelationship of functional skills of 100 community dwelling individuals living with moderate to severe traumatic brain injury, using a prospective descriptive study design. A statistical method of factorial analysis was used to explore these relationships.
The study found that there is a relationship between self-awareness and ability to be independent with IADLs. It found that there is a subset of people living with a moderate to severe brain injury that can engage in a range of IADLs and present with a higher level of self-awareness over those independently engaging in ADL tasks.
The article highlights that the key distinction between effectively performing basic ADLs and instrumental ADLs is the need to plan, use in the moment problem solving and decision making. A person might be able to perform an ADL such as eating breakfast at the same time each day, as this is a highly routine activity. However, an IADL task requires executive functions that can adapt to unpredictable and changing environments such as shopping for ingredients for breakfast in a busy supermarket that has recently changed the layout, maybe very difficult to perform.
The study discusses the relationship between self-awareness and successful occupational performance, highlighting that a person with reduced insight will not recognise poor task performance and will not be able to use compensatory strategies to improve this performance.
This may be a small study; however, it still has the potential to inform practice and lays the groundwork for a future larger study to explore this interrelationship of functional skills further.
As an occupational therapist, my career has focused on analysing people’s occupational performance and the barriers they experience in engaging in their chosen activities and daily routine. The recognition that functional skills depend on the person’s self-awareness of their occupational performance and ADL and IADL skills hierarchically organised, demonstrates that occupational performance is highly individual, and a one size fits all approach to rehabilitation will not suit a person living with a moderate to severe brain injury. In my role as a brain injury case manager, it high lights why rehabilitation for clients must be bespoke, personalised to their routine and priorities, and built around their self-awareness.
Read the full article here
If you would like to sign up to receive notifications about free resources and up to date information from Head First, click the link below.
https://link.head-first.org/signup
