Community rehabilitation outcomes across cultures following traumatic brain injury

This exploratory study investigates Traumatic Brain Injury (TBI) rehabilitation outcomes among culturally diverse outpatients in community-based rehabilitation who have sustained a Mild to Moderate TBI. The major aims of this study are twofold: firstly, to determine whether community-based rehabilitation outcomes following TBI differ across Măori, Pacific and Pakeha cultures; and secondly, to identify any service delivery needs Pacific people in TBI rehabilitation require that may be distinct from Pakeha.

A fixed comparative non-experimental design was utilised where participants were selected using direct control based on their self-identified ethnic group resulting in sub-samples of 11 Maori, 11 Pacific and 11 Pakeha (n=33). Each participant completed the Neurobehavioural Cognitive Status Examination (Cognistat) and the Brain Injury Community Rehabilitation Outcome Scales (BICRO-39 Scales).

Results indicate that all participants were at a similar level of overall cognitive functioning but Pacific peoples scored significantly lower than both Măori and Pakeha on two Language subtests and significantly lower than Pakeha on the Memory subtest. Individual handicap increased following TBI and decreased following rehabilitation, with no significant difference across cultures and suggesting good efficacy of rehabilitation.

There appears to be universalities in TBI experience and global rehabilitation outcomes that transcends individual cultures. However; there are micro-level cultural variations that have valuable implications when assessing and treating Pacific people in neuro-rehabilitation. Neuropsychologists need to take into account formal education levels and language abilities when working with Pacific people.