Neuropsychological problems in everyday life: A 5-year follow-up study of young severely closed-head-injured patients

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Abstract
The aim of this follow-up study was to examine the long-term disabilities and handicaps caused by severe head injuries and their effects on the everyday life of patients and their relatives. The group studied consisted of 19 subjects who had suffered a severe closed-head injury during 1984 and had been rehabilitated in the Käpylä Rehabilitation Center. In 1989 a thorough functional assessment of these patients was carried out. In addition, information concerning the quality of life, activities of daily living (ADL) and social situation was gathered by means of questionnaires filled in by the patient and, if possible, by a close relative. The results indicated the importance of changes in cognitive functions, personality and emotional reactions. Changes in personality and emotional reactions were especially emphasized by the relatives. We also correlated the patients' and their relatives' estimates of the occurrence of memory problems in everyday life with the results of objective memory tests. We found that verbal memory tests reached significant correlations with the estimates of everyday memory problems, whereas tests of visual memory, though able to discriminate the brain-injured from normal subjects, did not correlate on a statistically significant level with the estimates of patients and relatives. The implications of the results for methods of assessment and the planning of rehabilitation programmes are discussed.