Discussion
TBI, TBI-related difficulties, anxiety
SECONDARY
This RCT aimed to evaluate the effect of a home-based, individually tailored, and goal-oriented intervention in improving HRQOL and participation, TBI-related difficulties, and symptoms. Although the 2 primary outcomes, disease-specific HRQOL (as measured by QOLIBRI overall scale scores) and social participation (as measured by PART-O social subscale scores), did not reveal between-group differences, we did see group effects in favor of the intervention group for the secondary outcomes of generic HRQOL, target outcomes severity, TBI-related symptoms, and anxiety.The lack of significant between-group differences in the 2 primary outcomes warrants discussion. It is, however, noteworthy that a significant effect on HRQOL was found in the generic HRQOL measure. Some researchers argue that studies should include both generic and disease-specific measures of QOL.This RCT was modeled after a study by Winter et al,Reductions in TBI- and anxiety-related symptoms were seen. Reduced anxiety may signify less worry and stress as participants experienced less difficulty managing TBI-related problems. The fact that the intervention group showed within-group improvements over time on all outcome measures except the PART-O social subscale supports this interpretation. High goal attainment has been previously documented in this trial,This intervention aimed to address common health care needs among patients in the chronic phase of TBI. Although efforts were made to standardize intervention design and intensity, treatment content was individualized. There is an inherent challenge in measuring mean group effects of an intervention addressing individual needs, despite the fact that symptom heterogeneity requires individual tailoring of rehabilitation.The fact that this intervention resulted in positive changes many years after injury confirms that rehabilitation in the chronic phase of TBI may be effective.