Unmet Rehabilitation Needs Indirectly Influence Life Satisfaction 5 Years After Traumatic Brain Injury: A Veterans Affairs TBI Model Systems Study

Marc A. Silva, Alicia B. VandenBussche Jantz, Farina Klocksieben, Kimberley R. Monden, Amanda R. Rabinowitz, Bridget A. Cotner, Christina Dillahunt-Aspillaga, Risa Nakase-Richardson

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Objective: To describe the association between unmet rehabilitation needs and life satisfaction 5 years after traumatic brain injury (TBI). Design: Prospective observational cohort. Setting: Five Veterans Affairs (VA) Polytrauma Rehabilitation Centers. Participants: VA TBI Model Systems participants (N=301); 95% male; 77% white; average age, 39±14y). Interventions: Not applicable. Main Outcome Measures: Satisfaction With Life Scale (SWLS). Results: Average SWLS score was 22±8. Univariable analyses demonstrated several statistically significant predictors of life satisfaction, including employment status, participation, psychiatric symptom severity, past year mental health treatment, and total number of unmet rehabilitation needs (all P<.05). Multivariable analyses revealed that depression and participation were each associated with life satisfaction. An ad hoc mediation model suggested that unmet rehabilitation needs total was indirectly related to life satisfaction. Total unmet rehabilitation needs ranged from 0-21 (mean, 2.0±3.4). Correlational analyses showed that 14 of the 21 unmet rehabilitation needs were associated with life satisfaction. Conclusions: Findings support the need for rehabilitation engagement in later stages of TBI recovery. Ongoing assessment of and intervention for unmet rehabilitation needs in the chronic phase of recovery have the potential to mitigate decline in life satisfaction.

Original languageEnglish (US)
Pages (from-to)58-67
JournalArchives of Physical Medicine and Rehabilitation
Early online dateSep 16 2020
StatePublished - Sep 2020

Bibliographical note

Funding Information:
Supported by VHA Central Office VA TBI Model System Program of Research (Drs Richardson and Silva), Subcontract from General Dynamics Information Technology (GDIT) (W91YTZ-13-C-0015; HT0014-19-C-0004) (Dr Richardson) from the Defense and Veterans Brain Injury Center as official government work (contact dha.DVBICinfo@mail.mil with questions), and Rocky Mountain Regional Brain Injury System (90DPTB00070) (Dr Monden). The VA TBI Model Systems is a funded collaboration between the Department of Veterans Affairs and the Department of Health and Human Services: National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). This research was conducted with resources and the use of facilities at the Hunter Holmes McGuire Veterans Affairs Medical Center, James A. Haley Veterans’ Hospital, Minneapolis VA Health Care System, Palo Alto VA Health Care System, and South Texas Veterans Health Care System. The views, opinion, and/or findings contained in this article are those of the authors and should not be construed as an official US Department of Defense, Defense Health Agency, Department of Army/Navy/Air Force, Veterans Affairs, or any other federal agency position, policy, or decision unless so designated by other official documentation. No official endorsement should be inferred.

Publisher Copyright:
© 2020 American Congress of Rehabilitation Medicine


  • Brain injuries
  • Personal satisfaction
  • Personnel
  • Rehabilitation
  • Social participation
  • Traumatic
  • Veterans

PubMed: MeSH publication types

  • Journal Article
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Multicenter Study
  • Observational Study


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