DOI
https://doi.org/10.25772/RE40-R036
Defense Date
2022
Document Type
Thesis
Degree Name
Master of Science
Department
Counseling Psychology
First Advisor
Paul Perrin
Second Advisor
Bruce Rybarczyk
Third Advisor
Juan Arango
Abstract
A traumatic brain injury (TBI) can have a host of negative consequences including impairments to motor and cognitive function and can result in a decrease in quality of life (i.e., life satisfaction). TBI is one of the leading causes of death and disability worldwide and disproportionately affects Native Americans, who have the highest rates of TBI among all races in the U.S. and elevated likelihood for fatality and severe complications. The current study used a subsample of the national TBI Model Systems Database of 80 demographically and injury severity matched Native American and White individuals (total n = 160) to investigate whether disparities in functional and life satisfaction outcomes exist over the 5 years after injury, and if so, whether demographic and injury-related covariates account for them. A series of hierarchical linear models found that Native Americans demonstrated significantly lower Functional Independence Measure (FIM) Cognitive and Motor trajectories than did Whites; however, life satisfaction was comparable. Further, FIM cognitive trajectories changed differentially over time, with Native Americans demonstrating declining cognitive function over time relative to a slight increase in White individuals; however, this differential movement dissipated with the addition of employment status at the time of injury and type of health insurance held by the person with TBI. These results demonstrate a profound need to further investigate the cultural and contextual variables unique to Native Americans that underlie these differences and highlight the importance of culturally responsive treatment and rehabilitation in bridging the gap in recovery.
Rights
Jack D. Watson
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
12-7-2022