Wellness perception in persons with traumatic brain injury and its relation to functional independence

Bezner JR, Hunter DL. Wellness perception in persons with traumatic brain injury and its relation to functional independence. Arch Phys Med Rehabil 2001;82:787-92. Objectives: To test the reliability and validity of a perceptual wellness measure in persons after traumatic brain injury (TBI) and to determine whether a relation exists between functional independence and wellness perceptions in the same population. Design: Survey research. Setting: A private, residential brain injury program. Participants: A convenience sample of 49 patients (43 men, 6 women) with TBI whose mean age was 32.1 years (range, 18-61yr) and mean time since injury was 10.47 years (range, 1-21yr). Main Outcome Measures: The Perceived Wellness Survey (PWS) assessed wellness. The PWS has 6 subscales measuring physical, psychologic, emotional, intellectual, spiritual, and social wellness. The FIM™ instrument was used to measure functional status. Results: The mean PWS score (15.99) for the sample was comparable to published samples of adults (mean, 15.31-16.51); however, the reliability of the composite score (α =.58) and the subscales (α =.32-.64) was less than that obtained in previous samples (composite α = 0.91; subscale α =.64-.81). The correlations between the PWS and the FIM scores were not significant. Conclusions: The PWS in its composite form is a reliable measure for use with persons with TBI. The finding that perceived wellness and functional independence were not related suggests that these constructs are unique and thus should both be measured. The measurement of perceptions will enable the provider to consider a client holistically and to develop programs that address quality of life issues. Further, because perceptions influence behaviors, understanding a person's perceptions in multiple dimensions may provide a useful and necessary framework for developing intervention programs that address behavioral and cognitive issues that are important to that person.