Recording sentinel events in the life course of individuals with acquired brain injury: A preliminary study

Abstract

Objective: To describe the development of the Sentinel Events Questionnaire (SEQ) for recording key events occurring during the transition from hospital to home following acquired brain injury (ABI) and to examine its participant-proxy agreement. Design: Prospective longitudinal design, with the SEQ administered by interview prior to discharge and at 1, 3 and 6-months post discharge. Measures: The SEQ records the occurrence and timing of eight events identified through a pilot study and literature review of the transition from hospital to home after ABI. Sample: Ninety participants with ABI (64% due to traumatic brain injury and 26% due to stroke) and their nominated caregivers. Results: All SEQ items had high participant-proxy percentage agreement (all >83%). Five items (return to work, return to driving, moving to a more restricted living situation, regaining independence at home and return to independent use of transport) had good agreement based on kappa analyses. The incidence of sentinel events during community integration ranged from 18% (relationship breakdown) to 89% (independence at home). Participants with TBI were more likely to move to a more restrictive living situation and less likely to return to driving than participants with stroke (p<0.05). Conclusion: This research highlights the benefit of using the SEQ to systematically record the occurrence of sentinel events in order to better understand the process of transition from hospital to home following ABI.