749 Disability & Rehabilitation, 2013; 35(9): 749–757 © 2013 Informa UK, Ltd. ISSN 0963-8288 print/ISSN 1464-5165 online DOI: 10.3109/09638288.2012.707741 Purpose: To describe problems in body functions, activities, and participation and the influence of environmental factors as experienced after mild traumatic brain injury (TBI), using the ICF framework. To compare our findings with the Brief and Comprehensive ICF Core Sets for TBI. Methods: Six focus- group interviews were performed with 17 participants (nine women, eight men, age ranged from 22 to 55 years) within the context of an outpatient rehabilitation programme for patients with mild TBI. The interviews were transcribed verbatim and analysed using the ICF. Results: One-hundred and eight second- level categories derived from the interview text, showing a large diversity of TBI-related problems in functioning. Problems in cognitive and emotional functions, energy and drive, and in carrying out daily routine and work, were frequently reported. All ICF categories reported with high-to-moderate frequencies were present in the Brief ICF Core Set and 84% in the Comprehensive ICF Core Set. The reported environmental factors mainly concerned aspects of health and social security systems, social network and attitudes towards the injured person. Conclusions: This study confirms the diversity of problems and the environmental factors that have an impact on post-injury functioning of patients with mild TBI. Keywords: Functioning, ICF, patient perspective, traumatic brain injury Introduction A traumatic brain injury (TBI) is a disabling condition that afects diferent aspects of everyday life, including social and vocational participation [1,2]. Approximately 10 mil- lion people experience TBI every year [3]. In a study from Oslo, the Norwegian capital, the rate of patient admittance to hospitals ater TBI was 83.3 per 100 000 people [4], which is similar to the rates reported from the USA [5]. People with TBI constitute a heterogeneous group with several challenges in functioning that are linked to the severity of each person’s individual condition [6,7]. TBIs are usually classiied as mild, moderate or severe [8]. In Europe, 70–80% of all TBIs are classiied as mild based on the Glasgow Coma Scale (GCS) [9]. Despite the fact that people with mild TBI represent the largest group, they are less frequently studied than people with severe TBI [10]. Cognitive, emotional and behavioural functional problems are common to all TBI severity groups [7]. Typical impairments following mild TBI include a lack of energy and cognitive symptoms, such as reduced concentration and memory [11,12]. In a 1-year cohort of mainly mild TBI, the persistence of symptoms from the TBI, as well as activity limitations and participation restrictions, were observed during 1-year follow-up examinations [11,13]. RESEARCH PAPER Problems in functioning after a mild traumatic brain injury within the ICF framework: the patient perspective using focus groups Unni Sveen 1,2 , Sigrid Ostensjo 2 , Sara Laxe 3 & Helene L Soberg 1,2 1 Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway, 2 Faculty of Health Science, Oslo and Akershus University College of Applied Sciences, Oslo, Norway, and 3 Guttmann Institute Hospital for Neurorehabilitation, Universitat Autonoma de Barcelona, Badalona, Spain Correspondence: Unni Sveen, Department of Physical Medicine and Rehabilitation, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway. E-mail: unni.sveen@uus.no • Disabilities related to cognitive and emotional func- tions, energy and drive, and carrying out daily routine and work should be addressed in rehabilitation of people with mild traumatic brain injury (TBI). • Attention should be given to environmental facilita- tors and barriers for activities and participation. • Participation in everyday life ater a mild TBI, includ- ing social- and work-participation, constitutes a chal- lenge where multidisciplinary rehabilitation eforts should be considered. • he Brief Core Set does not attain all frequently observed categories of functioning among people with mild TBI. Implications for Rehabilitation (Accepted June 2012) Disabil Rehabil Downloaded from informahealthcare.com by Oslo universitetssykehus Ulleval on 07/15/13 For personal use only.