Establishment of a norm for neurobehavioral rating scales (NRS) in Taiwan

The present study was undertaken to evaluate the relationship between neurobehavioral changes and the degree of severity of head injury, and to adapt the Neurobehavioral Rating Scale (NRS) developed by Levin and his associates, for use in Taiwan. Based on previous experience with a modified NRS model, we employed a further modified model (termed by us the revised NRS). In 1991 and 1992, a total of 511 subjects were selected from the neurology sections of 8 general hospitals. The subjects were classified as suffering from severe, moderate, or mild head injury using the criteria of Kraus and his associates. The subjects' records and data were collected to assess the response variances among patients with different degrees of severity of head injury. Interviews were conducted by raters, who filled in a standardized questionnaire according to how closely the subjects matched the descriptions in the revised NRS model. The results obtained showed that the revised NRS could accurately identify cognitive and behavioral problems (more so than the modified NRS), but was still weak for evaluating emotional aspects. Independent variables, such as age, gender, and severity of head injury, were found to influence the revised NRS score. The present investigation applied the revised NRS model for use in Taiwan, and the findings can serve as a reference for future studies.