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Coco L, Hooker ER, Gilbert TA, Prewitt AL, Reavis KM, O'Neil ME, Clark KD, Henry JA, Zaugg T, Carlson KF. Associations Between Traumatic Brain Injury and Severity of Tinnitus-Related Functional Impairment Among US Military Veterans: A National, Population-Based Study. J Head Trauma Rehabil 2024; 39:218-230. [PMID: 38709830 DOI: 10.1097/htr.0000000000000896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
OBJECTIVE To describe associations between a history of traumatic brain injury (TBI) and the severity of tinnitus-related functional impairment among a national, stratified random sample of veterans diagnosed with tinnitus by the Department of Veterans Affairs (VA) healthcare system. SETTING A multimodal (mailed and internet) survey administered in 2018. Participants: VA healthcare-using veterans diagnosed with tinnitus; veterans with comorbid TBI diagnosis were oversampled. DESIGN A population-based survey. MAIN MEASURES TBI history was assessed using International Classification of Diseases (ICD) diagnosis codes in veterans' VA electronic health records. The severity of participants' overall tinnitus-related functional impairment was measured using the Tinnitus Functional Index. Population prevalence and 95% confidence intervals (CIs) were estimated using inverse probability weights accounting for sample stratification and survey nonresponse. Veterans' relative risk ratios of very severe or moderate/severe tinnitus-related functional impairment, versus none/mild impairment, were estimated by TBI history using bivariable and multivariable multinomial logistic regression. RESULTS The population prevalence of TBI was 5.6% (95% CI: 4.8-6.4) among veterans diagnosed with tinnitus. Veterans with a TBI diagnosis, compared with those without a TBI diagnosis, had 3.6 times greater likelihood of rating their tinnitus-related impairment as very severe (95% CI: 2.1-6.3), and 1.5 times greater likelihood of rating their impairment as moderate/severe (95% CI: 1.0-2.4), versus none/mild. CONCLUSIONS These findings suggest an important role of TBI in the severity of tinnitus-related functional impairment among veterans. This knowledge can help inform the integration of tinnitus management services into the care received by veterans with TBI.
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Affiliation(s)
- Laura Coco
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, California (Dr Coco); VA Health Services Research & Development Service Center of Innovation, Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon (Drs Coco, O'Neil, and Carlson, Ms Hooker and Gilbert, and Mr Prewitt); Oregon Health & Science University-Portland State University School of Public Health, Portland (Ms Hooker, Mr Prewitt, and Drs Reavis, Clark, Zaugg, and Carlson); VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, Portland, Oregon (Drs Reavis, Henry, and Carlson); and Departments of Medical Informatics and Clinical Epidemiology (Drs O'Neil and Clark); and Otolaryngology-Head and Neck Surgery (Dr Henry), Oregon Health & Science University, Portland
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2
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Carrier SL, Ponsford J, McKay A. Family experiences of supporting a relative with agitation during early recovery after traumatic brain injury. Neuropsychol Rehabil 2024; 34:510-534. [PMID: 37332244 DOI: 10.1080/09602011.2023.2219064] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 05/23/2023] [Indexed: 06/20/2023]
Abstract
During the early recovery period after traumatic brain injury (TBI), referred to as post-traumatic amnesia (PTA), approximately 44% of individuals may exhibit agitated behaviours. Agitation can impede recovery and poses a significant management challenge for healthcare services. As families provide significant support for their injured relatives during this time, this study aimed to explore the family's experience during PTA to better understand their role in agitation management. There were 20 qualitative semi-structured interviews conducted with 24 family members of patients exhibiting agitation during early TBI recovery (75% female, aged 30-71 years), predominantly parents (n = 12), spouses (n = 7) and children (n = 3). The interviews explored the family's experience of supporting their relative exhibiting agitation during PTA. The interviews were analyzed using reflexive thematic analysis, which revealed three key themes: family contributions to patient care, expectations of the health care service and supporting families to support patients. This study emphasized the significant role of families in managing agitation during early TBI recovery and highlighted that families who are well-informed and well-supported have the potential to minimize their relative's agitation during PTA, which may reduce the burden on healthcare staff and promote patient recovery.
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Affiliation(s)
- Sarah L Carrier
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Jennie Ponsford
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
- Rehabilitation and Mental Health Division, Epworth Healthcare, Melbourne, Australia
| | - Adam McKay
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
- Rehabilitation and Mental Health Division, Epworth Healthcare, Melbourne, Australia
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3
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Varela JL, Sperling SA, Block C, O’Leary K, Hart ES, Kiselica AM. A survey of neuropsychological assessment feedback practices among neuropsychologists. Clin Neuropsychol 2024; 38:529-556. [PMID: 37438247 PMCID: PMC10784416 DOI: 10.1080/13854046.2023.2233738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/30/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVE Feedback on neuropsychological assessment is a critical part of clinical practice, but there are few empirical papers on neuropsychological feedback practices. We sought to fill this gap in the literature by surveying practicing neuropsychologists in the United States. Questions addressed how they provide verbal and written feedback to patients and referral sources. Survey questions also addressed billing practices and training in the provision of feedback. METHODS A survey was developed using Qualtrics XM to survey currently licensed, independently practicing clinical neuropsychologists in the United States about their feedback practices. The survey was completed by 184 individuals. RESULTS Nearly all respondents reported that they provide verbal feedback to patients, most often in-person, within three weeks following testing. Typically, verbal feedback sessions with patients last 45 min. Verbal feedback was provided to referrals by about half of our sample, typically via a brief phone call. Most participants also reported providing written feedback to both the patient and referring provider, most commonly via the written report within three weeks after testing. Regarding billing, most respondents use neuropsychological testing evaluation codes. The COVID-19 pandemic appeared to have had a limited impact on the perceived effectiveness and quality of verbal feedback sessions. Finally, respondents reported that across major stages of professional development, training in the provision of feedback gradually increased but was considered inadequate by many participants. CONCLUSIONS Results provide an empirical summary of the "state of current practice" for providing neuropsychological assessment feedback. Further experimental research is needed to develop an evidence-base for effective feedback practices.
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Affiliation(s)
- Jacob L. Varela
- University of Missouri, Columbia, MO, 65211, USA
- Regent University, Virginia Beach, VA, 23464, USA
| | | | - Cady Block
- Emory University, Atlanta, GA, 30322, USA
| | | | - Eric S. Hart
- University of Missouri, Columbia, MO, 65211, USA
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Anders DM, Logan DM, Shelton JA, Walters GJ, Perry S, Carter KD, Malec JF. An Observational Cohort Study of the Role of Level of Effort in Post-Acute Brain Injury Rehabilitation. Arch Phys Med Rehabil 2023; 104:211-217. [PMID: 35934046 DOI: 10.1016/j.apmr.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 07/15/2022] [Accepted: 07/25/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the role of participant level of effort (LoE) on outcome in post-acute brain injury rehabilitation with the hypothesis that greater effort is associated with more positive outcomes. DESIGN Observational cohort study. SETTING Comprehensive integrated rehabilitation program for brain injury within a skilled nursing facility. PARTICIPANTS Consecutive admissions with acquired brain injury (N=101). INTERVENTIONS Individualized interdisciplinary brain injury rehabilitation; therapist rating of participant LoE with Acquired Brain Injury LoE Scale (ABI-LoES) during physical therapy, occupational therapy, and speech and language pathology sessions. MAIN OUTCOME MEASURES Mayo-Portland Adaptability Inventory, fourth edition (MPAI-4); Supervision Rating Scale (SRS). RESULTS Linear regression showed that discharge MPAI-4 Total T scores were significantly associated with mean ABI-LoES rating, admission MPAI-4 Total T scores, age at admission, and days from injury but not with standard deviation of ABI-LoES rating, sex, injury type, length of stay, or treatment before or during the COVID-19 pandemic. Discharge SRS scores were significantly associated with mean ABI-LoES rating, admission SRS scores, and age. A 1-unit increase in mean ABI-LoES rating was associated with 5.1-unit lower discharge MPAI-4 Total T scores and 1.5 lower discharge SRS scores, after controlling for other variables. Logistic regression showed that the odds of achieving a minimal clinically important difference on the MPAI-4 were 8.34 times higher with each 1-unit increase in mean ABI-LoES rating after controlling for other variables. Admission MPAI-4 was negatively associated with mean ABI-LoES rating (β=-0.07, t=-8.85, P<.0001). CONCLUSIONS After controlling for nonmodifiable variables, average ABI-LoES rating is positively associated with outcome. Initial level of disability is negatively associated with mean ABI-LoES rating.
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Affiliation(s)
| | | | | | | | - Sarah Perry
- Department of Biostatistics, The University of Iowa, Iowa City, IA
| | - Knute D Carter
- Department of Biostatistics, The University of Iowa, Iowa City, IA
| | - James F Malec
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, IN; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.
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A Scoping Review of Communicating Neuropsychological Test Results to Patients and Family Members. Neuropsychol Rev 2021; 32:294-315. [PMID: 33877569 PMCID: PMC9090678 DOI: 10.1007/s11065-021-09507-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 04/08/2021] [Indexed: 11/08/2022]
Abstract
Feedback of neuropsychological test results to patients and family members include psychoeducation and implications for daily life. This scoping review aimed to provide an overview of the literature on neuropsychological feedback and to offer clinical recommendations. In accordance with formal scoping review methodology, PubMed, PsycInfo, Web of Science, CINAHL, and Embase databases were searched. Studies were included if they reported on neuropsychological feedback, if full papers were available, and if they included human participants. All languages were included, and no limit was placed on the year of publication. Of the 2,173 records screened, 34 publications met the inclusion criteria. Five additional publications were included after cross-referencing. An update of the search led to the inclusion of two additional papers. Of these 41 publications, 26 were research papers. Neuropsychological feedback is provided for a wide spectrum of diagnoses and usually given in-person and has been related to optimal a positive effect on patient outcomes (e.g. increase the quality of life). Most papers reported on satisfaction and found that satisfaction with an NPA increased when useful feedback was provided. However, information retention was found to be low, but communication aids, such as written information, were found to be helpful in improving retention. The current review demonstrated the benefits of neuropsychological feedback and that this should be part of standard clinical procedures when conducting a neuropsychological assessment. Further research on the benefits of neuropsychological feedback and how to improve information provision would enrich the neuropsychological literature.
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Martin PK, Schroeder RW. Feedback with patients who produce invalid testing: Professional values and reported practices. Clin Neuropsychol 2020; 35:1134-1153. [PMID: 32031048 DOI: 10.1080/13854046.2020.1722243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Providing feedback to clinical patients who produce invalid neuropsychological test data presents with several potential challenges. Given the limited guidance available on the topic, neuropsychologists most likely utilize approaches that idiosyncratically incorporate professional values related to both assessment and patient care to address overarching feedback goals. The current article discusses professional values believed to inform feedback decisions and presents survey results regarding how neuropsychologists would approach feedback across various clinical scenarios where testing is invalid. METHOD Participants were 209 adult-focused clinical neuropsychologists recruited via professional listservs, the majority of whom reported being board certified. Respondents were provided three case vignettes of clinical patients who produced invalid test data and were asked how they would provide feedback to each patient. Open-ended responses were coded to determine the relative frequency of feedback approaches, explicit statements, and implied goals. RESULTS Nearly all respondents (98%) indicated that feedback would include some description of the invalid findings, and most respondents indicated that they would provide explanations for the reasons of invalidity (67%) and statements regarding the impact of invalidity on test interpretation (75%). There was little agreement across respondents, however, regarding specific feedback approach. Feedback goals included to Inform, Investigate, Treat, Educate, and Correct, with the presence of these implied goals also varying across respondents. CONCLUSIONS The findings indicate that there is minimal consensus regarding feedback approaches provided to patients who produce invalid test data and underscore a need for further development and validation of specific feedback methods. The results are discussed within the context of the potentially competing professional values of evidence-based assessment, patient-doctor collaboration, and aspirational principles of beneficence and fidelity.
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Affiliation(s)
- Phillip K Martin
- Psychiatry and Behavioral Sciences, University of Kansas School of Medicine, Wichita, KS, USA
| | - Ryan W Schroeder
- Psychiatry and Behavioral Sciences, University of Kansas School of Medicine, Wichita, KS, USA
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Caregiver Issues and Concerns Following TBI: A Review of the Literature and Future Directions. PSYCHOLOGICAL INJURY & LAW 2020. [DOI: 10.1007/s12207-019-09369-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Beaulieu CL, Peng J, Hade EM, Corrigan JD, Seel RT, Dijkers MP, Hammond FM, Horn SD, Timpson ML, Swan M, Bogner J. Level of Effort and 3 Hour Rule Compliance. Arch Phys Med Rehabil 2019; 100:1827-1836. [DOI: 10.1016/j.apmr.2019.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 12/14/2018] [Accepted: 01/06/2019] [Indexed: 01/07/2023]
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Wallace SE, Donoso Brown EV, Schreiber JB, Diehl S, Kinney J, Zangara L. Touchscreen tablet-based cognitive assessment versus paper-based assessments for traumatic brain injury. NeuroRehabilitation 2019; 45:25-36. [DOI: 10.3233/nre-192725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sarah E. Wallace
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA, USA
| | | | | | - Sarah Diehl
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA
| | | | - Lani Zangara
- Pediatric Therapy Specialists, Inc., Avonworth School District, Pittsburgh, PA, USA
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Oyesanya TO, Arulselvam K, Thompson N, Norelli J, Seel RT. Health, wellness, and safety concerns of persons with moderate-to-severe traumatic brain injury and their family caregivers: a qualitative content analysis. Disabil Rehabil 2019; 43:685-695. [PMID: 31298958 DOI: 10.1080/09638288.2019.1638456] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Persons with moderate-to-severe traumatic brain injury (TBI) face issues with health, wellness, and safety that affect their ability to independently manage their care, even for individuals who are ≥75% independent in activities of daily living. These issues often lead to increased family involvement in managing the person's condition after discharge home. PURPOSE We explored health, wellness, and safety concerns after discharge home from inpatient rehabilitation from the perspectives of persons with TBI who are ≥75% independent in activities of daily living and their family caregivers. MATERIALS AND METHODS We interviewed 27 persons with TBI and family caregivers and used conventional content analysis to analyse the data. RESULTS Seven themes related to health, wellness, and safety encompassed participants' experience. Health themes included: (1) attempting to manage medications and (2) navigating mental health difficulties. Wellness themes included: (1) working to stay physically active, (2) dealing with sleep and sleeplessness, and (3) adjusting to changing social relationships. Safety themes were: (1) addressing mobility challenges and (2) compensating for complications with cognitive functioning. CONCLUSIONS Findings can guide the development of tools, supports, and resources to promote health, wellness, and safety of persons with TBI as they recover after discharge home.Implications for rehabilitationFindings on numerous concerns related to health, wellness, and safety suggest the need for implementation or development and testing of tools, supports, and resources to promote health, wellness, and safety of persons with traumatic brain injury as they recover after discharge home.Our findings can be used to educate healthcare providers and increase awareness of the nuanced challenges patients and families face after discharge home.Findings can also be used by providers to educate patients and families on realistic expectations for life after discharge.
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Affiliation(s)
- Tolu O Oyesanya
- Shepherd Center, Crawford Research Institute, Atlanta, GA, USA.,School of Nursing, Duke University, Durham, NC, USA
| | | | - Nicole Thompson
- Shepherd Center, Crawford Research Institute, Atlanta, GA, USA
| | - Jenna Norelli
- Shepherd Center, Crawford Research Institute, Atlanta, GA, USA
| | - Ronald T Seel
- Shepherd Center, Crawford Research Institute, Atlanta, GA, USA.,Department of Physical Medicine and Rehabilitation, Center for Rehabilitation Science and Engineering, VCU School of Medicine, Richmond, VA, USA
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Goodridge D, McDonald M, New L, Scharf M, Harrison E, Rotter T, Watson E, Henry C, Penz ED. Building patient capacity to participate in care during hospitalisation: a scoping review. BMJ Open 2019; 9:e026551. [PMID: 31272973 PMCID: PMC6615828 DOI: 10.1136/bmjopen-2018-026551] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To map the existing literature and describe interventions aimed at building the capacity of patients to participate in care during hospitalisation by: (1) describing and categorising the aspects of care targeted by these interventions and (2) identifying the behaviour change techniques (BCTs) used in these interventions. A patient representative participated in all aspects of this project. DESIGN Scoping review. DATA SOURCES MEDLINE, Embase and CINAHL (Inception -2017). STUDY SELECTION Studies reporting primary research studies on building the capacity of hospitalised adult patients to participate in care which described or included one or more structured or systematic interventions and described the outcomes for at least the key stakeholder group were included. DATA EXTRACTION Title and abstract screening and full text screening were conducted by pairs of trained reviewers. One reviewer extracted data, which were verified by a second reviewer. Interventions were classified according to seven aspects of care relevant to hospital settings. BCTs identified in the articles were assigned through consensus of three reviewers. RESULTS Database searches yielded a total 9899 articles, resulting in 87 articles that met the inclusion criteria. Interventions directed at building patient capacity to participate in care while hospitalised were categorised as those related to improving: patient safety (20.9%); care coordination (5.7%); effective treatment (5.7%) and/or patient-centred care using: bedside nursing handovers (5.7%); communication (29.1%); care planning (14%) or the care environment (19.8%). The majority of studies reported one or more positive outcomes from the defined intervention. Adding new elements (objects) to the environment and restructuring the social and/or physical environment were the most frequently identified BCTs. CONCLUSIONS The majority of studies to build capacity for participation in care report one or more positive outcomes, although a more comprehensive analysis is warranted.
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Affiliation(s)
- Donna Goodridge
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Meghan McDonald
- School of Nursing, Saskatchewan Polytechnic, Saskatoon, Saskatchewan, Canada
| | - Lucia New
- School of Nursing, Saskatchewan Polytechnic, Saskatoon, Saskatchewan, Canada
| | - Murray Scharf
- College of Education, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Elizabeth Harrison
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Thomas Rotter
- Healthcare Quality Programs, Queen’s University, Kingston, Ontario, Canada
| | - Erin Watson
- Leslie and Irene Dube Health Sciences Library, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Chrysanthus Henry
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Erika D Penz
- Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Belanger HG, Vanderploeg RD, Curtiss G, Armistead-Jehle P, Kennedy JE, Tate DF, Eapen BC, Bowles AO, Cooper DB. Self-efficacy predicts response to cognitive rehabilitation in military service members with post-concussive symptoms. Neuropsychol Rehabil 2019; 30:1190-1203. [DOI: 10.1080/09602011.2019.1575245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Heather G. Belanger
- Defense and Veterans Brain Injury Center (DVBIC), Special Operations Command (SOCOM), Tampa, FL, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Rodney D. Vanderploeg
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Glenn Curtiss
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | | | - Jan E. Kennedy
- Department of Rehabilitation Medicine, Brooke Army Medical Center (BAMC)
| | - David F. Tate
- Missouri Institute of Mental Health and University of Missouri, St Louis, MO, USA
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Blessen C. Eapen
- Polytrauma Rehabilitation Center, South Texas Veterans Health Care System, San Antonio, TX, USA
- Department of Rehabilitation Medicine, University of Texas Health, San Antonio, TX, USA
| | - Amy O. Bowles
- Department of Rehabilitation Medicine, Brooke Army Medical Center (BAMC)
- Department of Physical Medicine & Rehabilitation, Uniformed Services University of Health Sciences (USUHS), Bethesda, MD, USA
| | - Douglas B. Cooper
- Polytrauma Rehabilitation Center, South Texas Veterans Health Care System, San Antonio, TX, USA
- Defense and Veteran’s Brain Injury Center (DVBIC), South Texas Veterans Health Care System, San Antonio, TX, USA
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Hart T, Driver S, Sander A, Pappadis M, Dams-O'Connor K, Bocage C, Hinkens E, Dahdah MN, Cai X. Traumatic brain injury education for adult patients and families: a scoping review. Brain Inj 2018; 32:1295-1306. [PMID: 30084694 DOI: 10.1080/02699052.2018.1493226] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Traumatic brain injury (TBI) is increasingly viewed as a chronic condition, bringing long-term needs for patient and caregiver knowledge pertaining to symptom and problem management over time. In light of these needs, we performed a scoping review of the literature on brain injury education provided to adult patients and/ or family members affected by TBI. Objectives were to describe the types of educational interventions that have been developed; to review the effects of these interventions; and to determine gaps that might be filled by future research efforts. Of 88 articles meeting search criteria and subjected to data extraction, 34 concerned education about mild TBI and 54, moderate to severe TBI. Most mild TBI articles focused on education in the Emergency Room, while most moderate/ severe TBI education was directed toward family members/ caregivers and was frequently combined with other treatment components, making the effects of education difficult to discern. Only 1 article incorporated elements of self-management training (SMT), a model proved effective in other chronic health conditions. We recommend further exploration of SMT principles in long-term TBI care, as well as more precise definition of treatment components in all patient and family interventions, so that the specific effects of education and other treatment elements may be more readily evaluated.
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Affiliation(s)
- Tessa Hart
- a Moss Rehabilitation Research Institute , Elkins Park , PA , USA
| | - Simon Driver
- b Department of Rehabilitation Research , Baylor Scott and White Institute for Rehabilitation , Dallas , TX , USA
| | - Angelle Sander
- c Department of Physical Medicine and Rehabilitation , Baylor College of Medicine , Houston , TX , USA.,d Brain Injury Research Center , TIRR Memorial Hermann , Houston , TX , USA
| | - Monique Pappadis
- d Brain Injury Research Center , TIRR Memorial Hermann , Houston , TX , USA.,e Division of Rehabilitation Sciences, School of Health Professions , University of Texas Medical Branch at Galveston , TX , USA
| | - Kristen Dams-O'Connor
- f Department of Rehabilitation Medicine, Department of Neurology Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Claire Bocage
- g American Institutes for Research , Washington , DC , USA
| | - Emma Hinkens
- g American Institutes for Research , Washington , DC , USA
| | - Marie N Dahdah
- b Department of Rehabilitation Research , Baylor Scott and White Institute for Rehabilitation , Dallas , TX , USA.,h Department of Medical Psychology , Baylor Scott and White Medical Center , Plano , TX , USA
| | - Xinsheng Cai
- g American Institutes for Research , Washington , DC , USA
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Oyesanya TO, Bowers B. "I'm Trying To Be the Safety Net": Family Protection of Patients With Moderate-To-Severe TBI During the Hospital Stay. QUALITATIVE HEALTH RESEARCH 2017; 27:1804-1815. [PMID: 28936928 PMCID: PMC6281395 DOI: 10.1177/1049732317697098] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Research has shown that during hospital stay, family caregivers of patients with traumatic brain injury (TBI) perceive that their role is to protect the patient; however, research on this topic is limited. The purpose of this article is to describe family caregivers' experience of protecting patients with TBI during the hospital stay. Grounded theory was used to conduct 24 interviews with 16 family caregivers. Findings showed family caregivers worked to protect the patient's physical and emotional safety, using the following strategies: (a) influencing the selection of staff, (b) breaking the patient's bad habits, (c) anticipating how to orchestrate the home environment; (d) connecting on an emotional level, (e) managing visitors, and (f) connecting on an emtoional level. The findings have practice implications for educating interdisciplinary health care providers about the experience of family caregivers and for developing an adversarial alliance between health care providers and family caregivers during the hospital stay to improve support provided to them.
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Mahoney JJ, Bajo SD, De Marco AP, Arredondo BC, Hilsabeck RC, Broshek DK. Referring Providers’ Preferences and Satisfaction with Neuropsychological Services. Arch Clin Neuropsychol 2017; 32:427-436. [DOI: 10.1093/arclin/acx007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 01/13/2017] [Indexed: 11/13/2022] Open
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Oyesanya T. The experience of patients with ABI and their families during the hospital stay: A systematic review of qualitative literature. Brain Inj 2017; 31:151-173. [PMID: 28055226 DOI: 10.1080/02699052.2016.1225987] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Patients with acquired brain injury (ABI) and their families have unique experiences and needs during the hospital stay; yet, limited literature exists on this topic. The purpose of this systematic review was to compile and synthesize literature on the experience of patients with ABI and their families during the hospital stay. METHODS A systematic review of qualitative studies was conducted by searching for studies from seven databases. Content analysis was used to analyse and synthesize studies' findings separately for the patient and family experience. RESULTS The initial search provided 2871 records. Ultimately, 11 studies relevant to the research question were included in this review. No studies were excluded based on critical quality appraisal. Findings on the patient experience showed patients had negative perceptions of the rehabilitation environment and a perceived need for information. Findings on the family experience included difficulty adjusting after the patient's injury, a desire to be involved in the patient's care, mixed feelings about staff support and a high perceived need for information. CONCLUSIONS Findings provide awareness for healthcare providers on the multifaceted experiences of patients with ABI and their families during the hospital stay, strategies to make care more patient- and family-centred and directions for future research.
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Sidani S, Epstein DR. Toward a Conceptualization and Operationalization of Satisfaction With Nonpharmacological Interventions. Res Theory Nurs Pract 2016; 30:242-257. [PMID: 28304269 DOI: 10.1891/1541-6577.30.3.242] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although satisfaction is recognized as an essential aspect in the evaluation of interventions' effectiveness, there is lack of clarity on its conceptualization and operationalization. In this article, we present conceptual and operational definitions that specify the domains and attributes of satisfaction with nonpharmacological interventions. METHODS An integrative review of conceptual and empirical literature was conducted to generate the conceptual and operational definitions of satisfaction with interventions. Fifty-six publications were included in the review. The definitions of satisfaction and the content of instruments measuring satisfaction were reviewed, compared, and contrasted to identify the domains and attributes of the concept. RESULTS Satisfaction is defined as the appraisal of the interventions' process and outcome. It is operationalized in 4 domains of process: (a) suitability and utility of the intervention's components, (b) attitude toward and desire to continue with the intervention, (c) competence and interpersonal style of interventionist, and (d) implementation (format and dose) of the intervention. The outcome domain includes improvement in the health problem and in everyday functions, discomfort, and attribution of the outcomes to the intervention. CONCLUSIONS The conceptual and operational definitions can guide the development of instruments to assess satisfaction with nonpharmacological interventions, which can point to aspects of interventions that are viewed favorably or unfavorably.
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Abstract
There have been no previous studies on how often psychologists conduct feedback and whether they view this practice as a useful component of assessment. To explore psychologists' feedback practices and their perception of the effects of feedback on their clients, the authors examined survey data from 719 psychologist members of the International Neuropsychological Society, the National Academy of Neuropsychology, and the Society for Personality Assessment who regularly conducted assessments as part of their professional activities. The results indicated that the majority of respondents (71%) frequently provided in-person assessment feedback to their clients and/or their clients' families. Furthermore, most respondents (72%) indicated that clients found this information to be helpful and positive. Factors contributing to perceived positive feedback effects, including graduate training and feedback session length, were also examined. Last, differences in the feedback practices of psychologists predominantly practicing neuropsychology versus those predominantly practicing personality assessment were sampled and discussed.
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Affiliation(s)
- Steven R Smith
- Department of Counseling, Clinical, and School Psychology, University of California-Santa Barbara, 1110 Phelps Hall, Santa Barbara, CA 93106, USA.
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Foran A, Millar E, Dorstyn D. Patient satisfaction with a hospital-based neuropsychology service. AUST HEALTH REV 2016; 40:447-452. [DOI: 10.1071/ah15054] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 09/07/2015] [Indexed: 11/23/2022]
Abstract
Objective
The aim of the present study was to develop and pilot a measure of patient satisfaction that encompasses themes, activities, settings and interactions specific to the neuropsychological assessment process.
Methods
A focus group of out-patients (n = 15) was surveyed to identify the factors commonly associated with a satisfactory neuropsychological experience. Responses informed a purposely designed 14-item patient satisfaction scale (α = 0.88) that was completed by 66 hospital out-patients with mild to moderate cognitive impairment.
Results
Satisfaction with the neuropsychological assessment process was generally reported, with the testing phase (85%) rated significantly more favourably than the pre-assessment (79%) and feedback (70%) phases. Commentaries provided by 32 respondents identified interpersonal facilitators to a satisfactory neuropsychological assessment experience, but also dissatisfaction with physical aspects of the testing environment in addition to service availability.
Conclusions
The patient satisfaction scale can be used as a quality assurance tool to evaluate neuropsychological service delivery. Large-scale research is needed to confirm the scale’s psychometric properties. Further research may also include a broader perspective on the consumers’ experience of neuropsychological services.
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Seel RT, Corrigan JD, Dijkers MP, Barrett RS, Bogner J, Smout RJ, Garmoe W, Horn SD. Patient Effort in Traumatic Brain Injury Inpatient Rehabilitation: Course and Associations With Age, Brain Injury Severity, and Time Postinjury. Arch Phys Med Rehabil 2015. [PMID: 26212400 DOI: 10.1016/j.apmr.2014.10.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To describe patients' level of effort in occupational, physical, and speech therapy sessions during traumatic brain injury (TBI) inpatient rehabilitation and to evaluate how age, injury severity, cognitive impairment, and time are associated with effort. DESIGN Prospective, multicenter, longitudinal cohort study. SETTING Acute TBI rehabilitation programs. PARTICIPANTS Patients (N=1946) receiving 138,555 therapy sessions. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Effort in rehabilitation sessions rated on the Rehabilitation Intensity of Therapy Scale, FIM, Comprehensive Severity Index brain injury severity score, posttraumatic amnesia (PTA), and Agitated Behavior Scale (ABS). RESULTS The Rehabilitation Intensity of Therapy Scale effort ratings in individual therapy sessions closely conformed to a normative distribution for all 3 disciplines. Mean Rehabilitation Intensity of Therapy Scale ratings for patients' therapy sessions were higher in the discharge week than in the admission week (P<.001). For patients who completed 2, 3, or 4 weeks of rehabilitation, differences in effort ratings (P<.001) were observed between 5 subgroups stratified by admission FIM cognitive scores and over time. In linear mixed-effects modeling, age and Comprehensive Severity Index brain injury severity score at admission, days from injury to rehabilitation admission, days from admission, and daily ratings of PTA and ABS score were predictors of level of effort (P<.0001). CONCLUSIONS Patients' level of effort can be observed and reliably rated in the TBI inpatient rehabilitation setting using the Rehabilitation Intensity of Therapy Scale. Patients who sustain TBI show varying levels of effort in rehabilitation therapy sessions, with effort tending to increase over the stay. PTA and agitated behavior are primary risk factors that substantially reduce patient effort in therapies.
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Affiliation(s)
- Ronald T Seel
- Crawford Research Institute, Shepherd Center, Atlanta, GA.
| | - John D Corrigan
- Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, OH
| | - Marcel P Dijkers
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ryan S Barrett
- Institute for Clinical Outcomes Research, International Severity Information Systems, Salt Lake City, UT
| | - Jennifer Bogner
- Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, OH
| | - Randall J Smout
- Institute for Clinical Outcomes Research, International Severity Information Systems, Salt Lake City, UT
| | - William Garmoe
- Medstar National Rehabilitation Hospital, Washington, DC
| | - Susan D Horn
- Institute for Clinical Outcomes Research, International Severity Information Systems, Salt Lake City, UT
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Brett CE, Sykes C, Pires-Yfantouda R. Interventions to increase engagement with rehabilitation in adults with acquired brain injury: A systematic review. Neuropsychol Rehabil 2015; 27:959-982. [DOI: 10.1080/09602011.2015.1090459] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Caroline Elizabeth Brett
- Department of Psychology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, City University London, London, UK
| | | | - Renata Pires-Yfantouda
- Department of Psychology, City University London, London, UK
- South London and the Maudsley NHS Trust, Liaison Psychiatry for Guy's and St Thomas's Hospital, London, UK
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Hoenig H, Lee J, Stineman M. Conceptual Overview of Frameworks for Measuring Quality in Rehabilitation. Top Stroke Rehabil 2015; 17:239-51. [DOI: 10.1310/tsr1704-239] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Short J, McCormack J, Copley A. The current practices of speech-language pathologists in providing information to clients with traumatic brain injury. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2014; 16:219-230. [PMID: 24588453 DOI: 10.3109/17549507.2014.882413] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The provision of information about cognitive-communication disorders (CCDs) following traumatic brain injury (TBI) is important given the impact these communication impairments can have on the rehabilitation of people with TBI. This study describes the results of an online survey which investigated the current practices of 74 Australian speech-language pathologists (SLPs) working with adults with TBI. Thirty-seven SLPs outlined their practices in information provision. SLPs reported they provide information to adults with TBI about CCDs, the impact of CCDs on participation in life activities, and rehabilitation from CCDs. In addition, SLPs identified barriers and facilitators to information provision. Barriers identified included time, impairments resulting from TBI, and personal characteristics of the client. Facilitators included family functioning and support and the multidisciplinary team. Findings of this research indicate a need for some changes in the format and content of information that SLPs provide to adults with TBI, to ensure they can achieve fundamental levels of health literacy and better health outcomes.
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Bench S, Day T, Griffiths P. Effectiveness of critical care discharge information in supporting early recovery from critical illness. Crit Care Nurse 2014; 33:41-52. [PMID: 23727851 DOI: 10.4037/ccn2013134] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Providing patients with information can alleviate or reduce relocation stress, but how best to provide information to patients being discharged from critical care units is unclear. This narrative critical review describes (1) the current evidence base on the use of discharge information for adult critical care patients and (2) the extent of involvement of service users in the design and evaluation of such information. Seven publications reported data from 121 patients, 252 relatives, and 33 nurses. Overall evidence was of low quality but use of individualized information was associated with beneficial physical effects for patients and increased knowledge and satisfaction for their relatives. Findings highlight the significant gaps in our knowledge and understanding. The consequences of such findings for the future development of information that meets service users' needs are discussed. Results should inform the design of future studies on this topic.
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Affiliation(s)
- Suzanne Bench
- Florence Nightingale School of Nursing and Midwifery, King’s College, 57 Waterloo Road, London, UK.
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Kontos P, Miller KL, Colantonio A, Cott C. Grief, Anger, and Relationality: The Impact of a Research-Based Theater Intervention on Emotion Work Practices in Brain Injury Rehabilitation. EVALUATION REVIEW 2014; 38:29-67. [PMID: 24743646 PMCID: PMC4318689 DOI: 10.1177/0193841x14531260] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Therapeutic emotion work is performed by health care providers as they manage their own feelings as well as those of colleagues and patients as part of efforts to improve the physical and psychosocial health outcomes of patients. It has yet to be examined within the context of traumatic brain injury rehabilitation. OBJECTIVE To evaluate the impact of a research-based theater intervention on emotion work practices of neurorehabilitation staff. RESEARCH DESIGN Data were collected at baseline and at 3 and 12 months postintervention in the inpatient neurorehabilitation units of two rehabilitation hospitals in central urban Canada. SUBJECTS Participants (N = 33) were recruited from nursing, psychology, allied health, recreational therapy, and chaplaincy. MEASURES Naturalistic observations (N = 204.5 hr) of a range of structured and unstructured activities in public and private areas, and semistructured interviews (N = 87) were conducted. RESULTS Preintervention analysis indicated emotion work practices were characterized by stringent self-management of empathy, suppression of client grief, adeptness with client anger, and discomfort with reactions of family and spouses. Postintervention analysis indicated significant staff changes in a relationality orientation, specifically improvements in outreach to homosexual and heterosexual family care partners, and support for sexual orientation and intimacy expression. No improvements were demonstrated in grief support. CONCLUSION Emotion work has yet to be the focus of initiatives to improve neurorehabilitative care. Our findings suggest the dramatic arts are well positioned to improve therapeutic emotion work and effect cultures of best practice. Recommendations are made for interprofessional educational initiatives to improve responses to client grief and potential intimate partner violence.
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Affiliation(s)
- Pia Kontos
- Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Karen-Lee Miller
- Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Angela Colantonio
- Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Cheryl Cott
- Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada Department of Physical Therapy at the University of Toronto, Toronto, Ontario, Canada
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Kontos PC, Miller KL, Gilbert JE, Mitchell GJ, Colantonio A, Keightley ML, Cott C. Improving client-centered brain injury rehabilitation through research-based theater. QUALITATIVE HEALTH RESEARCH 2012; 22:1612-32. [PMID: 22941919 PMCID: PMC3741155 DOI: 10.1177/1049732312458370] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Traumatic brain injury often results in physical, behavioral, and cognitive impairments perceived by health care practitioners to limit or exclude clients' full participation in treatment decision making. We used qualitative methods to evaluate the short- and long-term impact of "After the Crash: A Play About Brain Injury," a research-based drama designed to teach client-centered care principles to brain injury rehabilitation staff. We conducted interviews and observations with staff of two inpatient neurorehabilitation units in Ontario, Canada. Findings demonstrate the effectiveness of the play in influencing practice through the avoidance of medical jargon to improve clients' understanding and participation in treatment; newfound appreciation for clients' needs for emotional expression and sexual intimacy; increased involvement of family caregivers; and avoidance of staff discussions as if clients were unaware. These findings suggest that research-based drama can effect reflexivity, empathy, and practice change to facilitate a client-centered culture of practice in brain injury rehabilitation.
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Affiliation(s)
- Pia C Kontos
- Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.
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27
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Caligtan CA, Carroll DL, Hurley AC, Gersh-Zaremski R, Dykes PC. Bedside information technology to support patient-centered care. Int J Med Inform 2012; 81:442-51. [PMID: 22285034 DOI: 10.1016/j.ijmedinf.2011.12.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Revised: 11/21/2011] [Accepted: 12/10/2011] [Indexed: 11/25/2022]
Abstract
PURPOSE Patients and health care providers often lack real time access to information at the bedside required to provide safe patient-centered care. Both groups identified pertinent information needed at the patient's bedside. The purpose of our research was to identify the essential data elements that will be used to define requirements for a useful bedside communication tool in the acute care hospital setting. METHODS Descriptive research methods were used to identify bedside information requirements through group and individual interviews. Data from patients and health care providers were analyzed to identify common themes, compiled into a survey, and validated by both groups. RESULTS Thirty-seven information requirements were identified and classified under five themes: (1) plan of care, (2) patient education, (3) communication of safety alerts, (4) diet, and (5) medications. A survey completed by 30 patients and 30 health care providers confirmed 36 specific bedside information requirements (mean ≥ 5 on an 11-point scale). Patients and health providers each identified 24 specific information requirements that were similar in importance. When compared with nurses, significant differences were noted in the degree to which patients identified knowing the "daily routine schedule," e.g. when their doctor typically sees patients as a key requirement for the electronic bedside communication tool, t=3.52, p=.001. CONCLUSION Patients and health care providers identified information requirements at the bedside to promote self-care management of healthcare needs and an understanding of the hospital environment. Accurate, easily accessed information at the bedside is needed for providing safe patient-centered care.
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Affiliation(s)
- Christine A Caligtan
- Clinical Informatics Research & Development, Partners HealthCare System, Boston, MA 02481, USA.
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Niemeier JP, Kreutzer JS, Marwitz JH, Gary KW, Ketchum JM. Efficacy of a brief acute neurobehavioural intervention following traumatic brain injury: A preliminary investigation. Brain Inj 2011; 25:680-90. [DOI: 10.3109/02699052.2011.573520] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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29
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Gorske TT. Therapeutic Neuropsychological Assessment: A Humanistic Model and Case Example. JOURNAL OF HUMANISTIC PSYCHOLOGY 2007. [DOI: 10.1177/0022167807303735] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
One of the challenges the field of clinical neuropsychology faces is to develop an assessment process that is relevant to the needs of patients and referral sources and responsive to those needs. One method for meeting this need is for psychologists and neuropsychologists to extend their services to develop clinical interventions that serve to enhance patients' cognitive and emotional well-being. Feedback to patients from the results of neuropsychological tests is an intervention that is considered an important part of the assessment process, and there is evidence that direct feedback has positive therapeutic effects for patients. Although many authors have provided suggestions and principles for conducting neuropsychological test feedback, there is no agreed-on conceptual framework for doing so. The following article presents a humanistic model for providing feedback from the results of neuropsychological tests and a case example of its application with a young woman suffering from a brain tumor.
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Affiliation(s)
- Tad T. Gorske
- Cognitive Dynamic Therapy Associates in Pittsburgh,
Pennsylvania, University of Pittsburgh School of Medicine
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