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Laurie K, Foster MM, Borg DN, Gustafsson L. Perceived service adequacy and unmet need after discharge from brain injury rehabilitation. Disabil Rehabil 2023; 45:3252-3261. [PMID: 36111685 DOI: 10.1080/09638288.2022.2123054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 07/30/2022] [Accepted: 08/30/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The present study aimed to quantify the perceived needs and adequacy of realised access to post-acute services in a sample of people with acquired brain injury in the first 6-months after discharge from inpatient rehabilitation. A secondary focus was the influence of access to funding and specialist transitional rehabilitation on unmet needs. MATERIALS AND METHODS Participants were 51 adults with a median age of 50 (IQR 35-57) recruited from an inpatient rehabilitation unit in an Australian tertiary hospital. The sample was those who had an acquired brain injury, including 23 who sustained a traumatic injury and 28 who sustained a non-traumatic injury. Measures were collected via telephone at 3- and 6-months, in a prospective observational cohort design using the Needs and Provisions Complexity Scale. A series of logistic regression models were used to determine the effects of participation in a transitional rehabilitation program and funding pathway on adequacy and unmet needs. RESULTS Unmet needs for rehabilitation were most commonly reported (60%), followed by unmet needs in relation to health care (40%), social care (35%), personal care (32%) and environment-related (14%). Participants who attended transitional rehabilitation were more likely to indicate unmet health care needs (OR = 6.40, 95% CI = 1.40-29.24, p = 0.02). CONCLUSIONS The study highlights the need to look beyond functional impairment when conceptualising appropriate access. Additionally, the present research highlighted the need for greater work into an expectation of services.IMPLICATIONS FOR REHABILITATIONThe majority of people with an acquired brain injury report unmet needs at 6 months post discharge.Present findings support the utility of patient reported measures when considering treatment evaluation with people with ABI, where assessing the personal appraisal of individuals needs may prove to be a key indicator to facilitate optimal service access.There are specific services that needed and not provided including psychological, speech pathology, family carer needs and vocational rehabilitation, and therefore are a key target for ensuring appropriate support is provided.
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Affiliation(s)
- Kirstyn Laurie
- Division of Rehabilitation, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - Michele M Foster
- Division of Rehabilitation, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - David N Borg
- Division of Rehabilitation, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - Louise Gustafsson
- Division of Rehabilitation, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
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2
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Murray CM, Weeks S, van Kessel G, Guerin M, Watkins E, Mackintosh S, Fryer C, Hillier S, Stanley M. Perspectives of choice and control in daily life for people following brain injury: A qualitative systematic review and meta-synthesis. Health Expect 2022; 25:2709-2725. [PMID: 36314107 PMCID: PMC9700193 DOI: 10.1111/hex.13636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Acquired brain injury (ABI) can result in considerable life changes. Having choice and control over daily life is valued by people following ABI. This meta-synthesis will analyse and integrate international research exploring perspectives of choice and control in daily life following ABI. METHODS Databases were searched from 1980 to 13 January 2022 for eligible qualitative studies. After duplicates were removed, 22,768 studies were screened by title and abstract, and 241 studies received full-text assessment with 56 studies included after pearling. Study characteristics and findings were extracted that related to personal perspectives on choice and control by people with an ABI (including author interpretation and quotes). Data from each study were coded and then segments of coded data across the studies were compared to create multiple broad categories. FINDINGS Findings were then reduced from categories into 3 overarching themes with 12 subthemes. These themes were: (1) feeling like a second-class citizen; (2) reordering life and (3) choosing a path. Participants with an ABI tussled between their feelings of loss following brain injury and their thinking about how they start to regain control and become agents of their own choices. The themes describe their sense of self, their changed self and their empowered self in relation to 'choice and control'. CONCLUSIONS Re-engaging with choice and control after ABI is dynamic and can be challenging. Health professionals and supporters need to facilitate a gradual and negotiated return to agency for people following ABI. A sensitive and person-centred approach is needed that considers the readiness of the person with ABI to reclaim choice and control at each stage of their recovery. Clear service or process indicators that are built on lived experience research are needed to facilitate changes in service delivery that are collaborative and inclusive. PATIENT OR PUBLIC CONTRIBUTION This review included the voices of 765 people living with ABI and was conducted by a diverse team of allied health professionals with practice knowledge and research experience with people following ABI. Twenty-nine of the 56 included studies had participants contributing to their design or analysis.
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Affiliation(s)
- Carolyn M. Murray
- Allied Health and Human Performance Academic UnitUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Scott Weeks
- Allied Health and Human Performance Academic UnitUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | | | - Michelle Guerin
- Allied Health and Human Performance Academic UnitUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | | | - Shylie Mackintosh
- Allied Health and Human Performance Academic UnitUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Caroline Fryer
- Allied Health and Human Performance Academic UnitUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Susan Hillier
- Allied Health and Human Performance Academic UnitUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Mandy Stanley
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
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Mamman R, Mortenson WB, Fleming J, Schmidt J. Living in a reshaped reality: Exploring social participation and self-identity after TBI. Neuropsychol Rehabil 2022; 32:2102-2124. [PMID: 35997174 DOI: 10.1080/09602011.2022.2113100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Individuals with a moderate to severe traumatic brain injury (TBI) experience substantial changes in their life. This constructivist grounded theory study aimed to develop an explanatory model that explores the impact of changes in social participation and self-identity after sustaining a TBI. Sixteen participants with moderate to severe TBI (mean age = 49.8, 69% male) were recruited, and were on average 16.4 years post-injury (SD = 10.4). Data from semi-structured interviews were analysed thematically. An overarching theme of "living in a reshaped reality" was identified, which depicted how changes in social participation and self-identity influenced ongoing experiences with TBI. Three main themes were generated: (1) "there's nothing that's the same" highlighted the daily challenges individuals faced post-injury, (2) "rebuilding and restarting" described how individuals with TBI navigated through their unfamiliar reality, and (3) "embrace it and run with it" explored participants' reactions towards life with a TBI. An explanatory model was developed, consisting of the overarching theme ("living in a reshaped reality") with the three integrated themes. Future research and clinical practices can build on this understanding to develop programmes to help individuals address their needs in post-injury life.
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Affiliation(s)
- Rinni Mamman
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada
| | - W Ben Mortenson
- Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,International Collaboration on Repair Discoveries, Vancouver General Hospital, Vancouver, Canada
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Julia Schmidt
- Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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4
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Keegan LC, Müller N, Ball MJ, Togher L. Anger and aspirations: Linguistic analysis of identity after traumatic brain injury. Neuropsychol Rehabil 2022; 32:2029-2053. [DOI: 10.1080/09602011.2022.2071949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Louise C. Keegan
- Speech-Language Pathology, School of Rehabilitation Sciences, Moravian University, Bethlehem, PA, USA
| | - Nicole Müller
- Department of Speech and Hearing Sciences, School of Clinical Therapies, University College Cork, Ireland
| | - Martin J. Ball
- Department of Linguistics, English Language and Bilingualism, School of Arts, Culture and Language, Bangor University, Wales
| | - Leanne Togher
- Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, Australia
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5
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Vaghela R, Santoro C, Braham L. The psychological adjustment needs of individuals following an acquired brain injury: A systematic review. APPLIED NEUROPSYCHOLOGY-ADULT 2021:1-14. [PMID: 34340606 DOI: 10.1080/23279095.2021.1956927] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This systematic review explored the psychological adjustment needs of individuals following an acquired brain injury (ABI). Whilst the landscape of rehabilitation in ABI has changed rapidly over the last decade, there is still a lack of emphasis on psychological processes in this area. An electronic search of PsycArticles, PsycINFO, PubMed, JSTOR, and Cochrane Library databases was conducted for records between January 2009 and December 2019 detailing the psychological adjustment needs of individuals in a general ABI population. A total of 17 studies with varying methodologies were initially extracted. Methodological quality was then independently assessed by the three authors, with 14 articles meeting the quality threshold. Across methodologies, key themes emerged in relation to: difficulties adjusting to a new sense of self, the critical nature of social support, and the multifaceted nature of the adjustment process which incorporates many internal and external factors. These results illustrate the importance of psychological factors in ABI rehabilitation and as such highlight that the emphasis on functional outcomes in ABI may be an obstacle to the facilitation of the process of psychological adjustment. This provides justification for a more psychologically informed, holistic approach and inspires further debate as to the fundamental importance of psychological adjustment for individual's post-ABI.
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Affiliation(s)
- Radhika Vaghela
- Assistant Clinical Psychologist, Department of Clinical Neuropsychology, Leicestershire Partnership NHS Trust, Leicester, UK
| | - Christopher Santoro
- Senior Research Assistant, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Louise Braham
- Head of Psychology and Specialist Psychological Therapies, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
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6
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Allen N, Hevey D, Carton S, O'Keeffe F. Life is about "constant evolution": the experience of living with an acquired brain injury in individuals who report higher or lower posttraumatic growth. Disabil Rehabil 2021; 44:3479-3492. [PMID: 33459069 DOI: 10.1080/09638288.2020.1867654] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To explore the experience of living with an Acquired Brain Injury (ABI) in individuals who report higher or lower posttraumatic growth (PTG). METHOD A multi-method design was employed. Participant scores on the Posttraumatic Growth Inventory (PTGI) were used to identify groups for qualitative comparative analysis. Individual semi-structured interviews were conducted with fourteen individuals with ABI. Data were analysed thematically. RESULTS Four themes emerged. The first two themes: "In my mind I was fine" surviving in aftermath of acquiring a brain injury and The everyday as "derailing" capture the transition process from an initial rehabilitation state characterised by neuropsychological and avoidance coping, towards active rebuilding for PTG. Internal building blocks for PTG and Growing in the social world: "you need to have that social connection" elaborate on the internal (e.g., acceptance, integration of the pre and post-injury self) and external (e.g., social relationships) factors seen to facilitate or obstruct PTG. CONCLUSIONS Under certain conditions, individuals living with ABI may construe positive growth from their experiences. Practitioners can support PTG development by providing individual and family-based supports aimed at increasing acceptance, the integration of self, and social connection throughout all stages of ABI rehabilitation.IMPLICATIONS FOR REHABILITATIONInternal factors such as having a flexible and positive mindset and external factors such as one's social environment can affect how individuals living with an ABI construe positive growth.Individuals with ABI and their families require access to individualised longitudinal support for neuropsychological and social challenges that can result in increased distress and obstruct the development of PTG.Efforts to facilitate acceptance and support the integration of the pre and post-injury self through recognition of continuity of self and processing of new schematic beliefs can benefit PTG development.Rehabilitation providers should support individuals with ABI to develop or maintain a positive social identity within new or existing social groups.
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Affiliation(s)
- Niamh Allen
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - David Hevey
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Simone Carton
- National Rehabilitation Hospital, Dún Laoghaire, Dublin, Ireland
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7
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Lefkovits AM, Hicks AJ, Downing M, Ponsford J. Surviving the "silent epidemic": A qualitative exploration of the long-term journey after traumatic brain injury. Neuropsychol Rehabil 2020; 31:1582-1606. [PMID: 32660336 DOI: 10.1080/09602011.2020.1787849] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Previous studies examining life after traumatic brain injury (TBI) have taken a predominantly short-term and quantitative perspective, with generally narrow focus, and have not specifically investigated changes in experience over time post-injury to gain a uniquely long-term perspective. This study therefore aimed to qualitatively explore the broad long-term experience of living for 10 years or more with TBI. Thirty participants completed semi-structured interviews investigating the impact of TBI on various life domains, the rehabilitation experience and support received, and overall perspectives of the long-term journey after TBI. Results demonstrated that: (a) although some participants reported full recovery, several experienced persistent physical, cognitive and emotional problems that impacted their independence, employment and interpersonal relationships; (b) early rehabilitation was very helpful, but some participants experienced difficulties accessing ongoing services; (c) family and social support were important to recovery; (d) most participants drew upon inner strength to find positives in their experience. These findings have identified factors that facilitate and impede long-term recovery from TBI, which may inform better support and care for injured individuals over the years after injury to improve their quality of life.
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Affiliation(s)
- Aviva Margaret Lefkovits
- Monash Epworth Rehabilitation Research Centre (MERRC), Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Amelia J Hicks
- Monash Epworth Rehabilitation Research Centre (MERRC), Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Marina Downing
- Monash Epworth Rehabilitation Research Centre (MERRC), Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Jennie Ponsford
- Monash Epworth Rehabilitation Research Centre (MERRC), Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
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Fulcher-Rood K, Castilla-Earls A, Higginbotham J. What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:688-704. [PMID: 32176526 DOI: 10.1044/2019_ajslp-19-00171] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.
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Affiliation(s)
| | - Anny Castilla-Earls
- Department of Communication Sciences and Disorders, University of Houston, TX
| | - Jeff Higginbotham
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
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9
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Downing M, Hicks A, Braaf S, Myles D, Gabbe B, Cameron P, Ameratunga S, Ponsford J. Factors facilitating recovery following severe traumatic brain injury: A qualitative study. Neuropsychol Rehabil 2020; 31:889-913. [PMID: 32200692 DOI: 10.1080/09602011.2020.1744453] [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: 10/24/2022]
Abstract
Given the significant impact of severe traumatic brain injury (TBI), understanding factors influencing recovery is critical to inform prognostication and treatment planning. Previous research has focussed primarily on factors negatively associated with outcome, with less focus on factors facilitating the recovery process. The current qualitative study examined positive factors identified for recovery by individuals who had sustained severe TBI three years earlier. Semi-structured interviews were conducted with nine participants with TBI and 16 close-others. Participants were asked to identify factors about themselves (or the injured individual), those around them, and the care they received that they felt were positive for recovery. Using reflexive thematic analysis, three themes were identified as positive for recovery after a TBI. Having a support network included social supports such as family and friends, and receiving other funded/non-funded assistance towards improving independence and participation. Being positive and engaged included being able to participate, being positive, using compensatory strategies, and becoming fit, healthy and happy. Getting good care included patients perceiving they had a comprehensive and good quality hospital experience, and access to multidisciplinary outpatient services. A focus on enhancing these positive environmental, personal and service factors in service provision may enhance outcomes following severe TBI.
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Affiliation(s)
- Marina Downing
- Monash Epworth Rehabilitation Research Centre (MERRC) and School of Psychological Sciences, Monash University, Clayton, Australia.,Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Amelia Hicks
- Monash Epworth Rehabilitation Research Centre (MERRC) and School of Psychological Sciences, Monash University, Clayton, Australia.,Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Sandra Braaf
- School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
| | - Dan Myles
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
| | - Belinda Gabbe
- School of Public Health and Preventive Medicine, Monash University, Clayton, Australia.,Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, UK
| | - Peter Cameron
- School of Public Health and Preventive Medicine, Monash University, Clayton, Australia.,The Alfred Hospital, Emergency and Trauma Centre, Melbourne, Australia
| | - Shanthi Ameratunga
- School of Population Health, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| | - Jennie Ponsford
- Monash Epworth Rehabilitation Research Centre (MERRC) and School of Psychological Sciences, Monash University, Clayton, Australia.,Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
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Matérne M, Strandberg T, Lundqvist LO. Risk Markers for Not Returning to Work Among Patients with Acquired Brain Injury: A Population-Based Register Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:728-739. [PMID: 30830502 PMCID: PMC6838038 DOI: 10.1007/s10926-019-09833-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose The aim of this study is to investigate person-related, injury-related, activity-related and rehabilitation-related risk markers for not return to work among patients with acquired brain injury (ABI). Methods Retrospective data from the Quality register, WebRehab Sweden, on an ABI cohort of 2008 patients, was divided into two groups: those who had returned to work (n = 690) and those who had not returned to work (n = 1318) within a year of the injury. Results Risk ratio analyses showed that several factors were risk markers for not returning to work: personal factors, including being a woman, being born outside of Sweden, having a low education level, and not having children in the household; injury-related factors, including long hospital stay (over 2 months), aphasia, low motor function, low cognitive function, high pain/discomfort, and high anxiety/depression; activity-related factors, including low function in self-care, inability to perform usual activities, and not having a driver's license; and rehabilitation-related factors, including being dissatisfied with the rehabilitation process and the attentiveness of the staff having limited influence over the rehabilitation plan, or not having a rehabilitation plan at all. Conclusion Several factors in different aspects of life were risk markers for not returning to work among patients with ABI. This suggests that rehabilitation and interventions need to address not only direct injury-related issues, but also person-related, activity-related, and rehabilitation-related factors in order to increase the patient's opportunities to return to work.
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Affiliation(s)
- Marie Matérne
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
- The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
| | - Thomas Strandberg
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
- The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden
| | - Lars-Olov Lundqvist
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
- The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden
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D’Cruz K, Douglas J, Serry T. Narrative storytelling as both an advocacy tool and a therapeutic process: Perspectives of adult storytellers with acquired brain injury. Neuropsychol Rehabil 2019; 30:1409-1429. [DOI: 10.1080/09602011.2019.1586733] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Kate D’Cruz
- Department of Community and Clinical Allied Health, Discipline of Occupational Therapy, La Trobe University, Melbourne, Australia
| | - Jacinta Douglas
- Department of Community and Clinical Allied Health, Discipline of Speech Pathology, La Trobe University, Melbourne, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia
- Summer Foundation, Melbourne, Australia
| | - Tanya Serry
- Department of Community and Clinical Allied Health, Discipline of Speech Pathology, La Trobe University, Melbourne, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia
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12
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Matérne M, Strandberg T, Lundqvist LO. Change in quality of life in relation to returning to work after acquired brain injury: a population-based register study. Brain Inj 2018; 32:1731-1739. [DOI: 10.1080/02699052.2018.1517224] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Marie Matérne
- University Health Care Research Center, Region Örebro County, Örebro, Sweden
- The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden
| | - Thomas Strandberg
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
- The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden
| | - Lars-Olov Lundqvist
- University Health Care Research Center, Region Örebro County, Örebro, Sweden
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
- The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden
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13
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Fulcher-Rood K, Castilla-Earls AP, Higginbotham J. School-Based Speech-Language Pathologists' Perspectives on Diagnostic Decision Making. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:796-812. [PMID: 29625425 DOI: 10.1044/2018_ajslp-16-0121] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 01/09/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE This study used a structured open interview approach to elicit information from school-based speech-language pathologists (SLPs) regarding their assessment practices for children with suspected language impairment. METHOD Phone interviews were conducted with 39 school-based SLPs who were employed across the United States. The interviews explored assessment topics related to assessment tool selection and rationale and the integration of assessment data to determine treatment eligibility. RESULTS The results of this study suggest that SLPs use both standardized testing and informal testing for their diagnostic procedures. Standardized testing appears to be the tool that drives diagnostic decisions regarding eligibility and severity. Informal measures, such as parent/teacher interviews and language sampling, were used by school-based SLPs to gather information regarding naturalistic language use; however, they seem less important in the diagnostic decision-making process. Also, SLPs reported completing language sample transcription and analysis in real time while interacting with a child. CONCLUSIONS School-based SLPs appear to rely on the results from standardized testing when determining treatment eligibility for children with language impairment. The reliance on standardized testing appears to be driven by institutional policies. We discuss the potential impact of federal/state/district guidelines on diagnostic decisions and consider the research-to-practice gap.
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14
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Shaikh NM, Kersten P, Siegert RJ, Theadom A. Developing a comprehensive framework of community integration for people with acquired brain injury: a conceptual analysis. Disabil Rehabil 2018; 41:1615-1631. [PMID: 29509028 DOI: 10.1080/09638288.2018.1443163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE Despite increasing emphasis on the importance of community integration as an outcome for acquired brain injury (ABI), there is still no consensus on the definition of community integration. The aim of this study was to complete a concept analysis of community integration in people with ABI. MATERIALS AND METHODS The method of concept clarification was used to guide concept analysis of community integration based on a literature review. Articles were included if they explored community integration in people with ABI. Data extraction was performed by the initial coding of (1) the definition of community integration used in the articles, (2) attributes of community integration recognized in the articles' findings, and (3) the process of community integration. This information was synthesized to develop a model of community integration. RESULTS Thirty-three articles were identified that met the inclusion criteria. The construct of community integration was found to be a non-linear process reflecting recovery over time, sequential goals, and transitions. Community integration was found to encompass six components including: independence, sense of belonging, adjustment, having a place to live, involved in a meaningful occupational activity, and being socially connected into the community. Antecedents to community integration included individual, injury-related, environmental, and societal factors. CONCLUSION The findings of this concept analysis suggest that the concept of community integration is more diverse than previously recognized. New measures and rehabilitation plans capturing all attributes of community integration are needed in clinical practice. Implications for rehabilitation Understanding of perceptions and lived experiences of people with acquired brain injury through this analysis provides basis to ensure rehabilitation meets patients' needs. This model highlights the need for clinicians to be aware and assess the role of antecedents as well as the attributes of community integration itself to ensure all aspects are addressed in in a manner that will enhance the recovery and improve the level of integration into the community. The finding that community integration is a non-linear process also highlights the need for rehabilitation professionals to review and revise plans over time in response to a person's changing circumstances and recovery journey. This analysis provides the groundwork for an operational model of community integration for the development of a measure of community integration that assesses all six attributes revealed in this review not recognized in previous frameworks.
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Affiliation(s)
- Nusratnaaz M Shaikh
- a School of Clinical Sciences , Auckland University of Technology , Auckland , New Zealand
| | - Paula Kersten
- b School of Health Sciences , University of Brighton , Brighton , UK
| | - Richard J Siegert
- c School of Clinical Sciences/School of Public Health and Psychosocial Studies , Auckland University of Technology , Auckland , New Zealand
| | - Alice Theadom
- d National Institute for Stroke and Applied Neurosciences , Auckland University of Technology , Auckland , New Zealand
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15
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Gauld S, Kendall M. Exploring the impact of sharing personal narratives of brain injury through film in Australian Indigenous communities. ACTA ACUST UNITED AC 2018. [DOI: 10.5348/100037d05sg2018oa] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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16
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Brunner M, Hemsley B, Dann S, Togher L, Palmer S. Hashtag #TBI: A content and network data analysis of tweets about Traumatic Brain Injury. Brain Inj 2017; 32:49-63. [DOI: 10.1080/02699052.2017.1403047] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Melissa Brunner
- Speech Pathology, Faculty of Education and Arts, University of Newcastle, Newcastle, Australia
| | - Bronwyn Hemsley
- Speech Pathology, Faculty of Education and Arts, University of Newcastle, Newcastle, Australia
| | - Stephen Dann
- College of Business and Economics, Australian National University, Canberra, Australia
| | - Leanne Togher
- Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, Australia
- University of New South Wales, NHMRC Centre of Research Excellence in Brain Recovery, Sydney, Australia
| | - Stuart Palmer
- Dean’s Office, Faculty of Science, Engineering & Built Environment, Deakin University, Geelong, Australia
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17
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Mueller C, Wang Y, Brooks A, Morant N, Sullivan P, Raymont V. ‘Attending to the wound and the person' – patients’ experiences and expectations of a newly established traumatic brain injury clinic. Brain Inj 2017; 31:1863-1870. [PMID: 28945462 DOI: 10.1080/02699052.2017.1346290] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Christoph Mueller
- West London Mental Health NHS Trust, London, UK
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Programme for North West London, London, UK
| | | | | | - Nicola Morant
- Division of Psychiatry, University College London, London, UK
| | - Paul Sullivan
- Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Programme for North West London, London, UK
- Imperial College London, London, UK
| | - Vanessa Raymont
- West London Mental Health NHS Trust, London, UK
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
- University of Oxford, Department of Psychiatry, Oxford, UK
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18
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D’Cruz K, Douglas J, Serry T. Personal narrative approaches in rehabilitation following traumatic brain injury: A synthesis of qualitative research. Neuropsychol Rehabil 2017; 29:985-1004. [DOI: 10.1080/09602011.2017.1361844] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kate D’Cruz
- Department of Community and Clinical Allied Health, La Trobe University, Melbourne, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia
| | - Jacinta Douglas
- Department of Community and Clinical Allied Health, La Trobe University, Melbourne, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia
- Summer Foundation, Melbourne, Australia
| | - Tanya Serry
- Department of Community and Clinical Allied Health, La Trobe University, Melbourne, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia
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19
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Gelech J, Bayly M, Desjardins M. Constructing robust selves after brain injury: positive identity work among members of a female self-help group. Neuropsychol Rehabil 2017; 29:456-476. [PMID: 28393594 DOI: 10.1080/09602011.2017.1308872] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Despite common experiences of identity damage, decline, and deterioration, many brain injury survivors succeed in reconstructing robust identities in the wake of injury. Yet, while this accomplishment greatly benefits survivors' quality of life, little is known about how positive identity work might be facilitated or enhanced in therapeutic institutions. Drawing on data from a women's self-help group, we argue that an egalitarian, reflective, strength-focused, and gender-segregated environment can provide female ABI (acquired brain injury) survivors with a fertile scene for identity enhancement and offer unique opportunities for collective identity development. Sociolinguistic interactional analysis revealed four types of positive identity work undertaken within the group: constructing competent selves; tempering the threat of loss and impairment; resisting infantilisation and delegitimisation; and asserting a collective gender identity. This identity work was facilitated by specific programme attributes and activities and contributed to the global project of decentring disability and destigmatising impairments and losses. We call for increased attention to identity issues in brain injury rehabilitation and argue that gender-segregated programming can provide a unique space for female survivors to construct empowering individual and collective identities after injury.
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Affiliation(s)
- Jan Gelech
- a Department of Psychology , University of Saskatchewan , Saskatoon , Canada
| | - Melanie Bayly
- a Department of Psychology , University of Saskatchewan , Saskatoon , Canada
| | - Michel Desjardins
- a Department of Psychology , University of Saskatchewan , Saskatoon , Canada
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20
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Goldberg G. Toward a Postmodern Pragmatic Discourse Semioethics for Brain Injury Care: Empirically Driven Group Inquiry as a Dialogical Practice in Pursuit of the Peircean Aesthetic Ideal of 'Reasonableness'. Phys Med Rehabil Clin N Am 2017; 28:393-411. [PMID: 28390521 DOI: 10.1016/j.pmr.2016.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A postmodern framework is proposed for conceptualizing the impact of brain injury on the subjective being of the injured person. Semiosis, the 'action of signs,' is argued as necessary for this recovery of subjectivity that escapes the mechanistic materialism and mind-matter dualism of modern science. Ethical dilemmas in brain injury care are best approached through an empirical 'semioethics' implemented as a dialogical practice among a group of selected stakeholders seeking a logical solution that best addresses the criterion of maximizing reasonableness as a tempering of rationality with relational concerns in the face of the constraints imposed by the injury.
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Affiliation(s)
- Gary Goldberg
- Hunter Holmes McGuire VA Medical Center, Physical Medicine and Rehabilitation Service (117A), 1201 Broad Rock Boulevard, Richmond, VA 23249, USA.
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21
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Knox L, Douglas JM, Bigby C. “I’ve never been a yes person”: Decision-making participation and self-conceptualization after severe traumatic brain injury. Disabil Rehabil 2016; 39:2250-2260. [DOI: 10.1080/09638288.2016.1219925] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Lucy Knox
- Living with Disability Research Center, La Trobe University, Victoria, Australia
- Summer Foundation, Victoria, Australia
| | - Jacinta M. Douglas
- Living with Disability Research Center, La Trobe University, Victoria, Australia
- Summer Foundation, Victoria, Australia
| | - Christine Bigby
- Living with Disability Research Center, La Trobe University, Victoria, Australia
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22
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Bonds Shapiro A. A Story to Create: Stroke Survivors’ Broken Narratives. Top Stroke Rehabil 2015; 18:18-23. [DOI: 10.1310/tsr1801-18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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23
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Ulatowska HK, Reyes B, Santos TO, Garst D, Vernon J, McArthur J. Personal Narratives in Aphasia: Understanding Narrative Competence. Top Stroke Rehabil 2015; 20:36-43. [DOI: 10.1310/tsr2001-36] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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24
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Fraas MR. Enhancing Quality of Life for Survivors of Stroke Through Phenomenology. Top Stroke Rehabil 2015; 18:40-6. [DOI: 10.1310/tsr1801-40] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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25
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McLean AM, Jarus T, Hubley AM, Jongbloed L. Associations between social participation and subjective quality of life for adults with moderate to severe traumatic brain injury. Disabil Rehabil 2013; 36:1409-18. [DOI: 10.3109/09638288.2013.834986] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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26
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Transitions and Brain Injury: A Qualitative Study Exploring the Journey of People with Traumatic Brain Injury. BRAIN IMPAIR 2012. [DOI: 10.1017/brimp.2012.3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This qualitative study aimed to explore transitions from hospital to the home over a period of one year.Methods and procedures: A longitudinal, phenomenological approach was employed and 18 individuals with severe traumatic brain injury, their family members and rehabilitation professionals were interviewed using semistructured interviews, when the person with brain injury was discharged from the ward, after 6 months and again after one year.Results: Themes identified within the data included returning home, getting back to normal, moving forward and the role of rehabilitation in the transitional period. Further subthemes were also identified including issues of life-course disruption, self-identity, status and reconstruction.Conclusions: Data suggested that access to rehabilitation programs employing individualised, contextual interventions following discharge to the home were integral in enabling the transition through to autonomy and independence. Consideration of issues of identity and status can enable a different and potentially important perspective on the experience of transitions for those with brain injury. Reclaiming personal autonomy and control appeared to be central to the reconstruction of a coherent sense of self, enabling a meaningful life after brain injury.
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27
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Goldberg G. Medical phenomenology and stroke rehabilitation: an introduction. Top Stroke Rehabil 2011; 18:1-5. [PMID: 21371973 DOI: 10.1310/tsr1801-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This issue of Topics in Stroke Rehabilitation explores the theme of medical phenomenology and stroke rehabilitation through open peer commentary format. The theme is introduced by a brief summary and overview of phenomenology as a branch of philosophy whose focus is the development of methodology for describing and ordering human experience. The application of this philosophical approach to medicine in general and stroke rehabilitation in particular is then considered. An approach to patients informed by both phenomenology and science provides a more complete, holistic, and humanistic framework than science alone. Phenomenology helps the clinician to understand the importance of narrative, the process of adaptation at the level of the integrated whole person, and the important role of context in determining how recovery unfolds. Embodiment is presented as an organizing principle that links the nature of conscious experience in the lived body and the basic transformation in experience and function associated with an acquired pathology such as stroke. Finally, the nature of open peer commentary is considered and introduced in terms of how it has been specifically implemented in this issue of Topics in Stroke Rehabilitation.
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Affiliation(s)
- Gary Goldberg
- Polytrauma Transitional Rehabilitation Program, Hunter Holmes McGuire Veterans Administration Medical Center, Richmond, Virginia, USA
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28
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Medved MI. Recovered or recovering: negotiating rehabilitation after stroke. Top Stroke Rehabil 2011; 18:47-51. [PMID: 21371980 DOI: 10.1310/tsr1801-47] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The role of narrative discourse has been increasingly recognized as crucial to all partners involved in the rehabilitation process after acquired brain injury. Particularly within the family, narrative offers an experiential space for meaning-making. To better understand this joint meaning-making process, a narrative-discursive methodology was used to analyze a family's conversation that took place 1 year after the mother had a stroke. In one narrative, a particular incident was used to illustrate that the mother has recovered; in another narrative, the same event was used to demonstrate that the mother was still recovering. The 2 narratives are associated with different rights, responsibilities, and rehabilitation trajectories. To holistically understand the rehabilitation process, health professionals need to be aware of the often hidden narrative meaning-making processes that take place within the family.
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29
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Fraas M, Bellerose A. Mentoring programme for adolescent survivors of acquired brain injury. Brain Inj 2009; 24:50-61. [DOI: 10.3109/02699050903446781] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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