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Dawes K, Simpson G, Lines L, van den Berg M. Interventions to support children after a parental acquired brain injury: a scoping review. Brain Inj 2024; 38:773-786. [PMID: 38687294 DOI: 10.1080/02699052.2024.2347555] [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: 06/30/2023] [Accepted: 04/22/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE This scoping review aimed to identify manualised programs and practice suggestions to support children's health literacy, behaviors and emotions after a parental acquired brain injury. METHODS A systematic search of five scientific databases (PsychINFO, MEDLINE, ProQuest, Scopus, Cochrane) and gray literature occurred. Inclusion criteria included: studies and gray literature published 1989 to 2023, in English, child populations with relationship to parental acquired brain injury, identifying manualised programs or practice suggestions via content analysis approach. ETHICAL CONSIDERATIONS No data were collected from human participants. All included studies, where relevant, demonstrated consent and/or ethical processes. RESULTS Sixteen relevant studies and three gray literature resources (n = 19) were identified, including two studies that detailed manualised programs, and fifteen studies and two resource packs that included practice suggestions. Five common domains within practice suggestions were identified: systemic commitment (n = 17); family-centered approaches (n = 16); child-centered practices (n = 15); structured programs (n = 9); and peer support (n = 8). CONCLUSIONS More rigorous evaluation is required to test the potential benefits of manualised programs and practice suggestions. A systemic commitment at clinical and organizational levels to provide child and family-centered practices, structured programs, and access to peer support, early and throughout adult-health care settings, may help to meet the support needs of children.
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Affiliation(s)
- Kate Dawes
- South Australian Brain Injury Rehabilitation Service, SA Health, Adelaide, Australia
- Caring Futures Institute, Flinders University of South Australia, Adelaide, Australia
| | - Grahame Simpson
- Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, Sydney, Australia
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Lauren Lines
- Caring Futures Institute, Flinders University of South Australia, Adelaide, Australia
| | - Maayken van den Berg
- Caring Futures Institute, Flinders University of South Australia, Adelaide, Australia
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Ohan JL, Jackson HM, Bett R, Farmer GM, Martini A. Experiences and needs of children and adolescents affected by a parent's acquired brain injury: a systematic review and thematic synthesis. Disabil Rehabil 2024; 46:1034-1044. [PMID: 36861777 DOI: 10.1080/09638288.2023.2179673] [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: 05/09/2021] [Revised: 12/21/2022] [Accepted: 02/06/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE To identify the experiences and needs of dependent children who have a parent with an acquired brain injury (ABI) using a systematic review and thematic synthesis. MATERIALS AND METHODS A systematic search of Medline, Embase, PsycINFO, CINAHL Plus, and Web of Science was conducted. The search included variants of: "children," "parents," "acquired brain injury," and "experiences" or "needs." Eligible articles reported on the experiences/needs of dependent children who have a parent with an ABI, from the child's perspective. Thematic analysis was used to identify themes. RESULTS A total of 4895 unique titles were assessed, and 9 studies met inclusion. Four themes were identified: (1) Sustained Emotional Toll (subthemes: (i) Initial Shock and Distress; (ii) Ongoing Loss and Grief; (iii) Present-Day Stress and Emotions), (2) Responsibilities Change and Children Help Out, (3) Using Coping Strategies (subtheme: Talking Can Help), and (4) Wanting Information about the Injury. CONCLUSION Themes highlighted significant disruption and challenges to children's wellbeing across development, with ongoing and considerable impacts many years after the parent's injury. The nature of the experiences shifted with time since the parent's injury. These children need ongoing support starting shortly after their parent's injury that is grounded in their particular experiences.IMPLICATIONS FOR REHABILITATIONWhen a parent has an acquired brain injury (ABI), dependent children and adolescents face emotional upheaval, significant stressors, increased responsibilities, and lack of information about their parent's injury that persist even many years after injury.The nature of these experiences and therefore their needs change based on the acute versus later stages of the parent's injury.Children often do not ask questions or tell others how they feel, which means that they need support that asks about, and listens and responds to their needs.Support for children needs to start soon after the parent's injury, be grounded in the lived experiences of this group, consider their parent's recovery stage, and be embedded as part of service provision rather than rely on children or families to make service contact.
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Affiliation(s)
- Jeneva L Ohan
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia
| | - Hayley M Jackson
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia
- Brightwater Research Centre, Brightwater Care Group, Perth, Western Australia
| | - Robyn Bett
- Brightwater Research Centre, Brightwater Care Group, Perth, Western Australia
| | - Glenda M Farmer
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia
| | - Angelita Martini
- Brightwater Research Centre, Brightwater Care Group, Perth, Western Australia
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Chien WT, Lau CT. Traumatised Children's Perspectives on Their Lived Experience: A Review. Behav Sci (Basel) 2023; 13:bs13020170. [PMID: 36829399 PMCID: PMC9952495 DOI: 10.3390/bs13020170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 02/17/2023] Open
Abstract
Introduction: Most children have exposure of traumatic events during their life, such as natural disasters, accidents, and abuses. A review of traumatised children's perspective on traumatic events plays an important role in enhancing our understanding and promoting appropriate tailor-made intervention and support to these children. Methods: Four main health-related electronic databases were searched for all English full-text qualitative research articles over the past 11 years to uncover the recent best available perspective/evidence from traumatised children. The PRISMA checklist was adopted to guide the review process. Results: Five themes about children's experiences and perspectives towards the traumatic events encountered were summarised and integrated from 19 qualitative studies identified. They included daily life problems related to trauma, negative responses to trauma, perceived health needs, coping strategies related to trauma and stress, and growth from traumatic experience. Conclusions: This systematic review provides evidence about responses/impacts and perceived health needs of traumatised children and informs the direction caregivers' training can take, helping these children by early identification and timely intervention. More research is needed to examine/compare traumatised children's responses and coping between diverse traumatic experiences, time from exposure, and the sociodemographic characteristics of these children.
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Needs and Quality of Life of Caregivers of Patients with Prolonged Disorders of Consciousness. Brain Sci 2023; 13:brainsci13020308. [PMID: 36831851 PMCID: PMC9953960 DOI: 10.3390/brainsci13020308] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/30/2023] [Accepted: 02/04/2023] [Indexed: 02/15/2023] Open
Abstract
Background. Many patients with severe brain damage may survive and remain in a prolonged disorder of consciousness (PDoC), impacting the quality of life (QoL) and needs of their family caregivers. However, the current literature on the factors influencing these needs is contradictory. We aim to describe the needs, QoL, and emotional distress of caregivers of patients with PDoC. Methods. Questionnaires investigating the importance and satisfaction of six categories of needs (i.e., health information, emotional, instrumental, and professional supports, community support network, and involvement in care), QoL, and emotional distress were completed by the main caregivers of PDoC patients. Results. We analyzed 177 questionnaires. Seventy-nine percent of the needs were considered as important or very important, and 44% were partially met or unmet. The needs for health information and professional support were the most important, while the needs for involvement in care and for health information were the most satisfied. Mean QoL was low and emotional distress high. Variables such as care setting and time since brain injury affected the level of QoL and distress. Conclusion. The needs for health information and professional support should receive particular attention. Given their low QoL and high distress, adequate support structures should be provided to caregivers of PDoC patients.
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Gonzalez-Lara LE, Munce S, Christian J, Owen AM, Weijer C, Webster F. The multiplicity of caregiving burden: a qualitative analysis of families with prolonged disorders of consciousness. Brain Inj 2021; 35:200-208. [PMID: 33385307 DOI: 10.1080/02699052.2020.1865565] [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 understand the multiple and sometimes conflicting roles substitute decision makers (SDMs) of individuals in a vegetative state (VS), minimally conscious state (MCS), or with locked-in syndrome (LIS) perform while caring for a loved one and the competing priorities derived from these roles.Methods: We conducted semi-structured qualitative interviews using a constructive-grounded theory design. Twelve SDMs, who were also family members for 11 patients, were interviewed at two time points (except one) for a total of 21 in-depth interviews.Results: Participants described that caregiving is often the central role which they identify as their top priority and around which they coordinate and to some extent subordinate their other roles. In addition to caregiving, they participated in a wide variety of roles, which were sometimes in conflict, as they became caregivers for a loved one with chronic and complex needs. SDMs described the caregiver role as complex and intense that lead to physical, emotional, social, and economic burdens.Conclusion: SDMs report high levels of burdens in caring for a person with a prolonged disorder of consciousness. Lack of health system support that recognized the broader context of SDMs lives, including their multiple competing priorities, was a major contributing factor.
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Affiliation(s)
| | - Sarah Munce
- Toronto Rehabilitation Institute - University Health Network
| | | | - Adrian M Owen
- The Brain and Mind Institute, Western University, London, Ontario, Canada
| | | | - Fiona Webster
- Labatt Family School of Nursing, Western University, London, Ontario, Canada
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Dawes K, Carlino A, van den Berg M, Killington M. Life altering effects on children when a family member has an acquired brain injury; a qualitative exploration of child and family perceptions. Disabil Rehabil 2020; 44:282-290. [DOI: 10.1080/09638288.2020.1766582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Kate Dawes
- South Australian Brain Injury Rehabilitation Service, SA Health, Adelaide, Australia
- College of Nursing and Health Sciences, Flinders University of South Australia, Adelaide, Australia
| | - Ashley Carlino
- South Australian Brain Injury Rehabilitation Service, SA Health, Adelaide, Australia
| | - Maayken van den Berg
- College of Nursing and Health Sciences, Flinders University of South Australia, Adelaide, Australia
| | - Maggie Killington
- South Australian Brain Injury Rehabilitation Service, SA Health, Adelaide, Australia
- College of Nursing and Health Sciences, Flinders University of South Australia, Adelaide, Australia
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Hartman L, Jenkinson C, Morley D. Young People's Response to Parental Neurological Disorder: A Structured Review. Adolesc Health Med Ther 2020; 11:39-51. [PMID: 32273785 PMCID: PMC7105371 DOI: 10.2147/ahmt.s237807] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/08/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction A significant paucity of literature exists relating to the impact on children of parental neurological disorder, with the exception of multiple sclerosis. The wider literature in this field (parental cancer, depression, alcoholism, HIV/AIDS) exhibits the many potential challenges young people might experience during serious parental illness. Given this, a literature review of parental neurological disorder is long overdue. Methods This review is structured around the World Health Organisation (WHO) classification of neurological disorders. The WHO identifies 10 common neurological disorders; dementia, epilepsy, headache, multiple sclerosis, neuroinfections, neurological disorders associated with malnutrition, pain associated with neurological disorders, Parkinson's disease, stroke, and traumatic brain injury. A comprehensive search of the MEDLINE database was performed using key terms for each of the 10 conditions. Results for each condition were divided in to "negative", "positive and/or neutral" and "other" child responses. Results The search yielded a total of 6247 titles, of which 184 underwent a full-text assessment. Sixty-five met all eligibility criteria and were thus included in the review. A number of negative issues emerged across parental conditions including the prevalence of child mood disorders, parent-child role reversal, children's need for information on the parental condition, the importance of family cohesion, the negative effect of parental psychopathology and differences between male and female children. A limited number of positive outcomes were evident in a minority of parental conditions. Outcomes measured and methodologies employed were highly heterogeneous. Conclusion Children generally respond negatively to parental neurological disorder. Responses varied between neurological disorders, suggesting the need for parental disease-specific guidance and clinical management where required.
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Affiliation(s)
- Lilian Hartman
- Lincoln College, University of Oxford, Oxford OX1 3DR, UK
| | - Crispin Jenkinson
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - David Morley
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
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Holloway M, Orr D, Clark-Wilson J. Experiences of challenges and support among family members of people with acquired brain injury: a qualitative study in the UK. Brain Inj 2019; 33:401-411. [PMID: 30663417 DOI: 10.1080/02699052.2019.1566967] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PRIMARY OBJECTIVE Family members (FM) are affected by the impact of an Acquired Brain Injury (ABI) upon their relatives and play an important role in rehabilitation and long-term support. This study explores how families are affected and integrates their views on the formal/informal support received as a consequence of ABI. RESEARCH DESIGN A qualitative research design was employed to capture the lived experience of FM of people with ABI. METHOD Semi-structured interviews were conducted with 16 FM of people with severe ABI. Participants were chosen from respondents to a UK national online survey of affected individuals. Interview data were analysed using inductive thematic analysis. RESULTS Family members' experiences are complex, enduring and are affected by the context in which the ABI occurs as well as by formal/informal support. The grief experienced by FM is ambiguous, develops over time and FM perceive little option but to remain involved. Experience of formal and informal support is noted to vary significantly in availability and quality, poor support exacerbates difficulties and isolates family members. CONCLUSION Greater understanding of the lived experience of FM is needed to support more effective responses to both them and the individual with ABI, integrating services and families to improve quality-of-life.
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Affiliation(s)
| | - David Orr
- b University of Sussex , Brighton , UK
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Kinnunen L, Niemelä M, Hakko H, Miettunen J, Merikukka M, Karttunen V, Ristikari T, Gissler M, Räsänen S. Psychiatric diagnoses of children affected by their parents’ traumatic brain injury: the 1987 Finnish Birth Cohort study. Brain Inj 2018; 32:933-940. [DOI: 10.1080/02699052.2018.1470331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Lotta Kinnunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Mika Niemelä
- Department of Welfare, National Institute for Health and Welfare, Oulu, Finland
| | - Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marko Merikukka
- Department of Welfare, National Institute for Health and Welfare, Oulu, Finland
| | - Vesa Karttunen
- Department of Neurology, Oulu University Hospital, Oulu, Finland
| | - Tiina Ristikari
- Department of Welfare, National Institute for Health and Welfare, Oulu, Finland
| | - Mika Gissler
- Information Services Department, National Institute for Health and Welfare, Helsinki, Finland
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden
| | - Sami Räsänen
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
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