1
|
Tsow R, Pollock C, Mehta S, Turcott A, Kang R, Schmidt J. A Look at Traumatic Brain Injury Community Programs in British Columbia: Barriers and facilitators of implementation. Brain Inj 2024; 38:539-549. [PMID: 38465902 DOI: 10.1080/02699052.2024.2327471] [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: 06/13/2023] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Abstract
RESEARCH OBJECTIVES 1) Characterize the delivery of programs that support acceptance and resiliency for people with brain injury in the healthcare sector; 2) Understand the barriers and facilitators in implementation of programs to support self-acceptance and resiliency for people with brain injury. DESIGN Participatory focus groups were used to explore experiences of conducting brain injury programs and knowledge of the barriers and facilitators to their implementation. Focus group data were analyzed with manifest content analysis to minimally deviate from broad and structural information provided by participants. SETTING Four focus group sessions were conducted online through a video calling platform. PARTICIPANTS 22 individuals from community associations conducting programs for people with brain injury. Participants were recruited from a public brain injury organization database. RESULTS Systemic challenges such as access to and allocation of funding require navigation support. Resource consistency and availability, including stable program leaders and a welcoming atmosphere, are important for program implementation and sustainability. Shared experiences promote connection with the community and personal development. CONCLUSIONS This study informs individual- and community-level approaches to promote meaningful life after brain injury. Findings highlight existing resources and support future programming for people with brain injury.
Collapse
Affiliation(s)
- Rebecca Tsow
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada a
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Courtney Pollock
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada a
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Swati Mehta
- Parkwood Institute Research, Lawson Health Research Institute, London, ON, Canada
| | - Alyssa Turcott
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada a
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Ruthine Kang
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada a
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Julia Schmidt
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada a
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
2
|
Rajaram SS, Reisher P, Garlinghouse M, Chiou KS. IPV survivors' and service providers' perspectives on brain injury screening/evaluation process and impact. Neuropsychol Rehabil 2024:1-23. [PMID: 38372576 DOI: 10.1080/09602011.2024.2314873] [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: 02/10/2023] [Accepted: 11/13/2023] [Indexed: 02/20/2024]
Abstract
This study explores the perspectives of intimate partner violence (IPV) survivors and staff of brain injury (BI) screening, and the neuropsychological evaluation (NPE) process. We gathered qualitative data from 17 participants - 10 IPV survivors, at risk for a BI, who had received BI screening and a NPE and a total of 7 staff in IPV-serving organizations. Interviews were recorded, transcribed verbatim and analysed for key themes using thematic analysis. Survivors were over 18 years of age; the majority were between 19 and 45 years old, unemployed, unmarried, and had children. Survivors were angry, scared, and embarrassed to learn that they might have an IPV-related BI. They were thankful to have an explanation for some of their cognitive symptoms, which disrupted their daily activities, social relationships, and overall quality of life. Staff were pleased to be able to provide valuable information to their clients that could have a positive impact on their wellbeing. Overall, screening for a BI and participation in the NPE were well tolerated by IPV survivors with a possible BI. Inclusion of the perspectives of IPV survivors and support staff is an essential first step to better understanding their needs so interventions can be developed to aid their recovery.
Collapse
Affiliation(s)
- Shireen S Rajaram
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Peggy Reisher
- Brain Injury Alliance of Nebraska, Lincoln, Nebraska, USA
| | | | | |
Collapse
|
3
|
Bennett K, Dillahunt-Aspillaga C, Lasley C, Trexler LC, Schmeeckle W, Walker-Egea C, Gonzalez CM, Trexler LE. Traumatic brain injury vocational rehabilitation counselor competencies: Implications for training and practice. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-221198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The Administration for Community Living (ACL) TBI State Partnership Program grants support states by providing funding to build capacity and infrastructure to support and maintain a system of services and supports to maximize the independence, well-being, and health of persons with traumatic brain injury (TBI). A Transition and Employment (T&E) workgroup identified competencies needed by Vocational Rehabilitation Counselors (VRC) to support people with TBI to obtain and maintain employment. OBJECTIVE: To: (1) identify self-perceived VRC TBI competence and (2) inform individual state VR training activities and competency goals. METHODS: A self-assessment online survey was employed. RESULTS: A total of 269 VR professionals across four states completed the VRC Self-Assessment between December 2020 and February 2021. The T&E workgroup identified TBI competencies across four domains (1) brain injury medical and rehabilitation, (2) employment, (3) state and local systems, resources, and service coordination, and (4) national systems, research and best practice. The results by TBI competency and the overall score for all participants show that state and local systems, resources, and service coordination is the highest area of competency, placing them close to the proficient level of knowledge. CONCLUSIONS: Future VR education and training opportunities may be informed by the results of this study.
Collapse
Affiliation(s)
- Keri Bennett
- Program Director for Acquired Brain Injury, Nebraska VR, Nebraska Department of Education, Kearney, NE, USA
| | - Christina Dillahunt-Aspillaga
- Rehabilitation and Mental Health CounselingProgram, Child and Family Studies, University of South Florida, Tampa, FL, USA
| | - Carla Lasley
- Program Director of CommunityServices, Nebraska VR, Nebraska Department of Education, Lincoln, NE, USA
| | - Laura C. Trexler
- ACL Grant Clinical Program Manager, Rehabilitation Hospital of Indiana, Indianapolis, IN, USA
| | | | - Connie Walker-Egea
- Senior Social and Behavioral Researcher, Department of Child and Family Studies, College of Behavioral andCommunity Sciences, University of South Florida, Tampa, FL, USA
| | - Cristina M. Gonzalez
- Doctoral Student, Counseling and CounselorEducation, University of Florida, Gainesville, FL, USA
| | - Lance E. Trexler
- Consulting Rehabilitation Neuropsychologist, Rehabilitation Hospital of Indiana, Indianapolis, IN, USA
- Department of Physical Medicine andRehabilitation, Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
4
|
Ditchman N, Thomas JA, Johnson K, Haak C, Rafajko S. The impact of employment on quality of life for adults with brain injury. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-211168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Employment is associated with greater quality of life (QOL) for people with disabilities. Yet, for individuals with traumatic brain injury (TBI), the benefits of work are not often realized given high rates of unemployment. OBJECTIVE: This study examined the unique impact of psychosocial variables and employment status (working vs. not working) on self-reported QOL among adults with TBI. METHODS: Participants included 116 adults with TBI between the ages of 18-65, recruited through state brain injury associations in the United States to complete an anonymous online survey. Hierarchical regression analysis was used to examine the incremental impact of psychosocial variables (sense of community, social support, social network, and problem-solving confidence) and employment status on QOL controlling for age and symptom severity. RESULTS: In the final model, employment status, informal and formal support network ties, problem-solving confidence, sense of community, and emotional support explained 59% of the variance in QOL, which is considered a large effect size. Employment status uniquely explained 5% of the variance in QOL. CONCLUSIONS: Findings support the positive benefits of work for adults with TBI. Rehabilitation services that emphasize vocational considerations and employment supports are needed to impact work status and ultimately QOL for individuals with TBI.
Collapse
Affiliation(s)
- Nicole Ditchman
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
| | - Julia A. Thomas
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
| | - Kristina Johnson
- Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christopher Haak
- Center for Disabilities and Development, University of Iowa, Iowa City, IA, USA
| | - Sean Rafajko
- Gersten Center for Behavioral Health, Chicago, IL, USA
| |
Collapse
|
5
|
Lannin NA, Coulter M, Laver K, Hyett N, Ratcliffe J, Holland AE, Callaway L, English C, Bragge P, Hill S, Unsworth CA. Public perspectives on acquired brain injury rehabilitation and components of care: A Citizens' Jury. Health Expect 2020; 24:352-362. [PMID: 33264470 PMCID: PMC8077088 DOI: 10.1111/hex.13176] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/27/2020] [Accepted: 11/15/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Brain injury rehabilitation is an expensive and long-term endeavour. Very little published information or debate has underpinned policy for service delivery in Australia. Within the context of finite health budgets and the challenges associated with providing optimal care to persons with brain injuries, members of the public were asked 'What considerations are important to include in a model of care of brain injury rehabilitation?' METHODS Qualitative study using the Citizen Jury method of participatory research. Twelve adult jurors from the community and seven witnesses participated including a health services funding model expert, peak body representative with lived experience of brain injury, carer of a person with a brain injury, and brain injury rehabilitation specialists. Witnesses were cross-examined by jurors over two days. RESULTS Key themes related to the need for a model of rehabilitation to: be consumer-focused and supporting the retention of hope; be long-term; provide equitable access to services irrespective of funding source; be inclusive of family; provide advocacy; raise public awareness; and be delivered by experts in a suitable environment. A set of eight recommendations were made. CONCLUSION Instigating the recommendations made requires careful consideration of the need for new models of care with flexible services; family involvement; recruitment and retention of highly skilled staff; and providing consumer-focused services that prepare individuals and their carers for the long term. PATIENT AND PUBLIC CONTRIBUTION As jury members, the public deliberated information provided by expert witnesses (including a person with a head injury) and wrote the key recommendations.
Collapse
Affiliation(s)
- Natasha A Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Clayton, Vic., Australia.,Occupational Therapy Department, Alfred Health, Melbourne, Vic., Australia
| | - Megan Coulter
- Occupational Therapy Department, Alfred Health, Melbourne, Vic., Australia
| | - Kate Laver
- Flinders University, Adelaide, SA, Australia
| | - Nerida Hyett
- La Trobe Rural Health School, La Trobe University, Melbourne, Vic., Australia
| | - Julie Ratcliffe
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Anne E Holland
- Central Clinical School, Monash University, Clayton, Vic., Australia.,Physiotherapy Department, Alfred Health, Melbourne, Vic., Australia
| | | | - Coralie English
- School of Health Sciences, Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Callaghan, NSW, Australia
| | - Peter Bragge
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Clayton, Vic., Australia
| | - Sophie Hill
- Centre for Health Communication and Participation and School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia
| | - Carolyn A Unsworth
- Department of Neuroscience, Central Clinical School, Monash University, Clayton, Vic., Australia.,School of Health, Federation University, Churchill, Vic., Australia.,Department of Rehabilitation, Jonkoping University, Jonkoping, Sweden
| |
Collapse
|