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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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Corbin S, Damiolini E, Termoz A, Huchon L, Rode G, Schott AM, Haesebaert J. Rehabilitation professionals' views on individual peer support interventions for assisting stroke survivors with reintegration into the community: a qualitative study. Disabil Rehabil 2023; 45:4413-4423. [PMID: 36576210 DOI: 10.1080/09638288.2022.2152115] [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: 12/16/2021] [Accepted: 11/22/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE We aimed to explore stroke rehabilitation professionals' understanding and representations of peer support; the benefits they anticipated for patients; and the levers and barriers they perceived to implement the intervention in their practice. MATERIALS AND METHODS This qualitative study comprised four focus groups with 21 rehabilitation professionals and four semi-structured interviews. It was held in a French hospital. Interpretation was guided by the Consolidated Framework for Implementation Research. RESULTS Although professionals had poor knowledge on peer support, they identified many unmet needs of stroke survivors that peer support could meet such as social, emotional and informational support. Main barriers were the lack of human and financial resources, and of linkage between hospital and community professionals, and the fear that peer support would give false hope to survivors if not delivered properly. They showed ambivalence towards patient engagement, acknowledging its importance, but demonstrating top-down attitudes. They also identified potential avenues for the implementation of peer support for stroke survivors. CONCLUSIONS Our study supports the necessity to involve professionals in the construction of peer-support interventions and to sensitise them to provide patient-centred care. It delivers insights on effective implementation strategies to develop peer support interventions for stroke survivors reintegrating the community.
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Affiliation(s)
- Sara Corbin
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard, Lyon 1, France
| | - Eleonore Damiolini
- Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle Santé Publique, Lyon, France
| | - Anne Termoz
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard, Lyon 1, France
- Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle Santé Publique, Lyon, France
| | - Laure Huchon
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
- Equipe "Trajectoires", Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
| | - Gilles Rode
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
- Equipe "Trajectoires", Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
| | - Anne-Marie Schott
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard, Lyon 1, France
- Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle Santé Publique, Lyon, France
| | - Julie Haesebaert
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard, Lyon 1, France
- Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle Santé Publique, Lyon, France
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Exercise for People with Acquired Brain Injury: An ICF Perspective. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12083862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Exercise is an important element in the process of recovery from an acquired brain injury (ABI). However, specific guidance for exercise prescription and interventions in this population are missed. The aim of this study was to establish the key parameters to design and implement exercise programs based on the International Classification of Functioning, Disability, and Health (ICF) domains. A panel of experts that consisted of 13 professionals from neuro-rehabilitation centers evaluated the key parameters of this original proposal. The Heinemann methodology was used for all qualitative analyses. Additionally, Cronbach’s alpha was applied to the statistical analyses. According to the results, Cronbach’s alpha (0.97) indicated excellent internal consistency, and the experts perceptions ratified the proposed criteria to develop exercise programs for people with ABI. The proposed key parameters for the development of exercise programs for people with ABI based in ICF domains (body functions, activity—participation and environmental factors) bring a new, solid, and innovative tool for methodological design of these programs in sub-acute and chronic rehabilitation settings.
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Tate R, Simpson G, Lane‐brown A, Soo C, De wolf A, Whiting D. Sydney Psychosocial Reintegration Scale (SPRS‐2): Meeting the Challenge of Measuring Participation in Neurological Conditions. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2011.00060.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Robyn Tate
- Rehabilitation Studies Unit, Northern Clinical School, Sydney Medical School, University of Sydney
- Royal Rehabilitation Centre Sydney
| | - Grahame Simpson
- Rehabilitation Studies Unit, Northern Clinical School, Sydney Medical School, University of Sydney
- Brain Injury Rehabilitation Unit, Liverpool Hospital
| | - Amanda Lane‐brown
- Rehabilitation Studies Unit, Northern Clinical School, Sydney Medical School, University of Sydney
| | - Cheryl Soo
- Australian Centre for Child Neuropsychology Studies, Murdoch Children's Research Institute, Royal Children's Hospital
| | - Annelies De wolf
- Rehabilitation Studies Unit, Northern Clinical School, Sydney Medical School, University of Sydney
| | - Diane Whiting
- Brain Injury Rehabilitation Unit, Liverpool Hospital
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Choustikova J, Turunen H, Tuominen-Salo H, Coco K. Traumatic brain injury patients' family members' evaluations of the social support provided by healthcare professionals in acute care hospitals. J Clin Nurs 2020; 29:3325-3335. [PMID: 32497326 DOI: 10.1111/jocn.15359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES The study aimed to examine traumatic brain injury (TBI) patient family members' (FMs) experiences of the support they received from healthcare professionals in acute care hospitals. BACKGROUND The length of hospitalisation following TBI is constantly decreasing, and patients may return home with several problems. FMs care for the patients at home although they may not be prepared for the patient's medical needs or financial burden of the illness. The burden which some FMs experience can impair patient care and rehabilitation outcomes. Therefore, FMs require support during acute phases of TBI treatment. DESIGN A structured questionnaire was sent to 216 TBI patients FMs. The response rate was 47% (n = 102). METHODS A structured questionnaire-based on a systematic literature review and a previous questionnaire on TBI patient FMs' perceptions of support-was developed and used in the data collection. The questionnaire included 46 statements and 11 background questions. Data were collected via an electronic questionnaire. The STROBE checklist was followed in reporting the study. RESULTS A factor analysis identified five factors that describe the guidance of TBI patient FMs: guidance of TBI patients' symptoms and survival; benefits of guidance; needs-based guidance; guidance for use of services; and guidance methods. Most of the FMs (51%-88%) felt that they had not received enough guidance from healthcare professionals in acute care hospitals across all five aspects of support. CONCLUSIONS The content of guidance should be developed, and healthcare staff should be trained to consider a FM's starting point when providing guidance. A calm environment, proper timing, sufficient information in different forms and professional healthcare staff were found to be key factors to comprehensive guidance. Involving FMs in the discharge process and rehabilitation of their loved ones both supports the abilities of caregivers and promotes the outcome of the patient's rehabilitation. RELEVANCE TO CLINICAL PRACTICE This study provides varied information on the need for social support of TBI patients FMs in the early stages of treatment from the FMs' perspective. This research adopted the FM's perspective to identify various areas of social support that need to be developed so that the FMs of TBI patients receive enough support during the early stages of TBI treatment.
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Affiliation(s)
- Julia Choustikova
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Hannele Turunen
- Department of Nursing Science, University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | | | - Kirsi Coco
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Gross JMS, Monroe‐Gulick A, Nye C, Davidson‐Gibbs D, Dedrick D. Multifaceted interventions for supporting community participation among adults with disabilities: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2020; 16:e1092. [PMID: 37131415 PMCID: PMC8356358 DOI: 10.1002/cl2.1092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Judith M. S. Gross
- Center on Community Living and Careers, Indiana Institute on Disability and CommunityIndiana UniversityBloomingtonIndiana
| | | | - Chad Nye
- American Institutes for ResearchLakelandFlorida
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O’Shea A, Frawley P, Leahy JW, Nguyen HD. A Critical Appraisal of Sexuality and Relationships Programs for People with Acquired Brain Injury. SEXUALITY AND DISABILITY 2020. [DOI: 10.1007/s11195-020-09616-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Patterson F, Fleming J, Doig E. Patient perceptions of participation in group-based rehabilitation in an inpatient brain injury rehabilitation setting. PATIENT EDUCATION AND COUNSELING 2019; 102:148-154. [PMID: 30115414 DOI: 10.1016/j.pec.2018.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 07/31/2018] [Accepted: 08/01/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The use of groups is common in healthcare. There is a paucity of research which captures patient experiences of group participation. The aims of this study were to explore the perceptions and experiences of people with traumatic brain injury (TBI) about their participation in inpatient occupational therapy rehabilitation groups. METHOD A phenomenological approach guided the study. Patients with a TBI who were participating in an inpatient occupational therapy group program were recruited. Data were collected through semi-structured interviews and analysed using content analysis. RESULTS Fifteen participants consented to the study. Three themes emerged from the data; 1) feeling normal, comfortable and connected; 2) learning by doing, seeing and sharing and; 3) practicalities of groups. Participants highlighted that groups facilitated opportunities to practice skills and prepared them for the real world. Opportunities for interaction and support were also emphasised as positive by participants. CONCLUSION Perceptions of patients about participation in groups were generally positive, and as such a consumer-focused approach to healthcare would support the use of occupational therapy groups in TBI rehabilitation. PRACTICE IMPLICATIONS Recommendations from the perspectives of patients include consideration of the selection of group participants, and meeting individual needs and goals within a group setting.
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Affiliation(s)
- Freyr Patterson
- Occupational Therapy Department, The Princess Alexandra Hospital, Brisbane, Australia; The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| | - Jennifer Fleming
- Occupational Therapy Department, The Princess Alexandra Hospital, Brisbane, Australia; The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; Centre for Functioning and Health Research, Queensland Health, Brisbane, Australia
| | - Emmah Doig
- The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; Centre for Functioning and Health Research, Queensland Health, Brisbane, Australia
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Olofsson A, Larsson Lund M, Nyman A. Everyday activities outside the home are a struggle: Narratives from two persons with acquired brain injury. Scand J Occup Ther 2018; 27:194-203. [DOI: 10.1080/11038128.2018.1495762] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Alexandra Olofsson
- Department of Health Science, Occupational Therapy, Luleå University of Technology, Luleå, Sweden
| | - Maria Larsson Lund
- Department of Health Science, Occupational Therapy, Luleå University of Technology, Luleå, Sweden
| | - Anneli Nyman
- Department of Health Science, Occupational Therapy, Luleå University of Technology, Luleå, Sweden
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Patterson F, Fleming J, Doig E. Clinician perceptions about inpatient occupational therapy groups in traumatic brain injury rehabilitation. Brain Inj 2017; 31:1077-1087. [DOI: 10.1080/02699052.2017.1296974] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Freyr Patterson
- The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Jennifer Fleming
- The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Centre for Functioning and Health Research, Queensland Health, Brisbane, Queensland, Australia
| | - Emmah Doig
- The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Functioning and Health Research, Queensland Health, Brisbane, Queensland, Australia
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Wheeler S, Acord-Vira A, Davis D. Effectiveness of Interventions to Improve Occupational Performance for People With Psychosocial, Behavioral, and Emotional Impairments After Brain Injury: A Systematic Review. Am J Occup Ther 2016; 70:7003180060p1-9. [PMID: 27089290 DOI: 10.5014/ajot.115.020677] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This systematic review evaluates the effectiveness of interventions to improve occupational performance for people with psychosocial, behavioral, or emotional impairments after traumatic brain injury (TBI). METHOD Medline, PsycINFO, CINAHL, OTseeker, and the Cochrane Database of Systematic Reviews were searched. Of the 1,512 articles initially identified, 35 met the inclusion criteria. RESULTS Six types of interventions were identified: (1) education, (2) peer mentoring, (3) goal-directed therapy, (4) physical activity, (5) skills training, and (6) cognitive-behavioral therapy (CBT). Strong evidence from well-conducted research supports the use of CBT in individual and group settings. Moderate evidence supports goal-directed interventions, aquatic exercise, and functional skills training. Limited evidence supports peer mentoring, aerobic exercise, educational interventions, and various skills training. CONCLUSION An increasing body of evidence supports specific interventions to improve occupational performance and participation for people with psychosocial, behavioral, or emotional impairments after TBI.
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Affiliation(s)
- Steven Wheeler
- Steven Wheeler, PhD, OTR/L, CBIS, is Associate Professor and Associate Chair, Division of Occupational Therapy, Department of Human Performance and Applied Exercise Science, West Virginia University School of Medicine, Morgantown;
| | - Amanda Acord-Vira
- Amanda Acord-Vira, MOT, OTR/L, CBIS, is Assistant Professor, Division of Occupational Therapy, Department of Human Performance and Applied Exercise Science, West Virginia University School of Medicine, Morgantown
| | - Diana Davis
- Diana Davis, PhD, OTR/L, is Assistant Professor, Division of Occupational Therapy, Department of Human Performance and Applied Exercise Science, West Virginia University School of Medicine, Morgantown
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Powell JM, Rich TJ, Wise EK. Effectiveness of Occupation- and Activity-Based Interventions to Improve Everyday Activities and Social Participation for People With Traumatic Brain Injury: A Systematic Review. Am J Occup Ther 2016; 70:7003180040p1-9. [DOI: 10.5014/ajot.2016.020909] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
This systematic review presents research on the effectiveness of occupation- and activity-based interventions to improve everyday activities and areas of occupation and social participation for people with traumatic brain injury (TBI). Nineteen studies identified through a comprehensive database search were reviewed and synthesized into five themes: (1) multidisciplinary and interdisciplinary treatment approaches, (2) community-based rehabilitation programs, (3) treatment approaches using client-centered goals and relevant contexts, (4) social skills training and peer mentoring interventions, and (5) community mobility interventions. Evidence supports the use of multidisciplinary and interdisciplinary approaches across a variety of settings, with no single treatment approach or setting clearly superior to another. The specific contributions of occupational therapy practitioners and the nature of occupational therapy interventions have not been well studied, making it difficult to determine the extent to which occupation- and activity-based interventions provided by occupational therapy practitioners improve occupational performance and social participation after TBI.
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Affiliation(s)
- Janet M. Powell
- Janet M. Powell, PhD, OTR/L, FAOTA, is Associate Professor and Head, Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle;
| | - Timothy J. Rich
- Timothy J. Rich, MOT, OTR/L, is Doctoral Student, PhD in Rehabilitation Science Program, University of Washington, and Occupational Therapist, Harborview Medical Center, Seattle, WA
| | - Elizabeth K. Wise
- Elizabeth K. Wise, MOT, OTR/L, is Occupational Therapist, Bonner General Health, Sandpoint, ID
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Patterson F, Fleming J, Doig E. Group-based delivery of interventions in traumatic brain injury rehabilitation: a scoping review. Disabil Rehabil 2016; 38:1961-86. [DOI: 10.3109/09638288.2015.1111436] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Freyr Patterson
- The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia
| | - Jennifer Fleming
- The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health District, Queensland Health, Brisbane, Australia
| | - Emmah Doig
- The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health District, Queensland Health, Brisbane, Australia
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Gertler P, Tate RL, Cameron ID. Non-pharmacological interventions for depression in adults and children with traumatic brain injury. Cochrane Database Syst Rev 2015; 2015:CD009871. [PMID: 26663136 PMCID: PMC8761477 DOI: 10.1002/14651858.cd009871.pub2] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Following traumatic brain injury (TBI) there is an increased prevalence of depression compared to the general population. It is unknown whether non-pharmacological interventions for depression are effective for people with TBI. OBJECTIVES To investigate the effectiveness of non-pharmacological interventions for depression in adults and children with TBI at reducing the diagnosis and severity of symptoms of depression. SEARCH METHODS We ran the most recent search on 11 February 2015. We searched the Cochrane Injuries Group Specialised Register, The Cochrane Library, MEDLINE (OvidSP), Embase (OvidSP), three other databases and clinical trials registers. Relevant conference proceedings and journals were handsearched, as were the reference lists of identified studies. SELECTION CRITERIA Randomised controlled trials (RCTs) of non-pharmacological interventions for depression in adults and children who had a TBI. DATA COLLECTION AND ANALYSIS Two authors independently selected trials from the search results, then assessed risk of bias and extracted data from the included trials. The authors contacted trial investigators to obtain missing information. We rated the overall quality of the evidence of the primary outcomes using the GRADE approach. MAIN RESULTS Six studies met the inclusion criteria, with a total of 334 adult participants. We identified no studies that included children as participants. All studies were affected by high risk of bias due to a lack of blinding of participants and personnel; five studies were affected by high risk of bias for lack of blinding of outcome assessors. There was high or unclear risk of biases affecting some studies across all the Cochrane risk of bias measures.Three studies compared a psychological intervention (either cognitive behaviour therapy or mindfulness-based cognitive therapy) with a control intervention. Data regarding depression symptom outcome measures were combined in a meta-analysis, but did not find an effect in favour of treatment (SMD -0.14; 95% CI -0.47 to 0.19; Z = 0.83; P = 0.41). The other comparisons comprised of single studies of depression symptoms and compared; cognitive behaviour therapy versus supportive psychotherapy (SMD -0.09; 95% CI -0.65 to 0.48; Z = 0.30; P = 0.77); repetitive transcranial magnetic stimulation plus tricyclic antidepressant (rTMS + TCA) versus tricyclic antidepressant alone (SMD -0.84; 95% CI -1.36 to -0.32; Z = 3;19, P = 0.001); and a supervised exercise program versus exercise as usual (SMD -0.43; 95% CI -0.88 to 0.03; Z = 1.84; P = 0.07). There was very-low quality evidence, small effect sizes and wide variability of results, suggesting that no comparisons showed a reliable effect for any intervention.Only one study mentioned minor, transient adverse events from repetitive transcranial magnetic stimulation. AUTHORS' CONCLUSIONS The review did not find compelling evidence in favour of any intervention. Future studies should focus on participants with a diagnosed TBI and include only participants who have a diagnosis of depression, or who record scores above a clinical cutoff on a depression measure. There is a need for additional RCTs that include a comparison between an intervention and a control that replicates the effect of the attention given to participants during an active treatment.
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Affiliation(s)
- Paul Gertler
- University of SydneyJohn Walsh Centre for Rehabilitation ResearchKolling InstituteSt. LeonardsAustraliaNSW 2065
| | - Robyn L Tate
- University of SydneyJohn Walsh Centre for Rehabilitation ResearchKolling InstituteSt. LeonardsAustraliaNSW 2065
| | - Ian D Cameron
- University of SydneyJohn Walsh Centre for Rehabilitation ResearchKolling InstituteSt. LeonardsAustraliaNSW 2065
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McMonagle C, Rasmussen S, Elliott MA, Dixon D. Use of the ICF to investigate impairment, activity limitation and participation restriction in people using ankle-foot orthoses to manage mobility disabilities. Disabil Rehabil 2015; 38:605-12. [DOI: 10.3109/09638288.2015.1055374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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A Systematic Review of the Efficacy of Community-based, Leisure/Social Activity Programmes for People with Traumatic Brain Injury. BRAIN IMPAIR 2015. [DOI: 10.1017/brimp.2014.28] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background: Many people who have a severe traumatic brain injury (TBI) are not able to resume employment and consequently experience profound changes in their lifestyle. They have increased amounts of ’spare time’ yet often find it difficult to engage in meaningful activity. Leisure activities are one way in which meaningful activity can be increased.Aims: This systematic review has two purposes: first, to identify and evaluate the efficacy of community-based interventions for leisure/social activity after TBI, and second to provide details on the types of intervention.Method: Systematic searches were conducted of Medline, PsycINFO and PsycBITE to October 2014, as well as hand searches of two occupational therapy journals. Inclusion criteria were as follows: peer reviewed journal articles on adults with TBI who had participated in a trial evaluating a community-based intervention specifically targeting leisure/social activity. All research methodologies using primary studies that provided empirical, quantitative data were considered. Scientific quality of the studies was evaluated using the PEDro Scale for controlled trials and the Risk of Bias in N-of-1 Trials Scale for single-case designs.Results: Two independent raters screened 196 abstracts, resulting in nine articles that met selection criteria. Data were then independently extracted by the raters. Four of the nine studies used a control condition in their research design (two randomised controlled trials, one controlled but non-randomised study, and one single-case experiment using a changing criterion design). Two of the studies conducted between-group analyses with significant treatment effects for mood and quality of life using active leisure programmes (Tai Chi Qigong and a combined programme of outdoor adventure experiences and goal setting respectively). Intervention programmes identified in the review were then grouped and described according to the approach or model used, including active leisure programmes, social peer mentoring, individual brokered leisure services and a therapeutic recreation model. Additional intervention models and approaches that did not result directly from the systematic review were also described because they provide information on the current approaches used in practice (Clubhouse model and leisure education programmes in the stroke population).Conclusions: There is some evidence for the effectiveness of community-based interventions for leisure/social activity for people who have had a TBI to improve mood and quality of life. The conclusions of this review are that the interventions for this area need to be planned and specific, structured and goal-driven, intensive and conducted over a period of months.
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The effect of environmental barriers on community integration for individuals with moderate to severe traumatic brain injury. J Head Trauma Rehabil 2014; 29:125-35. [PMID: 23474885 DOI: 10.1097/htr.0b013e318286545d] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe environmental barriers endorsed by individuals with traumatic brain injury during the first 6 months after discharge and determine their effect on community integration. DESIGN Prospective longitudinal study with data collected at predischarge and at 1, 3, and 6 months postdischarge. PARTICIPANTS One hundred thirty-five individuals with a diagnosis of traumatic brain injury discharged from a large metropolitan hospital to a home/community environment. MEASURES Sydney Psychosocial Reintegration Scale; Craig Hospital Inventory of Environmental Factors; and Mayo-Portland Adaptability Inventory-4. RESULTS Multiple regression analyses indicated that environmental barriers arising during the transition from hospital to home had a negative association with community integration outcomes. Physical barriers were most commonly endorsed, but attitudinal barriers were significantly correlated with relationship changes. CONCLUSION Environmental barriers should be addressed in rehabilitation and considered in policy development for people with traumatic brain injury. Future research on the measurement of environmental barriers is recommended.
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Participation After Stroke: Do We Understand All the Components and Relationships As Categorised in the ICF? BRAIN IMPAIR 2012. [DOI: 10.1017/brimp.2012.9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Although advances in stroke care have been shown to improve functional outcomes and survival, evidence suggests that stroke survivors continue to report restricted participation and dissatisfaction with life after returning home. There remains a need to identify ways to improve participation after stroke, considering the person within their context. The International Classification of Functioning, Disability and Health (ICF) provides a valuable framework that can be useful for categorising key components associated with participation. The two parts of the ICF — (a) Functioning and Disability and (b) Contextual Factors — encourage consideration of the functions/body structures, activity and participation, and personal and environmental factors, respectively. Previous research has identified links between body functions, structures and activity, with increasing attention being given to the ways in which these link with participation. Although some of the components influencing participation poststroke are well defined, there is a need to further develop our understanding of how personal and environmental factors may affect participation. In this article, stroke literature is categorised using the ICF and a range of personal and environmental factors are investigated as potential contributors to levels of participation poststroke. This article concludes that research investigating contextual factors and their interactions with participation is warranted.
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Identifying Factors Associated With Perceived Success in the Transition From Hospital to Home After Brain Injury. J Head Trauma Rehabil 2012; 27:143-53. [DOI: 10.1097/htr.0b013e3182168fb1] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Appleton S, Browne A, Ciccone N, Fong K, Hankey G, Lund M, Miles A, Wainstein C, Zach J, Yee Y. A Multidisciplinary Social Communication and Coping Skills Group Intervention for Adults with Acquired Brain Injury (ABI): A Pilot Feasibility Study in an Inpatient Setting. BRAIN IMPAIR 2012. [DOI: 10.1375/brim.12.3.210] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThere is evidence that individuals with an acquired brain injury (ABI) are at increased risk of developing psychological problems and that they commonly experience difficulties in social communication, associated with poorer long-term outcomes. Although several relevant group interventions have been evaluated, there has been limited exploration of the feasibility of an ABI inpatient intervention. This nonrandomised pilot study tested the feasibility of an inpatient multidisciplinary social communication and coping skills group intervention within 1-year post traumatic/nontraumatic ABI. Seven participants completed a 4-week group program (3 × 1 hour sessions per week) facilitated by a speech pathologist and clinical psychologist and were assessed pre/post intervention and at 3 months with the La Trobe Communication Questionnaire, Correct Information Unit analysis, Hospital Anxiety and Depression Scale, Mini International Neuropsychiatric Interview, Coping Self-Efficacy scale and World Health Organization Quality of Life assessment. Most participants improved between baseline and 3 months post intervention in terms of greater informativeness and efficiency of connected speech and reduced anxiety and they provided positive feedback about the group program. Despite the challenges and limitations of this pilot study, the findings are encouraging and support both the value and feasibility of developing such a program into routine inpatient rehabilitation services.
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Abstract
BACKGROUND Management of intra-abdominal hypertension with an open abdomen and planned ventral hernia results in decreased mortality. But, delayed abdominal wall reconstruction (DAWR) is necessary. Results after DAWR demonstrate acceptable recurrence, morbidity, and mortality rates. However, little is known about quality of life (QOL) after DAWR. The purpose of this study was to analyze QOL after DAWR. METHODS Patients who had DAWR>15 years were identified from operative logs of a trauma center. Patients were contacted, and a QOL assessment was administered in person or via telephone. The QOL assessment contained the Short-Form 36-Item Health Survey 1.0, the Posttraumatic Stress Disorder (PTSD) Checklist-Civilian Version, and the Centers for Epidemiologic Studies Depression Scale. RESULTS The QOL assessment was completed by 41 of 152 patients. The indication for open abdomen was injury in 37 (90%) and emergency operation in 4 (10%). Time to follow-up ranged from 9 months to 14.6 years after DAWR. Of 31 patients working before DAWR, 23% had not returned to work secondary to DAWR. Also, 65% screened positive for depression and 23% screened positive for PTSD. Compared with population norms Physical Component Scores were significantly lower for the study population (41.1±13.2, p<0.05). CONCLUSION Patients who undergo DAWR have decreased physical functioning and have a high prevalence of PTSD and depression. Consideration should be given to screening for depression and PTSD in this patient population.
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Turner B, Fleming J, Ownsworth T, Cornwell P. Perceptions of recovery during the early transition phase from hospital to home following acquired brain injury: A journey of discovery. Neuropsychol Rehabil 2011; 21:64-91. [DOI: 10.1080/09602011.2010.527747] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Cerniauskaite M, Quintas R, Boldt C, Raggi A, Cieza A, Bickenbach JE, Leonardi M. Systematic literature review on ICF from 2001 to 2009: its use, implementation and operationalisation. Disabil Rehabil 2010; 33:281-309. [PMID: 21073361 DOI: 10.3109/09638288.2010.529235] [Citation(s) in RCA: 162] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE To present a systematic literature review on the state of the art of the utilisation of the International Classification of Functioning, Disability and Health (ICF) since its release in 2001. METHOD The search was conducted through EMBASE, MEDLINE and PsychInfo covering the period between 2001 and December 2009. Papers were included if ICF was mentioned in title or abstract. Papers focussing on the ICF-CY and clinical research on children and youth only were excluded. Papers were assigned to six different groups covering the wide scenario of ICF application. RESULTS A total of 672 papers, coming from 34 countries and 211 different journals, were included in the analysis. The majority of publications (30.8%) were conceptual papers or papers reporting clinical and rehabilitation studies (25.9%). One-third of the papers were published in 2008 and 2009. CONCLUSIONS The ICF contributed to the development of research on functioning and on disability in clinical, rehabilitation as well as in several other contexts, such as disability eligibility and employment. Diffusion of ICF research and use in a great variety of fields and scientific journals is a proof that a cultural change and a new conceptualisation of functioning and disability is happening.
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Affiliation(s)
- Milda Cerniauskaite
- Neurology, Public Health and Disability Unit-Scientific Directorate, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
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Scarponi F, Sattin D, Leonardi M, Raggi A, Zampolini M. The description of severe traumatic brain injury in light of the ICF classification. Disabil Rehabil 2010; 31 Suppl 1:S134-43. [PMID: 19968526 DOI: 10.3109/09638280903317906] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To review on the application of the ICF Classification to assess the person with traumatic brain injury (TBI) and his/her interaction with the environment. METHOD Studies and reviews about the use of ICF in TBI have been included, by searching in Pubmed and in the proceedings of international meetings. RESULTS Eleven studies have been identified and classified into three types: (a) application of the classification; (b) single case study; (c) the use of other scales. Some studies are related to the application of ICF checklist. Finally, we analyse the most used ICF codes. CONCLUSIONS The ICF is a useful tool describes conditions and needs of patients with TBI. A diffuse utilisation could become the key resource for both health professionals and administrators that are in charge of allocating resources to pursue quality of life improvement. The ICF could be applied as a shared language to define health programmes' goals and as system for carrying out epidemiological studies. For this reason, it is desirable to define and validate the ICF Core Sets for TBI to provide a mean to be easily used, comprehensive and universal.
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Affiliation(s)
- Federico Scarponi
- San Giovanni Battista Hospital, Department of Rehabilitation, Local Health Service n.3, Foligno, Italy
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Doig E, Fleming J, Kuipers P, Cornwell PL. Comparison of rehabilitation outcomes in day hospital and home settings for people with acquired brain injury – a systematic review. Disabil Rehabil 2010; 32:2061-77. [DOI: 10.3109/09638281003797356] [Citation(s) in RCA: 18] [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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