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Trevorrow S, Gustafsson L, Hodson T. Leisure Engagement Among People Living With Acquired Brain Injury: A Scoping Review. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024; 44:263-277. [PMID: 38234279 DOI: 10.1177/15394492231221962] [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] [Indexed: 01/19/2024]
Abstract
Return to previously valued occupations is a common goal of individuals following acquired brain injury (ABI). However, the focus of rehabilitation is often on self-care and productivity occupations. Return to leisure should be a priority of rehabilitation to support a person's physical, cognitive, social, and emotional well-being. Consequently, the aim of this article was to review the research evidence on engagement in leisure occupations among community-dwelling adults living with ABI. A six-step scoping review was conducted searching five databases. Articles were included if they focused on leisure engagement post-stroke or traumatic brain injury. Seventeen studies were included. Leisure engagement decreased post-ABI with engagement primarily in solitary, sedentary, cognitively inactive, home-based leisure. Leisure engagement was impacted by personal and contextual factors. The findings identify a need to focus on and address changes to leisure following ABI, with exploration of why these changes have occurred beyond personal factors.
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Affiliation(s)
- Shane Trevorrow
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Louise Gustafsson
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Tenelle Hodson
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
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Fleming J, Hamilton C, Ownsworth T, Doig E, Swan S, Holmes E, Griffin J, Shum DHK. The perspectives of participants with traumatic brain injury on prospective memory rehabilitation incorporating compensatory and metacognitive skills training. PATIENT EDUCATION AND COUNSELING 2024; 118:108023. [PMID: 37866073 DOI: 10.1016/j.pec.2023.108023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/09/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE Patient feedback is rarely gathered systematically in cognitive rehabilitation research. This study examined the perceptions and experiences of people with traumatic brain injury (TBI) who participated in a trial of a 6-session educational program for the rehabilitation of prospective memory (PM) impairment. METHODS A mixed methods design was used with 47 participants with TBI who completed a compensatory strategy training program (COMP) or COMP plus metacognitive strategy training program (COMP-MST) delivered by an occupational therapist. Data were collected via a participant survey, extracts from progress notes, and audiotaped discussions about learnings from the program during the final session. RESULTS Participants from both programs were highly satisfied and perceived improvements in everyday PM performance post-intervention. Elements that were highly valued include setting individualised client-centred goals, repetitive training of strategy use, establishing habits and routines, and receiving experiential, verbal, and written feedback.Changes including more therapy sessions were recommended. CONCLUSIONS Both the COMP and COMP-MST programs were perceived as effective by participants with TBI in improving their PM performance in everyday life using compensatory strategies such as assistive technology. PRACTICE IMPLICATIONS Routine collection of patient feedback on cognitive rehabilitation can provide valuable information to support person-centred implementation of clinical practice guidelines.
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Affiliation(s)
- Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| | - Caitlin Hamilton
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Tamara Ownsworth
- School of Applied Psychology & The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Brisbane, Australia
| | - Emmah Doig
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Brisbane, Australia
| | - Sarah Swan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Elizabeth Holmes
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Janelle Griffin
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia
| | - David H K Shum
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Hoyle M, Meredith P, Ownsworth T, Khan A, Gustafsson L. Associations between participation and personal factors in community-dwelling adults post-stroke. BRAIN IMPAIR 2023; 24:456-473. [PMID: 38167356 DOI: 10.1017/brimp.2022.31] [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] [Indexed: 12/24/2022]
Abstract
PURPOSE To examine associations between post-stroke participation and personal factors, including demographic characteristics, self- and threat appraisals, and personality variables. METHODS An exploratory cross-sectional study with purpose-designed survey was completed online or via mail. The survey was comprised of demographic and health-related questions and multiple questionnaires, including the Stroke Impact Scale Version 3.0 (SISv3) (participation/perceived recovery), Community Integration Questionnaire (CIQ) (participation), Head Injury Semantic Differential III (pre- vs post-stroke self-concept/self-discrepancy), Appraisal of Threat and Avoidance Questionnaire (threat appraisal), Life Orientation Test - Revised (optimism) and Relationships Questionnaire (adult attachment style) that measured variables of interest. Sixty-two participants, aged 24-96 years who had experienced a stroke (one or multiple events) and had returned to community living, completed the survey. Associations were examined using correlations, and univariate and multiple linear regression analyses. RESULTS Regression analysis showed that greater participation, measured using the CIQ, was associated with younger age, female gender, lower self-discrepancy and higher perceived recovery, explaining 69% of the variability in CIQ participation. Further, greater participation on the SISv3 was associated with lower self-discrepancy and higher perceived recovery, explaining 64% of the variability in SISv3 participation. CONCLUSIONS Results indicate that personal factors, particularly self-appraisals like self-concept/self-discrepancy, in combination with perceived recovery may be important in explaining a large portion of variance in post-stroke participation. Specifically, findings highlight the interrelatedness of self-concept change, perceived recovery and post-stroke participation. Further longitudinal research is needed to clarify the directionality of these associations throughout the hospital-to-home transition.
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Affiliation(s)
- Melanie Hoyle
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Pamela Meredith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| | - Tamara Ownsworth
- School of Applied Psychology, Griffith University, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Louise Gustafsson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
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Mamman R, Grewal J, Garrone JN, Schmidt J. Biopsychosocial factors of quality of life in individuals with moderate to severe traumatic brain injury: a scoping review. Qual Life Res 2023:10.1007/s11136-023-03511-0. [PMID: 37925675 DOI: 10.1007/s11136-023-03511-0] [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: 08/24/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE Individuals with moderate to severe traumatic brain injury (TBI) experience changes in their quality-of-life (QOL) post-injury. Given the vast literature that exists about QOL after TBI, a scoping review was performed to identify the different biopsychosocial factors that affect a person's QOL after a moderate to severe TBI. METHODS A scoping review was conducted using the following electronic databases: MEDLINE, CINAHL, Embase, and PsycINFO. Terms relating to TBI and QOL were used. RESULTS There were 7576 articles obtained from the databases, resulting in 535 full-text articles. Ultimately, 52 articles were extracted, which consisted of biopsychosocial QOL factors after TBI. The biopsychosocial factors of QOL after TBI included 19 biological factors (i.e., sex, TBI severity, cognition), 16 psychological factors (i.e., depression, self-efficacy, coping styles), and 19 social factors (i.e., employment, social participation, social support). Factors such as fatigue, self-awareness, transition, and discharge from hospitals are known issues in TBI literature but were minimally reported in studies in this review, identifying them as potential gaps in research. CONCLUSION Identifying biopsychosocial factors relating to QOL after TBI can enable health services to develop targeted rehabilitation programs for individuals with TBI.
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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, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Jasleen Grewal
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | | | - Julia Schmidt
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, Canada.
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Hoyle M, Gustafsson L, Meredith P. Personal factors, participation, and satisfaction post-stroke: A qualitative exploration. Scand J Occup Ther 2022; 30:572-584. [PMID: 36537995 DOI: 10.1080/11038128.2022.2154708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Decreased participation and life satisfaction are common post-stroke. Exploratory studies have indicated associations between these outcomes and personal factors. Information remains limited and experiences of people with stroke are not well-represented or understood. AIMS/OBJECTIVES The aim of this study was to explore how personal factors influence experiences of participation and life satisfaction for people with stroke living in the community. MATERIAL AND METHODS Qualitative in-depth semi-structured interviews were conducted with eight participants living in the community post-stroke, chosen purposively based on participation and life satisfaction levels. Data were interrogated using interpretative phenomenological analysis. RESULTS Three themes were identified: (1) What does participation mean to me? (2) Looking forward or looking back, and (3) Appraisals, avoidance, and "getting on with it". The first acknowledged the multifaceted nature of participation, although it was typically viewed as incorporating active involvement and social interaction. The additional two themes explored impacts of pre/post-stroke self-discrepancies and threat appraisals on participation and life satisfaction outcomes. CONCLUSIONS AND SIGNIFICANCE Relationships between participation and personal factors seem to be bidirectional. Life satisfaction appeared to be influenced by rumination on negative self-discrepancies based on difference in pre/post-stroke participation. Findings suggest there may be value in examining the influence of personal factor-related interventions on post-stroke outcomes.
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Affiliation(s)
- Melanie Hoyle
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Louise Gustafsson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Pamela Meredith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
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Neuropsychological functioning predicts psychosocial adjustment after postacute rehabilitation for traumatic brain injury. J Int Neuropsychol Soc 2022; 29:410-414. [PMID: 36200316 DOI: 10.1017/s1355617722000352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To examine neuropsychological functioning as a predictor of psychosocial adjustment difficulties at discharge from a postacute residential rehabilitation facility for traumatic brain injury (TBI) and depression as a potential mediator. METHODS A retrospective record review was conducted of 172 adults who received rehabilitation services for TBI. Individuals completed a full battery of neuropsychological tests, depression assessment, and functional assessments at admission. Functional assessments were also obtained at discharge. RESULTS A two-phase structural equation model analysis was performed. The first phase specified a good fitting model of a cognitive functioning (CF) latent construct with four indicators of cognitive domains measuring verbal fluency, cognitive flexibility, verbal learning, and working memory. Worse CF was associated with greater psychosocial adjustment impairment at discharge, but not related to depression. Psychosocial adjustment impairment at admission was positively associated with depression when controlling for CF, however depression did not predict psychosocial adjustment at discharge. Thus, depression was not found to be a significant mediator of psychosocial adjustment impairment at discharge. CONCLUSIONS Results provide support for neuropsychological functioning at the start of postacute rehabilitation for TBI as an important predictor of psychosocial functioning difficulties that remain upon discharge and highlights the need to examine mechanisms beyond depression.
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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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Chen F, Chi J, Niu F, Gao Q, Mei F, Zhao L, Hu K, Zhao B, Ma B. Prevalence of suicidal ideation and suicide attempt among patients with traumatic brain injury: A meta-analysis. J Affect Disord 2022; 300:349-357. [PMID: 34995702 DOI: 10.1016/j.jad.2022.01.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 10/03/2021] [Accepted: 01/02/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Suicidality is common among patients with traumatic brain injury (TBI). This meta-analysis aimed to assess the prevalence of suicidal ideation (SI) and suicide attempt (SA) in TBI patients. METHODS Databases including PubMed, Cochrane Library, Embase, CINAHL, Web of Science, PsycINFO, China National Knowledge Infrastructure (CNKI), VIP, WanFang Data, and Chinese Biomedical Literature Database (CBM) were searched for relevant literature from inception to 9th January 2021. Random effects models were used to estimate the prevalence of SI and SA. The methodological quality of the included studies was assessed using the modified Newcastle-Ottawa Scale. Subgroup analysis was performed based on the geographical location of the institutions. RESULTS A total of 16 studies involving 1,146,271 patients with TBI were included in our meta-analysis. The prevalence of SI and SA were 19.1% (95% CI 13.6-24.6%) and 2.1% (95% CI 1.8-2.4%), respectively, while the prevalence of SA in Asian and non-Asian countries were 2.0% (95% CI 0.3-3.7%) and 2.0% (95% CI 1.6-2.3%). Meta-regression analyses revealed that the publication year and age were positively associated, while the geographical location of the institution and sample size were negatively associated with the pooled prevalence of SI. On the other hand, the geographical location of the institution, sample size and age were negatively associated with the pooled prevalence of SA. LIMITATIONS The overall heterogeneity between studies was high. CONCLUSION SI and SA are common among TBI patients. Therefore, targeted preventive measures are paramount to manage TBI-related suicide.
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Affiliation(s)
- Fei Chen
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China; Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, Gansu 730000, China
| | - Junting Chi
- The First People's Hospital of Yunnan Province, Kunming, China
| | - Fang Niu
- Department of Intensive Care Unit, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China
| | - Qianqian Gao
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Fan Mei
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Li Zhao
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Kaiyan Hu
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Bing Zhao
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, Gansu 730000, China
| | - Bin Ma
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China; Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, Gansu 730000, China.
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Emery H, Padgett C, Ownsworth T, Honan CA. A systematic review of self-concept change in multiple sclerosis. Neuropsychol Rehabil 2022; 32:1774-1813. [PMID: 35168496 DOI: 10.1080/09602011.2022.2030367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Self-concept or sense of self is often altered in the context of neurological illness. Yet, these core aspects of subjective experience are poorly understood for people with multiple sclerosis (MS). This systematic review aimed to synthesize the findings of quantitative and qualitative studies investigating self-concept in MS. PsycINFO, MEDLINE (PubMed), CINAHL, Scopus, and Web of Science were last systematically searched in May 2021, with the Mixed Methods Appraisal Tool and Consolidated Criteria for Reporting Qualiatative Research used to appraise the quality of the eligible articles. Articles were included if they measured or explored self-concept in MS populations, were published in English and peer-reviewed. A total of 30 studies (11 quantitative, 19 qualitative) were identified. Quantitative studies were synthesized using a narrative approach, with results suggesting that MS is associated with some degree of self-concept change. Qualitative studies were synthesized using thematic synthesis, with results illustrating a complex process of self-concept change that is catalyzed by MS-related events and characterized by varying degrees of resistance to, or acknowledgement of, such changes. Future prospective longitudinal studies are needed to characterize the nature of self-concept change in MS using validated tools that measure relevant aspects of self-concept for the MS population.
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Affiliation(s)
- Holly Emery
- School of Psychological Sciences, University of Tasmania, Launceston, Australia
| | - Christine Padgett
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Tamara Ownsworth
- School of Applied Psychology, Griffith University, Mount Gravatt, Australia
| | - Cynthia A Honan
- School of Psychological Sciences, University of Tasmania, Launceston, Australia
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Emotional Disturbances After Traumatic Brain Injury: Prevalence, Assessment, and Treatment. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00311-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Klepo I, Sangster Jokić C, Tršinski D. The role of occupational participation for people with traumatic brain injury: a systematic review of the literature. Disabil Rehabil 2020; 44:2988-3001. [PMID: 33306915 DOI: 10.1080/09638288.2020.1858351] [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: 10/22/2022]
Abstract
PURPOSE Improving participation and quality of life is a desirable goal following traumatic brain injury (TBI). The purpose of this systematic review was to summarize existing findings concerning the role of occupational participation for persons with TBI. METHODS A systematic literature search using four electronic databases was followed by a review of all titles and abstracts. Articles were included if the studies were conducted with adults with TBI, used a qualitative methodology and explored the role or meaning of occupations and occupational participation from the perspectives of individuals with TBI. Following data extraction, a thematic synthesis was conducted. RESULTS A total of 642 articles were identified, of which 14 met all inclusion criteria. Three themes related to the role of occupations for people with TBI emerged: reflecting on change in occupational performance and occupational participation, occupational adaptation, and individual meaning of occupational participation. CONCLUSION The findings demonstrate the significance of occupational participation for people following TBI. Occupational participation enabled better understanding of one's abilities and limitations, assisted in occupational adaptation, and held unique meaning for participants. The findings also highlight the importance of providing long-term services focused on enabling participation in occupations in order to ensure successful adaptation following TBI.Implications for rehabilitationFor persons with TBI, occupational participation enables recognition of changes in their performance, contributes to the process of adaptation and identity (re)construction, fulfils various intrinsic needs and provides a sense of personal meaning.Rehabilitation professionals should recognize persons with TBI as occupational beings and work with individuals to identify the meaning of important occupations in the process of understanding and adapting to changes in capability, performance and participation.The rehabilitation process should focus on enabling persons to perform and participate in the occupations they want, need or are expected to do in their daily lives.National and regional health care systems should ensure that persons with TBI are provided with appropriate physical, social and institutional support and services in order to achieve meaningful occupational engagement.
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Affiliation(s)
- Ivana Klepo
- Department of Neurorehabilitation, Special Hospital for Medical Rehabilitation Krapinske Toplice, Krapinske Toplice, Croatia
| | - Claire Sangster Jokić
- Department of Occupational Therapy, University of Applied Health Sciences, Zagreb, Croatia
| | - Dubravko Tršinski
- Department of Neurorehabilitation, Special Hospital for Medical Rehabilitation Krapinske Toplice, Krapinske Toplice, Croatia
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Borg DN, Nielsen M, Kennedy A, Drovandi C, Beadle E, Bohan JK, Watter K, Foster MM, Fleming J. The effect of access to a designated interdisciplinary post-acute rehabilitation service on participant outcomes after brain injury. Brain Inj 2020; 34:1358-1366. [PMID: 32780595 DOI: 10.1080/02699052.2020.1802660] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to determine the influence of participation in a designated acquired brain injury (ABI) transitional rehabilitation service (ABI TRS) on outcome, in the context of a historical comparison group (HIST). Design: A cohort study, with retrospective comparison. Participants: 187 persons with ABI. Measures: The Depression, Anxiety and Stress Scale (DASS-21), Mayo-Portland Adaptability Index (MPAI-4) and Sydney Psychosocial and Reintegration Scale (SPRS) were completed at discharge and 3 months after discharge. Participation in the ABI TRS involved interdisciplinary rehabilitation, 2-4 times per week, for 3 months after hospital discharge. Results: There was evidence that at 3 months, participants with ABI TRS showed stabilized psychological wellbeing, and improvements in MPAI-4 ability and participation scores; in addition to improvements in SPRS occupational activity and living skills scores. Conclusion: A designated ABI TRS may improve the transition from hospital to home, and could form an important part of the brain injury rehabilitation continuum, between the inpatient and community setting.
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Affiliation(s)
- David N Borg
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University , Brisbane, Australia.,Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health , Brisbane, Australia
| | - Mandy Nielsen
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University , Brisbane, Australia.,Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health , Brisbane, Australia
| | - Areti Kennedy
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University , Brisbane, Australia.,Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health , Brisbane, Australia
| | - Christopher Drovandi
- Australian Research Council Centre of Excellence for Mathematical and Statistical Frontiers , Brisbane, Australia.,School of Mathematical Sciences, Queensland University of Technology , Brisbane, Australia
| | - Elizabeth Beadle
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University , Brisbane, Australia.,Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health , Brisbane, Australia
| | - Jaycie K Bohan
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University , Brisbane, Australia.,Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health , Brisbane, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane, Australia
| | - Kerrin Watter
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University , Brisbane, Australia.,Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health , Brisbane, Australia
| | - Michele M Foster
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University , Brisbane, Australia.,Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health , Brisbane, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane, Australia
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Harnod D, Lin CL, Harnod T, Kao CH. Increasing Risks of Suicide Attempt and Suicidal Drug Overdose After Head Trauma in Patients With Sleep-Disordered Breathing: A Population-Based Study. Front Psychiatry 2020; 11:533784. [PMID: 33362590 PMCID: PMC7756090 DOI: 10.3389/fpsyt.2020.533784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 10/14/2020] [Indexed: 12/01/2022] Open
Abstract
Objective: To determine the risks of suicide attempt (SA) and suicidal drug overdose (SDO) after head trauma in patients with sleep-disordered breathing (SDB) by using the National Health Insurance Research Database of Taiwan. Methods: We analyzed the data of patients aged ≥20 years who were diagnosed with SDB between 2000 and 2012. We further divided them into two cohorts [with admission for head injury (SBI) and without (SBN)], and we compared them against sex-, age-, comorbidity-, and index-date-matched healthy individuals. The adjusted hazard ratios (aHRs) and 95% confidence intervals of SA and SDO were calculated with adjustment of age, sex, and comorbidities. Results: Approximately 0.61% of patients among the overall 142,063 patients with SDB had SA, with 535 and 335 patients included in the SBN and SBI cohorts, respectively. Compared with patients with SBN, a significantly higher risk of SA was observed in patients with SBI (aHR = 2.22), especially in those aged under 50 years (aHR = 2.48). Notably, a SDO incidence of 1.20% was noted in patients with SDB, and the SBI cohort had a 1.81-fold higher risk for SDO when compared with the SBN cohort. Conclusion: The risks of subsequent SA and SDO are proportionally increased by the effects of head trauma with a moderating role of SDB, especially in those aged <50 years. SDB and head trauma can increase suicide behaviors individually and synergistically.
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Affiliation(s)
- Dorji Harnod
- Department of Emergency and Critical Care Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.,School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Tomor Harnod
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien County, Taiwan.,College of Medicine, Tzu Chi University, Hualien County, Taiwan
| | - Chia-Hung Kao
- Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.,Department of Nuclear Medicine and Positron Emission Tomography Center, China Medical University Hospital, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
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Increased Risks of Suicide Attempt and Suicidal Drug Overdose Following Admission for Head Injury in Patients with Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193524. [PMID: 31547202 PMCID: PMC6801720 DOI: 10.3390/ijerph16193524] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/12/2019] [Accepted: 09/16/2019] [Indexed: 12/11/2022]
Abstract
Aims: To determine the risks of suicide attempt (SA) and suicidal drug overdose (SDO) following the admission for head injury of patients with depression. Design: We analyzed the NHIRD data of patients aged ≥20 years who had received depression diagnoses between 2000 and 2010. They were divided into cohorts of those with admission for head injury (DHI) and those without it (DWI) during the follow-up period and compared against a sex-, age-, comorbidity-, and index-date-matched cohort from the general population. Setting: The Taiwan National Health Insurance Research Database (NHIRD). Participants/Cases: We analyzed the NHIRD data of patients (≥20 years) who had received depression diagnoses between 2000 and 2010. Intervention(s): Regular interventions. Measurements: We calculated the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of SA and SDO in these cohorts after adjustment for age, sex, and comorbidities. Findings: Up to the end of 2011, our results revealed extremely high incidences of SA and SDO with 63.3 and 88.6 per 10,000 person-years, respectively, in the DHI cohort. The DHI cohort had a 37.4-times higher risk for SA and a 17.1-times higher risk for SDO compared with the comparison group and had aHRs of 14.4 and 16.3, respectively, for poisoning by medicinal substances and poisoning by tranquilizers compared with patients in the DWI cohort. Patients with DHI aged <50 years, of female sex, with high incomes, living in more urbanized areas, and without other comorbidities had extraordinarily higher risks for SA. Conclusions: The risks of SA and SDO were proportionally increased by head injury in patients with depression in Taiwan. Our findings provide crucial information to implement efficient suicide prevention strategies in the future.
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