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Hudson C, Radford K, Kettlewell J. A Qualitative Study to Understand the Impact of Caring for Traumatic Injury Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16202. [PMID: 36498277 PMCID: PMC9737134 DOI: 10.3390/ijerph192316202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/08/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Following traumatic injury, an informal carer is often required to support recovery. Understanding the impact of caregiving is important to inform intervention design. AIM to explore the impact of caring on family and caregiver finances, employment, social life, and psychological wellbeing. METHOD Semi-structured interviews conducted with carers of traumatic injury survivors. Interviews were audio recorded, transcribed and thematically analysed, informed by the Roy Adaptation Model (RAM) and International Classification of Functioning, Disability and Health (ICF). RESULTS Ten participants were interviewed. Key themes included (1) financial impact/employment issues, (2) relationships and support and (3) psychological impact. Most carers did not receive professional support with daily care post-discharge. Carers' employers responded positively, supporting them even after extensive leave. Carers received inconsistent communication whilst visiting trauma survivors in hospital; carers with healthcare experience were favoured. Navigating and receiving benefits was complex. Some carers found it difficult to accept the trauma survivor's injury, whilst others focused on achieving goals. CONCLUSIONS Support from professional services is limited outside hospital settings for non-brain injuries. Future interventions and healthcare services should acknowledge the lack of psychological support for carers. Researchers should consider using the ICF/RAM when designing interventions to ensure the full impact on carers is addressed.
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Affiliation(s)
- Catherine Hudson
- Centre for Rehabilitation and Ageing Research, University of Nottingham, Nottingham NG7 2RD, UK
| | - Kate Radford
- Centre for Rehabilitation and Ageing Research, University of Nottingham, Nottingham NG7 2RD, UK
| | - Jade Kettlewell
- Centre for Academic Primary Care, University of Nottingham, Nottingham NG7 2RD, UK
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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.
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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
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