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Woods LR, Zachry AH. Factors that support and hinder recovery and adjustment after traumatic brain injury: a qualitative multiple case study. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2023. [DOI: 10.12968/ijtr.2021.0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Background/Aims The numbers of individuals acquiring brain injuries in childhood is increasing. The deficits caused by brain injury can often have long-term implications that require support from caregivers, friends and the community. This study was conducted to gain an understanding of the shared perspectives of parental caregivers and their adolescent children as to what factors supported and hindered recovery and adjustment after traumatic brain injury. Methods In this qualitative multiple case study, semi-structured interviews were conducted with a purposive sample of four individuals with traumatic brain injury and their five parental caregivers. A thematic, cross-case analysis was used to identify factors that support and hinder recovery and adjustment. Results Seven themes were identified from the interviews: lack of educational resources about traumatic brain injury; poor consistency of care; caregiver stress and guilt; disconnection and isolation; connection, empathy and social support; being high achieving and resourceful; and authentic relationships between adolescents with traumatic brain injury and their parents. Conclusions The findings highlight the need for improved access to follow-up or community-based services for adolescents with traumatic brain injury who do not experience a hospital or inpatient rehabilitation stay. Additionally, healthcare providers should capitalise on the relationships between adolescents with traumatic brain injury and their parents to support recovery. The information gained from this study can be used to inform allied health professionals when developing and implementing interventions to support recovery in adolescents with traumatic brain injury and their parental caregivers.
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Affiliation(s)
- Lauren Renee Woods
- Department of Occupational Therapy, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Anne H Zachry
- Department of Occupational Therapy, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Kakonge L, Charron VP, Vedder J, Wormald K, Turkstra LS. A mapping review of adolescent identity after TBI: what clinicians need to know. Neuropsychol Rehabil 2022; 32:1868-1903. [PMID: 35604405 DOI: 10.1080/09602011.2022.2071299] [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: 10/18/2022]
Abstract
ABSTRACTAdolescence is a critical period for developing a sense of identity, an iterative process that relies on the development of skills such as self-reflection and self-appraisal. Outcomes of identity development include personal ethics, knowledge of one's strengths and challenges, and, ultimately, independence. Traumatic brain injury (TBI) affects these outcomes in adults, when identity has been established and may need to be redefined; but what happens when an injury occurs while identity is being formed? To answer this question, we used mapping review methodology to explore TBI effects on adolescent identity formation, mapping the evidence onto a biopsychosocial framework for rehabilitation. We reviewed studies on identity in adolescents with mild to severe TBI ages 13-18 years, published from inception to 2021, with a focus on outpatient rehabilitation settings. Key findings of the mapping review noted adolescents post-TBI are likely to: (1) question their identity considering dissonance between the current self and their pre-injury self; and (2) seek to establish new, adaptive meanings and identities. All studies drew conclusions regarding identity and participation of adolescents post-TBI. Results provided insight into the importance of considering individualized rehabilitation interventions for adolescents, given their unique developmental path towards identity formation.
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Affiliation(s)
- Lisa Kakonge
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, Canada
| | - Victoria P Charron
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, Canada
| | - Janelle Vedder
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, Canada
| | - Kendra Wormald
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, Canada
| | - Lyn S Turkstra
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, Canada
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3
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You Only Get One Brain: Adult Reflections on the Long-Term Impacts of Traumatic Brain Injury in Adolescence. BRAIN IMPAIR 2021. [DOI: 10.1017/brimp.2021.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Background:
This research adds to scarce literature regarding adolescent experiences of traumatic brain injury (TBI). Retrospective accounts of young adults who had sustained a TBI in adolescence were analysed to explore the perceived impact this had on their lives and forming identities during this important developmental stage.
Methods:
Thirteen adults (aged 20–25 years; mean 23 years) who sustained a mild or moderate TBI during adolescence (i.e. aged 13–17 years at injury), approximately 7.7 years (range = 6.7–8.0 years) prior, participated in the research. Semi-structured individual interviews, analysed using thematic analysis, explored participants’ experiences following their TBIs.
Results:
Thematic analysis of interview data produced two categories of themes: (1) Impacts on Important Areas of Life, which included: schoolwork suffered, career opportunities became limited, struggling with work and missing out socially; and (2) Impacts on Identity: with themes including feeling ‘stupid’, feeling self-conscious, loss of social identity and being dependent.
Conclusions:
TBI sustained during adolescence can have broad impacts on important areas of life and on developing identity.
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Behavior Problems Following Childhood TBI: The Role of Sex, Age, and Time Since Injury. J Head Trauma Rehabil 2021; 35:E393-E404. [PMID: 32108717 DOI: 10.1097/htr.0000000000000567] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the frequency of behavioral problems after childhood traumatic brain injury (TBI) and their associations with injury severity, sex, and social environmental factors. SETTING Children's hospitals in the Midwestern/Western United States. PARTICIPANTS 381 boys and 210 girls with moderate (n = 359) and severe (n = 227) TBI, with an average age at injury of 11.7 years (range 0.3-18) who were injured ≤3 years ago. DESIGN Secondary data analysis of a multistudy cohort. MAIN MEASURES Child Behavior Checklist (CBCL) administered pretreatment. RESULTS Thirty-seven percent had borderline/clinical elevations on the CBCL Total Problem Scale, with comparable rates of Internalizing and Externalizing problems (33% and 31%, respectively). Less parental education was associated with higher rates of internalizing, externalizing, and total problems. Time since injury had a linear association with internalizing symptoms, with greater symptoms at longer postinjury intervals. Younger boys had significantly higher levels of oppositional defiant symptoms than girls, whereas older girls had significantly greater attention-deficit hyperactivity disorder symptoms than boys. CONCLUSIONS Pediatric TBI is associated with high rates of behavior problems, with lower socioeconomic status predicting substantially elevated risk. Associations of higher levels of internalizing symptoms with greater time since injury highlight the importance of tracking children over time.
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Mulligan T, Barker-Collo S, Gibson K, Jones K. You only get one brain. Adult reflections on acute and ongoing symptom experiences after traumatic brain injury in adolescence. Brain Inj 2021; 35:1308-1315. [PMID: 34487437 DOI: 10.1080/02699052.2021.1972336] [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: 10/20/2022]
Abstract
BACKGROUND This research adds to the scarce literature regarding adolescent experiences of traumatic brain injury (TBI). It uses a qualitative methodology to explore the symptoms experienced after sustaining a TBI at this unique stage of development including their persistence into adulthood. METHODS Thirteen adults (aged 20-25 years; mean 23 years) who sustained a mild-moderate TBI during adolescence (aged 13-17 years at injury), approximately 7.7 years (range = 6.7-8.0 years) prior, participated in the research. Semi-structured individual interviews, analyzed using thematic analysis, explored participants' experiences surrounding and following their TBIs. RESULTS TBI during adolescence can result in significant acute symptoms, particularly headaches, fatigue, and difficulties in thinking. Participants' descriptions of the extent and impact of these symptoms reflected feelings of frustration and often anxiety and/or depression. Difficulties could persist for years post-TBI and sometimes had not resolved at all. CONCLUSIONS Even mild TBI during adolescence can result in significant acute and ongoing symptoms, which can contribute to emotional distress in the long term.
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Affiliation(s)
- Therese Mulligan
- School of Psychology, The University of Auckland, Auckland, New Zealand
| | | | - Kerry Gibson
- School of Psychology, The University of Auckland, Auckland, New Zealand
| | - Kelly Jones
- National Institute for Stroke and Applied Neurorehabilitation, Auckland University of Technology, Auckland, New Zealand
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6
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Gauvin-Lepage J. Traumatic Brain Injury in Adolescence and the Family Resilience Process: A Case Study. SAGE Open Nurs 2019; 5:2377960819848231. [PMID: 33415241 PMCID: PMC7774431 DOI: 10.1177/2377960819848231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/01/2019] [Accepted: 04/13/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction The aim of this study was to better understand the family resilience process following
a severe traumatic brain injury during adolescence. Case Presentation Inspired by the humanistic model of nursing care as a disciplinary perspective, this
study used a qualitative and inductive case study design. Management and Outcome The data analysis yielded six themes as well as four subthemes that illustrate this
family’s resilience process. The most important factors that emerged are (a) family
characteristics (i.e., a fighter personality, cultural and spiritual
beliefs, presence of hope, keeping a sense of humor), (b) support of family members, (c)
support of friends, (d) practicing sports and leisure activities, (e) back-to-school
support, and (f) feeling helpful to the adolescent. Discussion This study provides interesting avenues with regard to the implementation of strategies
to foster the resilience process in families during particularly difficult situations in
their lives, such as a traumatic brain injury during adolescence.
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Affiliation(s)
- Jérôme Gauvin-Lepage
- University of Montreal, Montreal, Quebec, Canada.,Research Center of the Sainte-Justine University Hospital, Montreal, Quebec, Canada
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Mah K, Gladstone B, King G, Reed N, Hartman LR. Researching experiences of childhood brain injury: co-constructing knowledge with children through arts-based research methods. Disabil Rehabil 2019; 42:2967-2976. [PMID: 30973787 DOI: 10.1080/09638288.2019.1574916] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: In the knowledge base examining experiences of childhood brain injury, the perspectives of children with brain injury are notably lacking. This failure to represent the voices of pediatric clients has resulted in an incomplete knowledge base from which to inform evidence-based rehabilitation practice. In this paper, we examine why the perspectives of children with brain injury are rarely sought and propose a new way forward.Methods: We draw upon current evidence and practices in related fields and present an exemplar from an in-progress qualitative arts-based research project with children with brain injury.Results: Assumptions ingrained in research practices, particularly those surrounding the capacity of 'doubly vulnerable' children with brain injury to produce knowledge, have resulted in the relative exclusion of this group from research that concerns them. For the field to evolve, research practices must value children's first-hand accounts, engage them in co-constructing knowledge about their lives, and invite methods that meet their interests and abilities.Conclusion: By reframing how we think about the capacities of children with disabilities and shifting our research practices to include children with brain injury as knowledgeable participants, it becomes possible to expand the knowledge base upon which clinical rehabilitation practices are built.Implications for RehabilitationCurrent research practices preclude 'doubly vulnerable' pediatric populations, including children with brain injury, from actively contributing to research that concerns them.As a result, the perspectives of children with brain injury are virtually absent from research, rendering the evidence base upon which rehabilitative practices are built incomplete.Reframing how we think about the capacities of children with brain injury can shift how we engage with them, both in research and clinic, and may subsequently impact the knowledge available to us.Implications for client-centred rehabilitation are discussed, including the need to understand children as capable of insight into their own experience, as able to contribute to a more complete understanding of the health phenomena that affect them, and as invaluable and active participants in research and clinical care.
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Affiliation(s)
- Katie Mah
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Brenda Gladstone
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Centre for Critical Qualitative Health Research, University of Toronto, Toronto, Canada
| | - Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Nick Reed
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Laura R Hartman
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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Narad ME, Bedell G, King JA, Johnson J, Turkstra LS, Haarbauer-Krupa J, Wade SL. Social Participation and Navigation (SPAN): Description and usability of app-based coaching intervention for adolescents with TBI. Dev Neurorehabil 2018; 21:439-448. [PMID: 28762859 PMCID: PMC5796409 DOI: 10.1080/17518423.2017.1354092] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Adolescents with brain injury (BI) often experience impairment in participation, which is an important predictor of outcomes. OBJECTIVE Describe the Social Participation and Navigation (SPAN) program, and report participant feedback and preliminary outcomes. METHOD Four adolescents and four coaches participated. SPAN included a mobile app, online didactic information, and peer coaching. Adolescents met weekly with coaches via video-conference, developed participation goals, and plans to achieve goals. Social and behavioral functioning before and after was assessed, and feedback about SPAN was collected. RESULTS SPAN was well received. Participants used the app to define and achieve goals. Medium to large effect sizes were found on adolescent self-reported measures, with negligible effects on parent-report measures. Positive and critical feedback is described. CONCLUSIONS Findings support the usability of SPAN, which has the potential to improve social participation of adolescents with a history of TBI through an innovative use of technology and peer coaching.
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Affiliation(s)
- Megan E. Narad
- Division of Physical Medicine & Rehabilitation, Cincinnati
Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Gary Bedell
- Department of Occupational Therapy, Tufts University, Medford, MA,
USA
| | - Jessica A. King
- Division of Physical Medicine & Rehabilitation, Cincinnati
Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Jeremy Johnson
- Interactive Media Technology Center, Georgia Tech University,
Atlanta, GA, USA
| | - Lyn S. Turkstra
- Department of Communication Sciences and Disorders, University of
Wisconsin-Madison, Madison, WI, USA
| | - Julie Haarbauer-Krupa
- Division of Rehabilitation Services, Children’s Healthcare
of Atlanta, Atlanta, GA, USA
| | - Shari L. Wade
- Division of Physical Medicine & Rehabilitation, Cincinnati
Children’s Hospital Medical Center, Cincinnati, OH, USA
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Wade SL, Bedell G, King JA, Jacquin M, Turkstra LS, Haarbauer-Krupa J, Johnson J, Salloum R, Narad ME. Social Participation and Navigation (SPAN) program for adolescents with acquired brain injury: Pilot findings. Rehabil Psychol 2018; 63:327-337. [PMID: 30024207 PMCID: PMC6198824 DOI: 10.1037/rep0000187] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE/OBJECTIVE Our goal was to examine the feasibility and preliminary efficacy of an app-based coaching intervention (Social Participation and Navigation; SPAN) to help survivors of acquired brain injury attain social participation goals. Research Method/Design: This is a nonrandomized pilot trial of SPAN, including 15 adolescents (9 with traumatic brain injury, 6 with brain tumor) between the ages of 14-22. The SPAN intervention consisted of a mobile app to support the development and implementation of social participation goals, weekly video-conference coaching sessions to identify goals and step-by-step action plans, and online didactic materials. Assessments were completed pre- and postintervention. Satisfaction with the intervention, confidence in the adolescents' ability to participate in and plan social activities and manage their emotions and behaviors, and frequency and satisfaction with social participation were assessed via self- and parent-report questionnaires developed for this project. Behavior problems, social competence, and social problems were measured by using the Child Behavior Checklist and the Youth Self-Report. RESULTS High levels of participant and parent satisfaction were reported. Increases in parent-reported frequency of social participation and teen-reported confidence in their ability to participate and develop social participation goals and plans were observed. A decline in parent-reported total problems, internalizing problems, externalizing problems, and social problems was noted. CONCLUSION/IMPLICATIONS Results support the feasibility of the program, because participants were able to successfully meet with their coaches and use the app to develop and accomplish social participation goals. Further research will be needed to refine the app and program, particularly when reaching out to populations beyond traumatic brain injury. (PsycINFO Database Record
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10
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Ciccia AH, Beekman L, Ditmars E. A clinically focused systematic review of social communication in pediatric TBI. NeuroRehabilitation 2018; 42:331-344. [DOI: 10.3233/nre-172384] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Angela Hein Ciccia
- Department of Psychological Sciences, Communication Sciences Program, Case Western Reserve University, Cleveland, OH, USA
| | - Leah Beekman
- Department of Psychological Sciences, Communication Sciences Program, Case Western Reserve University, Cleveland, OH, USA
| | - Emily Ditmars
- Department of Psychological Sciences, Communication Sciences Program, Case Western Reserve University, Cleveland, OH, USA
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Bedell GM, Wade SL, Turkstra LS, Haarbauer-Krupa J, King JA. Informing design of an app-based coaching intervention to promote social participation of teenagers with traumatic brain injury. Dev Neurorehabil 2017; 20:408-417. [PMID: 27792407 DOI: 10.1080/17518423.2016.1237584] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To examine perspectives of multiple stakeholders to inform the design of an app-based coaching intervention to promote social participation in teenagers with traumatic brain injury (TBI). METHODS Teenagers and college students with and without TBI and parents of teenagers with TBI were recruited from two children's hospitals and two universities in the USA (n = 39). Data were collected via interviews, focus groups, and surveys and examined using descriptive statistics and content analyses. RESULTS Teenagers with TBI reported more social participation barriers and fewer strategies for addressing these barriers than teenagers without TBI. There was consensus across groups about the value of college student coaches and use of smartphones and apps. Participants expressed mixed views on the use of chat rooms and degree of parent involvement. CONCLUSION Results provided insights about the possible benefits of the intervention, and informed its initial design (e.g., desired coach qualities, and type of coach training and supervision).
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Affiliation(s)
- Gary M Bedell
- a Department of Occupational Therapy , Tufts University , Medford , Massachusetts , USA
| | - Shari L Wade
- b Department of Physical Medicine and Rehabilitation , Cincinnati Children's Hospital and Medical Center , Cincinnati , Ohio , USA
| | - Lyn S Turkstra
- c Department of Communication Sciences and Disorders, Neuroscience Training Program, Department of Surgery , University of Wisconsin-Madison , Madison , Wisconsin , USA
| | - Juliet Haarbauer-Krupa
- d Division of Rehabilitation Services , Children's Healthcare of Atlanta , Atlanta , Georgia , USA
| | - Jessica A King
- b Department of Physical Medicine and Rehabilitation , Cincinnati Children's Hospital and Medical Center , Cincinnati , Ohio , USA
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12
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Keck CS, Creaghead NA, Turkstra LS, Vaughn LM, Kelchner LN. Pragmatic skills after childhood traumatic brain injury: Parents' perspectives. JOURNAL OF COMMUNICATION DISORDERS 2017; 69:106-118. [PMID: 28898709 DOI: 10.1016/j.jcomdis.2017.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 08/02/2017] [Accepted: 08/21/2017] [Indexed: 06/07/2023]
Abstract
The purpose of this study was to characterize pragmatic deficits after childhood traumatic brain injury (TBI) within the home environment social contexts where they occur. We used a descriptive qualitative approach to describe parents' experiences in communicating with their child with TBI. Participants were ten mothers of children ages 6-12 years who had sustained a moderate to severe TBI more than one year prior to the study. Mothers' experiences were collected through semi-structured interviews and questionnaires. Interviews were analyzed using a deductive framework to develop social contexts and pragmatic deficit themes for communication in the home. Overall, mothers primarily described their children with TBI as exhibiting average or near average pragmatic skills at home, but nine observed some pragmatic deficits and/or social behavior problems. There were four in-home social contexts in which pragmatic deficits were observed. Emergent themes also included outside-of-the home social contexts and social behavior problems. There was some overlap of pragmatic deficit and social behavior problem themes among contexts, but many deficits were context specific. This study's pragmatic deficit themes expanded on prior childhood TBI pragmatic investigations by identifying contexts in and outside of the home in which pragmatic deficits may occur after TBI. Learning Outcomes Readers will be able to describe the day-to-day social contexts that may be impacted by pragmatic deficits after childhood TBI. Readers will be able to compare the pragmatic deficit themes identified as occurring in the home to those occurring outside of the home.
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Affiliation(s)
- Casey S Keck
- University of Cincinnati, Department of Communication Sciences and Disorders, 3202 Eden Ave., Cincinnati, OH 45267, United States.
| | - Nancy A Creaghead
- University of Cincinnati, Department of Communication Sciences and Disorders, 3202 Eden Ave., Cincinnati, OH 45267, United States.
| | - Lyn S Turkstra
- University of Wisconsin-Madison, Department of Communication Sciences and Disorders, 474 Goodnight Hall, 1975 Willow Dr., Madison, WI 53706, United States.
| | - Lisa M Vaughn
- Cincinnati Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229, United States.
| | - Lisa N Kelchner
- University of Cincinnati, Department of Communication Sciences and Disorders, 3202 Eden Ave., Cincinnati, OH 45267, United States.
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Hartman LR, Tibbles A, Paniccia A, Lindsay S. A Qualitative Synthesis of Families' and Students' Hospital-to-School Transition Experiences Following Acquired Brain Injury. Glob Qual Nurs Res 2015; 2:2333393615614307. [PMID: 28462322 PMCID: PMC5342636 DOI: 10.1177/2333393615614307] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 10/01/2015] [Accepted: 10/06/2015] [Indexed: 11/17/2022] Open
Abstract
Acquired brain injury (ABI) is one of the greatest causes of death and disability among children in Canada. Following ABI, children are required to transition back to school and adapt to the physical, cognitive, behavioral, social, and emotional demands of the school environment. We conducted a qualitative systematic review of students' and parents' experiences of the transition back to school following ABI. We identified 20 articles that met our inclusion criteria. Six themes emerged: (a) lack of ABI-specific education for families and professionals, (b) communication-related factors as a facilitator and/or barrier to transition, (c) emotional focus, (d) peer relationships, (e) supports, and (f) ABI sequelae in the classroom. Students' and families' personal motivations and abilities and the support they receive in their environment affect their experiences of transitioning back to school and the disrupted occupations they face.
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Affiliation(s)
- Laura R Hartman
- Bloovreiw Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Alana Tibbles
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Alicia Paniccia
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Sally Lindsay
- Bloovreiw Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
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14
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Iadevaia C, Roiger T, Zwart MB. Qualitative Examination of Adolescent Health-Related Quality of Life at 1 Year Postconcussion. J Athl Train 2015; 50:1182-9. [PMID: 26509684 DOI: 10.4085/1062-6050-50.11.02] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Moderate to severe traumatic brain injuries can negatively influence health-related quality of life (HRQOL) in adolescent patients. The effect of sport-related concussion on adolescent HRQOL remains unclear. OBJECTIVE To investigate the perceptions of adolescent student-athletes and their parents regarding the adolescents' HRQOL 1 year after sport-related concussion. DESIGN Qualitative study. SETTING Secondary school. PATIENTS OR OTHER PARTICIPANTS Seven adolescent student-athletes (age range, 12-16 years) who sustained a sport-related concussion at least 1 year (15.3 ± 2.8 months) before the study participated along with their primary care-giving parents (n = 7). DATA COLLECTION AND ANALYSIS Fourteen semistructured face-to-face interviews (7 adolescents, 7 parents) were completed. Interviews were transcribed and inductively analyzed by a team of 3 athletic trainers with 32 combined years of professional experience. Themes were negotiated through a consensual review process. Participant checks were completed to ensure trustworthiness of the results. RESULTS Four major themes emerged from the interviews: (1) significant effect of symptoms, (2) feelings of frustration, (3) influence on school attendance and activities, and (4) nature of interpersonal and team relationships. Participants indicated that the physical symptoms of the concussion substantially affected their emotional and academic function. The influence of the concussion on social interactions seemed to depend on the nature of interpersonal relationships. CONCLUSIONS Sport-related concussion can negatively influence physical and emotional function, academics, and interpersonal interactions as perceived by adolescent student-athletes and their parents. Education of parents and their children, school professionals, coaches, and teammates remains critical to effectively recognize and manage sport-related concussion. Secondary school districts also play a critical role in the concussion-management process by establishing and implementing accommodation policies that alleviate student concerns about falling behind while ensuring a healthy return to normal school routines. Furthermore, adolescent support systems must be considered throughout the recovery process.
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Affiliation(s)
- Cheree Iadevaia
- Department of Health and Nutritional Sciences, South Dakota State University, Brookings
| | - Trevor Roiger
- Department of Health and Nutritional Sciences, South Dakota State University, Brookings
| | - Mary Beth Zwart
- Department of Health and Nutritional Sciences, South Dakota State University, Brookings
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15
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Hartman LR, Duncanson M, Farahat SM, Lindsay S. Clinician and educator experiences of facilitating students’ transition back to school following acquired brain injury: A qualitative systematic review. Brain Inj 2015; 29:1387-99. [DOI: 10.3109/02699052.2015.1071431] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Ciccia AH, Threats T. Role of contextual factors in the rehabilitation of adolescent survivors of traumatic brain injury: emerging concepts identified through modified narrative review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2015; 50:436-451. [PMID: 25721403 DOI: 10.1111/1460-6984.12153] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 11/01/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Recently research in traumatic brain injury (TBI) intervention has identified the benefits of contextualized, embedded, functionally based approaches to maximize treatment outcomes. An essential component of contextualized intervention is the direct and purposeful consideration of the broader context, in which the person with TBI functions. However, systematic consideration of contextual factors remains limited both in research and clinical practice. AIMS The purposes of this modified narrative review were (1) to provide a succinct review of the available literature regarding the contextual factors that are specific to adolescent survivors of TBI, one of highest incidence groups for brain injury; (2) to connect these contextual factors to the direct long-term management of TBI and to identify their potential impact on outcome; and (3) to highlight areas that are open to research and clinical advances that could enhance positive outcomes for adolescent survivors of TBI. The framework of the World Health Organization's (WHO) International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY; 2007) was used as a foundation for this review. METHODS & PROCEDURES A systematic literature search was conducted using databases and hand searches. A total of 102 articles were originally identified. Twenty-five original research articles, eight review papers and four expert opinion papers met inclusion and exclusion criteria and were included in the final review. MAIN CONTRIBUTION The body of research specifically focused on contextual factors is an emerging area. Early findings indicate that a focus on the direct modification of contextual factors is promising for the facilitation of positive outcomes long into the chronic phase of management for adolescences who have survived a TBI. The contextual factors included in this review were the overall ability of the school to support a student post-TBI, family psychosocial risk (sibling/sibling relationships/stress/burden/support), coping style (TBI survivor and their caregivers), and socioeconomic status of the family. Given the promise of these findings, research and clinical application efforts should be focused on identifying well-prescribed rehabilitation paradigms that capitalize on the modification of contextual factors throughout the recovery process. CONCLUSIONS & IMPLICATIONS The results of this modified narrative review provide an initial summary of the available evidence for addressing contextual factors in the rehabilitation process for adolescents with TBI. This is an area that is wide open for both systematic research and clinical application and holds potential to improve long-term outcome for survivors of adolescent TBI.
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Affiliation(s)
- Angela Hein Ciccia
- Department of Psychological Sciences, Program in Communication Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Travis Threats
- Department of Communication Sciences and Disorders, McGannon Hall, St. Louis, MO, USA
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Gauvin-Lepage J, Lefebvre H, Malo D. Resilience in Families With Adolescents Suffering From Traumatic Brain Injuries. Rehabil Nurs 2015; 40:368-77. [PMID: 25772208 DOI: 10.1002/rnj.204] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2015] [Indexed: 11/08/2022]
Abstract
PURPOSE This study aims to coconstruct the building blocks for an intervention program to support family resilience in conjunction with families with an adolescent suffering from traumatic brain injury and rehabilitation professionals. DESIGN This is a qualitative and inductive study, supported by a collaborative research approach. METHODS Based on the complex intervention design and validation model, the investigator follows a three-stage data collection process: (1) identifying the building blocks of the intervention program in the eyes of families and rehabilitation professionals, (2) prioritizing, and (3) validating the building blocks with the same participants. FINDINGS After analyzing the data, the investigator identifies five encompassing themes as the building blocks of the intervention program. CONCLUSIONS/CLINICAL RELEVANCE This study offers promising avenues for practitioners and researchers in nursing and other fields with respect to the implementation of concrete strategies to support the resilience process of families facing particularly difficult times in their lives.
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Affiliation(s)
- Jérôme Gauvin-Lepage
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada.,Research Centre of the Sainte-Justine University Hospital, Montreal, QC, Canada
| | - Hélène Lefebvre
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
| | - Denise Malo
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
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Catroppa C, Crossley L, Hearps SJC, Yeates KO, Beauchamp M, Rogers K, Anderson V. Social and behavioral outcomes: pre-injury to six months following childhood traumatic brain injury. J Neurotrauma 2014; 32:109-15. [PMID: 24773028 DOI: 10.1089/neu.2013.3276] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study aimed to extend the limited research investigating social and behavioral outcomes following childhood traumatic brain injury (TBI). The study compared pre-and post-injury measures of these skills and investigated the role of pre-injury child status and pre-injury family functioning in the prediction of outcome at six months post-injury. A secondary aim was to compare rates of impairment at six months post-injury between children post-TBI and a typically developing (TD) control group. This study comprised 140 children, 97 survivors of TBI (67 males) and 43 TD children (24 males), matched for age, sex, and socio-economic status. All participants were ascertained between 2007 and 2010, and were between ages 5.5 and 15.0 years. Children with TBI represented consecutive hospital admissions and were recruited at time of injury into a longitudinal study. TD children were recruited from the community, through local schools chosen to provide a range of socio-economic backgrounds. Findings indicated a deterioration of social participation skills post-injury, particularly for those sustaining a more severe injury, and a consistently higher rate of impairment in social and behavioral outcomes in the TBI group. Pre-injury function, injury severity and restrictions to social participation (e.g., reduced sport activities) as recommended by clinicians contributed significantly to outcome. Difficulties are evident in the short-term post-childhood TBI in social and behavioral domains. It is essential to monitor children long-term, particularly as societal expectations and demands increase.
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Affiliation(s)
- Cathy Catroppa
- 1 Murdoch Childrens Research Institute , Melbourne, Australia
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Katia S, Normand B, Céline L. Current needs, the future of adolescents and young adults having sustained a moderate or severe Traumatic Brain Injury (TBI) and the potential of their social participation. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ojtr.2014.21009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ross KA, McMillan T, Kelly T, Sumpter R, Dorris L. Friendship, loneliness and psychosocial functioning in children with traumatic brain injury. Brain Inj 2011; 25:1206-11. [PMID: 21961568 DOI: 10.3109/02699052.2011.609519] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study compares friendship quality, rates of loneliness and general psychosocial functioning in children who have sustained a traumatic brain injury (TBI) with non-injured controls. METHODS A between-subjects design with 14 participants in the TBI group and 14 in the non-injured control group, aged between 7-13 years and matched for age, gender, receptive vocabulary and socio-economic status. Children completed measures of receptive vocabulary (BPVS II), friendship quality (FQQ-R) and loneliness (LSDS). The main caregiver was asked to assess social skills and social withdrawal (PIC-2) and general psychosocial and behavioural functioning (SDQ). RESULTS Significant differences were not found on measures completed by children or on the PIC-2. On the SDQ, total difficulties were rated as much greater by caregivers in the TBI group (z = -2.6, p = 0.009) and these were mainly associated with sub-scales relating to emotional problems and hyperactivity. CONCLUSIONS Whilst evidence for friendship problems was not found in children with TBI, evidence for emotional and behavioural difficulties that may lead to social vulnerabilities later in life were found. This indicates a need for prospective longitudinal research to explore the complex relationship between TBI and poorer social outcomes that may not become evident until adolescence.
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Affiliation(s)
- Kimberley A Ross
- Academic Unit for Mental Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Scotland, UK
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