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Mason SL, Barker RA, Andresen K, Gracey F, Ford C. The meaning of apathy in Huntington's disease: A qualitative study of caregiver perspectives. Neuropsychol Rehabil 2024:1-30. [PMID: 39102382 DOI: 10.1080/09602011.2024.2384519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 07/21/2024] [Indexed: 08/07/2024]
Abstract
Although one of the most prevalent and impactful features of Huntington's disease (HD), little is known about the impact of apathy on HD caregivers, although there is evidence it affects perceptions of distress and burden. Given the importance of the caregivers, we aimed to explore the lived experience of people supporting someone with HD and associated apathy. Semi-structured interviews were conducted with 11 caregivers and analysed using reflective thematic analysis, informed by a phenomenological framework. Five overarching themes were produced: (1) What even is apathy? (2) It makes my life harder: the practical impact of apathy, (3) They haven't forgotten me, but they have forgotten that they ever loved me, (4) I'm grieving for someone who hasn't died yet, and (5) I need a safe space to say what I really feel without fear of judgement. Inter-woven between these themes were complex narratives about the unspoken nature of HD, the invisibility of caregivers who felt trapped and unheard, and the one-sided nature of loving someone with the disease. Findings are discussed in relation to theoretical frameworks of anticipatory grief and ambiguous loss, and situated within the wider literature on caregiving for people with a neurodegenerative condition.
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Affiliation(s)
- Sarah Louise Mason
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK
| | - Roger Alistair Barker
- Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK
- NIHR Biomedical Research Centre, Cambridge University Hospitals Foundation Trust, Addenbrookes Hospital, Cambridge, UK
| | - Katie Andresen
- Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK
| | - Fergus Gracey
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK
| | - Catherine Ford
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK
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Guala T, Harries T, Button K, de Andrade D, Miller P, Tonner L, Hill H, Langbein A, Curtis A. Evaluating social rehabilitation of aggression for persons with Acquired Brain Injury: a systematic review. Disabil Rehabil 2024:1-16. [PMID: 39033395 DOI: 10.1080/09638288.2024.2380475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 07/09/2024] [Indexed: 07/23/2024]
Abstract
PURPOSE Social rehabilitation of aggression following an Acquired Brain Injury (ABI) is critically important for persons with ABI due to increased vulnerability of criminal behaviour related to post-injury changes in functioning. This review presents findings from studies that evaluated aggression interventions in both community and forensic populations of people with ABI. METHODS We searched PsycINFO, EMBASE, SocINDEX, CINAHL and Medline databases for studies published between 1st January 2000 and 15th October 2023. RESULTS There were 15 studies (14 community-based, one forensic) that met inclusion criteria. Pharmacological management (6) was largely ineffective and anger management interventions (6) presented with inconsistent effectiveness. Emotion regulation (1) may be effective for externalised aggression. Both mindfulness and transcranial direct current stimulation (1) were effective, and the results of a forensic peer group approach (1) were not tested for statistical significance. There was variability in the measurement of aggression, injury severity, and cognitive impairment. CONCLUSIONS Whilst community interventions for aggression in persons with ABI are prevalent, findings for effectiveness have been mixed and there is a paucity of evaluated interventions in forensic samples. Further research is needed to unravel the complex interplay of factors contributing to aggression and develop effective social rehabilitation for persons with ABI.
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Affiliation(s)
- Tahnee Guala
- School of Psychology, Deakin University, Geelong, Australia
| | - Travis Harries
- School of Psychology, Deakin University, Geelong, Australia
| | - Kira Button
- School of Psychology, Deakin University, Geelong, Australia
| | - Dominique de Andrade
- School of Psychology, Deakin University, Geelong, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
- School of Psychology, University of Queensland, Brisbane, Australia
- Griffith Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Peter Miller
- School of Psychology, Deakin University, Geelong, Australia
| | | | - Harry Hill
- Albury Wodonga Health, Wangaratta, Australia
- School of Medicine, Deakin University, Geelong, Australia
| | | | - Ashlee Curtis
- School of Psychology, Deakin University, Geelong, Australia
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Zarzycki M, Seddon D, Petrovic M, Morrison V. Supporting Individuals With an Acquired Brain Injury: An Interpretative Phenomenological Study Exploring the Everyday Lives of Caregivers. QUALITATIVE HEALTH RESEARCH 2024:10497323241242046. [PMID: 38884621 DOI: 10.1177/10497323241242046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Acquired brain injury (ABI) is one of the most common causes of disability and death globally. Support from informal caregivers is critical to the well-being and quality of life of people with ABI and supports the sustainability of global health and social care systems. This study presents an in-depth qualitative analysis of the experiences of eight British informal caregivers supporting someone with ABI. Semi-structured interviews were conducted with narratives transcribed verbatim and analysed using interpretative phenomenological analysis (IPA). Three superordinate themes were generated: making sense of brain injury; being consumed by caregiving; and, the changing self. These data highlight the impact of caregiving on the caregiver's illness perceptions and sense of self. By identifying negative and positive changes in the caregiver's sense of self, and dilemmas regarding the care recipient's behaviour, we address less understood aspects of caregiver experiences. Caregiving can pose both challenges to the caregiver's sense of identity and an opportunity for self-growth. Some caregivers exhibit resilience throughout their journey, with post-traumatic growth more apparent in the later stages of caregiving. Illness perceptions shape caregiver well-being and family dynamics and indicate the need to address stigmatisation and discrimination faced by ABI survivors and caregivers. Although some caregivers acquired positive meaning and enrichment from their caregiving, previously described challenges of ABI caregiving are supported. Overall, our findings support the need for timely psychological/mental health support for caregivers, caregiver education, and the provision of short breaks from caregiving.
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Affiliation(s)
- Mikołaj Zarzycki
- Department of Psychology, Liverpool Hope University, Liverpool, UK
| | - Diane Seddon
- School of Health Sciences, College of Medicine and Health, Bangor University, Bangor, UK
| | - Milica Petrovic
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Depression Research Centre of the German Depression Foundation, Department for Psychiatry, Psychosomatics and Psychotherapy, Goethe University, Frankfurt, Germany
| | - Val Morrison
- School of Psychology and Sports Science, College of Medicine and Health, Bangor University, Bangor, UK
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Tsow R, Pollock C, Mehta S, Turcott A, Kang R, Schmidt J. A Look at Traumatic Brain Injury Community Programs in British Columbia: Barriers and facilitators of implementation. Brain Inj 2024; 38:539-549. [PMID: 38465902 DOI: 10.1080/02699052.2024.2327471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Abstract
RESEARCH OBJECTIVES 1) Characterize the delivery of programs that support acceptance and resiliency for people with brain injury in the healthcare sector; 2) Understand the barriers and facilitators in implementation of programs to support self-acceptance and resiliency for people with brain injury. DESIGN Participatory focus groups were used to explore experiences of conducting brain injury programs and knowledge of the barriers and facilitators to their implementation. Focus group data were analyzed with manifest content analysis to minimally deviate from broad and structural information provided by participants. SETTING Four focus group sessions were conducted online through a video calling platform. PARTICIPANTS 22 individuals from community associations conducting programs for people with brain injury. Participants were recruited from a public brain injury organization database. RESULTS Systemic challenges such as access to and allocation of funding require navigation support. Resource consistency and availability, including stable program leaders and a welcoming atmosphere, are important for program implementation and sustainability. Shared experiences promote connection with the community and personal development. CONCLUSIONS This study informs individual- and community-level approaches to promote meaningful life after brain injury. Findings highlight existing resources and support future programming for people with brain injury.
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Affiliation(s)
- Rebecca Tsow
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada a
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Courtney Pollock
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada a
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Swati Mehta
- Parkwood Institute Research, Lawson Health Research Institute, London, ON, Canada
| | - Alyssa Turcott
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada a
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Ruthine Kang
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada a
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Julia Schmidt
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada a
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
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Hendryckx C, Couture M, Gosselin N, Nalder E, Gagnon-Roy M, Thibault G, Bottari C. A window into the reality of families living long term with challenging behaviours after a TBI. Neuropsychol Rehabil 2024:1-32. [PMID: 38781592 DOI: 10.1080/09602011.2024.2354402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 05/06/2024] [Indexed: 05/25/2024]
Abstract
Challenging behaviours are a long-term burden for people with traumatic brain injury (TBI) and their families. Families frequently shoulder the responsibility alone, but little is known about the strategies they use to manage these behaviours. This study aimed to 1) identify the coping strategies used by people with TBI living in the community and their family caregivers to manage challenging behaviours; and 2) describe the similarities and differences between strategies used by people with TBI and caregivers. In this qualitative descriptive design, individual semi-structured interviews were conducted with adults with TBI and their caregivers and were inductively analyzed. The sample included 10 dyads and two triads, totalling 12 caregivers (8 women) and 14 individuals with TBI (6 women; 21.71 ± 10.84 years post-injury). Participants' strategies were proactive (prevention), reactive (response), or retroactive (aftercare). Most strategies were described by caregivers. Some of them were effective and lasting, others not, reflecting how they adapted their approaches over time. Families put in place various strategies in their life's journey, such as giving feedback or adapting the environment. Despite these strategies supporting long-term community living, the need for ongoing support is underscored, as crises may still occur, impacting families' quality of life.
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Affiliation(s)
- Charlotte Hendryckx
- Department of Psychology, Université de Montréal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
- Center for Advanced Research in Sleep Medicine (CEAMS), Hôpital du Sacré-Cœur de Montréal, CIUSSS NIM Research Center, Montreal, Canada
| | - Mélanie Couture
- Centre for research and expertise in social gerontology (CREGÉS), CIUSSS West-Central Montreal, Côte Saint-Luc, Canada
- École de travail social, Faculté des lettres et sciences humaines, Université de Sherbrooke, Sherbrooke, Canada
| | - Nadia Gosselin
- Department of Psychology, Université de Montréal, Montreal, Canada
- Center for Advanced Research in Sleep Medicine (CEAMS), Hôpital du Sacré-Cœur de Montréal, CIUSSS NIM Research Center, Montreal, Canada
| | - Emily Nalder
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Mireille Gagnon-Roy
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
- Occupational Therapy program, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Geneviève Thibault
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- Service québécois d'expertise en troubles graves du comportement (SQETGC), CIUSSS MCQ, Montréal, Canada
| | - Carolina Bottari
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
- Occupational Therapy program, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
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Kelly C, Cornwell P, Copley A, Hewetson R. Speech pathologists' perspectives when managing adults following traumatic brain injury in community-based rehabilitation settings: A qualitative investigation. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:787-796. [PMID: 35996961 DOI: 10.1080/17549507.2022.2110940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Purpose: Across Australia and New Zealand, speech-language pathologists (SLPs) routinely assess and treat adults with cognitive-communication disorders following traumatic brain injury (TBI). Despite their regular involvement, little is known about how clinicians provide management to this client group, particularly in community-based contexts. Therefore the aim of this study is to explore the clinical practices of SLPs who have experience working in community-based rehabilitation services with adults with cognitive-communication disorders following TBI.Method: A qualitative descriptive study using one-on-one semi-structured interviews was conducted as part of an explanatory sequential mixed-methods design. Fourteen SLPs with experience working with individuals with TBI completed an interview with content analysis used to explore the data.Result: The overarching theme identified was that a "Client-centred and inclusive approach to community-based rehabilitation services" is required. The three subthemes to emerge from the data included the importance of utilising a (1) "flexible service delivery approach", with (2) "meaningful therapy focus", and (3) "collaboration" with multidisciplinary team members and significant others when managing this client group.Conclusion: SLPs play a crucial role in client-centred inclusive rehabilitation for community-dwelling adults with cognitive-communication disorders following TBI. The complexity of working with this population requires current and future models of care to incorporate an interdisciplinary approach that is flexible in its delivery and meaningful in focus.
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Affiliation(s)
- Crystal Kelly
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia and
| | - Petrea Cornwell
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia and
| | - Anna Copley
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Ronelle Hewetson
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia and
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Carlozzi NE, Graves C, Troost JP, Kallen MA, Tulsky DS, Hanks RA, Ianni PA, Miner JA, Sander AM. Initial Evidence for Reliable and Valid Use of Scores on the 8-Item Econ-QOL Short Form to Measure Economic Quality of Life in Caregivers of Persons With Traumatic Brain Injury. Arch Phys Med Rehabil 2023; 104:430-437. [PMID: 35944601 PMCID: PMC9899870 DOI: 10.1016/j.apmr.2022.07.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/21/2022] [Accepted: 07/28/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To provide reliability and validity data to support the clinical utility of Economic Quality of Life Measure (Econ-QOL) scores in caregivers of civilians and service members/veterans with traumatic brain injury (TBI). DESIGN Cross-sectional survey study. SETTING Three academic medical centers and a Veterans Affairs treatment facility. PARTICIPANTS 376 caregivers of civilians (n=213) and service members/veterans (n=163) with TBI (N=376). INTERVENTIONS N/A. MAIN OUTCOME MEASURES Econ-QOL and several patient-reported outcome measures (Traumatic Brain Injury Caregiver Quality of Life Caregiver-Specific Anxiety and Caregiver Strain, Patient-Reported Outcomes Measurement Information System sleep-related impairment, Neurological Quality of Life Measurement System positive affect and well-being) and measures of financial status (self-reported income). RESULTS Internal consistency reliability of the Econ-QOL Short Form scores were excellent (all Cronbach's alphas ≥.92). There were no floor or ceiling effects for scores. There was evidence of convergent and discriminant validity, with the Econ-QOL scores having the strongest relationships with self-reported income (convergent validity evidence) and weak relationships with the other measures (discriminant validity evidence). Individuals with scores that were "below or possibly below" the poverty line (according to 2016 federal government poverty level thresholds) reported worse economic quality of life relative to those individuals who were definitely above the poverty line, supporting known-groups validity. CONCLUSIONS This article establishes the clinical utility of scores on the Econ-QOL Short Form in caregivers of persons with TBI and provides evidence that it is valid and appropriate to use such scores not only in a variety of different disability populations (eg, spinal cord injury, stroke) but also in caregivers.
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Affiliation(s)
- Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
| | - Christopher Graves
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Jonathan P Troost
- Michigan Institute for Clinical & Health Research, University of Michigan, Ann Arbor, MI
| | - Michael A Kallen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; MHBS, James A. Haley Veterans' Hospital, Tampa, FL
| | - David S Tulsky
- Center for Health Assessment Research and Translation, and Departments of Physical Therapy and Psychological and Brain Sciences, University of Delaware, Newark, DE
| | - Robin A Hanks
- Department of Psychology and Neuropsychology, Rehabilitation Institute of Michigan, Detroit, MI; Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI
| | - Phillip A Ianni
- Michigan Institute for Clinical & Health Research, University of Michigan, Ann Arbor, MI
| | - Jennifer A Miner
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Angelle M Sander
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine/Harris Health System, Houston, TX; Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX, USA
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Norman A, Curro V, Holloway M, Percuklievska N, Ferrario H. Experiences of individuals with acquired brain injury and their families interacting with community services: a systematic scoping review. Disabil Rehabil 2023; 45:739-751. [PMID: 35244507 DOI: 10.1080/09638288.2022.2043465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE This scoping review aims to (1) synthesise the research findings on the experiences of individuals with acquired brain injuries, and their families, when interacting with, or accessing, community-based services and (2) identify where gaps in service provision may exist and their cause. METHODS A systematic search strategy was employed across multiple databases to identify all studies relating to the experiences of individuals with acquired brain injuries and their families when interacting with, or accessing, community-based services. Inclusion was assessed by at least two reviewers at each stage and data extraction was completed by one researcher and validity checked by another. A narrative synthesis was employed. RESULTS A total of 101 papers met the inclusion criteria with the narrative synthesis identifying three main themes of (1) unmet needs, (2) types of access, and (3) barriers to access. CONCLUSIONS The results identify that those with acquired brain injuries, and their families, experience significant difficulties interacting with community-based services and often do not receive appropriate access. Many barriers to access were identified including a lack of knowledge of the long-term effects of acquired brain injury amongst professionals working in health and social care services.Implications for rehabilitationBrain injury is a leading cause of disability worldwide with a range of physical, cognitive, emotional, and behavioural difficulties.It is important that service users and families are given appropriate information about the long-term difficulties associated with ABI so they are better informed about the types of support they may need upon discharge from hospital.Rehabilitation professionals need to ensure they have good level of knowledge of the difficulties associated with ABI to ensure appropriate access to services for individuals and their families.Understanding more about unmet needs allows community rehabilitation services to be tailored and person-centred.
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Affiliation(s)
- Alyson Norman
- School of Psychology, University of Plymouth, Plymouth, UK
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McKenna O, Fakolade A, Cardwell K, Pilutti LA. A continuum of languishing to flourishing: exploring experiences of psychological resilience in multiple sclerosis family caregivers. Int J Qual Stud Health Well-being 2022; 17:2135480. [PMID: 36333904 PMCID: PMC9645274 DOI: 10.1080/17482631.2022.2135480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2022] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Resilience research in family caregiving in chronic neurological conditions is growing, but multiple sclerosis (MS) caregivers are noticeably absent from this body of work. MS caregivers represent a unique population due to the disease's early onset, prolonged life expectancy, and heterogeneity. As such, this study aimed to explore MS caregivers' conceptualizations of resilience, examine MS caregivers' experiences of resilience development, and determine which assets and resources influence resilience in this role. METHODS Twenty-four Canadian MS caregivers were recruited. Semi-structured in-depth interviews were conducted with questions derived from an ecological resilience framework. Data were analysed using reflexive thematic analysis. RESULTS Themes constructed a cyclical resilience model, beginning with encounters with hardship and extending to thriving adjustment. Subthemes included reports of additive challenges, impactful individual and community resources, and multi-level adaptive pathways. Within this cycle, the achievement of healthy adjustment exerted a positive feedback function and informed future responses to lifelong challenges. CONCLUSIONS Despite the salience of resilience processes within caregiver testimonies, inadequate resources at societal levels were evident. These findings afford researchers and decision-makers relevant information for designing and implementing resilience-building interventions for MS caregivers that attend to contextual factors and current systemic support deficiencies.
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Affiliation(s)
- Odessa McKenna
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Afolasade Fakolade
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada
| | - Katherine Cardwell
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Lara A. Pilutti
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
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De-Torres I, Bustos F, Arango-Lasprilla JC, Fernández-Berrocal P. Training on Emotional Intelligence for Caregivers of Patients with Acquired Brain Injury and Cognitive Impairment: A Quasi-Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14050. [PMID: 36360930 PMCID: PMC9655065 DOI: 10.3390/ijerph192114050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/14/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Cognitive-behavioral alterations can occur after an acquired brain injury (ABI). OBJECTIVES To develop and evaluate a synchronous online training program on emotional intelligence (EI) for the caregivers of adult patients with cognitive-behavioral impairment due to ABI. METHODS Quasi-experimental study. Ten caregivers attended a one-month virtual synchronous course about EI. The emotional status of the caregivers was registered one-month-previous and one-month-post program using comparative measures: The Trait Meta-Mood Scale (TMMS-24), the Positive and Negative Affect Schedule (PANAS), Caregiver Burden Interview, the 10-item Connor-Davidson Resilience Scale, and the Emotional Health Survey. RESULTS After the training course, the favorable changes related to emotional affect measured with the PANAS questionnaire were found; both positive (increase; Mdn = 39.5; effect size -12.79; adjusted variance 95.75) and negative (decrease; Mdn = 14.5; effect size 0.73; adjusted variance 95.50) presented a statistical significance of p < 0.05. The TMMS-24 post-test showed that 90% of the caregivers reported an adequate or excellent emotional repair (p < 0.05; effect size -0.68; adjusted variance 94.75). No other significant differences were found. CONCLUSIONS After this training in EI, the caregivers had a more positive mood and improved aspects of their emotional intelligence, such as emotional regulation. More studies need to be conducted.
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Affiliation(s)
- Irene De-Torres
- Málaga Regional University Hospital, Hospital Civil, 29010 Málaga, Spain
| | - Fernando Bustos
- Department of Language and Linguistics, University of Essex, Colchester CO4 3SQ, UK
| | - Juan Carlos Arango-Lasprilla
- Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Pablo Fernández-Berrocal
- Department of Basic Psychology, Faculty of Psychology, University of Málaga, 29071 Málaga, Spain
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11
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Cox AD, Pontone M, Gunnarsson KF. Program evaluation of in-patient treatment units for adults with acquired brain injury and challenging behavior. Brain Inj 2022; 36:321-331. [DOI: 10.1080/02699052.2022.2033840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Alison D. Cox
- Department of Applied Disability Studies, Brock University, St. Catharines, Canada
| | - Madeline Pontone
- Department of Applied Disability Studies, Brock University, St. Catharines, Canada
| | - Karl F. Gunnarsson
- Acquired Brain Injury Behaviour Services, West Park Healthcare Centre, Toronto, Canada
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12
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Fisher A, Bellon M, Lawn S, Lennon S. Family perspectives on the acceptability and usefulness of the FAB Positive Behaviour Support program: A pilot study. Brain Inj 2021; 35:609-619. [PMID: 33678101 DOI: 10.1080/02699052.2021.1894479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: This pilot feasibility study aimed to gain preliminary insight into the acceptability and usefulness of the FAB-PBS program for providing behavior support to families following acquired brain injury (ABI) in community settings. The FAB-PBS program is based on a Positive Behavior Support (PBS) framework and principles of Family-Centered Care and Family-Directed Intervention. It consists of an education phase followed by individualized sessions during which the family is supported to develop and implement a PBS plan.Methods: A mixed-methods design was utilized, with feedback obtained from family members via short questionnaires and semi-structured interviews post education phase and individualized sessions, and at three-month follow up.Results: Two family members completed the full FAB-PBS program and reported high satisfaction with the program and increased confidence in providing behavior support. Findings also suggested an increase in desired behaviors and a decrease in challenging behaviors presented by family members with ABI.Conclusions: The FAB-PBS program may be an acceptable and feasible approach to increasing the capability of family caregivers in providing behavior support following ABI. Further pilot testing is required to inform the development of a larger feasibility study.
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Affiliation(s)
- Alinka Fisher
- Disability and Community Inclusion, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Michelle Bellon
- Disability and Community Inclusion, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Sharon Lawn
- Department of Psychiatry, School of Health Sciences, Flinders University, Adelaide, Australia
| | - Sheila Lennon
- Discipline of Physiotherapy, Repatriation General Hospital, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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Lond BJ, Williamson IR. Acceptance, grief and adaptation amongst caregivers of partners with acquired brain injury: an interpretative phenomenological enquiry. Disabil Rehabil 2020; 44:2285-2294. [PMID: 33044883 DOI: 10.1080/09638288.2020.1829104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Families provide vital support to relatives with brain injury yet shoulder significant stress and anxiety with little help threatening family cohesion and rehabilitative outcomes. This paper analyses the accounts of people caring for a long-term partner with brain injury to identify coping mechanisms and support systems that enhanced well-being. Materials and method: This study used semi-structured interviews with eight participants and interpretative phenomenological analysis. Results: Three themes are reported-"moving through denial toward acceptance"; "confronting and managing ambiguous loss"; and "becoming an expert carer". Theme one describes participants' struggles to accept the longevity of brain injury and use of strenuous care practices to deny or fight disability; this proved counterproductive and was later remedied by individuals embracing change and making adaptations. Theme two reports how participants split their partners' identities -before and after brain injury- to help grieve for the marital relationships they lost. Theme three looks at participants' development of self-reliant attitudes to caregiving due to perceived limited state help, while embracing peer support that enhanced information and emotion-based coping. Conclusions: Findings support therapeutic practices that help family members confront the permanence of brain injury, and target feelings of complex and unresolved grief. Future research proposals are discussed.IMPLICATIONS FOR REHABILITATION:Caregivers typically provide considerable rehabilitative support to spouses living with Acquired Brain Injury to manage the physical and psychosocial burdens of long-term disability.Therapeutic interventions should reconcile notions of hope and acceptance in order to help carers confront the permanence of brain injury and develop sustainable care practices.We recommend that interventions address feelings of unresolved grief and ambiguous loss and develop tailored support for caregivers which targets pertinent psychological concerns.
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Affiliation(s)
- Benjamin J Lond
- Division of Psychology, De Montfort University, Leicester, UK
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14
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Yasmin N, Riley GA. Psychological intervention for partners post-stroke: A case report. NeuroRehabilitation 2020; 47:237-245. [DOI: 10.3233/nre-203173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Following a brain injury, caregiving spouses/partners differ in their perceptions of relationship continuity/discontinuity (i.e. whether the relationship is experienced as similar or different to the pre-injury relationship). Perceptions of continuity are associated with better psychological wellbeing and a better relationship. OBJECTIVE: To conduct a pilot test of an intervention aimed at exploring the possibility of supporting caregiving partners to experience greater continuity within their relationship post-stroke. METHODS: A post-stroke couple was provided with integrated behavioural couples therapy for three months, which aimed to increase relationship continuity alongside addressing individual goals identified by the couple. Before and after measures were taken using a battery of six questionnaires evaluating changes in perceptions of continuity, relationship quality, and stress. RESULTS: Quantitative and qualitative data showed post-therapy improvement in all the measures. CONCLUSIONS: The study suggested that perceptions of relationship continuity can be improved by therapy, and that such an improvement might have a beneficial impact in terms of relationship quality and psychological wellbeing. The intervention is currently being further developed and evaluated.
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Affiliation(s)
- Natasha Yasmin
- School of Psychology, University of Birmingham, Birmingham, UK
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15
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Cariello AN, Perrin PB, Rodríguez-Agudelo Y, Olivera Plaza SL, Quijano-Martinez MC, Arango-Lasprilla JC. A Multi-Site Study of Traumatic Brain Injury in Mexico and Colombia: Longitudinal Mediational and Cross-Lagged Models of Family Dynamics, Coping, and Health-Related Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176045. [PMID: 32825253 PMCID: PMC7504148 DOI: 10.3390/ijerph17176045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/04/2020] [Accepted: 08/14/2020] [Indexed: 01/01/2023]
Abstract
Latin America has high rates of traumatic brain injury (TBI), yet reduced mental and physical health outcomes due to limited rehabilitation services. To understand the psychosocial adjustment process in TBI patients in Latin America, the incorporation of cultural values including family-based variables is imperative. The current study examined relations among healthy family dynamics, coping, and mental and physical health related quality of life (HRQL) among a sample of TBI patients across three sites and two countries over the first 4 months post-injury. A sample of 109 acute TBI patients from Mexico and Colombia were recruited, and a series of longitudinal mediation and cross-lag panel analyses were run. Mental and physical HRQL were positively associated with each other, as well as healthy family dynamics and coping. Coping partially mediated the effects of healthy family dynamics on both mental and physical HRQL. Family dynamics showed the strongest cross-lag relationships with coping going from 2 months to 4 months. Similarly, coping showed the strongest cross-lag relationships with both mental and physical HRQL going from baseline to 2 months. Results provide empirical support for the importance of a rehabilitation workforce that has been trained in and can effectively implement family-based interventions for individuals with TBI in Latin America.
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Affiliation(s)
- Annahir N. Cariello
- Virginia Commonwealth University, 907 Floyd Ave, Richmond, VA 23284, USA; (A.N.C.); (P.B.P.)
| | - Paul B. Perrin
- Virginia Commonwealth University, 907 Floyd Ave, Richmond, VA 23284, USA; (A.N.C.); (P.B.P.)
| | - Yaneth Rodríguez-Agudelo
- Neuropsychology Department, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico;
| | | | | | - Juan Carlos Arango-Lasprilla
- BioCruces Bizkaia Health Research Institute, Cruces University Hospital Barakaldo, 48903 Barakaldo, Spain
- IKERBASQUE, Basque Foundation for Science, 48013 Bilbao, Spain
- Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), 48940 Leioa, Biscay, Spain
- Correspondence:
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Families' Experiences Living with Acquired Brain Injury: "Thinking Family"-A Nursing Pathway for Family-Centered Care. Nurs Res Pract 2020; 2020:8866534. [PMID: 32832151 PMCID: PMC7422354 DOI: 10.1155/2020/8866534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/10/2020] [Accepted: 07/20/2020] [Indexed: 11/17/2022] Open
Abstract
The objective of this study was to examine families' experiences living with acquired brain injury (ABI) using a research approach that included both the affected individual family member and the family together as a family group. A narrative inquiry study, informed by the life-stage approach of Lieblich, Tuval-Mashiach, and Zilber, was used to obtain family stories. Families experiencing an ABI event were purposefully selected from different regions in a western Canadian province. Centered on the life stages of before the ABI event, now living with the ABI, and the future, thematic findings included: Families, a grounding force; Losses, individual and family; Family adaptive capacities; Experiences with the healthcare system-hospital to home; and A patchwork future-entering the unknown. Themes affirmed the significant impacts of ABI on individual and family members and acknowledged ABI as an ambiguous loss event. The findings also illuminated families' strengths and resiliencies in coping with living with ABI. The study results suggest by “thinking family” nurses can contribute towards a healthcare model that focuses on “family” as the central unit of care.
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King G, Nalder E, Stacey L, Hartman LR. Investigating the adaptation of caregivers of people with traumatic brain injury: a journey told in evolving research traditions. Disabil Rehabil 2020; 43:3102-3116. [PMID: 32078400 DOI: 10.1080/09638288.2020.1725158] [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: 10/25/2022]
Abstract
PURPOSE To examine how conceptualizations of caregiver adaptation to traumatic brain injury have changed over time. The objectives were to identify research traditions, adaptive outcomes assessed in these traditions, and psychosocial variables associated with adaptive outcomes. METHODS A meta-narrative review was conducted on 29 identified articles published over a 25-year period (1990-2015). RESULTS Four traditions were identified with varying storylines. Burden/Strain (1990-1999) focused on adjustment as the absence of a negative state. Appraisal/Coping (2000-2005) recognized that caregiving experiences could be both positive and negative. In Quality of Life (2006-2011), there was increasing recognition that both personal and contextual factors influence adaptation. Resiliency (2012-2015) used the term "resiliency" as an organizing framework for a broad group of variables and assessed resilience, quality of life, community re-integration, and life/marital satisfaction. CONCLUSIONS These storylines reflect an evolution from problem-based to strengths-based conceptualizations, from interest in crisis to considering adaptation as a process unfolding over time, from quantitative to qualitative methods, and towards more holistic views of adaptive outcomes. Variables significantly associated with outcomes across the traditions included social support, reframing and positive appraisal, and behavior strategies. Implications concern the need for longitudinal studies, measurement of environmental factors, and the development of best practices.IMPLICATIONS FOR REHABILITATIONResearch studies on the adaptation of caregivers for people with TBI have evolved from a focus on burden, to coping and quality of life, and most recently to resiliency.It is important to assist caregivers of people with TBI to obtain social support, find positive ways of viewing their experiences, and take part in respite and enjoyed activities.Service providers can help caregivers by adopting a strengths-based perspective to help them recognize available resources, supports, and opportunities.Since caregiver adaptation changes over time, service providers should pay attention to changes in family circumstances and the mental health of caregivers.
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Affiliation(s)
- Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Emily Nalder
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Lauren Stacey
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Laura R Hartman
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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18
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Bermejo-Toro L, Sánchez-Izquierdo M, Calvete E, Roldán MA. Quality of life, psychological well-being, and resilience in caregivers of people with acquired brain injury (ABI). Brain Inj 2020; 34:480-488. [DOI: 10.1080/02699052.2020.1725127] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Laura Bermejo-Toro
- Department of Psychology, Universidad Pontificia Comillas, Madrid, Spain
| | | | - Esther Calvete
- Department of Psychology, Universidad de Deusto, Bilbao, Spain
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19
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The Contribution of Social Support, Professional Support, and Financial Hardship to Family Caregiver Life Satisfaction After Traumatic Brain Injury. J Head Trauma Rehabil 2019; 34:233-240. [DOI: 10.1097/htr.0000000000000471] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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20
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Michalovic E, Rocchi M, Sweet SN. Motivation and participation in daily and social activities among adults with spinal cord injury: Applying self-determination theory. Disabil Health J 2019; 12:489-494. [PMID: 30655191 DOI: 10.1016/j.dhjo.2018.11.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 11/09/2018] [Accepted: 11/24/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Individuals with a spinal cord injury (SCI) report decreased participation in daily and social activities. Self-determination theory (SDT) posits that individuals' need satisfaction and frustration predicts participation in health-related behaviours and this relationship is mediated by their motivation. OBJECTIVES This study explored the role of psychological needs and motivation in relation to participation in daily and social activities among adults with SCI. It was hypothesized that: a) need satisfaction and need frustration were positively associated with autonomous and controlled motivation, respectively, which, positively and negatively predicted participation in daily and social activities; b) autonomous and controlled motivation mediated the need satisfaction/frustration and participation relationship, respectively; and c) need frustration was positively related to amotivation, with no relationship between amotivation and activity participation. METHODS In this cross-sectional study, adults with SCI (N = 131) completed a questionnaire regarding their need satisfaction/frustration, autonomous and controlled motivation, amotivation, and participation in daily and social activities. RESULTS Need satisfaction was positively related to autonomous motivation (β = 0.29, 95%bias-corrected confidence interval (bCI): [0.04, 0.67]) and need frustration to controlled motivation (β = 0.28, 95%bCI: [0.09, 0.55]). Autonomous motivation was positively associated with six participation categories: autonomous indoor, autonomous outdoor, family role, health, social life, and work/education. Autonomous motivation also mediated the relationship between need satisfaction and all six participation categories; whereas, neither controlled motivation nor amotivation mediated the relationship between need frustration and participation. CONCLUSIONS This study found that SDT provides a meaningful framework for understanding participation among adults with SCI.
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Affiliation(s)
- Emilie Michalovic
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Ave West, Montreal, Quebec, H2W 1S4, Canada.
| | - Meredith Rocchi
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Ave West, Montreal, Quebec, H2W 1S4, Canada.
| | - Shane N Sweet
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Ave West, Montreal, Quebec, H2W 1S4, Canada.
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21
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Fisher A, Bellon M, Lawn S, Lennon S. Brain injury, behaviour support, and family involvement: putting the pieces together and looking forward. Disabil Rehabil 2019; 42:1305-1315. [PMID: 30653928 DOI: 10.1080/09638288.2018.1522551] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: (1) to provide insight into the family's experience and support needs following acquired brain injury (ABI) specific to behavioural changes; (2) to provide an overview of empirically-based behaviour support approaches for individuals with ABI; and (3), to examine family involvement in implementing behavioural interventions.Methods: Review of the literature.Results: Family members experience significant distress resulting from neurobehavioural changes in relatives with ABI, and report unmet informational and practical support needs regarding this issue. The importance of utilising family expertise within the rehabilitation process is widely acknowledged, with the increasing involvement of family members being promoted. There is growing evidence supporting the use of positive behaviour support approaches for individuals with ABI in community settings, and evidence supporting the involvement of family within behavioural interventions.Conclusions: This review suggests the need to develop alternative support models that shift the focus towards building competence in everyday support people rather than dependency on the service system. A bottom-up approach is recommended, with the aim of addressing unmet support needs and increasing the competence of family members in supporting behaviour change in individuals with ABI. Recommendations are provided in informing an optimal community-based neurobehavioural support model. Implications for RehabilitationPositive behaviour support is recommended in supporting behavioural changes following brain injury, with family expertise utilised in this process.Evidence suggests that family members can be effectively trained in developing and implementing behaviour support strategies.Family involvement in behavioural interventions may address unmet support needs and increasing the competence of family members in supporting behavioural changes following brain injury.
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Affiliation(s)
- Alinka Fisher
- Disability and Community Inclusion, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Michelle Bellon
- Disability and Community Inclusion, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Sharon Lawn
- Department of Psychiatry, Flinders University, Adelaide, Australia
| | - Sheila Lennon
- Discipline of Physiotherapy, Flinders University, Adelaide, Australia
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22
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Research Priorities for Optimizing Long-term Community Integration after Brain Injury. Can J Neurol Sci 2018; 45:643-651. [PMID: 30430969 DOI: 10.1017/cjn.2018.334] [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: 11/07/2022]
Abstract
OBJECTIVE This paper reports on a funded summit, which convened a multidisciplinary group of experts to provide consensus on the research priorities necessary for improving long-term community integration of individuals with traumatic brain injury (TBI) and their caregivers. METHODS The 2-day summit was directed using the World Café Methodology, to engage stakeholders and collaboratively arrive at a consensus on the problems to be targeted in research. Participants (n=54), drawn from two Canadian provinces, included an interdisciplinary group of researchers, clinicians, representatives from brain injury associations, individuals with TBI, and caregivers. In small groups, participants discussed challenges to long-term community integration and potential initiatives that would address these barriers. Field notes from the discussions were analyzed using qualitative content analysis. RESULTS The consensus on prioritized research directions included developing interventions to optimize the functioning and participation of individuals with TBI, reducing caregiver burden, and evaluating how emerging technology can facilitate delivery of care. CONCLUSIONS The World Café Methodology was an effective method for developing research priorities. The breadth of expertise of participants and the collegial environment allowed for the identification of a broad perspective on important future research directions with potential to enhance the long-term community integration of individuals with brain injury.
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23
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Minney MJ, Roberts RM, Mathias JL, Raftos J, Kochar A. Service and support needs following pediatric brain injury: perspectives of children with mild traumatic brain injury and their parents. Brain Inj 2018; 33:168-182. [PMID: 30396278 DOI: 10.1080/02699052.2018.1540794] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To provide a qualitative examination of the service and support needs of children who have had a mild traumatic brain injury (mTBI), and their parents, in order to improve clinical services. METHODS Semi-structured interviews were conducted with 9 children (8-12 years; M = 10.6 years, SD = 0.8) and their parents (n = 9) 29-55 days (M = 34 days; SD = 9.3) after presenting to an Australian Paediatric Emergency Department (PED) for mTBI. Children's post-concussive symptoms (PCS) were additionally measured using the Post-Concussive Symptom Inventory (PCSI). Audio recordings were transcribed, and a thematic analysis was conducted. RESULTS Post-injury needs were reflected in four main themes: Communication; Family Burden; Continuity of Care; and Social and Community Support. These themes reflected children's and parents' needs for information, emotional/social/community support, and follow-up care. Both the children's and parents' needs, and the extent to which they were met, appeared to be related to the severity and duration of the child's PCS. CONCLUSIONS Dedicated pediatric mTBI follow-up services that build on family's resources and meet their individual needs for information, emotional support, and referral may assist in optimizing post-injury outcomes.
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Affiliation(s)
- M J Minney
- a School of Psychology , University of Adelaide , Adelaide , Australia
| | - R M Roberts
- a School of Psychology , University of Adelaide , Adelaide , Australia
| | - J L Mathias
- a School of Psychology , University of Adelaide , Adelaide , Australia
| | - J Raftos
- b Pediatric Emergency Department , Women's & Children's Hospital , North Adelaide , Australia
| | - A Kochar
- b Pediatric Emergency Department , Women's & Children's Hospital , North Adelaide , Australia
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24
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Fisher A, Bellon M, Lawn S, Lennon S. The development of a positive behaviour support programme for families following acquired brain injury. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.10.538] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Alinka Fisher
- Associate lecturer, Disability and Community Inclusion Unit, College of Nursing and Health Sciences, Flinders University Adelaide, Australia
| | - Michelle Bellon
- Senior lecturer, Disability and Community Inclusion Unit, College of Nursing and Health Sciences, Flinders University Adelaide, Australia
| | - Sharon Lawn
- Professor, Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Sheila Lennon
- Professor, Discipline of Physiotherapy, College of Medicine and Public Health, Flinders University Adelaide, Australia
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25
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Hawken T, Turner-Cobb J, Barnett J. Coping and adjustment in caregivers: A systematic review. Health Psychol Open 2018; 5:2055102918810659. [PMID: 30450216 PMCID: PMC6236498 DOI: 10.1177/2055102918810659] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
This systematic review assessed coping and adjustment in caregivers of all ages to provide a synthesis of existing literature in the context of methodological approaches and underlying theory. Four databases were searched. Reference lists, citations and experts were consulted. In total, 27 studies (13 quantitative and 14 qualitative) were included. Coping factors associated with adjustment (problem- versus emotion-focussed coping and cognitive strategies) and psychosocial factors associated with physiological adjustment (trait anxiety, coping style and social support) were identified. Results raised methodological issues. Future research requires physiological adjustment measures and longitudinal assessment of the long-term impact of childhood caregiving. Findings inform future caregiver research and interventions.
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26
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Carlozzi NE, Kallen MA, Sander AM, Brickell TA, Lange RT, French LM, Ianni PA, Miner JA, Hanks R. The Development of a New Computer Adaptive Test to Evaluate Anxiety in Caregivers of Individuals With Traumatic Brain Injury: TBI-CareQOL Caregiver-Specific Anxiety. Arch Phys Med Rehabil 2018; 100:S22-S30. [PMID: 29958902 DOI: 10.1016/j.apmr.2018.05.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/07/2018] [Accepted: 05/29/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To design a new measure of caregiver-specific anxiety for use in caregivers of individuals with traumatic brain injury (TBI), the Traumatic Brain Injury Caregiver Quality of Life (TBI-CareQOL) Caregiver-Specific Anxiety item bank. DESIGN Cross-sectional survey study. SETTING Three TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility. PARTICIPANTS Three hundred forty-four caregivers of civilians with TBI and 216 caregivers of service members/veterans with TBI (N=560). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES TBI-CareQOL Caregiver-Specific Anxiety item bank. RESULTS The retention of 40 Caregiver-Specific Anxiety items was supported by exploratory and confirmatory factor analyses. Graded response model (GRM) and differential item functioning analyses supported the retention of 33 items in the final measure. Expert review and GRM calibration data was used to select a 6-item static short form, and GRM calibration data was used to program the TBI-CareQOL Caregiver-Specific Anxiety computer adaptive test (CAT). CONCLUSIONS Established, rigorous measurement development standards were used to develop the new TBI-CareQOL Caregiver-Specific Anxiety CAT and corresponding 6-item short form. This measure is the first patient-reported outcome measure designed to assess caregiver-specific anxiety in caregivers of individuals with TBI. The measure exhibits strong psychometric properties.
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Affiliation(s)
- Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
| | - Michael A Kallen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Angelle M Sander
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine and Harris Health System, Houston, TX; Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX
| | - Tracey A Brickell
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Rael T Lange
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; University of British Columbia, Vancouver, British Columbia, Canada
| | - Louis M French
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Phillip A Ianni
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Jennifer A Miner
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Robin Hanks
- Rehabilitation Institute of Michigan, Department of Psychology and Neuropsychology, Detroit, MI; Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI
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27
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Nalder E, Hartman L, Hunt A, King G. Traumatic brain injury resiliency model: a conceptual model to guide rehabilitation research and practice. Disabil Rehabil 2018; 41:2708-2717. [DOI: 10.1080/09638288.2018.1474495] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Emily Nalder
- Department of Occupational Science and Occupational Therapy, and Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- March of Dimes Canada, Toronto, Ontario, Canada
| | - Laura Hartman
- Department of Occupational Science and Occupational Therapy, and Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Anne Hunt
- Department of Occupational Science and Occupational Therapy, and Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Gillian King
- Department of Occupational Science and Occupational Therapy, and Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
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28
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Sabella SA, Andrzejewski JH, Wallgren A. Financial hardship after traumatic brain injury: a brief scale for family caregivers. Brain Inj 2018; 32:926-932. [DOI: 10.1080/02699052.2018.1469168] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Scott A. Sabella
- Department of Counseling, School, and Educational Psychology, University at Buffalo, Buffalo, NY, USA
| | - Joshua H. Andrzejewski
- Department of Counseling, School, and Educational Psychology, University at Buffalo, Buffalo, NY, USA
| | - Alexandrea Wallgren
- Department of Counseling, School, and Educational Psychology, University at Buffalo, Buffalo, NY, USA
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29
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Zale EL, Heinhuis TJ, Tehan T, Salgueiro D, Rosand J, Vranceanu AM. Resiliency is independently associated with greater quality of life among informal caregivers to neuroscience intensive care unit patients. Gen Hosp Psychiatry 2018; 52:27-33. [PMID: 29549820 DOI: 10.1016/j.genhosppsych.2018.02.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/22/2018] [Accepted: 02/27/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Every year, millions of Americans become informal caregivers to loved ones admitted to Neuroscience Intensive Care Units (Neuro-ICU), and face challenges to Quality of Life (QoL). This study sought to identify associations between resiliency, distress, and caregiver QoL at time of Neuro-ICU admission. METHODS Informal caregivers (N = 79, Mage = 53, 64% female) of Neuro-ICU patients were recruited and completed self-report questionnaires during the hospitalization. We used hierarchical regression to test relative contributions of caregiver mindfulness, perceived coping abilities, and preparedness for caregiving to caregiver QoL, above-and-beyond non-modifiable patient and caregiver factors (e.g., gender) and caregiver psychological distress (i.e., anxiety, depression, history of mental health conditions). RESULTS Preparedness for caregiving was uniquely and positively associated with Physical Health QoL (sr2 = 0.07, p = 0.001), Social QoL (sr2 = 0.05, p = 0.021), and Environmental QoL (sr2 = 0.14, p < 0.001), even after accounting for psychological distress. Mindfulness was uniquely and positively associated with Physical Health QoL (sr2 = 0.12, p < 0.001) and Psychological QoL (sr2 = 0.07, p = 0.004), above-and-beyond variance accounted for by psychological distress. CONCLUSIONS Mindfulness and preparedness for caregiving emerged as consistent, unique resiliency factors associated with greater caregiver QoL across QoL dimensions. Results highlight the importance of resiliency factors in QoL among Neuro-ICU caregivers and the need for early interventions to support resiliency.
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Affiliation(s)
- Emily L Zale
- Department of Psychiatry, Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Tessa J Heinhuis
- Psychology Department, University of Amsterdam, Amsterdam, Netherlands
| | - Tara Tehan
- Neuroscience Intensive Care Unit, Institute for Brain Health, Massachusetts General Hospital, Boston, MA, USA
| | - Danielle Salgueiro
- Neuroscience Intensive Care Unit, Institute for Brain Health, Massachusetts General Hospital, Boston, MA, USA
| | - Jonathan Rosand
- Neuroscience Intensive Care Unit, Institute for Brain Health, Massachusetts General Hospital, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Department of Psychiatry, Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
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Segev E, Levinger M, Hochman Y. "Shared Destiny": The Dynamics of Relationships in Families of Patients With Brain Injury. QUALITATIVE HEALTH RESEARCH 2018; 28:112-125. [PMID: 29083267 DOI: 10.1177/1049732317737310] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This qualitative research focused on the relationships between family members of patients with acquired brain injury (ABI). The aim was to explore the dynamics between caregivers of the family member with a brain injury during rehabilitation hospitalization, and the relationships between them and the rest of the extended family. Twenty semistructured interviews were conducted with family members. In each family, the spouse of the patient and another family member involved in caregiving were interviewed. The importance of the relationships between family members during rehabilitation hospitalization justifies the examination undertaken in this research. Findings point at the change that took place in the relationships between family members because of the need to cope with a relative's injury. It is possible that direct intervention in the dynamics of the relationship, especially between the family of origin and the nuclear family of the injured person, can benefit extended families in coping with the crisis.
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Affiliation(s)
- Einav Segev
- 1 Sapir Academic College, D.N. Hof Ashkelon, Israel
| | | | - Yael Hochman
- 1 Sapir Academic College, D.N. Hof Ashkelon, Israel
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Fisher A, Bellon M, Lawn S, Lennon S, Sohlberg M. Family-directed approach to brain injury (FAB) model: a preliminary framework to guide family-directed intervention for individuals with brain injury. Disabil Rehabil 2017; 41:854-860. [PMID: 29171308 DOI: 10.1080/09638288.2017.1407966] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE This article proposes a theoretical framework to help professionals include family as active members in brain injury rehabilitation. A trend towards greater family involvement has lead to the development of family-collaboration models. However, current models appear to focus on information sharing rather than increasing the capability of family members. This article introduces a family-directed approach to brain injury model, which provides a theoretical framework for supporting family as facilitators of change. METHODS Family-collaboration models and literature regarding family experiences following brain injury and support needs are reviewed to identify the driving forces behind family engagement in rehabilitation, including effective professional-family relationships, and important factors in the delivery of education underpinned by evidence-based practices. RESULTS The family-directed approach to brain injury model is based on principles of hope, family expertise, education/skill building, and family-directed intervention. CONCLUSIONS The family-directed approach to brain injury model provides a theoretical framework for educating and training family members as facilitators in the management process: promoting competence rather than dependency on service systems. Guiding recommendations encourage professionals to reflect on the importance of their therapeutic relationships and their capacity to positively impact rehabilitation outcomes beyond the technical aspects of health care and treatment. Implications for Rehabilitation Training family members as facilitators in the rehabilitation process is suggested to reduce dependency on the service system, address families' unmet support needs, and to optimize rehabilitation outcomes for individuals with brain injury. The family-directed approach to brain injury model is proposed to guide the increased involvement of family as active members in the rehabilitation team and to define potential active ingredients in this process.
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Affiliation(s)
- Alinka Fisher
- a Disability and Community Inclusion, College of Nursing and Health Sciences , Flinders University , Adelaide , Australia
| | - Michelle Bellon
- a Disability and Community Inclusion, College of Nursing and Health Sciences , Flinders University , Adelaide , Australia
| | - Sharon Lawn
- b Department of Psychiatry , Flinders University , Adelaide , Australia
| | - Sheila Lennon
- c Discipline of Physiotherapy , Flinders University , Adelaide , Australia
| | - McKay Sohlberg
- d Communication Disorders & Sciences , University of Oregon , Eugene, OR, USA
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Reliability of Videoconferencing Administration of a Communication Questionnaire to People With Traumatic Brain Injury and Their Close Others. J Head Trauma Rehabil 2017; 32:E38-E44. [DOI: 10.1097/htr.0000000000000282] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Aadal L, Angel S, Langhorn L, Pedersen BB, Dreyer P. Nursing roles and functions addressing relatives during in-hospital rehabilitation following stroke. Care needs and involvement. Scand J Caring Sci 2017; 32:871-879. [DOI: 10.1111/scs.12518] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 08/08/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Lena Aadal
- Hammel Neurorehabilitation and Reseach Centre; Denmark
| | - Sanne Angel
- Section for Nursing; Institute of Public Health; Aarhus University; Aarhus Denmark
- Department for Health and Social Care; Molde University College; Molde Norway
| | - Leanne Langhorn
- Department of Neurosurgery; Department of Anaesthesiology and Intensive Care; Aarhus University Hospital; Aarhus Denmark
| | | | - Pia Dreyer
- Department of Anaesthesiology and Intensive Care; Aarhus University Hospital; Aarhus Denmark
- Institute of Public Health; Section of Nursing; Aarhus University; Aarhus Denmark
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Lond BJ, Williamson IR. "Stuck in a loop of fear": a phenomenological exploration of carers' experiences supporting a spouse with acquired brain injury. Disabil Rehabil 2017; 40:2907-2915. [PMID: 28793807 DOI: 10.1080/09638288.2017.1363299] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Family caregivers are important to facilitating the rehabilitation of individuals with brain injury. However, research shows spousal carers often reporting poorer health and well-being with psychosocial challenges including increased marital dissatisfaction. This study explores the accounts of participants caring for a spouse with brain injury. MATERIALS AND METHODS This study used semi-structured interviewing and interpretative phenomenological analysis. RESULTS One theme, "Living in and beyond the loop of fear", with two subheadings is reported. Participants' attempts to manage their fears prominently defined their early caregiving. Fears were aggravated by the vulnerability of their spouse's health which partially owed to brain injury sometimes having no symptoms prior to its onset. Consequently, participants anxiously strove to prevent further harm to their spouse's health due to what they perceived as the continued "hidden" threat of brain injury. Therefore, participants became hypervigilant, leaving themselves vulnerable to burnout. Over time, some participants modified care practices and managed fears using beliefs accepting their limits to protect their spouses' health. CONCLUSIONS Findings suggest that beliefs conducive to acceptance helped carers to develop more sustainable, less over-protective, care. Interventions to help carers develop similar beliefs could be provided in therapeutic settings. Recommendations for future research are made. Implications for Rehabilitation Caring for a long-term partner with acquired brain injury has considerable challenges which can threaten an individual's health and well-being. Our research reports on carers' experiences of anxiety which they managed through hypervigilant and overprotective practices which put them at risk of burnout. Consequently, we recommend the promotion of care beliefs that reframe caregiving: recognising the carer's limitations to safeguard a spouse, whilst accepting the vulnerability of the spouse's health. We propose that promoting such principles in therapeutic settings may better equip carers emotionally to provide sustainable care, something which could benefit the carer and spouse's rehabilitation alike.
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Affiliation(s)
- Benjamin J Lond
- a Division of Psychology , De Montfort University , Leicester , UK
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Identifying Current Practices and Supports in Behaviour Management Following ABI in South Australian Community Settings: A Delphi Study. BRAIN IMPAIR 2017. [DOI: 10.1017/brimp.2016.36] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Objectives: To consider the strategies currently used by family care givers to manage challenging behaviour in the community following ABI, and to identify what supports are available that support family care givers in addressing this issue.Research design: Delphi study.Methods: Service providers (n = 8) and family care givers (n = 3) completed a three-round Delphi process with the aim of reaching consensus (75% agreement) regarding research objectives. Round 1 consisted of an open-ended questionnaire in which items were identified; these items were then rated in Round 2 and 3 using a Likert scale. Statistical aggregation then allowed for quantitative analysis.Results: The findings suggest a number of behaviour management approaches are being used by family care givers, including basic antecedent strategies, agreeing with the person's demands, and medication. Consensus was reached that only two services in SA provide specific support to family care givers regarding behaviour management in the community: Families4Families Inc. (a peer support network) and Private Specialists (e.g., [neuro]psychologists and [neuro]psychiatrists).Conclusions: Findings emphasise the need for more specialised services specific to educating and supporting family care givers in the management of challenging behaviours following ABI. These services should be accessible, centralised, and easy for family care givers to navigate.
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Schipper K, Landeweer E, Abma TA. Living with end-stage renal disease: Moral responsibilities of patients. Nurs Ethics 2017; 25:1017-1029. [PMID: 28095759 DOI: 10.1177/0969733016687154] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND: Living with a renal disease often reduces quality of life because of the stress it entails. No attention has been paid to the moral challenges of living with renal disease. OBJECTIVES: To explore the moral challenges of living with a renal disease. RESEARCH DESIGN: A case study based on qualitative research. We used Walker's ethical framework combined with narrative ethics to analyse how negotiating care responsibilities lead to a new perspective on moral issues. PARTICIPANTS AND RESEARCH CONTEXT: One case was chosen from 20 qualitative interviews with renal patients in the Netherlands. ETHICAL CONSIDERATIONS: Several actions have been taken to ensure the informed consent, privacy, anonymity and confidentiality of the patient in this article. More details are offered in this article. The study has been conducted in line with the recommendations of the Medical Ethical Committee of the VU Medical Center. FINDINGS: A renal disease can force people to change their identity, relationships, values and responsibilities. The case study illustrates the moral challenges confronting renal patients. DISCUSSION AND CONCLUSION:: Moral issues can be raised by the changes to identities, relationships, values and responsibilities caused by renal disease. Support services for renal patients and their relatives should pay more attention to these issues in order to promote self-management.
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Affiliation(s)
| | | | - Tineke A Abma
- VU University Medical Centre (VUmc), The Netherlands
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Riley GA. The partner's experience of traumatic brain injury and its recovery. Concussion 2016; 1:CNC18. [PMID: 30202560 PMCID: PMC6094063 DOI: 10.2217/cnc-2016-0012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 06/27/2016] [Indexed: 11/25/2022] Open
Affiliation(s)
- Gerard A Riley
- School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
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Butera-Prinzi F, Charles N, Story K. Holding Resilience in Trust: Working Systemically With Families Following an Acquired Brain Injury. JOURNAL OF SOCIAL WORK IN DISABILITY & REHABILITATION 2016; 15:285-304. [PMID: 27618587 DOI: 10.1080/1536710x.2016.1220882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The conceptualization of resilience following acquired brain injury needs to remain sensitive to the complex nature and enduring dimensions of trauma, loss, and stress. It is essential that a systemic and dynamic view be maintained with a focus on the key adaptation tasks that families face: grieving, restructuring, identity redefinition, and growing through adversity. These tasks are explored in a case example illustrating how these challenges reemerge across the life cycle. The key theme in this contribution is that resilience is a fluid property, a potential that practitioners and service systems can listen for, support, strengthen, and hold in trust.
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Affiliation(s)
| | - Nella Charles
- a Bouverie Family Centre, LaTrobe University , Bundoora , Australia
| | - Karen Story
- a Bouverie Family Centre, LaTrobe University , Bundoora , Australia
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Chukwuorji JC, Amazue LO, Ekeh OH. Loneliness and psychological health of orthopaedic patients’ caregivers: does gender make a difference? PSYCHOL HEALTH MED 2016; 22:501-506. [DOI: 10.1080/13548506.2016.1173711] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Tverdov AH, S. McClure K, Brownsberger MG, Armstrong SL. Family needs at a post-acute rehabilitation setting and suggestions for supports. Brain Inj 2016; 30:324-33. [DOI: 10.3109/02699052.2015.1113566] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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