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Grewal J, Citton K, Sing G, Biagioni JB, Schmidt J. Priorities for quality of life after traumatic brain injury. PLoS One 2024; 19:e0306524. [PMID: 38968208 PMCID: PMC11226113 DOI: 10.1371/journal.pone.0306524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 06/19/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND After traumatic brain injury (TBI), individuals can experience changes to quality of life (QOL). Despite understanding the factors that impact QOL after TBI, there is limited patient-oriented research to understand the subjective priorities for QOL after TBI. This study aims to understand the priorities for QOL after TBI using a group consensus building method. METHODS The Technique for Research of Information by Animation of a Group of Experts (TRIAGE) method was used to determine priorities for QOL after TBI. In phase one, expert participants were consulted to understand the context of QOL after TBI. In phase two, participants with TBI completed a questionnaire to broadly determine the factors that contributed to their QOL. In phase three, a portion of participants from phase two engaged in focus groups to identify the most relevant priorities. Data was analyzed thematically. In phase four, expert participants were consulted to finalize the priorities. RESULTS Phase one included three expert participants who outlined the complexity and importance of QOL after TBI. Phase two included 34 participants with TBI who described broad priorities for QOL including social support, employment, and accessible environments. Phase three included 13 participants with TBI who identified seven priorities for QOL: ensuring basic needs are met, participating in everyday life, trusting a circle of care, being seen and accepted, finding meaning in relationships, giving back and advocating, and finding purpose and value. In phase four, four expert participants confirmed the QOL priorities. INTERPRETATIONS Findings emphasize the critical need to address priorities for QOL after TBI to ensure improved health outcomes.
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Affiliation(s)
- Jasleen Grewal
- Rehabilitation Science Graduate Program, University of British Columbia, Vancouver, Canada
- Rehabilitation Research Program, Centre for Aging SMART at Vancouver Coastal Health, Vancouver, Canada
| | - Kix Citton
- Nanaimo Brain Injury Society, Nanaimo, Canada
- British Columbia Brain Injury Association, Vancouver, Canada
| | - Geoff Sing
- British Columbia Brain Injury Association, Vancouver, Canada
- The Cridge Centre for the Family, Victoria, Canada
| | | | - Julia Schmidt
- Rehabilitation Science Graduate Program, University of British Columbia, Vancouver, Canada
- Rehabilitation Research Program, Centre for Aging SMART at Vancouver Coastal Health, Vancouver, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
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Pillen H, Attrill S, Fisher A, Forte S, Brebner C, Robinson S. Educating for supported decision making and shared decision making: a scoping review of educational design and outcomes for education and training interventions. Disabil Rehabil 2024:1-12. [PMID: 38591714 DOI: 10.1080/09638288.2024.2337099] [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: 02/16/2023] [Accepted: 03/24/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE To characterise existing knowledge about the design and learning outcomes of education and training programs for supported or shared decision making. MATERIALS AND METHODS A scoping review was performed to identify academic and grey literature, published between January 2006 and February 2022, that reported on the design and/or learning outcomes of supported or shared decision making education or training programs. Eligible literature was mapped across domains of educational design and Kirkpatrick's hierarchy of learning effectiveness, and then qualitatively synthesised using cross-case analysis. RESULTS A total of 33 articles were identified (n = 7 for supported decision making and n = 26 for shared decision making) that provided education or training to supporters of persons with mental illness or substance use disorders (n = 14), dementia or neurocognitive disorders (n = 6), cognitive disability (n = 5), mixed populations (n = 1), and those receiving end-of-life care (n = 7). In their design, most programs sought specific changes in practice (behaviour) via experiential learning. Reported educational outcomes also focused on supporter behaviour, with limited evidence for how changes in learner attitudes, skills, or knowledge might be contributing to changes in supporter behaviour. CONCLUSIONS Future education and training would benefit from a closer engagement with theories of teaching and learning, particularly those oriented towards co-design.
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Affiliation(s)
- Heath Pillen
- School of Allied Health Science and Practice, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Stacie Attrill
- School of Allied Health Science and Practice, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Alinka Fisher
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Sabrina Forte
- Council for Intellectual Disability, Surry Hills, Australia
| | - Chris Brebner
- Office of the Deputy Vice-Chancellor, Flinders University, Adelaide, Australia
| | - Sally Robinson
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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Mamman R, Mortenson WB, Fleming J, Schmidt J. Living in a reshaped reality: Exploring social participation and self-identity after TBI. Neuropsychol Rehabil 2022; 32:2102-2124. [PMID: 35997174 DOI: 10.1080/09602011.2022.2113100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Individuals with a moderate to severe traumatic brain injury (TBI) experience substantial changes in their life. This constructivist grounded theory study aimed to develop an explanatory model that explores the impact of changes in social participation and self-identity after sustaining a TBI. Sixteen participants with moderate to severe TBI (mean age = 49.8, 69% male) were recruited, and were on average 16.4 years post-injury (SD = 10.4). Data from semi-structured interviews were analysed thematically. An overarching theme of "living in a reshaped reality" was identified, which depicted how changes in social participation and self-identity influenced ongoing experiences with TBI. Three main themes were generated: (1) "there's nothing that's the same" highlighted the daily challenges individuals faced post-injury, (2) "rebuilding and restarting" described how individuals with TBI navigated through their unfamiliar reality, and (3) "embrace it and run with it" explored participants' reactions towards life with a TBI. An explanatory model was developed, consisting of the overarching theme ("living in a reshaped reality") with the three integrated themes. Future research and clinical practices can build on this understanding to develop programmes to help individuals address their needs in post-injury life.
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Affiliation(s)
- Rinni Mamman
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada
| | - W Ben Mortenson
- Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,International Collaboration on Repair Discoveries, Vancouver General Hospital, Vancouver, Canada
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Julia Schmidt
- Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Brunner M, Togher L, Palmer S, Dann S, Hemsley B. Rehabilitation professionals’ views on social media use in traumatic brain injury rehabilitation: gatekeepers to participation. Disabil Rehabil 2019; 43:1955-1964. [DOI: 10.1080/09638288.2019.1685604] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Melissa Brunner
- Speech Pathology, Graduate School of Health, University of Technology Sydney, Ultimo, Australia
| | - Leanne Togher
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Sydney, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
| | - Stuart Palmer
- Melbourne Centre for the Study of Higher Education, The University of Melbourne, Melbourne, Australia
| | - Stephen Dann
- College of Business and Economics, Australian National University, Canberra, Australia
| | - Bronwyn Hemsley
- Speech Pathology, Graduate School of Health, University of Technology Sydney, Ultimo, Australia
- Faculty of Education and Arts, The University of Newcastle, Newcastle, Australia
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Werner S, Holler R. Attitudes toward guardianship, social work goals, and perspectives of disability among social work students. Disabil Rehabil 2019; 42:712-721. [PMID: 30612475 DOI: 10.1080/09638288.2018.1508510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Guardianship of people with disabilities has been under growing scrutiny, leading some welfare states to offer supported decision-making as a legal alternative. This study examined the attitudes of Israeli social work students toward guardianship and supported decision-making and the relationship between these attitudes and the perceived importance of social work goals, as mediated by perceptions of disability.Materials and methods: Participants were 414 undergraduate and graduate level social work students from Israel. Participants completed a structured questionnaire that measured: attitudes toward guardianship and supported decision-making, importance of social work goals, and perception of disability.Results: Although social work students tended to support limiting the scope of guardianship, they did not clearly oppose it. Individual model perspective of disability mediated the association between the social work goal of social control and attitudes toward guardianship. Social model perspective of disability mediated the association between the social work goal of social justice and attitudes toward guardianship.Conclusion: To reduce guardianship appointments, social work educators should educate students better regarding current supported decision-making trends, emphasize the importance of social justice goals, and discuss critically the necessity of social control. Further, educators need to embrace the social model of disability, in particular its view of autonomy and interdependence.Implications for rehabilitationThe UN Convention on the Rights of Persons with Disabilities has urged limiting guardianship practices, and developing instead less restrictive alternatives, especially supported decision making.In order to fully implement the Convention's vision, efforts must be placed in social work training programs on discussing the limitations of guardianship, the dilemmas it raises and the advantages of other less restrictive alternatives, including that of supported decision-making.Social work educators should also emphasize the importance of social justice goals and discuss critically the necessity of social control.Similar emphasis should be placed on exposing students to the social model of disability, including its view of autonomy and interdependence.
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Affiliation(s)
- Shirli Werner
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Roni Holler
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
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Usher R, Stapleton T. Overview of the Assisted Decision-Making (Capacity) Act (2015). IRISH JOURNAL OF OCCUPATIONAL THERAPY 2018. [DOI: 10.1108/ijot-08-2018-0013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
In Ireland, the Assisted Decision Making (Capacity) Act 2015 provides a statutory framework to adults who are experiencing difficulties with decision-making. This legislation has significant implications for all who work in health and social care. Increasing age and life expectancy, alongside the rising incidence of chronic health conditions and dementia-related diseases, indicates that more individuals are likely to experience challenges regarding decision-making capacity. Therefore, the need for more consistent, best-practice processes to assess decision-making capacity is likely to increase. To ensure occupational therapists are responsible in their contributions, and to ensure those with disabilities are supported, clinicians must be well-informed of the principles underscoring the Act. The purpose of this paper is to provide an overview of this multidisciplinary issue, including recent legislation, and consider how occupational therapy can contribute.
Design/methodology/approach
The authors reviewed current literature and considered occupational therapy’s role in decision-making capacity assessment.
Findings
Occupational therapists have potential to play a key role in multi-disciplinary assessments of decision-making capacity for clients. Further research is required to explore professional issues, identify clinical best practices and determine training and resource needs.
Originality/value
This paper seeks to provoke consideration of how occupational therapists can contribute to capacity assessment from a client-centred, occupation-based perspective that is mindful of ethical and legislative considerations.
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Douglas J, Bigby C. Development of an evidence-based practice framework to guide decision making support for people with cognitive impairment due to acquired brain injury or intellectual disability. Disabil Rehabil 2018; 42:434-441. [DOI: 10.1080/09638288.2018.1498546] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Jacinta Douglas
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia
- Summer Foundation, Melbourne, Australia
| | - Christine Bigby
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia
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“Time's Up”: The Experience of Entering Residential Aged Care for Young People with Acquired Neurological Disorders and Their Families. BRAIN IMPAIR 2018. [DOI: 10.1017/brimp.2018.13] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background and aims: Previous research has highlighted that living in residential aged care (RAC) is associated with a range of negative outcomes for adults with acquired neurological disorders. This study sought to understand the lived experience of entering RAC for young people and their family members and characterise their needs during this process.Method: Data included 64 written and verbal submissions to the 2015 Senate Inquiry into the Adequacy of existing residential care arrangements available for young people with severe physical, mental or intellectual disabilities in Australia. In line with hermeneutic tradition, text was analysed using thematic analysis.Results: Entry to RAC was experienced as a complex process that coalesced around three key events: an unexpected health crisis, a directive that time's up and the individual is required to leave the healthcare setting, with a subsequent decision to move into RAC. This decision was made in the absence of time, knowledge of options or adequate support.Conclusions: Findings suggest that there are both immediate practice changes and longer term policy responses that can support the health and disability systems to uphold the rights of people with acquired disability to choose where and how they will live their lives.
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Jackson K, Hamilton S, Jones S, Barr S. Patient reported experiences of using community rehabilitation and/or support services whilst living with a long-term neurological condition: a qualitative systematic review and meta-aggregation. Disabil Rehabil 2018; 41:2731-2749. [PMID: 29911901 DOI: 10.1080/09638288.2018.1473508] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objectives: The objective of this study is to identify patient reported experiences of using community rehabilitation and/or support services whilst living with a long-term neurological condition, and perceptions of their impact on quality of life.Methods: Nine electronic databases were searched for peer-reviewed qualitative studies from 2005 to 2016, which met the inclusion criteria. Critical appraisal, data extraction, and quality assessment of 37 included papers were performed by three reviewers. One hundred and one findings were extracted. Meta-aggregation was used to synthesize findings.Findings: Seven 'synthesized findings' [SF] were produced: Interactions with some professionals provide active participation, choice, confidence and autonomy [SF1]; Interactions with some professionals are disempowering and depersonalized [SF2]; Effective communication, specialist knowledge and an individualized approach to information provision is needed [SF3]; Indicators of success vary and may not be clear [SF4]; Informal support from family/friends is valued [SF5]; Opportunities for peer support/social interaction is valued [SF6]; Coordination required to ensure continuity during transition to community [SF7].Conclusion: Patient reported experiences identified common factors associated with process quality (respect, choice, autonomy, information provision, communication) and activities of patient centered care (personalized care, shared decision-making, self-management support) despite heterogeneity of neurological conditions, service configurations, and geographical location. These factors impact quality of life.Implications for RehabilitationPatient reported experiences provide useful information about courtesy, respect, choice, autonomy, information provision, and communication.Outcomes of self-efficacy and self-management are important for people with stable and progressive long-term neurological conditions.Interactions with individual professionals influence engagement, self-efficacy, and self-management for people with long-term neurological conditions.Training for health and social care professionals should develop the advanced communication skills and behavior required to facilitate self-efficacy and self-management.
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Affiliation(s)
- Katherine Jackson
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Sharon Hamilton
- School of Health and Social Care, Teesside University, Middlesbrough, UK.,Teesside Centre for Evidence Informed Practice: A Joanna Briggs Institute Centre of Excellence, Teesside University, Middlesbrough, UK
| | - Susan Jones
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Steven Barr
- School of Health and Social Care, Teesside University, Middlesbrough, UK
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Knox L, Douglas JM, Bigby C. “I’ve never been a yes person”: Decision-making participation and self-conceptualization after severe traumatic brain injury. Disabil Rehabil 2016; 39:2250-2260. [DOI: 10.1080/09638288.2016.1219925] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Lucy Knox
- Living with Disability Research Center, La Trobe University, Victoria, Australia
- Summer Foundation, Victoria, Australia
| | - Jacinta M. Douglas
- Living with Disability Research Center, La Trobe University, Victoria, Australia
- Summer Foundation, Victoria, Australia
| | - Christine Bigby
- Living with Disability Research Center, La Trobe University, Victoria, Australia
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Matérne M, Lundqvist LO, Strandberg T. Support Persons’ Perceptions of Giving Vocational Rehabilitation Support to Clients With Acquired Brain Injury in Sweden. ACTA ACUST UNITED AC 2016; 15:351-369. [DOI: 10.1080/1536710x.2016.1220880] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Assumptions of Decision-Making Capacity: The Role Supporter Attitudes Play in the Realisation of Article 12 for People with Severe or Profound Intellectual Disability. LAWS 2016. [DOI: 10.3390/laws5010006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Everyday Choice Making: Outcomes of Young People with Acquired Brain Injury After Moving from Residential Aged Care to Community-Based Supported Accommodation. BRAIN IMPAIR 2016. [DOI: 10.1017/brimp.2015.32] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objectives: (1) Examine the opportunities young people with acquired brain injury (ABI) have to make everyday choices after moving out of residential aged care (RAC) into community-based shared supported accommodation (SSA); (2) Compare everyday choice making of this group with a group of people with ABI living in RAC.Research design: Mixed methods comparing two independent groups.Method and procedures: Responses on eleven relevant items of the Resident Choice Scale (RCS) were compared between two groups; 45 people with ABI living in RAC and 20 people with ABI who had moved from RAC to live in SSA. In addition, the choice making experiences of the SSA group were investigated through semi-structured interviews with the individual and/or their family member. Interviews were recorded, transcribed and thematically analysed.Results: Greater opportunities for everyday choice making were demonstrated on 10 out of the 11 RCS items for people living in SSA, compared to RAC. These included improved choice regarding meals, bedtime and leisure activities. Qualitative data also illustrated new choice opportunities afforded to the SSA group. Five key themes relating to choice were identified: rules and routines, communication, things to do, food and home-like environment.Conclusions: Community-based, age-appropriate and small-scale supported accommodation provides people with ABI more opportunities for everyday choice making than RAC.
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Knox L, Douglas JM, Bigby C. Becoming a decision-making supporter for someone with acquired cognitive disability following traumatic brain injury. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/23297018.2015.1077341] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Douglas J, Bigby C, Knox L, Browning M. Factors that Underpin the Delivery of Effective Decision-making Support for People with Cognitive Disability. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/23297018.2015.1036769] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Knox L, Douglas JM, Bigby C. ‘The biggest thing is trying to live for two people’: Spousal experiences of supporting decision-making participation for partners with TBI. Brain Inj 2015; 29:745-57. [DOI: 10.3109/02699052.2015.1004753] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Lucy Knox
- Department of Human Communication Sciences, La Trobe University, Victoria, Australia,
| | - Jacinta M. Douglas
- Department of Human Communication Sciences, La Trobe University, Victoria, Australia,
- Summer Foundation, Victoria, Australia, and
| | - Christine Bigby
- Department of Social Work and Social Policy, La Trobe University, Victoria, Australia
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Knox L, Douglas JM, Bigby C. “I won't be around forever”: Understanding the decision-making experiences of adults with severe TBI and their parents. Neuropsychol Rehabil 2015; 26:236-60. [DOI: 10.1080/09602011.2015.1019519] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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