Video-consulting to address mental health needs after traumatic brain injury: evaluation of a training workshop to build capacity among psychologists

Clinician perspectives on cognitive behavioral therapy and health education for sleep disturbance and fatigue after acquired brain injury: A qualitative study

Sleep disturbance and fatigue are persistent, clinically significant problems for many with acquired brain injury (ABI). A recent randomized controlled trial (RCT) demonstrated that cognitive and behavioral therapy tailored for post-ABI sleep and fatigue (CBT-SF) produced larger and faster effects compared to an active health education (HE) control intervention. The current study aimed to qualitatively explore the perspectives of the six clinicians, all clinical neuropsychologists, who delivered the CBT-SF and HE interventions to 126 individuals with ABI in the RCT. One-on-one semi-structured interviews were conducted, and transcripts were analyzed using reflexive thematic analysis. Seven themes were generated, encompassing client-related factors (Client Awareness and Readiness as Precursors to Engagement and Navigating Client Differences Throughout Treatment) and clinician-related factors that influenced treatment delivery (Building on Pre-Existing Expertise and Strengths and Challenges of Delivering a Manualized Intervention), as well as other themes directly related to treatment delivery itself (Challenges and Successes Relating to Client Engagement, CBT Strategies That Work, and Navigating Practical Considerations in Treatment Delivery). The findings reinforce the value of psychoeducation and cognitive-behavioral strategies for managing sleep and fatigue problems after ABI. They also provide valuable insights to guide the translation of CBT-SF from an RCT to real-world clinical practice.

Factors Associated with Device, Internet and Videoconferencing Use Amongst Individuals with Moderate-to-Severe Traumatic Brain Injury

Videoconferencing (VC) has the potential to improve access to quality healthcare for individuals with traumatic brain injury (TBI) who require intensive and ongoing rehabilitation post-injury. Gaps in information and communication technology (ICT) use, access, and skills, however, may undermine equitable participation in remotely delivered healthcare and rehabilitation. This cross-sectional study sought to identify which demographic, injury-related, and psychological factors are associated with gaps in digital inclusion amongst individuals with a TBI. Between March 2020 and December 2023, 186 adults with a moderate-to-severe TBI who were aged 18-65 years and were within five years post-injury completed a range of self-report measures. The results demonstrated that most individuals with a moderate-to-severe TBI reported high levels of technology skills and access and used the internet from multiple devices daily. While injury severity was unrelated to technology use, this finding may reflect an overestimation of technology use amongst individuals with the most severe injuries, who were excluded from the study. Several demographic and psychological factors were found to predict VC readiness and are presented within a model to guide clinicians considering client suitability for VC rehabilitation. The current findings indicate that the use of VC in clinical settings following a moderate-to-severe TBI is feasible and suggest that individuals with a TBI may benefit from the greater provision of remotely delivered healthcare than is currently offered.

Misconceptions about traumatic brain injury among nursing students: A cross-sectional study

AIM

This study aimed to evaluate nursing students' potential misconceptions about traumatic brain injuries and the relationship between these misconceptions and students' sociodemographic characteristics.

BACKGROUND

Although traumatic brain injuries have severe consequences, misconceptions about traumatic brain injury are widespread among healthcare professionals. Studying misconceptions about traumatic brain injury among nursing students can help enhance nursing curricula for better traumatic brain injury care and rehabilitation.

DESIGN

This is a cross-sectional observational study reported according to the STROBE guideline.

METHODS

We conducted a survey among nursing students in Morocco using a questionnaire "Common Misconceptions about Traumatic Brain Injury". A total of 550 nursing students from multiple nursing institutes in different cities in Morocco participated in the study. We calculated the average percentage of misconceptions for 7 different questionnaire domains. To study the relationship between misconceptions and sociodemographic factors, we used a t-test for independent samples and ANOVA, considering the total score for each participant.

RESULTS

Out of the 550 nursing students who participated in the study, most were female and the 20-21 years old category represented two-thirds of our sample. The domain related to "Amnesia" had the highest rate of misconceptions, followed by "Recovery", while the "brain damage" domain had the lowest rate of misconceptions. The overall mean score of misconceptions was higher than the value defined in our study as a reference cut-off. Interestingly, there were significant differences in the total score of misconceptions based on variables such as age, state of origin, city of the Institute and year of study.

CONCLUSIONS

Misconceptions about traumatic brain injuries were prevalent among nursing students, which could have a negative impact on patient assessment, treatment and education. The findings indicate the need to improve the level of knowledge related to traumatic brain injury among nursing students and to strengthen the nursing curriculum in Morocco.

Change in the form of work of psychologists after the outbreak of the COVID-19 pandemic in Poland, and the subjective mental state of this professional group

Objectives. The first wave of the COVID-19 pandemic in Poland in spring 2020 forced psychologists to fight the psychological consequences, which were triggered by drastic life changes among the entire population. This group of professionals had an incredibly difficult role to play in society; the level of their overload in studies was even compared to doctors treating COVID-19. This article aims to analyze the situation of both personal and professional psychologists in the first wave of the pandemic. Methods. During the study, 341 psychologists were surveyed using the snowball method (hybrid access). Data were collected between 12 March and 3 May 2020. The study is part of a large project from all waves of the pandemic. Results. In total, 82.7% of psychologists experienced moderate to high-intensity stress, and 61.29% switched to a remote or hybrid mode of working with patients. Subjectively depressed mood occurred in 16.13%, reduced drive in 27.57% and dyssomnia in 18.77%. A total of 61.58% had concerns about their professional and/or financial future after the pandemic. Conclusion. The challenges during, as well as after, the pandemic period require taking care of individual mental well-being for psychologists. This is a necessary condition for undertaking a committed job.

A psychometric evaluation of a new social subscale for the Common Misconceptions about Traumatic Brain Injury (CM-TBI) questionnaire: toward the CM-TBI-II

OBJECTIVE

Existing TBI misconception measures are critiqued for failing to measure postinjury social experiences. This study developed a social subscale for the Common Misconceptions about TBI (CM-TBI) questionnaire for use in the general public.

METHODS

Seven experts independently review items drawn from the literature. Shortlisted items were administered online to 158 adults (aged ≥18 years; 51% postschool educated; 60% no TBI experience), the CM-TBI, and a measure of construct validity (a published TBI-adaptation of the Community Attitudes Towards the Mentally Ill; CAMI-TBI). One week later, the new items were redeployed (n = 46).

RESULTS

Expert review and iterative correlations identified a 10-item social subscale (internal consistency, test-retest reliability, α's>.80). When added to the CM-TBI (ie. CM-TBI-II), the internal consistency was .71. The social subscale was significantly correlated with CAMI-TBI measures (p's <.05, r's > .3). There was no significant difference on the social subscale for education subgroups (school vs post-school, p = 0.056) or previous TBI experience; but there was a difference for the CM-TBI-II (post-school>school; Cohen's d = 7.83, large effect).

CONCLUSION

This study found strong preliminary psychometric support for a new social subscale, administered as the CM-TBI-II. This subscale shows promise as a measure of misconceptions about social functioning post-TBI. The CM-TBI-II could support evaluations of programs aiming to improve social engagement and community participation for people with TBI.

Telehealth use by mental health professionals during COVID-19

OBJECTIVE

To examine and describe telehealth use and attitudes among mental health professionals in Australia and New Zealand during the initial stages of the COVID-19 pandemic.

METHODS

Participants completed a brief online survey between May and July 2020. Participants were recruited via peak and professional organisations and through psychology-focused social media groups and networks. The survey examined frequency of telehealth use, reasons for non-use, telehealth modalities, prior use, attitudes towards use, plans for future use, and training, information or resource needs.

RESULTS

A total of 528 professionals (85.2% female) participated in the survey, of which 98.9% reported using telehealth and 32.2% reported using telehealth exclusively. Respondents were less likely to use telehealth if they worked with clients experiencing complex issues (e.g. trauma), had more hours of weekly client contact, had a choice about whether to use telehealth or felt less positive about using technology. Respondents were more likely to hold positive views towards telehealth if they were female, had used online programmes with clients previously, were frequent telehealth users and were comfortable using technology. Participants expressed mixed views on client safety and the impact of telehealth on therapeutic process and effectiveness.

CONCLUSION

Telehealth has a clear and ongoing role within mental healthcare and there is a need for strong guidance for professionals on how to manage client risk, privacy, security and adapt therapy for delivery via telehealth. In particular, there is a need for individual-, organisational-, professional- and policy-level responses to ensure that telehealth remains a viable and effective healthcare medium into the future.