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Babbage DR, Drown JC, Van Solkema M, Armstrong J, Levack W, Kayes N. Inpatient trial of a tablet app for communicating brain injury rehabilitation goals. Disabil Rehabil Assist Technol 2024; 19:1287-1297. [PMID: 36634029 DOI: 10.1080/17483107.2023.2167009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 01/06/2023] [Indexed: 01/13/2023]
Abstract
PURPOSE We examine the use of a custom iPad application, the Rehab Portal, to provide clients in an inpatient brain injury rehabilitation service with access to short videos where clinicians-or the clients themselves-discuss their current rehabilitation goals. MATERIALS AND METHODS We developed an initial version of the Rehab Portal app based on our previous co-design with service users, their families, and clinicians. This was examined in a field trial with a series of six clients over the course of their stays in inpatient rehabilitation, collecting quantitative data on clinician and client engagement with the Rehab Portal, alongside a thematic analysis of qualitative interviews with clients and clinicians at the point of discharge. RESULTS Engagement with the platform was high for two clients while it was limited with four more. In our thematic analysis we discuss how introduction of the Rehab Portal disrupted practice, changing how things are done, causing deviation from usual routines, adding burden, and threatening professional integrity. At the same time, where it worked well it led to a repositioning of goal planning away from being clinician directed and towards an ongoing, dynamic collaboration between clinicians, clients and their families. Finally, in some cases we identified a reverting to the status quo, with client demotivation having an unexpected impact on clinician behaviour leading to the process being abandoned. CONCLUSIONS The current findings do not provide wholesale support for this approach, yet we continue to feel that approaches that support clinician-client communication using asynchronous video may offer considerable future value and are worthy of further investigation.
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Affiliation(s)
- Duncan R Babbage
- Centre for eHealth, Auckland University of Technology, Auckland, New Zealand
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Juliet C Drown
- Centre for eHealth, Auckland University of Technology, Auckland, New Zealand
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Maegan Van Solkema
- Clinical Lead Speech Language Therapist, ABI Rehabilitation NZ Ltd, Auckland, New Zealand
| | - Jonathan Armstrong
- Director of Rehabilitation, ABI Rehabilitation NZ Ltd, Auckland, New Zealand
| | - William Levack
- Rehabilitation Teaching & Research Unit, University of Otago, Dunedin, New Zealand
| | - Nicola Kayes
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
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Ingebretsen SMH, Stubberud J, Kirmess M. Family members' and friends' reports after standard and intensive group treatment for social communication difficulties following acquired brain injury - a mixed method approach. Brain Inj 2024; 38:304-315. [PMID: 38318845 DOI: 10.1080/02699052.2024.2311345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE To examine family members/friends' perception of change following standard and intensive group interactive structured treatment (GIST) for persons with social communication difficulties (SCDs). METHODS A parallel mixed methods design combining data from questionnaires, the Goal Attainment Scale, and interviews. PARTICIPANTS Forty-nine adult (>18 years) family members/friends (69.4% female) of persons with SCDs and acquired brain injury (ABI) (cohabitating partner, 53.1%; other relatives, 30.6%; friends, 16.3%). INTERVENTION Standard GIST consisted of 12 weekly outpatient sessions (2.5 h). Intensive GIST consisted of 4 weeks of inpatient rehabilitation (2 × 3 days/week, 2 × 4 days/week). Both treatments included 3- and 6-month follow-ups. MAIN OUTCOME MEASURES Quantitative measures (n = 49) included the following informant reports: Latrobe Communication Questionnaire (LCQ), Social Communication Skills Questionnaire-Adapted (SCSQ-A), Behavior Rating Inventory for Executive Functions-Adult version (BRIEF-A), and Goal Attainment Scale. The qualitative measure (n=9) was an interview performed at 6-month follow-up. RESULTS Converging results were found, suggesting a perceived positive change over time for both standard and intensive GIST, with no substantial differences reported between the treatments. CONCLUSIONS Family members/friends reported improved social communication skills of the persons with SCDs following standard and intensive GIST. However, the integration of data showed the complexity of assessing SCDs and the need for further investigation.
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Affiliation(s)
- Silje Merethe Hansen Ingebretsen
- Department of Special Needs Education, University of Oslo, Oslo, Norway
- Research department, Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Jan Stubberud
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Melanie Kirmess
- Department of Special Needs Education, University of Oslo, Oslo, Norway
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Morgan KA, Paton S, Patten A, Tucker S, Walker K. Community-based exercise goals of persons with spinal cord injury: Interpreted using the International Classification of Functioning, Disability, and Health. J Spinal Cord Med 2024; 47:229-238. [PMID: 34698620 PMCID: PMC10885771 DOI: 10.1080/10790268.2021.1970896] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To identify goals for exercising among community-dwelling persons with spinal cord injury (PwSCI). DESIGN Qualitative descriptive study. SETTING Community-based exercise facility for persons with a disability. PARTICIPANTS Fifty-five PwSCI identified their exercise goals prior to participation in a community-based exercise intervention. INTERVENTIONS None. OUTCOME MEASURES A modified version of the Canadian Occupational Performance Measure was used to ask about exercise goals. The International Classification of Functioning, Disability, and Health (ICF) was used to code the goals for themes. RESULTS The participants were predominantly male (76%) and Black (56%) with thoracic-level injury (51%) and a mean age of 39.44 (standard deviation [SD] 13.62). A total of 231 goals (mean 4.2 goals per participant; SD 1.25) were identified. Participants rated their performance and satisfaction with their goals as 4.256 (SD 1.55) and 3.57 (SD 1.67), respectively. Participants most frequently reported goals related to endurance, muscle strengthening, weight loss, activities of daily living, transferring, and home and community mobility. The most commonly reported goals fell into five ICF domains: Functions of Cardiovascular, Hematological, Immunological, and Respiratory Systems; Neuromusculoskeletal and Movement-Related Functions; Structures Related to Movement; Mobility; and Self-Care. CONCLUSION PwSCI have goals they would like to achieve through participation in exercise. The goals are multifaceted and encompass improving health and fitness as well as improving performance in everyday activities such as transferring and mobility. Identifying themes of goals for PwSCI to achieve through exercise is an important step in developing programs and interventions needed to support PwSCI living in the community.
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Affiliation(s)
- Kerri A. Morgan
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Samantha Paton
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Anna Patten
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Susan Tucker
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Kimberly Walker
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
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Kelly C, Cornwell P, Hewetson R, Copley A. The pervasive and unyielding impacts of cognitive-communication changes following traumatic brain injury. Int J Lang Commun Disord 2023; 58:2131-2143. [PMID: 37424402 DOI: 10.1111/1460-6984.12923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 06/07/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Cognitive-communication disorders (CCDs) are common in the traumatic brain injury (TBI) population. Despite this, there has been limited research that explores the long-term impacts of reduced cognitive-communication functioning on daily life for this population. AIMS To identify the long-term impacts of cognitive-communication impairment as reported by adults with TBI and their significant others. METHODS & PROCEDURES A qualitative descriptive approach grounded in phenomenology was used. Semi-structured, one-on-one interviews were conducted with adults with CCDs following TBI (n = 16) and their significant others (n = 12) to explore their lived experiences. OUTCOMES & RESULTS Reflexive thematic analysis revealed an overarching theme of 'The pervasive and unyielding impacts of cognitive-communication changes on daily life following TBI'. Within this overarching theme, three subthemes were identified: (1) self-awareness of communication changes; (2) fatigue; and (3) self-identity and life roles. CONCLUSION & IMPLICATIONS The findings from this study highlight the long-term negative impacts of reduced cognitive-communication functioning on daily life. Health professionals supporting this population should consider ways to reduce the significant impact CCDs have on the lives of adults following TBI and their significant others. In addition, the findings highlight the importance of long-term rehabilitation services following TBI, with further research needed that explores how these services can be optimised. WHAT THIS PAPER ADDS What is already known on this subject Cognitive-communication disorders (CCDs) affect the majority of adults who experience moderate to severe traumatic brain injury (TBI) and encompass any component of communication that is affected by cognition. The hallmark characteristic of CCDs are breakdowns that affect social communication skills as well as cognitive-linguistic deficits. Combined, these can have dramatic implications for a person's quality of life, their level of independence, employment opportunities and social participation. There has been limited research to date that explores the long-term impacts of CCDs on the lives of adults following TBI. Further research that explores these impacts is needed to improve the support services and rehabilitation models of care available for this population. What this study adds The overarching theme was 'The pervasive and unyielding impacts of communication changes on daily life following TBI' with subthemes including changed communication, self-awareness of communication changes, fatigue and self-identity and life roles. The findings from this study highlight the long-term negative impacts of reduced cognitive-communication functioning on everyday functioning and quality of life as well as the importance of long-term rehabilitation services following TBI. What are the clinical implications of this work? Speech-language therapists and other health professionals working with this clinical population should consider how to address the significant and long-lasting impacts of CCDs. Due to the complex nature of the barriers experienced by this clinical population, an interdisciplinary targeted approach is advised wherever possible when providing rehabilitation services.
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Affiliation(s)
- Crystal Kelly
- School of Health Sciences and Social Work, Griffith University, Queensland, Australia
| | - Petrea Cornwell
- School of Health Sciences and Social Work, Griffith University, Queensland, Australia
| | - Ronelle Hewetson
- School of Health Sciences and Social Work, Griffith University, Queensland, Australia
| | - Anna Copley
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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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. Int J Speech Lang Pathol 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Miller LR, Divers R, Reed C, Cherry J, Patrick A, Calamia M. Value-consistent rehabilitation is associated with long-term psychological flexibility and quality of life after traumatic brain injury. Neuropsychol Rehabil 2023:1-19. [PMID: 37708399 DOI: 10.1080/09602011.2023.2256964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023]
Abstract
Meaningful steps have been taken toward using holistic approaches in outpatient rehabilitation for traumatic brain injury (TBI) (i.e., treating the whole individual); however, research and practice continue to disproportionately focus on adapting to physical and cognitive changes. Research suggests treatment focusing on individual values may be important for psychological adjustment after TBI. The current study sought to explore individual values across multiple life domains in those with TBI as well as what values outpatient rehabilitation was helpful for, and to examine discrepancies between these factors (i.e., value-consistent rehabilitation) in relation to important long-term treatment outcomes. 215 adults with a history of TBI who had participated in outpatient rehabilitation completed online surveys assessing how consistent outpatient rehabilitation was with individual values, psychological flexibility, and quality of life. The life domains with the greatest discrepancies between individual importance and rehabilitation helpfulness were spirituality, intimate relations, and family relations. Greater value-consistent rehabilitation was associated with higher levels of psychological flexibility and quality of life beyond demographics and injury characteristics. Our findings provide further support in favour of holistic, client-centred approaches that are facilitated by neurological rehabilitation programs.
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Affiliation(s)
- Luke R Miller
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Ross Divers
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Christopher Reed
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Jared Cherry
- Department of Neurology, Yale School of Medicine, New Haven, CT, United States
| | - Abihail Patrick
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
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Meimandi M, Azad A, von Rosen P, Taghizadeh G. Consensus on Feedback Statements That Create Responsibility Among People With Parkinson's Disease: A Delphi Study. Am J Occup Ther 2023; 77:7704205160. [PMID: 37585597 DOI: 10.5014/ajot.2023.050231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
IMPORTANCE Sense of agency is associated with a sense of responsibility, which is essential to performing goal-directed occupations. OBJECTIVE To reach consensus on a set of extrinsic feedback statements that have the potential to create a sense of responsibility among patients with neurological disorders in the course of performing daily or social occupations. DESIGN Anonymous Delphi study with two rounds with international experts and one round with Irani patients with Parkinson's disease (PD). SETTING Electronic survey. PARTICIPANTS One hundred experts and 73 patients with idiopathic PD. OUTCOMES AND MEASURES Experts and patients anonymously rated (5 = strongly agree/very effective, 4 = agree/effective, 3 = neither agree nor disagree/uncertain, 2 = disagree/ineffective, 1 = strongly disagree/very ineffective) their level of agreement with each survey statement and the effectiveness of each statement in creating a sense of responsibility in the course of performing daily or social occupations. Consensus was set as an interquartile range of ≤1 and ≥70% agreement in two adjacent categories of a Likert scale. RESULTS In the experts' first round, consensus was reached on the level of agreement and effectiveness of 18 statements. In the second round, final consensus was achieved on all statements. In the one patient round, patients reached consensus on all statements. Finally, 34 statements were rated as 4 or 5 in terms of agreement and effectiveness, based on the opinions of experts and patients. CONCLUSIONS AND RELEVANCE This study has produced a collection of feedback statements that might be useful in occupation-based interventions. What This Article Adds: Extrinsic responsibility feedback delivered while administering occupation-based interventions may increase volition, motivation, and engagement.
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Affiliation(s)
- Mahsa Meimandi
- Mahsa Meimandi, MSc, is PhD Candidate, Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Akram Azad
- Akram Azad, PhD, is Associate Professor, Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Philip von Rosen
- Philip von Rosen, PhD, is Associate Professor, Division of Physiotherapy, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Huddinge, Sweden
| | - Ghorban Taghizadeh
- Ghorban Taghizadeh, PhD, is Associate Professor, Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran; or
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Velez M, Lugo-Agudelo LH, Patiño Lugo DF, Glenton C, Posada AM, Mesa Franco LF, Negrini S, Kiekens C, Spir Brunal MA, Roberg ASB, Cruz Sarmiento KM. Factors that influence the provision of home-based rehabilitation services for people needing rehabilitation: a qualitative evidence synthesis. Cochrane Database Syst Rev 2023; 2:CD014823. [PMID: 36780267 PMCID: PMC9918343 DOI: 10.1002/14651858.cd014823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND To increase people's access to rehabilitation services, particularly in the context of the COVID-19 pandemic, we need to explore how the delivery of these services can be adapted. This includes the use of home-based rehabilitation and telerehabilitation. Home-based rehabilitation services may become frequently used options in the recovery process of patients, not only as a solution to accessibility barriers, but as a complement to the usual in-person inpatient rehabilitation provision. Telerehabilitation is also becoming more viable as the usability and availability of communication technologies improve. OBJECTIVES To identify factors that influence the organisation and delivery of in-person home-based rehabilitation and home-based telerehabilitation for people needing rehabilitation. SEARCH METHODS We searched PubMed, Global Health, the VHL Regional Portal, Epistemonikos, Health Systems Evidence, and EBM Reviews as well as preprints, regional repositories, and rehabilitation organisations websites for eligible studies, from database inception to search date in June 2022. SELECTION CRITERIA: We included studies that used qualitative methods for data collection and analysis; and that explored patients, caregivers, healthcare providers and other stakeholders' experiences, perceptions and behaviours about the provision of in-person home-based rehabilitation and home-based telerehabilitation services responding to patients' needs in different phases of their health conditions. DATA COLLECTION AND ANALYSIS: We used a purposive sampling approach and applied maximum variation sampling in a four-step sampling frame. We conducted a framework thematic analysis using the CFIR (Consolidated Framework for Implementation Research) framework as our starting point. We assessed our confidence in the findings using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. MAIN RESULTS: We included 223 studies in the review and sampled 53 of these for our analysis. Forty-five studies were conducted in high-income countries, and eight in low-and middle-income countries. Twenty studies addressed in-person home-based rehabilitation, 28 studies addressed home-based telerehabilitation services, and five studies addressed both modes of delivery. The studies mainly explored the perspectives of healthcare providers, patients with a range of different health conditions, and their informal caregivers and family members. Based on our GRADE-CERQual assessments, we had high confidence in eight of the findings, and moderate confidence in five, indicating that it is highly likely or likely respectively that these findings are a reasonable representation of the phenomenon of interest. There were two findings with low confidence. High and moderate confidence findings Home-based rehabilitation services delivered in-person or through telerehabilitation Patients experience home-based services as convenient and less disruptive of their everyday activities. Patients and providers also suggest that these services can encourage patients' self-management and can make them feel empowered about the rehabilitation process. But patients, family members, and providers describe privacy and confidentiality issues when services are provided at home. These include the increased privacy of being able to exercise at home but also the loss of privacy when one's home life is visible to others. Patients and providers also describe other factors that can affect the success of home-based rehabilitation services. These include support from providers and family members, good communication with providers, the requirements made of patients and their surroundings, and the transition from hospital to home-based services. Telerehabilitation specifically Patients, family members and providers see telerehabilitation as an opportunity to make services more available. But providers point to practical problems when assessing whether patients are performing their exercises correctly. Providers and patients also describe interruptions from family members. In addition, providers complain of a lack of equipment, infrastructure and maintenance and patients refer to usability issues and frustration with digital technology. Providers have different opinions about whether telerehabilitation is cost-efficient for them. But many patients see telerehabilitation as affordable and cost-saving if the equipment and infrastructure have been provided. Patients and providers suggest that telerehabilitation can change the nature of their relationship. For instance, some patients describe how telerehabilitation leads to easier and more relaxed communication. Other patients describe feeling abandoned when receiving telerehabilitation services. Patients, family members and providers call for easy-to-use technologies and more training and support. They also suggest that at least some in-person sessions with the provider are necessary. They feel that telerehabilitation services alone can make it difficult to make meaningful connections. They also explain that some services need the provider's hands. Providers highlight the importance of personalising the services to each person's needs and circumstances. AUTHORS' CONCLUSIONS This synthesis identified several factors that can influence the successful implementation of in-person home-based rehabilitation and telerehabilitation services. These included factors that facilitate implementation, but also factors that can challenge this process. Healthcare providers, program planners and policymakers might benefit from considering these factors when designing and implementing programmes.
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Affiliation(s)
- Marcela Velez
- Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | | | | | - Claire Glenton
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Ana M Posada
- Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | | | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University La Statale , Milano, Italy
- Laboratory of Evidence Based Rehabilitation, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Doig E, Prescott S, Pick V, Turner B, Suleman S, Douglas D, Foster M. Normalising interdisciplinary role-based goal setting in inpatient brain injury rehabilitation: reflections and recommendations of clinicians. Disabil Rehabil 2023; 45:673-683. [PMID: 35282717 DOI: 10.1080/09638288.2022.2040612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE Person-centred goal setting with people with brain injury, by interdisciplinary teams has benefits including improved communication between patients, families and clinicians, person-centred care, and improved engagement in rehabilitation. Exploring the experiences of team members who have adopted interdisciplinary, person-centred goal setting may assist in understanding what is needed to implement this complex, core component of rehabilitation practice. This study explored experiences of clinicians working in an extended inpatient brain injury rehabilitation unit about implementing a role-based goal planning approach within an interdisciplinary team. MATERIALS AND METHODS Semi-structured interviews with 13 clinicians working at the rehabilitation unit explored their experiences about the cognitive participation and collective actions required to carry out the practice, with data analysed using inductive content analysis guided by Normalisation Process Theory. RESULTS Three primary themes were identified: putting the person at the centre, accepting the mind-shift to participation focused goals and working collaboratively. CONCLUSIONS This study has elucidated some key processes that occurred and were necessary to carry out goal setting. A mind-shift towards holistic, participation-focussed goal setting was described as "unlearning" discipline-specific goal setting. Development and ownership by the team, acceptance of team members and willingness to share, and structured processes and resources were necessary.IMPLICATIONS FOR REHABILITATIONNormalising interdisciplinary role-based goal setting in multi-professional teams requires a mind-shift away from traditional, discipline-specific goal setting.Implementation of interdisciplinary, collaborative team goal setting within health service settings requires collective actions including collaborative working by team members, structured processes including organised time for collaborative team and family meetings, practical resources and training to support processes.Clinicians perceived the goal setting approach to put the person at the centre resulting in a deep understanding of the person, shared understanding, and motivation for rehabilitation.
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Affiliation(s)
- Emmah Doig
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Hospital Service, Brisbane, Australia
| | - Sarah Prescott
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Valerie Pick
- Brain Injury Rehabilitation Service, Metro South Health, Brisbane, Australia
| | - Ben Turner
- Acquired Brain Injury Outreach Service, Metro South Health, Brisbane, Australia
| | - Sameera Suleman
- Brain Injury Rehabilitation Service, Metro South Health, Brisbane, Australia
| | - David Douglas
- Brain Injury Rehabilitation Service, Metro South Health, Brisbane, Australia.,School of Medicine, University of Queensland, Brisbane, Australia
| | - Michele Foster
- The Hopkins Centre, Griffith University, Brisbane, Australia
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Collins A, D'Cruz K, Jackman A, Anderson V, Jenkin T, Scheinberg A, Muscara F, Knight S. Engaging children and adolescents with acquired brain injury and their families in goal setting: The family perspective. Neuropsychol Rehabil 2023; 33:1-23. [PMID: 34538207 DOI: 10.1080/09602011.2021.1977154] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study explored the experiences of goal setting in paediatric rehabilitation from the perspectives of children and adolescents with acquired brain injury (ABI) and their parents in paediatric rehabilitation. Using a qualitative research design, 15 semi-structured interviews were conducted with 13 parents and 8 young people with ABI aged between 9 and 18 years who were engaged in outpatient rehabilitation. Interview transcripts were analysed using constructivist grounded theory methods. Two main themes and several sub-themes emerged: Experiences of goal setting: The role of professionals; The role of the young person; and The role of the parents. Working as a team: Understanding each other and building trust; Communicating, sharing knowledge and different perspectives; and Being flexible. These themes reflect parent's and young people's experience of goal setting during paediatric rehabilitation for ABI and suggest clinicians play an important role in educating young people and their families about goal setting in the outpatient rehabilitation context. Young people and their parents also perceive the focus of outpatient rehabilitation as working collaboratively with clinicians to gain knowledge to manage the consequences of ABI. Our findings emphasize the importance of the therapeutic consumer-clinician relationship and the need to actively engage young people in goal setting.
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Affiliation(s)
- Alana Collins
- Department of Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | | | - Angie Jackman
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Vicki Anderson
- Department of Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.,Psychology Service, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Taylor Jenkin
- Department of Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Adam Scheinberg
- Department of Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Victorian Paediatric Rehabilitation Service, Royal Children's Hospital, Melbourne, Australia
| | - Frank Muscara
- Department of Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia.,Psychology Service, Royal Children's Hospital, Melbourne, Australia
| | - Sarah Knight
- Department of Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Victorian Paediatric Rehabilitation Service, Royal Children's Hospital, Melbourne, Australia
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Downing MG, Hicks AJ, Braaf S, Myles DB, Gabbe BJ, Ponsford J. "It's been a long hard road": challenges faced in the first three years following traumatic brain injury. Disabil Rehabil 2022; 44:7439-7448. [PMID: 34890511 DOI: 10.1080/09638288.2021.1992517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE There is limited qualitative research exploring challenges experienced following severe traumatic brain injury (TBI). We investigated challenges to recovery identified by individuals who sustained severe TBI three years earlier or their close others (COs), as well as suggestions for managing these challenges. MATERIALS AND METHODS Nine participants with TBI and 16 COs completed semi-structured interviews. Using reflexive thematic analysis, challenges were identified across several timeframes (i.e., at the injury, acute care, inpatient rehabilitation, outpatient rehabilitation, and at home/other location). RESULTS Challenges experienced across all timeframes included: lack of information and poor communication, pre-existing conditions, missed injuries, and issues with medical staff, and continuity of care. From acute care onwards, there were TBI-related consequences, issues with coping and emotional adjustment, negative outlook, insufficient treatment, lack of support for COs, and issues with compensation and funding for rehabilitation needs. Some challenges were unique to a specific timeframe (e.g., over-stimulating ward setting during acute care, and limited or unsupportive families once injured individuals went home). Suggestions for managing some of the challenges were provided (e.g., information provision, having peer supports). CONCLUSION Suggestions should be considered to promote successful outcomes following severe TBI.IMPLICATIONS FOR REHABILITATIONRecovery following a severe traumatic brain injury can be hindered by challenges, such as poor communication, limited information provision, injury-related consequences, limited services and emotional support for the injured individual and their Close Others, and a need for education of the broader community about traumatic brain injury.Suggestions for managing these challenges (e.g., peer supports; services closer to home) could be used to inform clinical guidelines that could be used in a rehabilitation context.These suggestions ultimately aim to improve the post-injury experience and outcomes of individuals with traumatic brain injury and their Close Others.
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Affiliation(s)
- Marina G Downing
- Monash Epworth Rehabilitation Research Centre (MERRC), School of Psychological Sciences, Monash University, Melbourne, Australia.,School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Amelia J Hicks
- Monash Epworth Rehabilitation Research Centre (MERRC), School of Psychological Sciences, Monash University, Melbourne, Australia.,School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Sandy Braaf
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Daniel B Myles
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Belinda J Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, UK
| | - Jennie Ponsford
- Monash Epworth Rehabilitation Research Centre (MERRC), School of Psychological Sciences, Monash University, Melbourne, Australia.,School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
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12
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Raya-Ruiz MA, Rodríguez-Bailón M, Castaño-Monsalve B, Vidaña-Moya L, Fernández-Solano AJ, Merchán-Baeza JA. Study protocol for a non-randomised controlled trial: Community-based occupational therapy intervention on mental health for people with acquired brain injury (COT-MHABI). PLoS One 2022; 17:e0274193. [PMID: 36206208 PMCID: PMC9543977 DOI: 10.1371/journal.pone.0274193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 08/18/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The sequelae of moderate-severe acquired brain injury (ABI) encompass motor, cognitive, sensory, emotional and behavioural areas that affect meaningful occupational participation and quality of life, with a high prevalence of associated mental disorders. When the patient returns to community life after discharge from the hospital, specialised care is generally insufficient due to the lack of consideration of the dual condition of mental disorder and ABI. Since there is a negative impact on competence and thus on occupational participation, occupational therapy represents a convenient way of intervention. On these assumptions, a community-based occupational therapy protocol on mental health for people with moderate/severe acquired brain injury (COT-MHABI) is presented. It is focused on meaningful occupational participation and looks for improvement in the quality of life. METHODS AND ANALYSIS This study aims: (i) to design a protocol to evaluate the effectiveness of a community occupational therapy intervention based on MOHO for patients with a dual (mental health/ABI) for improving quality of life and self-perceived occupational performance; (ii) to analyse the outcomes of occupational and social variables (occupational balance, participation level, satisfaction with occupation and performed roles and community integration) after the COT-MHABI process; (iii) to analyse the impact of quality of life on satisfaction with occupations performed by this population. A non-randomised controlled clinical trial will be performed. Patients assigned to the experimental group will receive over one year of on-site and telematic occupational therapy sessions, 16 sessions on average. Variables such as quality of life, community integration or satisfaction with occupational performance will be collected at baseline, 6, and 12 months. DISCUSSION The needs for the dual mental/ABI population in their reintegration into the community are related to the associated deficits and to the absence of specialised services for the complexity of this patient profile. Few studies consider the coexistence of mental health and ABI issues. The COT-MHABI protocol is proposed to provide continuity to the community needs of this population, conceptualised from occupational participation, person-centred and focused on meaningful activities. CLINICAL TRIAL REGISTRATION Trial identifier and registry name ClinicalTrials.gov ID: NCT04586842 https://clinicaltrials.gov/ct2/show/NCT04586842?term=252136&draw=2&rank=1; Pre-results; Community-based Occupational Therapy Intervention on Mental Health for People With Acquired Brain Injury (COT-MHABI).
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Affiliation(s)
- Marco Antonio Raya-Ruiz
- Faculty of Health Science and Welfare, Social Sciences and Community Health Department, Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain
- Specialised Support and Assessment Team (EASE), Institut Guttmann, Badalona, Spain
| | | | | | - Laura Vidaña-Moya
- Research Group GrEUIT., Escola Universitària d’Infermeria i Teràpia Ocupacional de Terrassa (EUIT), Universitat Autònoma de Barcelona, Terrassa, Spain
| | | | - José Antonio Merchán-Baeza
- Faculty of Health Science and Welfare, Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain
- * E-mail:
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13
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Mamman R, Cheng A, Tsow R, Schmidt J. Clinician reports of self-awareness after traumatic brain injury: a retrospective chart review. BMC Health Serv Res 2022; 22:1124. [PMID: 36068541 PMCID: PMC9450399 DOI: 10.1186/s12913-022-08444-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Impaired self-awareness (i.e., a lack of insight) is experienced by most individuals who have sustained a moderate to severe traumatic brain injury (TBI). During the early recovery period post-injury, these individuals may not be able to recognize their abilities and limitations, hence, negatively impacting their daily life and function. Although there are assessments and interventions to improve self-awareness after TBI, little is known about how clinicians assess and address this impairment in an inpatient rehabilitation setting. OBJECTIVE To examine how clinicians assess, report, and provide interventions for impaired self-awareness after TBI. METHODS A retrospective chart review was conducted on interdisciplinary rehabilitation clinician entries for individuals with TBI (n = 67) who received inpatient rehabilitation within a five-year period (2014-2019). A reflexive thematic analysis was used to identify themes pertaining to self-awareness. RESULTS Three themes were generated to explore clinician responses to their clients' impaired self-awareness: 1) 'recalling and understanding' described clinician observations of client behaviors and expressions of self-awareness, 2) 'applying and analyzing' identified clinicians providing relevant tasks and advice to clients, and 3) 'evaluating and creating' described clinicians actively interacting with clients by providing feedback, guided prompts, and a follow-up plan. CONCLUSION Clinicians produced varied responses to clients' impaired self-awareness after TBI. Findings may help to develop research priorities and integrated knowledge translation initiatives to increase evidence-based practice for impaired self-awareness after TBI.
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Affiliation(s)
- Rinni Mamman
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.,Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada
| | - Anika Cheng
- Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada.,Graduate Program in Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Rebecca Tsow
- Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada.,Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Julia Schmidt
- Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada. .,Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada.
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14
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Şahin A, Agar A, Ertürk C. The effect of telerehabilitation on early outcomes in patients undergoing primary total knee replacement: A prospective randomized study. Journal of Surgery and Medicine 2022; 6:139-43. [DOI: 10.28982/josam.1035076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Leeson R, Collins M, Douglas J. Finding Goal Focus With People With Severe Traumatic Brain Injury in a Person-Centered Multi-Component Community Connection Program (M-ComConnect). Front Rehabil Sci 2021; 2:786445. [PMID: 36188811 PMCID: PMC9397994 DOI: 10.3389/fresc.2021.786445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022]
Abstract
Background and Objectives: Loss of social connections in the community is a common consequence of severe traumatic brain injury (TBI), resulting in reduced well-being and quality of life. M-ComConnect is an individualized multi-component community connection intervention with the key objectives of increasing social activity, developing social relationships, and supporting community participation following severe TBI. As part of the M-ComConnect approach, semi-structured initial interviews were conducted to develop a holistic understanding of each participant and their goal focus for the project. In this paper we describe how clinicians worked with participants to identify a desired community-based social activity in which to participate. Method: Transcripts of initial interviews between participant and clinician were analyzed using the phases of reflexive thematic analysis developed by Braun and Clarke. Participants were ten individuals aged between 24 and 75 with severe TBI. All were living in the community and reported reduced social connections since their TBI. The aim of the analysis was to evaluate the skills and strategies used by clinicians in their interactions with participants to derive goal focus for the program. Results: Thematic analysis of initial interview data revealed three main categories and fourteen sub-categories of clinical strategies. These were: (1) Humanizing (curiosity; demonstrating respect and empathy; providing compliments and affirmations; simple reflections; revealing aspects of self; and humor and laughter), (2) Empowering (emphasizing choice and control; highlighting strengths; identifying roadblocks and reframing to reveal opportunities; and collaborative problem solving), and (3) Focusing (making suggestions; identifying preferences; working with ideas; and negotiating). These strategies aligned with the program's relational approach and supported the core processes of the goal-focussing framework, namely understanding and connecting with you, building a relationship, and working together with you to find focus. Conclusion: The goal-focusing framework and clinical strategies outlined provide guidance for clinicians working with people with TBI in the community and is a promising way to engage clients when focusing on individualized social activity-based goals.
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Affiliation(s)
- Rebecca Leeson
- Living With Disability Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Michelle Collins
- Living With Disability Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Jacinta Douglas
- Living With Disability Research Centre, La Trobe University, Melbourne, VIC, Australia
- The Summer Foundation, Melbourne, VIC, Australia
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16
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Brown J, Ackley K, Knollman-Porter K. Collaborative Goal Setting: A Clinical Approach for Adults With Mild Traumatic Brain Injury. Am J Speech Lang Pathol 2021; 30:2394-2413. [PMID: 34529919 DOI: 10.1044/2021_ajslp-21-00078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose Speech-language pathologists (SLPs) have many available procedural options when setting treatment goals. Extant literature supports goal setting protocols that include and value the perspectives of the client; however, in practice, rehabilitation professionals may lean toward expert models of care when planning treatment. Our purpose is to describe a newly developed approach for SLPs and individuals with mild traumatic brain injury (mTBI) to work together to build meaningful, relevant goals. Method We utilized a multiple case study format to exemplify goal setting procedures. Specifically, we describe procedures and outcomes for a 29-year-old female 28 days postinjury and a 70-year-old male 9 months postinjury. Results Clients who engaged in this protocol worked collaboratively with a clinician to identify strengths and challenges postinjury, select and prioritize goal areas, and discuss and develop meaningful, personalized treatment activities. For both participants, use of the proposed protocol resulted in meaningful goals that addressed their self-reported deficits as well as their respective cognitive-linguistic deficits noted on objective, standardized measures. Conclusions Clinician and client collaboration during treatment goal development can facilitate increased client motivation and functional outcomes. The described approach is feasible from a clinical resource standpoint and promotes a systematic approach to placing the client at the forefront of clinical decision making to enhance therapeutic gains. Such client-centered approaches may be particularly valuable for individuals with mTBI who experience substantial cognitive and communicative challenges but may maintain high levels of self-awareness postinjury.
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Affiliation(s)
- Jessica Brown
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, AZ
| | - Kristen Ackley
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, AZ
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17
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Collins K, Layne K. Exploring the Opportunities and Challenges of a Virtual Community-Based Older Adult Fall Prevention Program During COVID-19. Topics in Geriatric Rehabilitation 2021; 37:145-51. [DOI: 10.1097/tgr.0000000000000320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Ahmadjou A, Sadeghi S, Zareinejad M, Talebi HA. A compact valveless pressure control source for soft rehabilitation glove. Int J Med Robot 2021; 17:e2298. [PMID: 34097353 DOI: 10.1002/rcs.2298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/24/2021] [Accepted: 06/03/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Soft pneumatic robots have shown great promises in hand rehabilitation systems as alternatives to conventional rigid systems. However, their application is limited to clinical rehabilitation programs due to their dependency on large-sized compressors as air suppliers. This disadvantage triggered the search for compact portable pneumatic sources. METHOD A compact valveless pneumatic source to control the bending angle of a soft actuator is proposed in this paper. The source incorporates two series of serially connected commercially available microcompressors to provide additional pressure and flowrate in two directions. In the proposed design, an inner-loop controller, controls the output characteristics of the source while an outer-loop controller handles the trajectory tracking of the angular position. RESULTS Experimental results show that the source is capable of providing up to 160 kPa of output. The controller is able to track up to 2 rad/sec sinusoidal trajectory with a maximum 0.066 rad root-mean-square error. CONCLUSION Experimental measurements showed satisfactory results in the maximum ratings and tracking errors whilst relatively low average power was consumed by eliminating control valves.
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Affiliation(s)
- Ahmadreza Ahmadjou
- Department of Electrical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Sajad Sadeghi
- Department of Mechanical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Mohammad Zareinejad
- New Technologies Research Center, Amirkabir University of Technology, Tehran, Iran
| | - Heidar Ali Talebi
- Department of Electrical Engineering, Amirkabir University of Technology, Tehran, Iran
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19
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Jenkin T, Anderson V, D'Cruz K, Collins A, Muscara F, Scheinberg A, Knight S. Engaging children and adolescents with acquired brain injury and their families in goal setting: The clinician perspective. Neuropsychol Rehabil 2020; 32:104-130. [PMID: 32811301 DOI: 10.1080/09602011.2020.1801470] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This paper explored clinicians' experiences of the goal setting process with children and adolescents with acquired brain injuries (ABI) and their families in paediatric neurorehabilitation. Semi-structured interviews were conducted with 13 clinicians, all members of an interdisciplinary paediatric rehabilitation service, who work with children and adolescents with ABI and their families. Interview transcripts and additional data were analysed using constructivist grounded theory methods. Three main themes and sub-themes were developed: (1) Seeing the bigger picture: Goals change over time; Families set bigger picture goals; Need-to-dos: Goals that the child/adolescent needs to achieve; and Want-to-dos: Goals that the child/adolescent wants to achieve; (2) Collaborating as a team: Everyone needs to be on the same page; Hearing the child's/adolescent's voice; and Parents as advocates; and (3) Recognizing and navigating challenges: Child-/adolescent- and family-related challenges and Time as a service-related challenge. Participants perceived the clinician's role during goal setting as that of an active collaborator, enabling children and adolescents with ABI and their families to generate meaningful goals. These findings demonstrate insights into goal setting in paediatric ABI neurorehabilitation from clinicians' perspectives, and highlight the importance of collaboration, flexibility and anticipation of challenges in facilitating children's, adolescents' and families' involvement in this process.
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Affiliation(s)
- Taylor Jenkin
- Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Vicki Anderson
- Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | | | - Alana Collins
- Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Frank Muscara
- Murdoch Children's Research Institute, Melbourne, Australia.,Psychology Service, Royal Children's Hospital, Melbourne, Australia
| | - Adam Scheinberg
- Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Victorian Paediatric Rehabilitation Service, Royal Children's Hospital, Melbourne, Australia
| | - Sarah Knight
- Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Victorian Paediatric Rehabilitation Service, Royal Children's Hospital, Melbourne, Australia
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20
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Angeli JM, Schwab SM, Huijs L, Sheehan A, Harpster K. ICF-inspired goal-setting in developmental rehabilitation: an innovative framework for pediatric therapists. Physiother Theory Pract 2019; 37:1167-1176. [DOI: 10.1080/09593985.2019.1692392] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Jennifer M. Angeli
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Rehabilitation, Exercise, and Nutrition Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Sarah M. Schwab
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Center for Cognition, Action, and Perception, Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Lobke Huijs
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Rehabilitation, Exercise, and Nutrition Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Amber Sheehan
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Karen Harpster
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Rehabilitation, Exercise, and Nutrition Sciences, University of Cincinnati, Cincinnati, OH, USA
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21
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Behn N, Marshall J, Togher L, Cruice M. Setting and achieving individualized social communication goals for people with acquired brain injury (ABI) within a group treatment. Int J Lang Commun Disord 2019; 54:828-840. [PMID: 31250537 DOI: 10.1111/1460-6984.12488] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 05/24/2019] [Accepted: 06/05/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Cognitive-communication disorders are common following an acquired brain injury (ABI). Remediation should involve individualized goal-setting, yet few reports describe the effectiveness of setting communication goals in a group setting. AIMS To describe a process for setting and achieving goals for people with ABI. METHODS & PROCEDURES A total of 21 participants with ABI participated in a group treatment (triads and dyads) over 6 weeks (20 h in total). Specific social communication goals were set using goal attainment scaling (GAS) with the participant and their communication partner. Goals targeted strategy use that accounted for existing cognitive abilities. The participant and their communication partner evaluated the goals post-treatment and 6-8 weeks later. Data were analysed using Friedman's test to identify the achievement of GAS goals. OUTCOMES & RESULTS A total of 20 participants recalled goals independently post-treatment. Significant improvement post-treatment on GAS goals was rated by both the participant (p < 0.001) and their communication partner (p < 0.001). This improvement was maintained at follow-up. No significant differences in ratings were found between participants and their communication partners at either time point. CONCLUSIONS & IMPLICATIONS Individualized social communication goals can be set and achieved for people with ABI in group treatment, even when participants are several years post-injury. GAS offers a method for structuring and quantifying goal progress. Involving communication partners and cognitive strategies were effective in improving communication.
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Affiliation(s)
- Nicholas Behn
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
| | - Jane Marshall
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
| | - Leanne Togher
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| | - Madeline Cruice
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
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Abstract
RÉSUMÉCette étude a examiné les mécanismes complexes intervenant lors de la prestation de soins axés sur la personne et la famille (SAPF) par des équipes de soins gériatriques à domicile. Une approche par synthèse réaliste a été utilisée pour élaborer un cadre d’évaluation qui a inclus 159 références provenant de la littérature scientifique, des consultations d’experts canadiens en SAPF, des recherches ciblées dans les bases PubMed/MEDLINE® et CINAHL, et des recensions de la littérature grise canadienne. Les références ont été sélectionnées par deux personnes, selon une approche consensuelle avec évaluation de la qualité. Les données ont été extraites et synthétisées en tenant compte du contexte, des mécanismes et des configurations des résultats dans un cadre théorique de SAPF d’équipe pour les soins gériatriques à domicile. Le cadre présente les contributions spécifiques prédominantes des infirmières, des ergothérapeutes et des physiothérapeutes, leurs apports collectifs impliquant des communications pour des équipes virtuelles, ainsi que le soutien du système nécessité pour la prestation de SAPF d’équipe complets. Les résultats de cette étude pourraient contribuer à l’amélioration de l’éducation sur les SAPF et des lignes directrices sur les pratiques exemplaires, en vue d’assurer une prestation plus intégrée des SAPF dans les soins gériatriques offerts à domicile ou dans d’autres milieux comportant des équipes de soins.
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Affiliation(s)
- Sarah Prescott
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Emmah Doig
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Nowell C, Downing M, Bragge P, Ponsford J. Current practice of cognitive rehabilitation following traumatic brain injury: An international survey. Neuropsychol Rehabil 2019; 30:1976-1995. [PMID: 31164047 DOI: 10.1080/09602011.2019.1623823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Traumatic brain injury (TBI) is a global public health issue, frequently resulting in impairments in the cognitive domains of attention, information processing speed, memory, executive function, and communication. Despite the importance of rehabilitating cognitive difficulties, and the release of clinical practice guidelines (CPGs) for cognitive rehabilitation, little is known about current clinician practice. This study aimed to explore current international clinician practice of cognitive rehabilitation. One hundred and fifteen English-speaking allied health professionals, including neuropsychologists and occupational therapists, from 29 countries outside Australia, were surveyed online about their current practice and reflections on cognitive rehabilitation. Both cognitive retraining and functional compensation approaches to cognitive rehabilitation were commonly utilized. Clinicians mostly targeted deficits in attention and executive functioning with retraining interventions, whilst memory deficits were mostly targeted with compensatory interventions. Clinicians were aware of and utilized various resources for cognitive rehabilitation, including CPGs. Clinicians considered the client's social support network, client engagement and motivation in rehabilitation, multidisciplinary team collaboration, and goal setting and implementation as highly impactful factors on the success of cognitive rehabilitation interventions. Whilst practice is broadly consistent with current CPG recommendations, addressing facilitating factors can further optimize client outcomes and quality of life following TBI.
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Affiliation(s)
- Clare Nowell
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monsah University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Marina Downing
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monsah University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Peter Bragge
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Melbourne, Australia
| | - Jennie Ponsford
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monsah University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
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Behn N, Marshall J, Togher L, Cruice M. Participants' perspectives of feasibility of a novel group treatment for people with cognitive communication difficulties following acquired brain injury. Disabil Rehabil 2019; 43:171-180. [PMID: 31130016 DOI: 10.1080/09638288.2019.1618929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To determine whether treatment was acceptable to participants and perceived as beneficial by exploring the experiences of people with cognitive communication difficulties following acquired brain injury who participated in a novel, group, communication, project-based treatment. The purpose of the treatment was to improve participants' communication skills and quality of life, by focussing group activity towards the production of a project and by incorporating individualised communication goals into group sessions.Methods: Twenty-one people with acquired brain injury recruited from community settings participated in project-based treatment, which comprised one individual and nine group sessions (of 2-3 people) over six weeks. Structured interviews were conducted post-treatment as part of a broader assessment battery. Interviews were transcribed verbatim and analysed using content analysis to identify codes, categories, and themes.Results: Themes identified from the analysis centred around the treatment experience (general experience; group experience; project experience; working on goals) and benefit of treatment (communicative benefit; other benefits; emotional effects; meeting others; something to do). These themes were consistent with the treatment being perceived as acceptable and having initial efficacy for the participant group.Conclusion: The qualitative data presented here provide positive feasibility findings (acceptability and initial efficacy) of project-based treatment for people with acquired brain injury. The results highlight the value of incorporating participants' views in assessing feasibility in developing novel interventions.Implications for rehabilitationInviting people (with cognitive communication difficulties following acquired brain injury) to feedback on their treatment experience provides valuable information that can confirm treatment choice and content or inform adjustments to future treatment.Group treatment with a meaningful and motivating focus, and individualised communication goals, seem to promote positive change in communication, emotional state, cognition, self-awareness, and social interaction.This study highlights the value of individuals' perspectives in evaluating feasibility of a novel intervention.
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Affiliation(s)
- Nicholas Behn
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
| | - Jane Marshall
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
| | - Leanne Togher
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Madeline Cruice
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
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Prescott S, Doig E, Fleming J, Weir N. Goal statements in brain injury rehabilitation: A cohort study of client-centredness and relationship with goal outcome. BRAIN IMPAIR 2019; 20:226-39. [DOI: 10.1017/brimp.2019.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractBackground:Currently, there is increasing recognition of the need to use a client-centred approach to goal setting in rehabilitation. However, there is limited research to guide practice with community-dwelling clients with acquired brain injury. An understanding of the characteristics of client-centred goals and the extent to which client-centeredness influences goal outcomes is required.Objective:To examine the relationships between the client-centredness of goals and their characteristics, content, recall and outcomes of client-centred goals in brain injury rehabilitation.Methods:A prospective cohort design study was employed. Participants were 45 clients with brain injury receiving outpatient rehabilitation, who completed measures of client-centredness after goal setting. Each goal was classified according to whether it was specific, measurable, non-jargonistic, and participation-focussed, included a timeframe and was recalled by participants.Results:Participants set 223 goals with 20 clinicians from multiple disciplines. Levels of client-centredness did not differ according to the characteristics, content and recall of goals, with the exception of goal specificity (p< 0.01). Client-centredness was significantly and positively correlated with goal outcomes (p< 0.05).Conclusions:The use of client-centred goals is recommended for improved rehabilitation outcomes. Applying goal documentation criteria does not necessarily mean that goals will be client-centred, and highly specific goal statements may not reflect what is important and meaningful to clients.
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Arcuri F, Cortese MD, Riganello F, Lucca LF, Serra S, Mazzucchi A, Cerasa A, Tonin P. The Reliability of the Progression of Autonomies Scale Applied on Acquired Brain Injured Patients. Front Neurol 2019; 10:342. [PMID: 31024435 PMCID: PMC6469362 DOI: 10.3389/fneur.2019.00342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 03/20/2019] [Indexed: 11/13/2022] Open
Abstract
The Progression of Autonomies Scale (PAS) is a behavioral scale useful to assess the autonomy levels in acquired brain-injured patients. It provides a broad profile, assessing different domains of human activities ranging from personal, domestic, and extradomestic autonomies. This cross-sectional study is aimed at evaluating the reliability of this scale on a large cohort of acquired brain injury (ABI) patients. Fifty-one ABI patients (49% traumatic, 33.3% hemorrhagic, 17.7% other etiologies), hospitalized in the S. Anna Institute of Crotone, Italy (mean age male 46.08 ± 14.53 and mean age female patients 43.2 ± 11.3) were recruited. We found a high level of reliability of the scale, with a coefficient at the inter-rater agreement between substantial (0.61 ≤ k ≤ 0.8) and almost perfect (0.81 ≤ k ≤ 1), and almost perfect at the test-retest (intra-rater). We confirm that the PAS is a well-structured tool for the assessment of the autonomy levels in brain-injured patients. These findings encourage the application of this scale in the clinical practice of rehabilitation unit to design a tailored rehabilitation treatment on real goals and to monitor the generalization of the recovered abilities to the daily routine activities.
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Affiliation(s)
- Francesco Arcuri
- Research in Advanced Neurorehabilitation, S. Anna Institute, Crotone, Italy
| | | | | | | | - Sebastiano Serra
- Research in Advanced Neurorehabilitation, S. Anna Institute, Crotone, Italy
| | - Anna Mazzucchi
- Department for ABI Care and Rehabilitation, Don Gnocchi Foundation, Milan, Italy
| | - Antonio Cerasa
- Research in Advanced Neurorehabilitation, S. Anna Institute, Crotone, Italy.,Neuroimaging Unit, IBFM-CNR, Catanzaro, Italy
| | - Paolo Tonin
- Research in Advanced Neurorehabilitation, S. Anna Institute, Crotone, Italy
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Prescott S, Fleming J, Doig E. Refining a clinical practice framework to engage clients with brain injury in goal setting. Aust Occup Ther J 2019; 66:313-325. [DOI: 10.1111/1440-1630.12556] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Sarah Prescott
- School of Health and Rehabilitation Sciences The University of Queensland Brisbane Queensland Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences The University of Queensland Brisbane Queensland Australia
| | - Emmah Doig
- School of Health and Rehabilitation Sciences The University of Queensland Brisbane Queensland Australia
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29
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Angeli JM, Harpster KL, Hanson E, Sheehan A, Schwab SM. Patient- and caregiver-identified preferences: Dimensions of change in developmental therapy treatment goals. Dev Neurorehabil 2019; 22:39-46. [PMID: 29370557 DOI: 10.1080/17518423.2018.1425754] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To describe patterns in preferred dimensions of change in therapy goals identified by individuals with developmental disability and their caregivers. METHODS A retrospective chart review of Goal Attainment Scaling (GAS) goals for patients aged 2-32 years (n = 124) participating in a program of episodic care was conducted. Dimensions of change were analyzed through a mixed-methods study design. Co-occurrence rates and descriptor-to-code comparisons were computed in order to relate the dimension of change to diagnosis, International Classification of Functioning, Disability, and Health (ICF) goal domain, gender, age, and goal setter. RESULTS Decreased level of assistance was the most commonly identified preferred dimension of change, cited in 31.0% of goals. Decreased level of assistance remained the most frequently reported dimension of change in multiple subgroup analyses. CONCLUSION Independence is highly valued by parents and individuals with developmental disability. This finding should help guide therapy plans or program development addressing task performance.
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Affiliation(s)
- Jennifer M Angeli
- a Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.,b Department of Rehabilitation Sciences , University of Cincinnati , Cincinnati , OH , USA
| | - Karen L Harpster
- a Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.,b Department of Rehabilitation Sciences , University of Cincinnati , Cincinnati , OH , USA
| | - Elizabeth Hanson
- a Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.,b Department of Rehabilitation Sciences , University of Cincinnati , Cincinnati , OH , USA
| | - Amber Sheehan
- a Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA
| | - Sarah M Schwab
- a Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.,b Department of Rehabilitation Sciences , University of Cincinnati , Cincinnati , OH , USA
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30
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van Seben R, Smorenburg SM, Buurman BM. A qualitative study of patient-centered goal-setting in geriatric rehabilitation: patient and professional perspectives. Clin Rehabil 2018; 33:128-140. [PMID: 30103621 PMCID: PMC6311617 DOI: 10.1177/0269215518791663] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE: To characterize how rehabilitation goals of older patients change over time and to explore professionals' attitudes toward patient-centered goal-setting and their perspectives on rehabilitation goals. DESIGN: Qualitative interview study. SETTING: Three geriatric rehabilitation centers. SUBJECTS: Ten patients (aged ⩾ 80), who had recently received inpatient geriatric rehabilitation, and seven professionals were purposively recruited. METHODS: Semi-structured interviews. Patients were interviewed in the third or fourth week after discharge from inpatient rehabilitation, to reflect on their inpatient goals and to investigate long-term goals now that they were at home. A thematic analysis was performed. RESULTS: During inpatient rehabilitation, participants' main goals were regaining independence in self-care activities and going home. Post-discharge, patients were not at their baseline functioning level. Rehabilitation goals appeared to shift over time, and once at home, patients formulated more ambitious rehabilitation goals that were related to regaining full independence and being able to perform activities. Although professionals thought goal-setting together with the patient is important, they also stated that older individuals often are either unable to formulate goals or they set unrealistic ones. In addition, professionals indicated that goals have to be related to discharge criteria, such as performing basic self-care activities, and rehabilitation revolves around getting patients ready for discharge. CONCLUSION: During inpatient rehabilitation, patient goals are related to going home. After discharge, patients have ambitious goals, related to their premorbid functioning level. Rehabilitation services should distinguish between goals that are important while patients are inpatient and goals that are important after discharge.
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Affiliation(s)
- Rosanne van Seben
- 1 Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Bianca M Buurman
- 1 Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, Amsterdam, The Netherlands.,3 ACHIEVE-Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
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31
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Chui A, Mazzitti D, Nalder E, Cameron D, Polatajko HJ, Dawson DR. Therapists' experience of the cognitive orientation to daily occupational performance (CO-OP) approach: Shifting from conventional practice. Scand J Occup Ther 2018; 27:133-141. [PMID: 29983084 DOI: 10.1080/11038128.2018.1483424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: The CO-OP ApproachTM has been increasingly used in research and practice, yet its critical elements and implementation challenges are largely undescribed. Obtaining therapists' perspectives on CO-OP may reveal insights into potential critical and mediating factors.Aim/Objective: To explore the experiences of CO-OP therapists by understanding their perceptions on the approach compared with conventional practice, and by identifying mediating factors in its implementation.Material and Method: This exploratory study utilized a qualitative descriptive design. A purposive sample of occupational therapists (n = 3) was interviewed. Data were analyzed using thematic analysis and themes were validated within a focus group.Results/Findings: Three themes were identified: 'CO-OP works,' 'CO-OP delivery is mediated by contextual factors,' and 'CO-OP shifts the therapeutic approach.' Therapists perceived CO-OP to be efficacious for client-centred goal attainment. Guided discovery and the problem-solving strategy were identified as unique and challenging CO-OP elements. Mediating factors such as level of cognitive impairment and quality of family member involvement may affect CO-OP efficacy.Conclusions: Therapists found CO-OP to be efficacious and adopted unique elements into their professional approaches.Significance: This is the first study to investigate CO-OP therapists' experiences. Future research is recommended to enhance training of therapists in key CO-OP features.
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Affiliation(s)
- Adora Chui
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | - Daniela Mazzitti
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Emily Nalder
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,March of Dimes Canada, Toronto, Canada
| | - Debra Cameron
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Helene J Polatajko
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Deirdre R Dawson
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
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Affiliation(s)
- Maria Ranner
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Susanne Guidetti
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lena von Koch
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Kerstin Tham
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Faculty of Health and Society, Malmö University, Malmö, Sweden
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Sansonetti D, Nicks RJ, Unsworth C. Barriers and enablers to aligning rehabilitation goals to patient life roles following acquired brain injury. Aust Occup Ther J 2018; 65:512-522. [DOI: 10.1111/1440-1630.12492] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Danielle Sansonetti
- Acquired Brain Injury Rehabilitation Centre; Caulfield Hospital; Melbourne Victoria Australia
| | - Rebecca J. Nicks
- Occupational Therapy Department; Alfred Health; Melbourne Victoria Australia
| | - Carolyn Unsworth
- School of Health, Medical and Applied Science; Central Queensland University; Queensland Australia
- Department of Occupational Therapy; Jönköping University; Jönköping Sweden
- Department of Occupational Therapy; La Trobe University; Bundoora Victoria Australia
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Allen D, Scarinci N, Hickson L. The Nature of Patient- and Family-Centred Care for Young Adults Living with Chronic Disease and their Family Members: A Systematic Review. Int J Integr Care 2018; 18:14. [PMID: 30127698 PMCID: PMC6095060 DOI: 10.5334/ijic.3110] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 05/09/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND AND AIM The published literature addressing the nature of patient- and family-centred care (PFCC) among young adults (16-25 years old) living with chronic disease and their family members is diverse. The aim of this systematic review was to collect and interpretatively synthesise this literature to generate a conceptual understanding of PFCC in this age group. METHOD From an initial pool of 10,615 papers, 51 were systematically identified as relevant to the research question and appraised using the Critical Appraisal Skills Programme tools. A total of 24 papers passed the quality appraisal and proceeded to a qualitative meta-synthesis. RESULTS The qualitative meta-synthesis revealed three major elements of PFCC relevant to young adults living with chronic disease and their family members: (1) patients and practitioners felt able to engage with each other on an emotional and social level; (2) patients and families felt empowered to be part of the care process; and (3) patients and families experienced care as effective at addressing their individual needs. CONCLUSION There is agreement among young adult patients and families about what constitutes PFCC in a chronic disease setting, independent of the aetiology of the pathological process. Patients and families also have strong feelings about how practitioners can achieve PFCC in practice. These findings have implications for the delivery of health services to young adults living with chronic disease and their family members.
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Affiliation(s)
- David Allen
- The HEARing CRC, The University of Queensland, AU
- The HEARing CRC, Department of Audiology and Speech Pathology, The University of Melbourne, 550 Swanston Street, Carlton, Victoria, AU
- School of Health and Rehabilitation Sciences, The University of Queensland, AU
| | - Nerina Scarinci
- The HEARing CRC, The University of Queensland, AU
- The HEARing CRC, Department of Audiology and Speech Pathology, The University of Melbourne, 550 Swanston Street, Carlton, Victoria, AU
- School of Health and Rehabilitation Sciences, The University of Queensland, AU
| | - Louise Hickson
- The HEARing CRC, The University of Queensland, AU
- The HEARing CRC, Department of Audiology and Speech Pathology, The University of Melbourne, 550 Swanston Street, Carlton, Victoria, AU
- School of Health and Rehabilitation Sciences, The University of Queensland, AU
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Oña ED, Cano-de la Cuerda R, Sánchez-Herrera P, Balaguer C, Jardón A. A Review of Robotics in Neurorehabilitation: Towards an Automated Process for Upper Limb. J Healthc Eng 2018; 2018:9758939. [PMID: 29707189 DOI: 10.1155/2018/9758939] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/26/2018] [Accepted: 02/08/2018] [Indexed: 11/17/2022]
Abstract
Robot-mediated neurorehabilitation is a growing field that seeks to incorporate advances in robotics combined with neuroscience and rehabilitation to define new methods for treating problems related with neurological diseases. In this paper, a systematic literature review is conducted to identify the contribution of robotics for upper limb neurorehabilitation, highlighting its relation with the rehabilitation cycle, and to clarify the prospective research directions in the development of more autonomous rehabilitation processes. With this aim, first, a study and definition of a general rehabilitation process are made, and then, it is particularized for the case of neurorehabilitation, identifying the components involved in the cycle and their degree of interaction between them. Next, this generic process is compared with the current literature in robotics focused on upper limb treatment, analyzing which components of this rehabilitation cycle are being investigated. Finally, the challenges and opportunities to obtain more autonomous rehabilitation processes are discussed. In addition, based on this study, a series of technical requirements that should be taken into account when designing and implementing autonomous robotic systems for rehabilitation is presented and discussed.
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Margot-Cattin I, Page J, Petrig A, Rossini E, Agustoni S, Galli-Hudec C, Roos K, Meyer S. Creating a continuing professional development course on setting occupation-focused goals. World Federation of Occupational Therapists Bulletin 2018. [DOI: 10.1080/14473828.2018.1434469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Isabel Margot-Cattin
- School of Social Work and Health (EESP), Division of Occupational Therapy, University of Applied Sciences and Arts of Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Julie Page
- School of Health Professions, Institute of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Andrea Petrig
- School of Health Professions, Institute of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Emmanuelle Rossini
- Department of Business Economics, Health and Social Care (DEASS), Division of Occupational Therapy, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland
| | - Stefania Agustoni
- Department of Business Economics, Health and Social Care (DEASS), Division of Occupational Therapy, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland
| | | | - Kim Roos
- School of Health Professions, Institute of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Sylvie Meyer
- School of Social Work and Health (EESP), Division of Occupational Therapy, University of Applied Sciences and Arts of Western Switzerland (HES-SO), Lausanne, Switzerland
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Li D, Yang Z, Kang P, Xie X. Home-Based Compared with Hospital-Based Rehabilitation Program for Patients Undergoing Total Knee Arthroplasty for Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Phys Med Rehabil 2017; 96:440-7. [PMID: 27584144 DOI: 10.1097/PHM.0000000000000621] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The aim of this study was to compare the effects of home-based with those of hospital-based rehabilitation on patients undergoing total knee arthroplasty (TKA). DESIGN PubMed, Web of Science, EMBASE, and Cochrane Library were systematically searched for randomized controlled trials; the studies were assessed with the modified Jadad scale. Ten trials involving 1240 patients were eligible for meta-analysis. RESULTS The results revealed that home-based rehabilitation is not inferior to hospital-based rehabilitation according to the total Western Ontario and McMaster Universities Osteoarthritis index score, physical function, stiffness, walk test, and Oxford Knee Score at 12 or 52 weeks after TKA (P > 0.05). Neither pain nor knee flexion range of motion differed between the groups in the first 12 weeks. Unexpectedly, the pain score in the hospital-based group was better than that in the home-based group (P < 0.05), whereas the knee flexion range of motion in the home-based group was superior to that in the hospital-based group (P < 0.05) at 52 weeks. The meta-analysis revealed that the 2 rehabilitation programs have similar costs (P > 0.05). CONCLUSION Home-based rehabilitation after primary TKA was comparable to hospital-based rehabilitation and thus is a significant alternative for patients.
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D’Cruz K, Douglas J, Serry T. Personal narrative approaches in rehabilitation following traumatic brain injury: A synthesis of qualitative research. Neuropsychol Rehabil 2017; 29:985-1004. [DOI: 10.1080/09602011.2017.1361844] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kate D’Cruz
- Department of Community and Clinical Allied Health, La Trobe University, Melbourne, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia
| | - Jacinta Douglas
- Department of Community and Clinical Allied Health, La Trobe University, Melbourne, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia
- Summer Foundation, Melbourne, Australia
| | - Tanya Serry
- Department of Community and Clinical Allied Health, La Trobe University, Melbourne, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia
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Affiliation(s)
- Alison M. Cogan
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Mike Carlson
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
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41
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Prescott S, Fleming J, Doig E. Rehabilitation goal setting with community dwelling adults with acquired brain injury: a theoretical framework derived from clinicians’ reflections on practice. Disabil Rehabil 2017; 40:2388-2399. [DOI: 10.1080/09638288.2017.1336644] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sarah Prescott
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Occupational Therapy Department, Princess Alexandra Hospital and the Centre for Functioning and Health Research, Metro South Health District, Queensland Health, Brisbane, Australia
| | - Emmah Doig
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Patterson F, Fleming J, Doig E, Griffin J. Participant evaluation of an inpatient occupational therapy groups programme in brain injury rehabilitation. Aust Occup Ther J 2017; 64:408-418. [DOI: 10.1111/1440-1630.12392] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2017] [Indexed: 01/15/2023]
Affiliation(s)
- Freyr Patterson
- Occupational Therapy Department; The Princess Alexandra Hospital; Brisbane Queensland Australia
- The School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Queensland Australia
| | - Jennifer Fleming
- Occupational Therapy Department; The Princess Alexandra Hospital; Brisbane Queensland Australia
- The School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Queensland Australia
- Centre for Functioning and Health Research; Queensland Health; Buranda Queensland Australia
| | - Emmah Doig
- The School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Queensland Australia
- Centre for Functioning and Health Research; Queensland Health; Buranda Queensland Australia
| | - Janelle Griffin
- Occupational Therapy Department; The Princess Alexandra Hospital; Brisbane Queensland Australia
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Patterson F, Fleming J, Doig E. Clinician perceptions about inpatient occupational therapy groups in traumatic brain injury rehabilitation. Brain Inj 2017; 31:1077-1087. [DOI: 10.1080/02699052.2017.1296974] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Freyr Patterson
- The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Jennifer Fleming
- The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Centre for Functioning and Health Research, Queensland Health, Brisbane, Queensland, Australia
| | - Emmah Doig
- The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Functioning and Health Research, Queensland Health, Brisbane, Queensland, Australia
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Abstract
Introduction The theory of occupational adaptation was articulated with an emphasis on client-centered and occupation-based practice. The Occupational Adaptation Practice Guide is an instrument designed to facilitate therapists’ application of this theory in evaluation and treatment planning to influence clients’ internal occupational adaptation and participation in daily life. Method The purpose of this study was to trial the instrument and to assess percentage of agreement and perceived feasibility of the Occupational Adaptation Practice Guide in an inpatient rehabilitation setting. Eight therapists completed the Occupational Adaptation Practice Guide according to a videoed case study for evaluation of percentage of agreement. Each therapist then administered the guide to separate clients and subsequently completed an open-ended questionnaire to assess acceptability and practicality feasibility. Results Percentage of agreement was 100% for motor control, perception and environmental ratings, with the cognition and psychosocial ratings each at 75%. Themes gathered from qualitative data revealed perceptions of the instrument as comprehensive and efficient. Conclusion The instrument was reported to be an efficient, thorough tool that facilitated the use of the theory of occupational adaptation.
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Affiliation(s)
- Anna E Boone
- PhD Candidate in Rehabilitation and Participation Science, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Lorrie A George-Paschal
- Associate Professor, Department of Occupational Therapy, University of Central Arkansas, Conway, AR, USA
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Amsters DI, Kendall MB, Kuipers P, Schuurs SB. The Person-Environment Profile: Preliminary Development of a Clinical Tool for Enhancing Goal-Based Rehabilitation Programs. Rehabil Process Outcome 2016. [DOI: 10.4137/rpo.s40455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The World Health Organization's International Classification of Functioning, Disability and Health identifies environmental and personal factors as contextually relevant to functioning following disability. Goal setting is also central to rehabilitation practice and enhances functioning. No current assessment exists that recognizes the interaction of environmental factors as they relate to goal setting in rehabilitation. The person-environment profile (PEP) was developed to explore an individual's subjective view of personal and environmental factors on the achievement of rehabilitation goals. A draft PEP underwent initial face validity testing, and the resulting version was then piloted with 13 participants across 34 rehabilitation goals within a goal-based community rehabilitation setting. Results of this pilot suggest that PEP may have the ability to detect differences in perceived barriers and facilitators across personal and environmental factors for different rehabilitation goals. While showing promise as a clinical tool, the pilot identified feasibility concerns over implementation as a standardized assessment. Substantial additional psychometric evaluation and testing needs to be undertaken before the tool can be recommended for clinical use.
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Affiliation(s)
- Delena I. Amsters
- Spinal Outreach Team, Queensland Spinal Cord Injuries Service, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Melissa B. Kendall
- Transitional Rehabilitation Program, Queensland Spinal Cord Injuries Service, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- Acquired Brain Injury Outreach Service, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Meadowbrook, QLD, Australia
| | - Pim Kuipers
- Menzies Health Institute Queensland, Griffith University, Meadowbrook, QLD, Australia
- Centre for Functioning and Health Research (CFAHR), Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Sarita B. Schuurs
- Spinal Outreach Team, Queensland Spinal Cord Injuries Service, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
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Doig E, Prescott S, Fleming J, Cornwell P, Kuipers P. Reliability of the Client-Centeredness of Goal Setting (C–COGS) Scale in Acquired Brain Injury Rehabilitation. Am J Occup Ther 2016; 70:7004290010. [DOI: 10.5014/ajot.2016.017046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. To examine the internal reliability and test–retest reliability of the Client-Centeredness of Goal Setting (C–COGS) scale.
METHOD. The C–COGS scale was administered to 42 participants with acquired brain injury after completion of multidisciplinary goal planning. Internal reliability of scale items was examined using item–partial total correlations and Cronbach’s α coefficient. The scale was readministered within a 1-mo period to a subsample of 12 participants to examine test–retest reliability by calculating exact and close percentage agreement for each item.
RESULTS. After examination of item–partial total correlations, test items were revised. The revised items demonstrated stronger internal consistency than the original items. Preliminary evaluation of test–retest reliability was fair, with an average exact percent agreement across all test items of 67%.
CONCLUSION. Findings support the preliminary reliability of the C–COGS scale as a tool to evaluate and promote client-centered goal planning in brain injury rehabilitation.
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Affiliation(s)
- Emmah Doig
- Emmah Doig, PhD, BOccThy Hons, is Research Fellow, School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia Campus, Brisbane, Australia;
| | - Sarah Prescott
- Sarah Prescott, BOccThy Hons, is PhD Candidate, School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia Campus, Brisbane, Australia
| | - Jennifer Fleming
- Jennifer Fleming, PhD, BOccThy Hons, is Associate Professor, School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia Campus; Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia; and Occupational Therapist, Centre for Functioning and Health Research, Metro South Health District, Queensland Health, Brisbane, Australia
| | - Petrea Cornwell
- Petrea Cornwell, PhD, BSpPath Hons, is Principal Research Fellow, Metro North Hospital and Health Service, Department of Health, and School of Applied Psychology, Menzies Health Institute, Griffith University, Queensland, Australia, and Associate Professor, School of Allied Health Sciences, Griffith University, Brisbane, Australia
| | - Pim Kuipers
- Pim Kuipers, PhD, BA Hons, MA, Grad Dip Rehab, is Associate Professor, Centre for Functioning and Health Research, Metro South Health District, Queensland Health, and Centre of National Research on Disability and Rehabilitation Medicine, Griffith Health Institute, Griffith University, Brisbane, Australia
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Pagan E, Ownsworth T, Mcdonald S, Fleming J, Honan C, Togher L. A Survey of Multidisciplinary Clinicians Working in Rehabilitation for People with Traumatic Brain Injury. BRAIN IMPAIR 2015; 16:173-95. [DOI: 10.1017/brimp.2015.34] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Little is known about clinicians’ experiences in rehabilitation for people with traumatic brain injury (TBI). This survey study aimed to investigate clinicians’ scope of practice, perceived barriers to practice, factors influencing confidence levels and professional development preferences. Participants included 305 clinicians (88% female, 97% aged 20–60 years) from psychology (28%), occupational therapy (27%), speech pathology (15%), physiotherapy (11%), social work (6%), rehabilitation medicine (3%) and nursing (3%) disciplines. Survey results indicated that goal setting, client or family education, and assessment for rehabilitation, were the most common activities across all disciplines (>90%). Client-related barriers, family-related barriers and client–therapist relationship barriers were more frequently selected than workplace context and professional skill barriers (p <.05). Clinicians working with clients with mild TBI reported significantly fewer barriers (p< .05); yet, they were less confident in overcoming barriers than clinicians working with clients with more severe TBI (p< .001). Clinicians with fewer years of experience (<2 years) reported significantly lower confidence in overcoming barriers than clinicians with 2–10 years and >10 years of experience (p< .01). The most commonly selected professional development areas included new interventions and therapies, translating rehabilitation research into everyday practice and client specific topics. These findings provide a unique multidisciplinary perspective on clinicians working in TBI rehabilitation in Australia. Understanding of the perceived barriers to practice and professional development needs may guide training and support initiatives for clinicians which, in turn, may enhance the quality of brain injury rehabilitation.
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D’Cruz K, Unsworth C, Roberts K, Morarty J, Turner-Stokes L, Wellington-Boyd A, Matchado J, Lannin NA. Engaging patients with moderate to severe acquired brain injury in goal setting. International Journal of Therapy and Rehabilitation 2016. [DOI: 10.12968/ijtr.2016.23.1.20] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kate D’Cruz
- Lecturer, Department of Community and Clinical Allied Health, La Trobe University, Melbourne, Australia
| | - Carolyn Unsworth
- Professor, Department of Community and Clinical Allied Health, La Trobe University, Melbourne, Australia
| | - Karen Roberts
- Occupational therapist, Alfred Health, Melbourne, Australia
| | - Jacqui Morarty
- Manager, ABI Community and Transitional Living Service, Alfred Health, Melbourne, Australia
| | - Lynne Turner-Stokes
- Herbert Dunhill Professor of Rehabilitation, Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London and Director, Regional Rehabilitation Unit, Northwick Park Hospital, Harrow, Middlesex, UK
| | - Anna Wellington-Boyd
- Clinical support and development leader–acute social work, Alfred Health, Melbourne, Australia
| | - Joanne Matchado
- Social worker–acute neurosurgery, Alfred Health, Melbourne, Australia
| | - Natasha A Lannin
- Associate professor in occupational therapy, La Trobe University, Melbourne, Australia
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Kendall M, Wallace M. Measuring goal attainment within a community-based multidisciplinary rehabilitation setting for people with spinal cord injury. ACTA ACUST UNITED AC 2016. [DOI: 10.5348/d05-2016-10-oa-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Prescott S, Fleming J, Doig E. Goal setting approaches and principles used in rehabilitation for people with acquired brain injury: A systematic scoping review. Brain Inj 2015; 29:1515-29. [DOI: 10.3109/02699052.2015.1075152] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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