The experiences of support staff in a traumatic brain injury rehabilitation center

PURPOSE

Employee turnover is a major issue for health care organizations. Burnout is a leading contributor to such turnover. Extensive research on burnout has been conducted in health care settings; however, it has primarily been focused on health care professionals ignoring other critical staff. In particular, traumatic brain injury rehabilitation is an area of health care that includes unique challenges and stressors that may contribute to burnout. Brain injury professionals report experiencing high levels of burnout that further increase as they spend more time with patients; however, little is known about the experiences of brain injury paraprofessionals. This study explores the unique experiences of support staff in traumatic brain injury rehabilitation centers.

METHOD

The present study used a grounded theory method to explore the phenomena of burnout, turnover, and job satisfaction from the perspective of paraprofessional support staff in 1 posthospital brain injury rehabilitation center. Support staff participated in the research via small group interviews (N = 4) and survey (N = 11).

RESULTS

The analysis resulted in a grounded theory model, entitled "The Balance model of Rehabilitation Support Work." This model is a framework of risk and protective factors that appeared to influence whether these frontline rehabilitation staff experienced negative outcomes from this often challenging/stressful work environment. The model includes 4 axial-level themes: doing the work, protective factors, risk factors, and imbalance of factors. Within the 4 axial categories are twenty open-coding level categories.

IMPLICATIONS

Implications for traumatic brain injury rehabilitation organizations and areas for future research are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Further validation of the Elderly Mobility Scale for measurement of mobility of hospitalized elderly people

OBJECTIVE

To further assess the validity and inter-rater reliability of the Elderly Mobility Scale (EMS). Also whether the scale reflects elderly people's perceptions regarding their mobility, and whether it can predict discharge destination, or likelihood of falling.

DESIGN

Questionnaire-based study completed on admission and weekly after this on all patients referred to physiotherapy for mobility problems over the course of one month.

SETTING

Care of the elderly wards in the Bristol General Hospital.

SUBJECTS

Sixty-six patients (ages 66-69 years, 66% female) were included in the validity study. Nineteen patients (ages 71-95 years, 47% female) were included in the inter-rater reliability study.

INTERVENTIONS

EMS, Barthel and patients' perceptions of mobility were tested with routine physiotherapy treatment carried out as necessary.

MAIN OUTCOME MEASURES

Concurrent validity was assessed by correlating EMS scores with Barthel scores using Spearman's test. Inter-rater reliability was also tested using a Spearman's correlation. EMS scores of patients were also evaluated in conjunction with whether or not they fell and their destination on discharge.

RESULTS

A significant correlation between EMS and Barthel scores indicated concurrent validity. Inter-rater reliability was demonstrated on 19 patients with a significant correlation between scores. No predictive validity could be ascribed to EMS in terms of discharge destination or likelihood of falling. Results do indicate a possible predictive validity of the functional reach component of the EMS regarding the risk of future falls.

CONCLUSIONS

The EMS was found to be a valid scale with good inter-rater reliability that could be readily applied during daily clinical work. However, it was found to have no predictive validity in terms of falling or discharge destination.