Supporting self-continuity during the hospital to community transition after acquired brain injury: A qualitative study of priorities, expectations and experiences of rehabilitation.

Abstract

Rehabilitation during community integration after acquired brain injury (ABI) focuses on supporting individuals to make sense of and manage injury-related changes in the context of occupational engagement. To improve understanding of the role of rehabilitation in facilitating early adjustment to ABI, the study aimed to understand individuals' rehabilitation priorities and expectations at hospital discharge and experiences at 3-months post-discharge. Semi-structured interviews were conducted with adults with ABI at discharge (n = 28) and 3-months post-discharge (n = 24) from a brain injury rehabilitation unit in Queensland, Australia. Data were thematically analysed using the Framework Method. Analysis identified an overarching theme of "Supporting self-continuity," comprising three interrelated themes. "Life's getting back on track" represented individuals' priority to access ongoing contextualized rehabilitation, enabling resumption of valued activities and roles. "My life on pause" reflected uncertainty about post-discharge processes for resuming occupations and feeling restricted by limitations and support gaps. "Collaborative fit: Matching my needs″, depicting the alignment between individual's mindset and expectations of life after ABI and personalization of rehabilitation services, and was central to self-continuity. Following discharge, collaborative fit between people with ABI and support systems is central to supporting self-continuity through enabling engagement in activities and roles important to self-identity.