Brain Impairment最新文献

{"title":"Applying implementation science theories to support practice change in the assessment of cognition by occupational therapists.","authors":"Jacqueline Wheatcroft, Rebecca J Nicks, Laura Jolliffe, Danielle Sansonetti, Carolyn Unsworth, Natasha A Lannin","doi":"10.1071/IB23105","DOIUrl":"https://doi.org/10.1071/IB23105","url":null,"abstract":"<p><p>Background Understanding cognitive impairments is essential for effective rehabilitation and discharge planning for adults with neurological conditions. The aim of this study was to identify barriers to completing standardised cognitive assessments and evaluate the implementation of an intervention to support practice change. Methods A mixed-methods approach was applied to translate cognitive assessment recommendations into clinical practice using the Theoretical Domains Framework (TDF) and the Capability, Opportunity, and Motivation Behaviour model (COM-B) theories. Occupational therapists at one metropolitan health service in Australia were invited to participate. Pre- and post-implementation file audits and surveys were conducted, along with focus groups that collected qualitative data analysed using the TDF and COM-B. Results Survey 1 (n =40) and focus group data (n =24) identified barriers in the TDF domains of knowledge (selection of assessments), environment and resources (equipment and time constraints), and social influences (pressure from other disciplines). To address barriers to implementing a cognitive assessment framework, scripts, cue cards, video-recorded training, and posters were developed as guided by the Behaviour Change Wheel (BCW). Survey 2 showed increased capability to physically administer cognitive assessments (53-74%) and improved clinician understanding of relevant clinical practice guideline (CPG) recommendations (22-50%). File audit data indicated a 30% increase in the number of standardised assessments completed. Conclusions The application of two implementation theories led to the development of an intervention that increased occupational therapists' confidence and their adherence to CPG recommendations. This study serves as a potential model for using the TDF and COM-B to create implementation interventions in various clinical practice areas.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"25 ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life after lockdown: loneliness, exclusion and the impact of hidden disability.","authors":"Chloe Bradbury, Abbey Fletcher, Stephen Dunne","doi":"10.1071/IB23111","DOIUrl":"https://doi.org/10.1071/IB23111","url":null,"abstract":"<p><p>Background Stroke survivors are a population at increased risk of experiencing loneliness, thus exploring the effect of lockdown measures on stroke survivors is of paramount importance. We explored the personal experiences of loneliness among stroke survivors during lockdown in the COVID-19 pandemic and the lessons that can be learned from these experiences. Methods Seventeen stroke survivors from across the United Kingdom (10 females, 7 males; 45-83years old; M age =63.47) participated in semi-structured interviews. Reflexive thematic analysis was employed in the interpretation of the data. Results Three overarching themes were constructed: (1) hidden struggles, isolated lives; (2) divergent experiences and adaptations; and (3) rebuilding after lockdown. These themes explore survivors' experiences of loneliness generally after stroke and how this loneliness was assuaged with online video conferencing and other technological solutions. They also chronicle how these feelings changed during lockdown and survivors' feelings regarding society returning to 'normal' and the associated apprehension and anxiety this brings. Conclusions We recommend a focus on improving understanding of the challenges faced after stroke to reduce stigma, increase empathy and promote inclusive attitudes within society, alongside better pandemic preparedness through engagement with hybrid support solutions.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"25 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141322137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation of young stroke presentations, pathways of care, and support for 'invisible' difficulties: a retrospective clinical audit study.","authors":"Michaela Grech, Toni Withiel, Marlena Klaic, Caroline A Fisher, Leonie Simpson, Dana Wong","doi":"10.1071/IB23059","DOIUrl":"https://doi.org/10.1071/IB23059","url":null,"abstract":"<p><p>Background Young stroke survivors are likely to be discharged home from acute hospital care without rehabilitation more quickly than older survivors, but it is not clear why. File-audit studies capturing real-world clinical practice are lacking for this cohort. We aimed to compare characteristics and care pathways of young and older survivors and describe stroke presentations and predictors of pathways of care in young survivors (≤45years), including a focus on care received for 'invisible' (cognitive, psychological) difficulties. Methods A retrospective audit of 847 medical records (67 young stroke survivors, mean age=36years; 780 older patients, mean age=70years) was completed for stroke survivors admitted to an Australian tertiary hospital. Stroke characteristics and presence of cognitive difficulties (identified through clinician opinion or cognitive screening) were used to predict length of stay and discharge destination in young stroke survivors. Results There were no differences in length of stay between young and older survivors, however, young stroke survivors were more likely to be discharged home without rehabilitation (though this may be due to milder strokes observed in young stroke survivors). For young stroke survivors, stroke severity and age predicted discharge destination, while cognitive difficulties predicted longer length of stay. While almost all young survivors were offered occupational therapy and physiotherapy, none received psychological input (clinical, health or neuropsychology). Conclusions Cognitive and psychological needs of young stroke survivors may remain largely unmet by a service model designed for older people. Findings can inform service development or models of care, such as the new Australian Young Stroke Service designed to better meet the needs of young survivors.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"25 ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of remotely delivered interventions to support wellbeing amongst caregivers of adults with acquired brain injuries.","authors":"Nils Rickardsson, Daniel Jon Stopforth, David Gillanders","doi":"10.1071/IB23099","DOIUrl":"https://doi.org/10.1071/IB23099","url":null,"abstract":"<p><p>Background There is a need for improved access to evidence-based interventions supporting the wellbeing of caregivers of adults with acquired brain injury (ABI). Remotely delivered interventions could address this need. The present systematic review sought to collate studies evaluating remotely delivered interventions designed to improve the wellbeing of caregivers of adults with an ABI, to summarise findings and to comment on the quality of this research. Methods Systematic searches were conducted up until December 2023. Study characteristics, populations, interventions and outcomes were outlined, and papers were appraised on methodological quality. The review was pre-registered (PROSPERO: CRD42020189235). Results Eleven studies meeting inclusion criteria were identified. Methodological quality was generally low to adequate. Most studies evaluated an intervention for caregivers of people with stroke, with a variety of types of interventions trialled. The majority of studies reported non-significant findings on wellbeing outcomes when compared to control conditions. Conclusions There is limited evidence supporting a remotely delivered intervention to improve wellbeing outcomes for ABI caregivers. Specific recommendations are provided, including the development of a core set of outcomes and replication of findings over time, which can improve research into the development and evaluation of remote interventions for this population.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"25 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heads Together Online Peer Education (HOPE): co-design of a family-led, video-based resource for families affected by paediatric acquired brain injury.","authors":"Marnie Drake, Taylor Jenkin, Kate Heine, Penelope Analytis, Michael Kendall, Adam Scheinberg, Sarah Knight","doi":"10.1071/IB23101","DOIUrl":"10.1071/IB23101","url":null,"abstract":"<p><p>Background Many families of children with acquired brain injuries (ABI) desire opportunities to connect with peers who have shared similar experiences, but such opportunities are often unavailable. Heads Together Online Peer Education (HOPE) is a co-designed online video-based resource that provides information and early support to families following paediatric ABI. This study is part of a larger co-creation project using a community-based participatory research approach to develop and implement HOPE for families impacted by paediatric ABI in Australia. This study aimed to explore parents' and clinicians' perspectives regarding HOPE's usability, acceptability, and future implementation. Methods Parents and clinicians were recruited from a state-wide, interdisciplinary rehabilitation service. Parents were eligible to participate if their child had sustained an ABI within 2 years of recruitment. Participants accessed HOPE, completed the System Usability Scale (SUS), and participated in a semi-structured interview. Transcripts were analysed using inductive content analysis. Results Ten parents and 13 rehabilitation clinicians participated. Average SUS scores were 80.5/100 and 81.73/100, respectively. Participants were satisfied with HOPE's family-centred content and delivery. They expressed having benefited from using HOPE and offered suggestions for its optimisation. Finally, participants reflected on how HOPE could be introduced to and used by families, and its potential usefulness in educating others about paediatric ABI. Conclusions HOPE was developed through a family-led co-design process and aims to provide information and support to families in the early stages following paediatric ABI. This study's findings demonstrate HOPE's usability and acceptability from end-users' perspectives and will guide implementation.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"25 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Corrigendum to</i>: Healing Right Way randomised control trial enhancing rehabilitation services for Aboriginal people with brain injury in Western Australia: translation principles and activities.","authors":"Neil Drew, Meaghan McAllister, Juli Coffin, Melanie Robinson, Judith Katzenellenbogen, Elizabeth Armstrong","doi":"10.1071/IB23109_CO","DOIUrl":"10.1071/IB23109_CO","url":null,"abstract":"","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"25 ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of public views about sports concussion recovery with current guidelines: where are the gaps and overlaps?","authors":"Karen A Sullivan, Kannan Singaravelu Jaganathan","doi":"10.1071/IB23122","DOIUrl":"https://doi.org/10.1071/IB23122","url":null,"abstract":"<p><p>Background Sports concussion (SC) management guidelines have recently been updated. A key focus is the emphasis on rest (immediately postinjury) followed by gradual resumption of activity (active recovery). This study aimed to explore community views on SC management and compared these with the guidelines. Methods A total of 157 volunteers completed an online SC survey, including listing three pieces of advice for a concussed person immediately postinjury, and after 2weeks (subacute). Quantitative data were statistically compared, and qualitative data underwent content analysis. Results Almost all participants offered different immediate versus subacute advice; however, rest featured highly at both timepoints. Commonly expressed themes, consistent with guidelines were immediate rest; safety and reinjury prevention; and symptom monitoring. Two themes were identified in the community advice with limited emphasis in the guidelines: general health advice and psychological and social support. Expert clinical assessment was not always identified in community advice. Conclusion Community members hold some views that align with expert advice for SC, particularly the importance of immediate postinjury rest. However, there is scope to grow public awareness of some recommended practices, including expert clinical assessment following injury and when to engage in active recovery.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"25 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of a physiotherapist-supervised walking program with telephone coaching to increase physical activity following acquired brain injury.","authors":"Caitlyn Payne, Janelle Gesch, Esther Smits, Charlotte Brakenridge, Venerina Johnston, Paul A Gardiner, Tracy Comans, Ryan Bell, Elise Gane","doi":"10.1071/IB23095","DOIUrl":"https://doi.org/10.1071/IB23095","url":null,"abstract":"<p><p>Background Physical activity has health benefits for adults with acquired brain injury, but it is a challenge to increase physical activity during inpatient rehabilitation. The objectives of this pilot study were to determine whether a physiotherapy-supervised inpatient walking program was feasible and able to improve physical activity and sedentary behaviour in the short and medium term. Methods Adults with acquired brain injury receiving inpatient rehabilitation undertook twice-weekly supervised walks plus behavioural therapy for 4 weeks. Feasibility was measured via recruitment, participation and drop out rates, adverse events and intervention delivery costs. Physical activity and sedentary behaviour were measured with an activPAL. Assessments were conducted at baseline, post-intervention and 3-6 months post-intervention. Results The program was safe to deliver (no adverse events), recruitment rate was 55% (16/29) and the participation rate for eligible individuals was high (14/19, 74%). However, the program had a high drop out rate (7/16, 44%) and physical activity and sedentary behaviour did not significantly change during the 4-week intervention. Costs were AU$427.71/participant. Physical activity and sedentary behaviour did improve 3-6 months after the intervention (vs baseline, on average: +3913 steps per day, 95% CI: 671, 7156). Conclusion This pilot study demonstrated a supervised physiotherapy walking program is safe and feasible to recruit in an inpatient setting. However, drop out during the study was high and behaviour change did not occur. More work is required to boost physical activity during sub-acute rehabilitation for acquired brain injury.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"25 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healing Right Way randomised control trial enhancing rehabilitation services for Aboriginal people with brain injury in Western Australia: translation principles and activities.","authors":"Neil Drew, Meaghan McAllister, Juli Coffin, Melanie Robinson, Judith Katzenellenbogen, Elizabeth Armstrong","doi":"10.1071/IB23109","DOIUrl":"10.1071/IB23109","url":null,"abstract":"<p><p>Background This report provides the theory, method and practice of culturally secure translation and knowledge exchange in the Healing Right Way Clinical Trial (2017-2022), outlining activities to date. Healing Right Way was a stepped wedge cluster randomised controlled trial conducted in Western Australia, aimed at enhancing rehabilitation services and quality of life for Aboriginal Australians following acquired brain injury. The trial translation plan was aspirational and action-oriented, with its implementation iterative and ongoing. Translational activities aimed to inform service and research planning for Aboriginal people with brain injury. Situated in the intercultural space, the work guards against undertaking activities that are monocultural, colonial and appropriating in favour of work that is authentically viewed through the dual lens of whiteness and Aboriginal and Torres Strait Islander ways of knowing, being and doing, and is strengths-based. Methods Three translational and knowledge exchange components were identified, relating to the role of Aboriginal Brain Injury Coordinators, cultural training of hospital staff and the research process itself. Knowledge plans were developed for key audiences, with potential translation products to be monitored for ongoing impact. Results Results demonstrate that translational and knowledge exchange were iteratively embedded throughout the trial life cycle. Data sources included community engagement, partnership meetings and interviews. Activities involved presentations to diverse audiences including bureaucrats, community and participants. Conclusions This report provides a snapshot of the first translation knowledge exchange plan and activities constructed in relation to brain injury rehabilitation services for Aboriginal people. Challenges encountered, as well as successes to date, are discussed.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"25 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding factors that influence goal setting in rehabilitation for paediatric acquired brain injury: a qualitative study using the Theoretical Domains Framework.","authors":"Sarah Knight, Jill Rodda, Emma Tavender, Vicki Anderson, Natasha A Lannin, Adam Scheinberg","doi":"10.1071/IB23103","DOIUrl":"https://doi.org/10.1071/IB23103","url":null,"abstract":"<p><p>Background While goal setting with children and their families is considered best practice during rehabilitation following acquired brain injury, its successful implementation in an interdisciplinary team is not straightforward. This paper describes the application of a theoretical framework to understand factors influencing goal setting with children and their families in a large interdisciplinary rehabilitation team. Methods A semi-structured focus group was conducted with rehabilitation clinicians and those with lived experience of paediatric acquired brain injury (ABI). The 90-min focus group was audio-recorded and transcribed verbatim. Data were thematically coded and mapped against the Theoretical Domains Framework (TDF) to understand influencing factors, which were then linked to the Capability, Opportunity, Motivation - Behaviour (COM-B) model. Results A total of 11 participants (nine paediatric rehabilitation clinicians, one parent and one young person with lived experience of paediatric ABI) participated in the focus group. Factors influencing collaborative goal setting mapped to the COM-B and six domains of the TDF: Capabilities (Skills, Knowledge, Beliefs about capabilities, and Behavioural regulation), Opportunities (Environmental context and resources), and Motivation (Social/professional role and identity). Results suggest that a multifaceted intervention is needed to enhance rehabilitation clinicians' and families' skills and knowledge of goal setting, restructure the goal communication processes, and clarify the roles clinicians play in goal setting within the interdisciplinary team. Conclusion The use of the TDF and COM-B enabled a systematic approach to understanding the factors influencing goal setting for children with acquired brain injury in a large interdisciplinary rehabilitation team, and develop a targeted, multifaceted intervention for clinical use. These represent important considerations for the improvement of collaborative goal setting in paediatric rehabilitation services to ensure that best practice approaches to goal setting are implemented effectively in clinical practice.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"25 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}