Brain Impairment最新文献

{"title":"We are human – an invisible and fundamental aspect of rehabilitation in acquired brain injury","authors":"C. Ellis-Hill, N. Kayes, J. Douglas","doi":"10.1017/brimp.2022.1","DOIUrl":"https://doi.org/10.1017/brimp.2022.1","url":null,"abstract":"The fact that acquired brain injury (ABI) rehabilitation services are made up of human beings supporting other human beings is not often considered in research or practice. In this special issue of Brain Impairment we are delighted to be able to share the work of academics who are engaging with this aspect of ABI rehabilitation. As editors, when we met in 2018 at the 41st annual conference of the Australasian Society for the Study of Brain Iimpairment (ASSBI), we were struck by how several presentations, although using slightly different language, were all touching on the same aspect of rehabilitation - human connection. Despite consensus and anecdotal evidence that human connection is a critical component of rehabilitation, there is remarkably little written in the literature to help us unpack, reflect on and harness human connection. Human connection is therefore not only ‘ invisible ’ in itself but also in developments in rehabilitation research and practice. As a first step, we would like to encourage service managers, researchers and clinicians to consider the value of human connection within service provision, to explore new ways of researching which allows human connection to come to the fore, and to celebrate the experience and power of human connection in our therapeutic relationships. In this special issue we invite you, the reader into the world of the invisible and immeasurable - human connection. We have a diverse range of authors and topics ranging from those reflecting individual lived experience, through therapeutic relationship, to wider social discourses. Although the focus for each author is discrete we feel that each contribution adds to this continuum as each part cannot exist without each other; the individual experience is always relational and social in an ever changing and powerful sea of meaning. The first author in our issue, Rixon sets the scene and in a way ‘ says it all ’ . Through sharing his own experience of","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"21 1","pages":"1 - 3"},"PeriodicalIF":0.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86825181","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":"Connection: stories not statistics","authors":"C. Rixon","doi":"10.1017/BrImp.2021.37","DOIUrl":"https://doi.org/10.1017/BrImp.2021.37","url":null,"abstract":"When health professionals and systems reduce people who survive brain injury to their symptoms and “survivor narratives” they create The Isolation Industry an industry that perpetuates a feeling of difference and deficit that caps the potential of those who they seek to help. So, how might stories disrupt this? I think the sharing of survival stories should be sexy. Not to be confused with sexual I’m talking about making lived experiences of brain injury palatable, relatable and investible. Narratives that evoke empathy, understanding and excitement eliminate stigma and end isolation. This paper holds familiar themes drawn from values consistent with research found in Brain Impairment; the importance of listening to the stories of people with lived experience of brain injury. Within the journal, I have read the work of many researchers on this topic; fancy-pants people with lots of degrees, who know a lot about brain injury. I am not a researcher; I am not an academic. I am a stroke survivor, a storyteller and a community mobiliser with firsthand experience of empowerment built through story-sharing. Sharing (and listening to) stories is important, but the challenge for health professionals is to use these stories to improve their practice and the experiences for survivors. Through their research, Tevendale and Armstrong (2015) found that when survivors shared their stories with health professionals, it improved the health professionals’ understanding of issues affecting people with lived experience and helped to refocus their beliefs of what mattered most in assisting people living with brain injury. Stories invite an emotional response and offer a narrative that likely differs from the patient history engaged by some health professionals. This work is an attempt to use my early stories to cast a spotlight on the disconnection that can occur in the rehabilitation process. By sharing these, I hope to start a conversation about the isolation that occurs for people with living experience of brain injury and how health professionals, policymakers and the system contribute to this. I want to create a dialogue loud enough to inspire you to pause and reflect on the part you could play in building a more connected rehab journey. Let us create a stronger connection; one built through stories, not statistics. The rhetoric we use and the paternalistic approach we engage reduces survivors to their disability; disempowering engagement leads to more isolation and increases mental health problems. We can change these outcomes by creating safe spaces for peers to connect and build capacity, using supportive and empowering language, recognising the wisdom people with lived experience hold, and by making collaboration, not compliance, an industry standard. I know this because I live it and it has been my journey for the past 13 years. Some of the most oppressive interactions that halted my recovery journey involved members of my healthcare team, particularly thos","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"66 1","pages":"4 - 8"},"PeriodicalIF":0.8,"publicationDate":"2022-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73491208","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":"Comparing participation in sports discussion and art therapy groups in ABI","authors":"Bronwyn Moorhouse, Erica R. Mainprize, J. Douglas, C. Fisher","doi":"10.1017/BrImp.2021.32","DOIUrl":"https://doi.org/10.1017/BrImp.2021.32","url":null,"abstract":"Abstract Background: Social connection is often impacted by acquired brain injury (ABI), contributing to isolation and compromised mental health. Group therapy is thought useful in this context. For those experiencing cognitive communication challenges, finding alternative ways to engage is also valuable. Art therapy may offer pro-social support through shared activity, self-expression, organic subject matter and enduring visual prompts. Method: A multiple A-B-A single case experimental design compared participation in sports discussion and art therapy groups on a long-stay secure unit. Nine individuals with ABI and complex combinations of communication, cognitive and mental health needs were studied. It was hypothesised that for some individuals, participation would be greater in art therapy than sports discussion groups. Results: Results from six individuals with at least five measurement points per phase are reported. Tau statistics revealed significant interphase differences for three individuals. Significantly less participation was recorded for two individuals in art than sports discussion, however they still appeared invested in the art groups. The remaining participant, with the most severe communication difficulties, avoided all baseline sports discussion groups, but participated in almost all art groups, with significant increase between initial sports discussion and art phases. Conclusion: Further research is warranted regarding the potential art therapy offers for group engagement, particularly where complex challenges render traditional talking-style groups less appropriate. Furthermore, disparate and complex needs in severe ABI require diverse, well-designed groups offering different opportunities and responding to individual strengths and motivations. More research into such approaches may increase group participation in this challenging cohort.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"37 1","pages":"76 - 90"},"PeriodicalIF":0.8,"publicationDate":"2022-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86328405","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":"Developing connections for engagement in stroke rehabilitation","authors":"N. Kayes, C. Cummins, K. McPherson, Linda Worrall, F. Bright","doi":"10.1017/BrImp.2021.27","DOIUrl":"https://doi.org/10.1017/BrImp.2021.27","url":null,"abstract":"Abstract Background and Aims: Engagement is increasingly recognised as important for maximising rehabilitation outcome following stroke. However, engagement can be challenging when neurological impairment impacts a persons’ ability to activate the regulatory processes necessary for engagement and in the context of a changed self. We explored engagement in stroke rehabilitation from the perspective of people with stroke with a primary focus on identifying key processes that appeared important to engagement in stroke rehabilitation. Design and Methods: This study drew on Interpretive Description methodology. Maximum variation and theoretical sampling were used to capture diversity in the sample and access a depth and breadth of perspectives. Data collection included semi-structured interviews with people with stroke (n = 19). Data were analysed through a collaborative and iterative process drawing on range of analytical tools including coding, memoing, diagramming and group discussions. Findings: Our findings highlight that engagement is a complex, nuanced, responsive, flexible and inherently two-way process. Developing connections appeared central to engagement with connections taking various forms. The most fundamental was the therapeutic connection between the person with stroke and their practitioner as it provided the foundation on which to build other connections. Connection was made possible through five collaborative processes: Knowing, Entrusting, Adapting, Investing and Reciprocating. Conclusions: Engagement is a social and relational process enabled through an inherently person-centred approach and active and ongoing reflexivity – highlighting the importance of a humanising approach to care where aspects of self, care and emotion are evident, for both the person with stroke and their practitioner.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"1 1","pages":"42 - 59"},"PeriodicalIF":0.8,"publicationDate":"2021-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83211293","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":"‘The wairua first brings you together’: Māori experiences of meaningful connection in neurorehabilitation","authors":"Bob Wilson, F. Bright, C. Cummins, H. Elder, N. Kayes","doi":"10.1017/BrImp.2021.29","DOIUrl":"https://doi.org/10.1017/BrImp.2021.29","url":null,"abstract":"Abstract Background and Aims: Therapeutic connections enhance patient experience and outcomes after neurological injury or illness. While we have some understanding of the components necessary to optimise therapeutic connections, these have developed from western-centric ideals. This study sought to explore the perspectives of Māori brain injury survivors, and their whānau (wider family and community), to develop more culturally informed understandings of what matters most for Māori in the development and experience of therapeutic connection. Design and Methods: A bicultural approach underpinned by principles of Kaupapa Māori Research was used. Whānau views and experiences were gathered through wānanga (focus groups). These perspectives were analysed drawing on Māori methods of noho puku (self-reflection), whanaungatanga (relational linkage) and kaitiakitanga (guardianship). Findings: Three wānanga were held with 16 people – 5 brain injury survivors and 11 whānau members. The phrase ‘therapeutic connection’ did not resonate; instead, people spoke of meaningful connections. For rehabilitation encounters to be meaningful, three layers of connection were acknowledged. The elemental layer features wairua (spirit) and hononga (connection) which both underpinned and surrounded interactions. The relational layer reflects the importance of whānau identity and collectivism, of being valued, known, and interactively spoken with. Finally, the experiential layer consists of relational aspects important within the experience: relationships of reciprocity that are mana-enhancing and grounded in trust. These layers are interwoven, and together serve as a framework for meaningful connections. Conclusions: Meaningful connections in neurorehabilitation are underpinned by wairua and hononga; are multi-layered; are enabled through interactions with people, practice, process and place; are inclusive of whānau and resonate with Māori worldviews. The primacy of wairua and whānau within an interconnected view of health, challenges individualistic notions inherent in western health models and deepens existing understandings of meaningful connections in neurorehabilitation which can guide future rehabilitation research, teaching and practice.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"101 1","pages":"9 - 23"},"PeriodicalIF":0.8,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88969857","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":"It takes two to tango: The therapeutic alliance in community brain injury rehabilitation","authors":"Liz M. Williams, J. Douglas","doi":"10.1017/BrImp.2021.26","DOIUrl":"https://doi.org/10.1017/BrImp.2021.26","url":null,"abstract":"Abstract Objective: A positive therapeutic (or working) alliance has been associated with better outcomes for clients in the psychotherapeutic and traumatic brain injury (TBI) rehabilitation literature. The aim of this pilot study was to gain an understanding of the therapeutic alliance in community rehabilitation from the perspectives of adults with TBI and their close others who have completed a community rehabilitation programme. Method: This study used a constructivist, qualitative methodology which applied grounded theory analysis techniques. Using purposeful sampling, three pairs of participants (adults with TBI and close others) who had finished a community rehabilitation programme completed separate in-depth interviews which were transcribed verbatim and progressively analysed using a process of constant comparison. Results: A preliminary framework illustrating participants’ experience of a therapeutic alliance was generated, comprising three interconnected themes: being recognised as an individual, working together and feeling personally connected. All participants viewed being able to work together as important in their experience of community rehabilitation and described features that helped and hindered the alliance. Conclusion: These pilot study results demonstrate the importance of the therapeutic alliance to the rehabilitation experience of individuals with TBI and those close to them.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"41 1","pages":"24 - 41"},"PeriodicalIF":0.8,"publicationDate":"2021-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83384645","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":"Thinking Otherwise: Bringing Young People into Pediatric Concussion Clinical and Research Practice","authors":"K. Mah, B. Gladstone, Deb Cameron, N. Reed","doi":"10.1017/BrImp.2021.28","DOIUrl":"https://doi.org/10.1017/BrImp.2021.28","url":null,"abstract":"Abstract Background: As rates of pediatric concussion have steadily risen, and concerns regarding its consequences have emerged, pediatric concussion has received increased attention in research and clinical spheres. Accordingly, there has been a commitment to determine how best to prevent and manage this injury that so commonly affects young people. Despite this increased attention, and proliferation of research, pediatric concussion as a concept has rarely, if ever, been taken up and questioned. That is, little attention has been directed toward understanding what concussion ‘is’, or how young people are regarded in relation to it. As a result, pediatric concussion is understood in decidedly narrow terms, constructed as such by a biomedical way of knowing. Aim: We aim to demonstrate how conceptualizing concussion, and young people, ‘otherwise’, enabled the co-production of a more nuanced and complex understanding of the experience of pediatric concussion from the perspective of young people. Approach: Drawing on an illustrative case example from a critical qualitative arts-based study, we demonstrate how bringing young people into research as ‘knowers’ enabled us to generate much-needed knowledge about concussion in young people. Implications: The critical thinking put forward in this paper suggests a different approach to pediatric concussion, which is shared in the form of implications for clinical and research practice.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"5 1","pages":"104 - 117"},"PeriodicalIF":0.8,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75324001","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":"ASSBI Prize Winning Abstracts","authors":"","doi":"10.1017/BrImp.2021.21","DOIUrl":"https://doi.org/10.1017/BrImp.2021.21","url":null,"abstract":"","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"95 1","pages":"349 - 351"},"PeriodicalIF":0.8,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83640440","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":"‘Dazed and Confused!’ Context and Social Disconnect in the Time of Pandemic","authors":"O. Piguet","doi":"10.1017/BrImp.2021.23","DOIUrl":"https://doi.org/10.1017/BrImp.2021.23","url":null,"abstract":"Abstract Humans are social animals. Our sense of identity and ‘self’ is defined in part by the roles we perform in the social groups to which we belong. This article discusses some of the variables that contribute to our sense of self, including language, place of origin, education and shared social norms. It also outlines some of the general mechanisms that underpin our various social networks. In its final part, this article reviews the impact of social isolation, such as that happened during the COVID pandemic, on these social mechanisms and the resulted disruption of psychological wellbeing in individuals diagnosed with dementia.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"36 1","pages":"343 - 348"},"PeriodicalIF":0.8,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85015089","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":"The Lived Experience of Interdependence: Support Worker Relationships and Implications for Wider Rehabilitation","authors":"J. Bourke","doi":"10.1017/BrImp.2021.24","DOIUrl":"https://doi.org/10.1017/BrImp.2021.24","url":null,"abstract":"Abstract Engaging in a meaningful life where one can exercise autonomy has been proposed as a key aim of rehabilitation. Influenced by a neoliberal worldview, this has traditionally been characterised by a pursuit towards individual functional independence in which one completes tasks and activities unassisted. However for many persons, individual functional independence may not be a realistic, prioritised or beneficial goal. Many individuals must learn to work with support workers to exercise choice and control. Such relationships extend beyond a transactional nature and involve many subtle characteristics. In this article, I draw on my lived experience of partnering with support workers to illustrate the complexity of such relationships and how they can enable interdependence to serve as a vehicle to self-determination. I finish with some ideas about what rehabilitation can do to recognise the important role human connections play in facilitating interdependence. Understanding the nature of these relationships is necessary to provide services which value interdependence, supporting people to pursue a meaningful life following impairment.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"27 1","pages":"118 - 124"},"PeriodicalIF":0.8,"publicationDate":"2021-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87475692","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}