Community-Based Rehabilitation Following Brain Injury: Comparison of a Transitional Living Program and a Home-Based Program

2012 ◽  
Vol 13 (1) ◽  
pp. 44-61 ◽  
Author(s):  
Kate Hopman ◽  
Robyn L. Tate ◽  
Annie McCluskey
Keyword(s):  
Brain Injury ◽  
Longitudinal Design ◽  
Community Integration ◽  
Self Awareness ◽  
Community Based ◽  
Significant Group ◽  
Rehabilitation Programs ◽  
Home Based ◽  
Community Based Rehabilitation ◽  
Transitional Living

Background and aims: Community-based rehabilitation programs for people with a brain injury are diverse. Comparative program evaluation is required to identify optimal type, intensity and duration of programs. The aim of this study was to compare the effectiveness of two community-based rehabilitation programs using a set of standardised outcome measures.Methods: The study used a quantitative, multicentre, longitudinal design. Persons with severe traumatic brain injury (TBI,n= 39) and acquired brain impairment (n= 2) were recruited from two residential, transitional living programs (TLU;n= 21) and two home-based community rehabilitation programs (CR;n= 20). Participants were assessed via interview at program entry, 2 months and 6 months later using a broad range of standardised measures. The quantity and types of intervention provided to study participants were recorded. Results: No significant differences were identified between the TLU and CR groups at baseline or 6-month follow-up. Two significant group-by-time interactions were identified on the Community Integration Questionnaire (CIQ). First, the CR group had significantly greater changes in productivity (p= .003;d= 1.0) compared to the TLU group over time; by contrast, the TLU group showed significantly greater improvements in social integration (p= .007;d= .86). The TLU participants received up to five times more intervention than the CR participants. This finding is significant considering the similar levels of improvement in function made by both TLU and CR participants.Conclusions: Both TLU and CR groups improved on a range of measures. The TLU group however, received significantly more face-to-face interventions. Further examination of the relationship between participant contextual factors, such as coping style and self-esteem, and impairments such as challenging behaviour and decreased self-awareness, of people attending TLU and CR programs is required.

Beyond Dressing and Driving: Using Occupation to Facilitate Community Integration in Neurorehabilitation

2000 ◽  
Vol 1 (2) ◽  
pp. 141-150 ◽  
Author(s):  
Jennifer M. Fleming ◽  
Emmah Doig ◽  
Noomi Katz
Keyword(s):  
Brain Injury ◽  
Occupational Therapy ◽  
Community Integration ◽  
Care Home ◽  
Real Life ◽  
Executive Dysfunction ◽  
Occupational Performance ◽  
Community Based ◽  
Community Based Rehabilitation ◽  
Life Context

AbstractDuring the process of community integration, individuals with acquired brain injury may experience difficulties in all areas of occupational performance including self-care, home management, community access, leisure, social activities and vocational pursuits. Community based rehabilitation services provide opportunities to minimise such difficulties by working with clients as they engage in meaningful real-life context-based occupations. The therapeutic use of occupation is at the core of occupational therapy practice. We reflect on the nature and principles of occupation and highlight particular benefits for facilitating community integration after brain injury. This is illustrated using the example of executive dysfunction. Several challenges for the occupational therapy profession arise from the shift in focus from hospital to community based rehabilitation, and the need for further research on community integration after brain injury from an occupational perspective is recognised.

A Preliminary Exploration of Goal-setting in Community-based Rehabilitation for People with Brain Impairment

2004 ◽  
Vol 5 (1) ◽  
pp. 30-41 ◽  
Author(s):  
Pim Kuipers ◽  
Glenys Carlson ◽  
Sandra Bailey ◽  
Anshu Sharma
Keyword(s):  
Brain Injury ◽  
Goal Setting ◽  
Service Provider ◽  
Service Providers ◽  
Acquired Brain Injury ◽  
Rehabilitation Service ◽  
Future Research ◽  
Training Experience ◽  
Community Based ◽  
Community Based Rehabilitation

AbstractCommunity-based rehabilitation for people with acquired brain injury (ABI) is largely driven by goals set in the course of rehabilitation by clients and service providers. A preliminary study investigating the perspectives and practice of experienced rehabilitation coordinators was undertaken to explore issues that influence goal-setting in community rehabilitation settings. Detailed interviews and subsequent rounds of clarification were conducted with six experienced rehabilitation coordinators. Key themes identified through inductive analysis include cognitive influences, other client influences, service provider influences and the client-service provider relationship in the goal-setting process. Based on the findings, a preliminary descriptive schema of goal-setting in a community-based rehabilitation service for people with acquired brain injury is suggested. Factors such as training, experience, and values of the rehabilitation coordinators are also discussed in terms of their influence on goal-setting. Some strategies to assist a person with ABI to identify and work towards achieving realistic goals are identified. Suggestions for enhancing community-based rehabilitation practices with people with ABI, and scope for future research are noted. This paper constitutes a general overview of goal-setting in community-based ABI rehabilitation.

scholarly journals Preferred rehabilitation setting among stroke survivors in Nigeria and associated personal factors

2018 ◽  
Vol 7 ◽  
Author(s):  
Grace Vincent-Onabajo ◽  
Zulaiha Mohammed
Keyword(s):  
Inpatient Rehabilitation ◽  
Outpatient Setting ◽  
Outpatient Rehabilitation ◽  
Personal Factors ◽  
Stroke Patients ◽  
Community Based ◽  
Cross Sectional ◽  
Home Based ◽  
Community Based Rehabilitation ◽  
Cross Sectional Design

Background: Incorporating patients’ preferences in the care they receive is an important component of evidence-based practice and patient-centred care.Objective: This study assessed stroke patients’ preferences regarding rehabilitation settings.Methods: A cross-sectional design was used to examine preferences of stroke patients receiving physiotherapy at three hospitals in Northern Nigeria. Personal factors and preferred rehabilitation setting data were obtained using the Modified Rankin Scale (to assess global disability) and a researcher-developed questionnaire. Associations between preferences and personal factors were explored using bivariate statistics.Results: Sixty stroke patients whose mean age was 53.6 ± 14.8 years participated in the study. Most of the participants (38.3%) preferred an outpatient setting, 19 (31.7%) preferred rehabilitation in their homes, 14 chose inpatient rehabilitation (23.3%), while 4 (6.7%) preferred the community. Age and source of finance were significantly associated with preferences. The majority (66.7%) of those aged ≥ 65 years expressed a preference for rehabilitation in the home or community (X2 = 6.80; p = 0.03). Similarly, most of the participants (53.3%) who depended on family finances preferred home- or community-based rehabilitation, while most of those who depended on employment income for finances preferred an outpatient rehabilitation setting (X2 = 16.80; p = 0.01).Conclusion: A preference for rehabilitation in outpatient facilities predominated followed by home-based rehabilitation, and preferences varied based on age and source of finance. These variations in preferences have implications for making rehabilitation decisions.

scholarly journals Am I there yet? The views of people with learning disability on forensic community rehabilitation

2015 ◽  
Vol 6 (3/4) ◽  
pp. 148-164 ◽  
Author(s):  
Alana Davis ◽  
Michael Doyle ◽  
Ethel Quayle ◽  
Suzanne O'Rourke
Keyword(s):  
Learning Disability ◽  
Interpretative Phenomenological Analysis ◽  
Community Integration ◽  
Current Model ◽  
Service Users ◽  
Structured Interviews ◽  
Community Based ◽  
Content Type ◽  
Community Rehabilitation ◽  
Community Based Rehabilitation

Purpose – Previously, diversion from the criminal justice system for people with learning disability (LD) and serious forensic needs in Scotland meant hospitalisation. More recently new legislation has meant that community-based rehabilitation is possible for this group. The purpose of this paper is to qualitatively explore the views of people with LD subject to these legal orders. This is both a chance to work in partnership to improve services and also to make the voices of this potentially vulnerable group heard. Design/methodology/approach – Semi-structured interviews were conducted with ten participants subject to a community-based order. All participants were male. Ages, index behaviour, and time spent on order varied. The data was transcribed and analysed using interpretative phenomenological analysis. Findings – The main themes which emerged from the data were a taste of freedom, not being in control, getting control back, loneliness, and feeling like a service user. Participants described positives about community-based rehabilitation but also a number of negatives. Practical implications – Participant accounts suggest that the current community rehabilitation model has some shortcomings which need to be addressed. Suggestions are made for improvements to the current model relating to: achieving clarity over the role of support staff and pathways out of the system; increasing opportunities for service users to voice concerns; empowering staff teams via extensive training and supervision; and directly addressing internalised stigma to promote community integration. Originality/value – This is the first piece of work evaluating compulsory community forensic care for people with LD from the perspective of service users. It highlights difficulties with the system which could lead to helpful ways to evolve this model.

Community-based Rehabilitation Needs: Perceptions of Individuals with Brain Injury and Their Families in the Midwestern United States

2013 ◽  
Vol 19 (2) ◽  
pp. 155-163 ◽  
Author(s):  
Veronica I. Umeasiegbu ◽  
Brittany Waletich ◽  
Laura A. Whitten ◽  
Malachy Bishop
Keyword(s):  
Brain Injury ◽  
Family Involvement ◽  
Independent Living ◽  
Descriptive Analysis ◽  
Focus Group Interviews ◽  
Community Based ◽  
Community Based Rehabilitation ◽  
Group Interviews ◽  
Rehabilitation Needs ◽  
Age Range

This study investigated the rehabilitation and services needs, rehabilitation goals and barriers of individuals with brain injury (n = 81, males = 59%, females = 41%, age range 18 to 87), and their family members (n = 19; females = 75%, age range 18 to 65), (ethnicity = white = 89%). Data were collected using a survey instrument and focus group interviews. A descriptive analysis of the quantitative data was conducted, while content analysis was used to analyse the qualitative data. Results suggest that individuals with brain injury and their families experience many unmet needs across the domains of employment, independent living, financial resources and housing. Family involvement was found to be important to community participation after brain injury.

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