The Transition from Hospital to Home: Protocol for a Longitudinal Study of Australian Aboriginal and Torres Strait Islander Traumatic Brain Injury (TBI)

2018 ◽  
Vol 19 (3) ◽  
pp. 246-257 ◽  
Author(s):  
India Bohanna ◽  
Michelle S. Fitts ◽  
Katrina Bird ◽  
Jennifer Fleming ◽  
John Gilroy ◽  
...  

Background: Traumatic brain injury (TBI) is a leading cause of disability in Australia. Evidence shows that multidisciplinary rehabilitation and support in the six months following TBI is important for successful independent living and social re-integration. Despite this, access to services and supports during this period is often limited by environmental, socio-economic, geographic and cultural factors. Australian studies on outcomes after brain injury have reported primarily on non-Indigenous people. This study will investigate key sentinel events during the transition from hospital to home after a TBI in the first longitudinal study with Indigenous Australians.Method: Indigenous Australians admitted to one of three major trauma hospitals in northern Australia with a TBI, and their care givers, will be recruited. Clinical and brain injury risk factor information, along with measures of cognitive function, transition events, mental health and community re-integration will be collected at three time points prior to hospital discharge, and at three and six months post-discharge. Qualitative interviews will also be conducted. Data will be analysed using regression methods for the quantitative component, and situational analysis for the qualitative component. Annual rates of brain injury will be calculated for patients admitted to tertiary hospital facilities in the study region with a diagnosis of TBI.Discussion: Understanding the experience and events which shape the transition period is critical to determining the services and supports that may enhance transition outcomes, and ensure that such services are culturally appropriate and endorsed by Indigenous families and communities.

2019 ◽  
Vol 20 (2) ◽  
pp. 160-170 ◽  
Author(s):  
India Bohanna ◽  
Michelle Fitts ◽  
Katrina Bird ◽  
Jennifer Fleming ◽  
John Gilroy ◽  
...  

AbstractBackground:Increasingly, narrative and creative arts approaches are being used to enhance recovery after traumatic brain injury (TBI). Narrative and arts-based approaches congruent with Indigenous storytelling may therefore provide benefit during the transition from hospital to home for some Indigenous TBI patients. This qualitative study explored the use and impact of this approach as part of a larger, longitudinal study of TBI transition with Indigenous Australians.Method:A combined narrative and arts-based approach was used with one Indigenous Australian artist to describe his transition experiences following TBI. Together with the researchers and filmmaking team, the artist was involved in aspects of the process. The artist contributed two paintings, detailing the story of his life and TBI. Based on the artworks, a film was co-created. Following the viewing of the film, impacts of the narrative and arts-based process were examined through semi-structured interviews with the artist, a service provider and a family member. Multiple sources of data were used in the final thematic analysis including transcripts of the interviews and filming, paintings (including storylines) and researcher notes.Results:Positive impacts from the process for the artist included positive challenge; healing and identity; understanding TBI and raising awareness.Discussion:This approach may enable the individual to take ownership over their transition story and to make sense of their life following TBI at a critical point in their recovery. A combined narrative and arts-based approach has potential as a culturally responsive rehabilitation tool for use with Indigenous Australians during the transition period following TBI.


2016 ◽  
Vol 97 (2) ◽  
pp. S46-S53 ◽  
Author(s):  
Emily Nalder ◽  
Jennifer Fleming ◽  
Petrea Cornwell ◽  
Michele Foster ◽  
Elizabeth Skidmore ◽  
...  

Author(s):  
Duangsuda Siripituphum ◽  
Praneed Songwathana ◽  
Natenapha Khupantavee ◽  
Ishan Williams

Objective: We aimed to explore the situations and experiences of Thai traumatic brain injury (TBI) caregivers and nurses who care for TBI patients during their transition from hospital to home. Material and Methods: A descriptive qualitative study was conducted in a tertiary hospital, in Songkhla province, Thailand. Five TBI family caregivers and nine nurses, who cared for TBI patients from admission to discharge, were selected for in-depth interviews and focus group discussions. Reviews of existing documents related to caring for someone during a transition period; such as: the caregiver’s booklet manual, nurse’s guideline, discharge education, and the service plan were also analyzed. Content analysis was used to explore caring for someone during a TBI situation, within the Thai context. Results: The findings revealed six main barriers in the current care system for TBI caregivers and nurses. These included: (1) inadequate discharge teaching information, (2) less time in caregiver’s supervision and support, (3) lack of a comprehensive discharge plan, (4) lack of coordination and communication in follow-up care, (5) less confidence in providing care without support at home, and (6) poor availability of resources and time for consultation. Conclusion: Caregivers require more information and supportive care in order to enhance their adaptation in taking care of TBI patients in the long term. Developing a tele-nursing based caregiver transitional support program among TBI caregivers is suggested.


2019 ◽  
Vol 20 (2) ◽  
pp. 137-159 ◽  
Author(s):  
Michelle S. Fitts ◽  
Katrina Bird ◽  
John Gilroy ◽  
Jennifer Fleming ◽  
Alan R. Clough ◽  
...  

AbstractObjective:A growing body of qualitative literature globally describes post-hospital experiences during early recovery from a traumatic brain injury. For Indigenous Australians, however, little published information is available. This study aimed to understand the lived experiences of Indigenous Australians during the 6 months post-discharge, identify the help and supports accessed during transition and understand the gaps in service provision or difficulties experienced.Methods and Procedure:Semi-structured interviews were conducted at 6 months after hospital discharge to gain an understanding of the needs and lived experiences of 11 Aboriginal and Torres Strait Islander Australians who had suffered traumatic brain injury in Queensland and Northern Territory, Australia. Data were analysed using thematic analysis.Results:Five major themes were identified within the data. These were labelled ‘hospital experiences’, ‘engaging with medical and community-based supports’, ‘health and wellbeing impacts from the injury’, ‘everyday living’ and ‘family adjustments post-injury’.Conclusions:While some of the transition experiences for Indigenous Australians were similar to those found in other populations, the transition period for Indigenous Australians is influenced by additional factors in hospital and during their recovery process. Lack of meaningful interaction with treating clinicians in hospital, challenges managing direct contact with multiple service providers and the injury-related psychological impacts are some of the factors that could prevent Indigenous Australians from receiving the supports they require to achieve their best possible health outcomes in the long term. A holistic approach to care, with an individualised, coordinated transition support, may reduce the risks for re-admission with further head injuries.


2017 ◽  
Vol 98 (11) ◽  
pp. 2118-2125.e1 ◽  
Author(s):  
Pradeep Suri ◽  
Kelly Stolzmann ◽  
Katherine M. Iverson ◽  
Rhonda Williams ◽  
Mark Meterko ◽  
...  

2015 ◽  
Vol 23 (4) ◽  
pp. 211-224 ◽  
Author(s):  
Ann Glang ◽  
Deborah Ettel ◽  
Bonnie Todis ◽  
Wayne A. Gordon ◽  
Jennifer M. Oswald ◽  
...  

2018 ◽  
Vol 61 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Gian Candrian ◽  
Andreas Müller ◽  
Patrizia Dall’Acqua ◽  
Kyveli Kompatsiari ◽  
Gian-Marco Baschera ◽  
...  

2021 ◽  
Vol 36 (5) ◽  
pp. 388-395 ◽  
Author(s):  
Anthony V. Herrera ◽  
Linda Wastila ◽  
Jessica P. Brown ◽  
Hegang Chen ◽  
Steven R. Gambert ◽  
...  

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