The Potential of a Narrative and Creative Arts Approach to Enhance Transition Outcomes for Indigenous Australians Following Traumatic Brain Injury

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.

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.


2012 ◽  
Vol 13 (1) ◽  
pp. 108-122 ◽  
Author(s):  
Emily Nalder ◽  
Jennifer Fleming ◽  
Petrea Cornwell ◽  
Michele Foster

The transition from hospital to home following traumatic brain injury (TBI) has been identified as the point where responsibility for care shifts from rehabilitation services to informal family caregivers. There has, however, been little research examining the experiences of family members during this important transition that involves adopting or, in some cases, resuming a caring role (e.g., a parent caring for an adult child). The aim of this qualitative investigation was to understand the experiences of family caregivers during the transition from hospital to home, defined as the first six months postdischarge. The sample included 10 family caregivers, of which all were female and either a mother, spouse or ex-partner of an individual with TBI. Semistructured interviews were conducted on average nine months following community reentry and data were analysed thematically using a framework approach. The overarching theme was that caregivers wished to move past the injury. This desire to move forward stemmed from a realisation of how their life had changed and the weight of the care responsibility. Caregivers were also aware of how the life of the individual with a TBI had changed and hoped for a return to normality (by regaining independence, engaging in meaningful occupation and having meaningful relationships). Implications of the findings for research and clinical practice are discussed. There is a need for services to support family caregivers during the transition from hospital to home.


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.


Author(s):  
Samantha Jayne Crewe-Brown ◽  
Alexandra Maria Stipinovich ◽  
Ursula Zsilavecz

Individuals with Mild Traumatic Brain Injury (MTBI) often perform within normal limits on linguistic and cognitive assessments. However, they may present with debilitating communicative difficulties in daily life. A multifaceted approach to MTBI with a focus on everyday communication in natural settings is required. Significant others who interact with the individual with MTBI in a variety of settings may be sensitive to communicative difficulties experienced by the individual with MTBI. This article examines communication after MTBI from the perspective of the spouse. A case study design was implemented. The spouses of two individuals with MTBI served as the participants for this study. Semi-structured interviews were held during which each participant was requested to describe the communication of their spouse with MTBI. The content obtained from the interviews was subjected to a discourse analysis. The results show that both participants perceived changes in the communication of their spouse following the MTBI. The results further show that MTBI impacted on the communication of the two individuals in different ways. The value of a significant other in providing information regarding communication in natural settings is highlighted. The implications of these findings for the assessment and management of the communication difficulties associated with MTBI is discussed.


Biomolecules ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 1196
Author(s):  
Nicolas Rouleau ◽  
Mattia Bonzanni ◽  
Joshua D. Erndt-Marino ◽  
Katja Sievert ◽  
Camila G. Ramirez ◽  
...  

Injury progression associated with cerebral laceration is insidious. Following the initial trauma, brain tissues become hyperexcitable, begetting further damage that compounds the initial impact over time. Clinicians have adopted several strategies to mitigate the effects of secondary brain injury; however, higher throughput screening tools with modular flexibility are needed to expedite mechanistic studies and drug discovery that will contribute to the enhanced protection, repair, and even the regeneration of neural tissues. Here we present a novel bioengineered cortical brain model of traumatic brain injury (TBI) that displays characteristics of primary and secondary injury, including an outwardly radiating cell death phenotype and increased glutamate release with excitotoxic features. DNA content and tissue function were normalized by high-concentration, chronic administrations of gabapentinoids. Additional experiments suggested that the treatment effects were likely neuroprotective rather than regenerative, as evidenced by the drug-mediated decreases in cell excitability and an absence of drug-induced proliferation. We conclude that the present model of traumatic brain injury demonstrates validity and can serve as a customizable experimental platform to assess the individual contribution of cell types on TBI progression, as well as to screen anti-excitotoxic and pro-regenerative compounds.


2013 ◽  
Vol 21 (4) ◽  
pp. 868-875 ◽  
Author(s):  
Rita de Cássia Almeida Vieira ◽  
Edilene Curvelo Hora ◽  
Daniel Vieira de Oliveira ◽  
Maria do Carmo de Oliveira Ribeiro ◽  
Regina Márcia Cardoso de Sousa

OBJECTIVE: to describe the quality of life of victims of traumatic brain injury six months after the event and to show the relationship between the results observed and the clinical, sociodemographic and return to productivity data. METHOD: data were analyzed from 47 victims assisted in a trauma reference hospital in the municipality of Aracaju and monitored in an outpatient neurosurgery clinic. The data were obtained through analysis of the patient records and structured interviews, with the application of the World Health Organization Quality of Life, brief version, questionnaire. RESULTS: the victims presented positive perceptions of their quality of life, and the physical domain presented the highest mean value (68.4±22.9). Among the sociodemographic characteristics, a statistically significant correlation was found between marital status and the psychological domain. However, the return to productivity was related to all the domains. CONCLUSION: the return to productivity was an important factor for the quality of life of the victims of traumatic brain injury and should direct the public policies in promoting the health of these victims.


Biofeedback ◽  
2009 ◽  
Vol 37 (3) ◽  
pp. 108-111
Author(s):  
Jay Gunkelman

Abstract Mild traumatic brain injury is often missed in the course of treating other injuries. This failure to identify the brain injury can be critically important, even life threatening. This report shows one such case in which the brain injury was overlooked, possibly because of the differential effect of age on the severity of the damage incurred from what appeared to be a mild trauma. Distant to the time of the injury, deficits in speech fluency and word finding led the individual to seek further evaluation, and imaging studies revealed a large subdural hematoma. CT scan images are included.


1993 ◽  
Vol 24 (1) ◽  
pp. 38-46 ◽  
Author(s):  
Craig A. Michaels ◽  
Donald A. Risucci

This study compared employers' and vocational rehabilitation counselors' attitudes and willingness to consider various workplace accommodations for individuals with traumatic brain injury (TBI). In addition to comparing what types of accommodations might be considered reasonable, the study also investigated both employers' and counselors' lack of willingness to make various accommodations. Lack of willingness to make accommodations was addressed in terms of the three most commonly offered reasons for why an accommodation is potentially not reasonable: (a) not fair to co-workers, (b) too time consuming, and (c) too costly. Scenarios were developed to directly gather information on potential accommodations for workers who displayed functional limitations within the seven capacity areas mentioned by the Rehabilitation Services Administration in their definition of severe disability. While for the most part counselors' views tended to be similar to those of employers, in general counselors tended to rate accommodations as more problematic than employers. In addition, counselors tended to view functional limitations within the individual as most problematic while employers viewed limitations in actual job performance as most problematic.


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

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