Supervision Needs Following Veteran and Service Member Traumatic Brain Injury: A VA TBIMS Study

2016 ◽  
Author(s):  
Erin K. Bailey ◽  
Risa N. Richardson ◽  
Scott D. Barnett ◽  
Christina Dillahunt-Aspillaga ◽  
Mary Jo Pugh ◽  
...  
2017 ◽  
Vol 32 (4) ◽  
pp. 245-254 ◽  
Author(s):  
Erin K. Bailey ◽  
Risa Nakase-Richardson ◽  
Nitin Patel ◽  
Christina Dillahunt-Aspillaga ◽  
Susan A. Ropacki ◽  
...  

10.2196/14170 ◽  
2019 ◽  
Vol 8 (11) ◽  
pp. e14170
Author(s):  
Christine Melillo ◽  
Kiersten Downs ◽  
Christina Dillahunt-Aspillaga ◽  
Jason Lind ◽  
Karen Besterman-Dahan ◽  
...  

Background Numerous studies of community reintegration (CR) in traumatic brain injury (TBI) have been conducted in civilian populations, but research is limited in veteran and military service member populations. Little is known about how knowledge from civilian studies translates into veterans’ experiences and needs. The US Department of Veterans Health Administration (VHA) recognizes the distinctive health care needs of post-9/11 veteran and military service members, particularly with TBI, including the need to bridge health and rehabilitation-related services from acute care and inpatient settings to veteran and military service members’ homes and communities to facilitate CR. Objective The goal of this study is to better understand the experiences of veterans with complicated mild, moderate, or severe TBI; their families; and CR workers as veterans and servicemembers transition to and sustain living in communities. This paper describes the rationale, design, and methods used to reach this goal. Methods This five-year longitudinal mixed methods study uses both a community-engaged research (CEnR) approach and an ethnographic approach. The sample includes 30 veterans and service members with TBI, 13 family caregivers, 11 CR specialists, 16 key stakeholders, and 82 community events. Interviews and observations are coded and analyzed using hierarchical coding schemes and thematic analysis. Analyses include data from surveys, interviews, and participant observations. Content analysis is used to highlight the complex social context of reintegration and to triangulate quantitative data. Egocentric (personal) social network analysis is used to examine the support system a veteran or service member has in place to facilitate reintegration. Results Study enrollment and data collection are completed. Data analyses are underway. Conclusions The results of this study may provide a heightened understanding of environmental factors affecting CR in complicated mild, moderate, or severe TBI. Veteran, servicemember and family voices and insights provide VHA clinicians and policy makers with an ecological view of CR that is grounded in the life experiences of veterans, military service members, and families. The results of this study provide a roadmap for designing and testing interventions to maximize CR in a variety of domains. The longitudinal ethnographic approach allows for capturing detailed experiences within the naturalistic context. CEnR allows collaborative assessment of the social context of reintegration with community members. International Registered Report Identifier (IRRID) DERR1-10.2196/14170


2020 ◽  
Vol 32 (4) ◽  
pp. 341-351
Author(s):  
Tracey A. Brickell ◽  
Louis M. French ◽  
Sara M. Lippa ◽  
Megan M. Wright ◽  
Rael T. Lange

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A57-A57
Author(s):  
C Pattinson ◽  
T Brickell ◽  
J Bailie ◽  
L Hungerford ◽  
S Lippa ◽  
...  

Abstract Introduction Sleep disturbances are pervasively reported in military service members and veterans, especially following traumatic brain injury (TBI). The purpose of this study was to examine the association between sleep disturbances and neurobehavioural outcomes in a large group of U.S. military service members and veterans, with and without a history of TBI. Methods Participants were enrolled into the Defense and Veterans Brain Injury Center/Traumatic Brain Injury Center of Excellence, 15-Year Longitudinal TBI study (N = 606). Participants self-reported sleep disturbances (PROMIS 8A) and neurobehavioral symptoms. Data were analyzed using analysis of variance with post-hoc comparisons. Four groups were analyzed separately: uncomplicated mild TBI (MTBI; n=218); complicated mild, moderate, severe, or penetrating - combined TBI (CTBI; n=118); injured controls (IC, i.e., orthopedic or soft-tissue injury without TBI; n=162); and non-injured controls (NIC; n=108). Results Participants in the MTBI group reported the highest proportion of moderate-severe sleep disturbances (66.5%) compared to the IC (54.9%), CTBI (47.5%), and NIC groups (34.3%). Participants classified as having Poor Sleep reported significantly worse scores on almost all TBI-QOL scales compared to those classified as having Good Sleep, regardless of TBI severity or even the presence of TBI (ps<.05, Cohen’s ds>.3). Discussion This study demonstrates that sleep disturbances remain a prevalent and debilitating concern in service member and veteran populations. Regardless of group (injured or NIC), sleep disturbances were common and were associated with significantly worse neurobehavioral functioning. When assessing and treating neurobehavioural symptoms, it is important to assess sleep, especially in service member and veteran populations.


2019 ◽  
Author(s):  
Christine Melillo ◽  
Kiersten Downs ◽  
Christina Dillahunt-Aspillaga ◽  
Jason Lind ◽  
Karen Besterman-Dahan ◽  
...  

BACKGROUND Numerous studies of community reintegration (CR) in traumatic brain injury (TBI) have been conducted in civilian populations, but research is limited in veteran and military service member populations. Little is known about how knowledge from civilian studies translates into veterans’ experiences and needs. The US Department of Veterans Health Administration (VHA) recognizes the distinctive health care needs of post-9/11 veteran and military service members, particularly with TBI, including the need to bridge health and rehabilitation-related services from acute care and inpatient settings to veteran and military service members’ homes and communities to facilitate CR. OBJECTIVE The goal of this study is to better understand the experiences of veterans with complicated mild, moderate, or severe TBI; their families; and CR workers as veterans and servicemembers transition to and sustain living in communities. This paper describes the rationale, design, and methods used to reach this goal. METHODS This five-year longitudinal mixed methods study uses both a community-engaged research (CEnR) approach and an ethnographic approach. The sample includes 30 veterans and service members with TBI, 13 family caregivers, 11 CR specialists, 16 key stakeholders, and 82 community events. Interviews and observations are coded and analyzed using hierarchical coding schemes and thematic analysis. Analyses include data from surveys, interviews, and participant observations. Content analysis is used to highlight the complex social context of reintegration and to triangulate quantitative data. Egocentric (personal) social network analysis is used to examine the support system a veteran or service member has in place to facilitate reintegration. RESULTS Study enrollment and data collection are completed. Data analyses are underway. CONCLUSIONS The results of this study may provide a heightened understanding of environmental factors affecting CR in complicated mild, moderate, or severe TBI. Veteran, servicemember and family voices and insights provide VHA clinicians and policy makers with an ecological view of CR that is grounded in the life experiences of veterans, military service members, and families. The results of this study provide a roadmap for designing and testing interventions to maximize CR in a variety of domains. The longitudinal ethnographic approach allows for capturing detailed experiences within the naturalistic context. CEnR allows collaborative assessment of the social context of reintegration with community members. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/14170


2019 ◽  
Vol 42 ◽  
Author(s):  
Colleen M. Kelley ◽  
Larry L. Jacoby

Abstract Cognitive control constrains retrieval processing and so restricts what comes to mind as input to the attribution system. We review evidence that older adults, patients with Alzheimer's disease, and people with traumatic brain injury exert less cognitive control during retrieval, and so are susceptible to memory misattributions in the form of dramatic levels of false remembering.


2020 ◽  
Vol 5 (1) ◽  
pp. 88-96
Author(s):  
Mary R. T. Kennedy

Purpose The purpose of this clinical focus article is to provide speech-language pathologists with a brief update of the evidence that provides possible explanations for our experiences while coaching college students with traumatic brain injury (TBI). Method The narrative text provides readers with lessons we learned as speech-language pathologists functioning as cognitive coaches to college students with TBI. This is not meant to be an exhaustive list, but rather to consider the recent scientific evidence that will help our understanding of how best to coach these college students. Conclusion Four lessons are described. Lesson 1 focuses on the value of self-reported responses to surveys, questionnaires, and interviews. Lesson 2 addresses the use of immediate/proximal goals as leverage for students to update their sense of self and how their abilities and disabilities may alter their more distal goals. Lesson 3 reminds us that teamwork is necessary to address the complex issues facing these students, which include their developmental stage, the sudden onset of trauma to the brain, and having to navigate going to college with a TBI. Lesson 4 focuses on the need for college students with TBI to learn how to self-advocate with instructors, family, and peers.


2019 ◽  
Vol 28 (3) ◽  
pp. 1363-1370 ◽  
Author(s):  
Jessica Brown ◽  
Katy O'Brien ◽  
Kelly Knollman-Porter ◽  
Tracey Wallace

Purpose The Centers for Disease Control and Prevention (CDC) recently released guidelines for rehabilitation professionals regarding the care of children with mild traumatic brain injury (mTBI). Given that mTBI impacts millions of children each year and can be particularly detrimental to children in middle and high school age groups, access to universal recommendations for management of postinjury symptoms is ideal. Method This viewpoint article examines the CDC guidelines and applies these recommendations directly to speech-language pathology practices. In particular, education, assessment, treatment, team management, and ongoing monitoring are discussed. In addition, suggested timelines regarding implementation of services by speech-language pathologists (SLPs) are provided. Specific focus is placed on adolescents (i.e., middle and high school–age children). Results SLPs are critical members of the rehabilitation team working with children with mTBI and should be involved in education, symptom monitoring, and assessment early in the recovery process. SLPs can also provide unique insight into the cognitive and linguistic challenges of these students and can serve to bridge the gap among rehabilitation and school-based professionals, the adolescent with brain injury, and their parents. Conclusion The guidelines provided by the CDC, along with evidence from the field of speech pathology, can guide SLPs to advocate for involvement in the care of adolescents with mTBI. More research is needed to enhance the evidence base for direct assessment and treatment with this population; however, SLPs can use their extensive knowledge and experience working with individuals with traumatic brain injury as a starting point for post-mTBI care.


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