Grace Notes: feasibility of a manualized intervention to advance spiritual well-being for clients with acquired brain injury

Abstract Background Following an acquired brain injury, individuals frequently experience anxiety and/or depressive symptoms. However, current treatments for these symptoms are not very effective. A promising treatment is acceptance and commitment therapy (ACT), which is a third-wave behavioural therapy. The primary goal of this therapy is not to reduce symptoms, but to improve psychological flexibility and general well-being, which may be accompanied by a reduction in symptom severity. The aim of this study is to investigate the effectiveness of an adapted ACT intervention (BrainACT) in people with acquired brain injury who experience anxiety and/or depressive symptoms. Methods The study is a multicenter, randomized, controlled, two-arm parallel trial. In total, 94 patients who survive a stroke or traumatic brain injury will be randomized into an ACT or control (i.e. psycho-education and relaxation) intervention. The primary outcome measures are the Hospital Anxiety and Depression Scale and the Depression Anxiety Stress Scale. Outcomes will be assessed by trained assessors, blinded to treatment condition, pre-treatment, during treatment, post-treatment, and at 7 and 12 months. Discussion This study will contribute to the existing knowledge on how to treat psychological distress following acquired brain injury. If effective, BrainACT could be implemented in clinical practice and potentially help a large number of patients with acquired brain injury. Trial registration Dutch Trial Register, NL691, NTR 7111. Registered on 26 March 2018. https://www.trialregister.nl/trial/6916.

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Spiritual Well-Being as a Predictor of Emotional Impairment Following Mild Traumatic Brain Injury

Journal of Clinical Psychology in Medical Settings ◽

10.1007/s10880-019-09687-3 ◽

2019 ◽

Vol 27 (4) ◽

pp. 859-866

Author(s):

Angela Sekely ◽

Yimin Xie ◽

Aalim Makani ◽

Tyler Brown ◽

Konstantine K. Zakzanis

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Well Being ◽

Spiritual Well Being ◽

Emotional Impairment

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Support for family members who are caregivers to relatives with acquired brain injury

Journal of Mind and Medical Sciences ◽

10.22543/7674.81.p7685 ◽

2021 ◽

Vol 8 (1) ◽

pp. 76-85

Author(s):

Janet Walker ◽

Lourens Schlebusch ◽

Bernhard Gaede

Keyword(s):

Brain Injury ◽

Suicidal Ideation ◽

Family Caregivers ◽

Qualitative Data ◽

Family Members ◽

Acquired Brain Injury ◽

Well Being ◽

Self Report ◽

Cross Sectional ◽

Significance Level

Objectives. Family members caring for a patient with acquired brain injury (ABI) are coping with inordinate levels of stress partially due to their lack of understanding of the neuropsychological effects of acquired brain injury in the patient. The objective of this research is to show that as the caregivers’ stress levels increase, there is an increase in suicidal ideation. This highlights the causal relationship between unhealthy stress and reduced psychological well-being in these caregivers. In addition, qualitative research evidence regarding the caregivers’ views of their main sources of stress are presented. Methods. The participants were a random sample of 80 family caregivers of patients with acquired brain injury, out of whom 72.5% (58) are primary caregivers and 27.5% (22) are secondary caregivers. A mixed methodology was utilized. It comprised cross-sectional descriptive and phenomenological approaches. Quantitative data were obtained from two standardized measures: The Stress Symptom Checklist (SSCL) and item 9 of the Beck Depression Inventory. The qualitative data were derived from self-report procedures that were part of a structured questionnaire administered individually during the interviews. Results. The Kruskal-Wallis test with a significance level of p = .05 was used to compare the stress and suicidal ideation scores, which revealed that increasing levels of stress led to increased suicidality. The analysis of the qualitative data revealed five themes which were identified as the triggers of the caregivers’ profound stress. Most caregivers felt that it was predominantly the patient’s neuropsychological deficits, such as emotions and/or moods, cognitive ability, behavior and personality, executive function, and social factors that caused them profound stress. Conclusions. Support and education are needed to help family caregivers understand the neuropsychological impact of acquired brain injury on the patient. Once caregivers have an improved understanding and receive better support from healthcare providers, they should experience less stress and be better prepared to provide the appropriate support to patients with acquired brain injury.

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Case management after acquired brain injury compared to care as usual: study protocol for a two-year pragmatic randomized controlled trial

10.21203/rs.3.rs-29724/v1 ◽

2020 ◽

Author(s):

Annemarie Stiekema ◽

Christine Resch ◽

Mireille Donkervoort ◽

Natska Jansen ◽

Kitty HM Jurrius ◽

...

Keyword(s):

Cost Effectiveness ◽

Brain Injury ◽

Case Management ◽

Self Efficacy ◽

Unmet Needs ◽

Acquired Brain Injury ◽

Well Being ◽

Family Needs ◽

Randomized Controlled

Abstract Background: People with acquired brain injury may suffer from cognitive, emotional and behavioural changes in the long term. Continuity of care is often lacking, leading to a variety of unmet needs and hindering psychosocial functioning from the occurrence of brain injury up to years thereafter. Case management aims to prevent (escalation of) problems and to facilitate timely access to appropriate services. In other populations, case management has shown to improve psychosocial well-being. In this study, we aim to evaluate the feasibility of case management after acquired brain injury and its effectiveness and cost-effectiveness, compared to care as usual.Methods: This is a pragmatic randomized controlled study with repeated measures in adults with ABI and their family, taking place between November 2019 and December 2021 in three provinces in the Netherlands. Participants will be randomly allocated to either the case management group, receiving case management from hospital discharge up to two years thereafter, or the control group, receiving care as usual. Effectiveness will be evaluated every six months for 18-24 months by patient-reported psychosocial well-being (Hospital Anxiety and Depression Scale (HADS), Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P) restriction subscale and the Life Satisfaction Questionnaire (LiSat)), self-management (Patient Activation Measure (PAM)) and care needs (Longer-term Unmet Needs after Stroke (LUNS)). Family outcomes include self-efficacy (Carer Self-Efficacy Scale (CSES)), caregiver burden (Caregiver Strain Index (CSI)), psychosocial well-being (LiSat, HADS), family needs (Family Needs Questionnaire (FNQ)). Feasibility will be evaluated using qualitative methods, assessing fidelity, dose delivered, dose received, reach, recruitment and context. Cost-effectiveness will be determined by the EQ-5D-3L and service use.Discussion: At the moment there is no integrated health care service for people with acquired brain injury and their family members in the long-term. If case management is shown to be feasible and (cost)-effective, it could bridge the gap between patients’ and families’ needs and the available services.Trial registration: Netherlands Trial Register, NL8104. Registered 22 October 2019, https://www.trialregister.nl/trial/8104.

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Quality of life, psychological well-being, and resilience in caregivers of people with acquired brain injury (ABI)

Brain Injury ◽

10.1080/02699052.2020.1725127 ◽

2020 ◽

Vol 34 (4) ◽

pp. 480-488 ◽

Cited By ~ 3

Author(s):

Laura Bermejo-Toro ◽

Macarena Sánchez-Izquierdo ◽

Esther Calvete ◽

María Angustias Roldán

Keyword(s):

Quality Of Life ◽

Brain Injury ◽

Acquired Brain Injury ◽

Well Being ◽

Psychological Well Being

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The Intensive Cognitive-Communication Rehabilitation Program for Young Adults With Acquired Brain Injury

American Journal of Speech-Language Pathology ◽

10.1044/2018_ajslp-17-0153 ◽

2019 ◽

Vol 28 (1S) ◽

pp. 341-358 ◽

Cited By ~ 2

Author(s):

Natalie Gilmore ◽

Katrina Ross ◽

Swathi Kiran

Keyword(s):

Young Adults ◽

Brain Injury ◽

Classroom Behavior ◽

Large Population ◽

Acquired Brain Injury ◽

Skills Training ◽

Well Being ◽

Individual Therapy ◽

Cognitive Linguistic ◽

Being There

PurposeThis study investigated the effects of an intensive cognitive-communication rehabilitation (ICCR) program for young individuals with chronic acquired brain injury.MethodICCR included classroom lectures; metacognitive instruction, modeling, and application; technology skills training; and individual cognitive–linguistic therapy. Four individuals participated in the intensive program (6 hr with 1-hr lunch break × 4 days × 12 weeks of treatment): 3 participants completed 3 consecutive semesters, and 1 participant completed 1 semester. Two controls did not receive treatment and completed assessments before and after the 12-week treatment interval only.ResultsAll 4 experimental participants demonstrated significant improvements on at least 1 standardized cognitive–linguistic measure, whereas controls did not. Furthermore, time point significantly predicted participants' scores on 2 of the 4 standardized outcome measures, indicating that as duration in ICCR increased, scores also increased. Participants who completed multiple semesters of ICCR also improved in their therapy and personal goals, classroom behavior, life participation, and quality of life.ConclusionAfter ICCR, participants showed gains in their cognitive–linguistic functioning, classroom participation, and individual therapy. They also demonstrated improvements outside the classroom and in their overall well-being. There is a gap between the large population of young adults with acquired brain injury who wish to return to higher education and a lack of rehabilitation programs supporting reentry into academic environments; ICCR is a first step in reducing that gap.

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A systematic review of the qualitative literature on older individuals’ experiences of care and well‐being during physical rehabilitation for acquired brain injury

Journal of Advanced Nursing ◽

10.1111/jan.15016 ◽

2021 ◽

Author(s):

Panagiota Lafiatoglou ◽

Caroline Ellis‐Hill ◽

Mary Gouva ◽

Avraam Ploumis ◽

Stefanos Mantzoukas

Keyword(s):

Systematic Review ◽

Brain Injury ◽

Acquired Brain Injury ◽

Well Being ◽

Physical Rehabilitation ◽

Older Individuals ◽

Qualitative Literature

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A therapeutic songwriting intervention to promote reconstruction of self-concept and enhance well-being following brain or spinal cord injury: pilot randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215519831417 ◽

2019 ◽

Vol 33 (6) ◽

pp. 1045-1055 ◽

Cited By ~ 2

Author(s):

Felicity A Baker ◽

Jeanette Tamplin ◽

Nikki Rickard ◽

Jennie Ponsford ◽

Peter W New ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Brain Injury ◽

Controlled Trial ◽

Intervention Group ◽

Acquired Brain Injury ◽

Well Being ◽

Community Dwelling ◽

Retention Rates ◽

Cord Injury

Objective: To determine the size of the effects and feasibility (recruitment and retention rates) of a therapeutic songwriting protocol for in-patients and community-dwelling people with acquired brain injury or spinal cord injury. Design: Randomized controlled trial with songwriting intervention and care-as-usual control groups, in a mixed measures design assessed at three time points. Participants: A total of 47 participants (3 in-patients with acquired brain injury, 20 community participants with acquired brain injury, 12 in-patients with spinal cord injury, and 12 community participants with spinal cord injury: 23 1208 days post injury). Interventions: The intervention group received a 12-session identity-targeted songwriting programme, where participants created three songs reflecting on perceptions of past, present, and future self. Control participants received care as usual. Measures: Baseline, postintervention, and follow-up measures comprised the Head Injury Semantic Differential Scale (primary outcome measure), Patient Health Questionnaire-9, Emotion Regulation Questionnaire, and Satisfaction with Life Scale. Results: No significant between group pre–post intervention differences were found on the primary self-concept measure, the Head Injury Semantic Differential Scale ( p = 0.38, d = 0.44). Significant and large effect sizes from baseline to post between groups in favour of the songwriting group for Satisfaction with Life ( p = 0.04, n2 p = 0.14). There were no significant between group pre-post interaction effects for the Emotion Regulation Suppression subscale ( p = 0.12, n2 p = –0.08) although scores decreased in the songwriting group over time while increasing for the standard care group. There were no significant differences in baseline to follow-up between groups in any other outcome measures. Recruitment was challenging due to the small number of people eligible to participate combined with poor uptake by eligible participants, particularly the in-patient group. Retention rates were higher for the community-dwelling cohorts. Conclusion: This study demonstrates the challenges in recruitment and retention of participants invited to participate in a music therapy study. Findings suggest this identity-focused therapeutic songwriting protocols may be more beneficial for people who have transitioned from in-patient to community-contexts given the greater proportion of participants who consent and complete the intervention. Preliminary effects in favour of the intervention group were detected in a range of well-being measures suggesting that a larger study is warranted.

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