Strategies to Facilitate Successful Community Reintegration Following Acquired Brain Injury (ABI)

Acquired brain injury (ABI) is considered to be the primary cause of disability in our society. People with ABI face an array of challenges, which include emotional lability, disinhibition, irritability, distractibility, executive dysfunction, memory difficulties, inattention and noticeable changes to personality. Effective rehabilitation and community reintegration is considered essential for those with ABI but impeding the process is society's lack of knowledge and understanding. This is due in some part to the invisible nature of the disability. The focus of this article is to introduce the key areas that influence reintegration, being the rehabilitation process, service access and interventions. It is clear the reintegration process is greatly restricted by the lack of services and programs available to improve the long-term outcomes for people with ABI. To help facilitate successful community reintegration the article developed and lists a significant number of management strategies to assist those who are involved in the lives of people with ABI.

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Right people, right time? a qualitative study of service access experiences of adults with acquired brain injury following discharge from inpatient rehabilitation

Brain Impairment ◽

10.1017/brimp.2020.12 ◽

2020 ◽

pp. 1-16

Author(s):

Michele Foster ◽

Melissa Legg ◽

Eloise Hummell ◽

Letitia Burridge ◽

Kirsty Laurie

Keyword(s):

Brain Injury ◽

Acquired Brain Injury ◽

Inpatient Rehabilitation ◽

Service Access ◽

Personal Recovery ◽

Structured Interviews ◽

Perceived Needs ◽

Specialist Services ◽

Positive Experiences

Abstract Purpose: The intention of this paper is to develop the personal concept of appropriate access. We report on the service access experiences and opportunities of adults with an acquired brain injury after leaving inpatient rehabilitation. The benefits of appropriate access underpin standards in early and long-term recovery, though users’ access needs are highly personal. Methods: The study used a qualitative design involving 16 semi-structured interviews with Australian adults with an acquired brain injury after discharge from inpatient brain rehabilitation. Data were thematically analysed. Results: Three main themes were derived from the analysis. Theme 1 shows that participants valued being steered to services that providers thought appropriate for them early after discharge from inpatient rehabilitation. Theme 2 highlights the tensions between timing and personal recovery and perceived needs. Theme 3 captures participants’ insights into the challenges of gaining access vis-a-vis what the system offers and the enablers of actualising appropriate access. Conclusion: The positive experiences of being directed to specialist services early after discharge suggest that continuity of care constitutes appropriateness of access for participants in this study. However, it is also clear that continuity should not displace flexibility in the timing of services, to accord with individuals’ perceived needs. This, in addition to enablement of access opportunities, through funding and transport, are important in maintaining a personalised approach.

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Short-Term and Long-Term Outcomes of a Vocational Rehabilitation Program for Patients with Acquired Brain Injury in The Netherlands

Journal of Occupational Rehabilitation ◽

10.1007/s10926-017-9738-6 ◽

2017 ◽

Vol 28 (3) ◽

pp. 523-530 ◽

Cited By ~ 4

Author(s):

Caroline H. van Dongen ◽

Paulien H. Goossens ◽

Inge E. van Zee ◽

Kirsten N. Verpoort ◽

Thea P. M. Vliet Vlieland ◽

...

Keyword(s):

Brain Injury ◽

The Netherlands ◽

Vocational Rehabilitation ◽

Acquired Brain Injury ◽

Rehabilitation Program ◽

Long Term Outcomes ◽

Short Term

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Neurobehavioural rehabilitation

Oxford Textbook of Neuropsychiatry ◽

10.1093/med/9780198757139.003.0040 ◽

2020 ◽

pp. 475-482

Author(s):

Rodger L. Wood ◽

Nick Alderman ◽

Andrew Worthington

Keyword(s):

Social Cognition ◽

Brain Injury ◽

Self Regulation ◽

Acquired Brain Injury ◽

Challenging Behaviour ◽

Community Settings ◽

Functional Skills ◽

Rehabilitation Process ◽

Brain Injured

Helping brain-injured people re-adapt to society requires a system that provides individuals with opportunities to learn and apply social and functional skills in community settings. However, many types of acquired brain injury cause damage to prefrontal structures that are central to behavioural self-regulation, giving rise to complex patterns of socially challenging behaviour that can deny access to rehabilitation. Neurobehavioural rehabilitation was initially developed to address long-term problems of challenging behaviour that prevented individuals from engaging meaningfully with the rehabilitation process. However, it has evolved to promote psychosocial recovery more broadly, with the aim of changing behaviour from disabled, inappropriate, and socially handicapped to adaptive, purposeful, and ‘independent’. It is a paradigm that incorporates methods of associational learning within a structured environment that emphasizes clear feedback to raise awareness of behaviour, in a way that improves social cognition and self-regulation, to promote community independence.

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Traumatic Brain Injury: A Trauma Surgeon's Perspective

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld22.3.82 ◽

2012 ◽

Vol 22 (3) ◽

pp. 82-89

Author(s):

Oscar D. Guillamondegui

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Multidisciplinary Approach ◽

Trauma Team ◽

The United States ◽

Long Term Outcomes ◽

Term Care ◽

Injured Brain ◽

The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

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Incremental Validity of Neuropsychological Evaluations and CT Scans in Predicting Long-Term Outcomes for Persons With Traumatic Brain Injury

PsycEXTRA Dataset ◽

10.1037/e708332011-001 ◽

2011 ◽

Cited By ~ 1

Author(s):

Michael W. Williams ◽

Lisa J. Rapport ◽

Hillary A. Greene ◽

Robin A. Hanks ◽

Scott R. Millis

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Incremental Validity ◽

Ct Scans ◽

Long Term Outcomes ◽

Neuropsychological Evaluations

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Petroclival meningiomas: long-term outcomes of multimodal treatments and management strategies based on 30 years of experience at a single institution

Journal of Neurosurgery ◽

10.3171/2019.2.jns182604 ◽

2020 ◽

Vol 132 (6) ◽

pp. 1675-1682 ◽

Cited By ~ 5

Author(s):

Jin Wook Kim ◽

Hee-Won Jung ◽

Yong Hwy Kim ◽

Chul-Kee Park ◽

Hyun-Tai Chung ◽

...

Keyword(s):

Adjuvant Treatment ◽

Management Strategies ◽

Local Tumor Control ◽

Tumor Control ◽

Years Of Experience ◽

Local Tumor ◽

Long Term Outcomes ◽

Single Institution ◽

Petroclival Meningiomas

OBJECTIVEA thorough investigation of the long-term outcomes and chronological changes of multimodal treatments for petroclival meningiomas is required to establish optimal management strategies. The authors retrospectively reviewed the long-term clinical outcomes of patients with petroclival meningioma according to various treatments, including various surgical approaches, and they suggest treatment strategies based on 30 years of experience at a single institution.METHODSNinety-two patients with petroclival meningiomas were treated surgically at the authors’ institution from 1986 to 2015. Patient demographics, overall survival, local tumor control rates, and functional outcomes according to multimodal treatments, as well as chronological change in management strategies, were evaluated. The mean clinical and radiological follow-up periods were 121 months (range 1–368 months) and 105 months (range 1–348 months), respectively.RESULTSA posterior transpetrosal approach was most frequently selected and was followed in 44 patients (48%); a simple retrosigmoid approach, undertaken in 30 patients, was the second most common. The initial extent of resection and following adjuvant treatment modality were classified into 3 subgroups: gross-total resection (GTR) only in 13 patients; non-GTR treatment followed by adjuvant radiosurgery or radiation therapy (non-GTR+RS/RT) in 56 patients; and non-GTR without adjuvant treatment (non-GTR only) in 23 patients. The overall progression-free survival rate was 85.8% at 5 years and 81.2% at 10 years. Progression or recurrence rates according to each subgroup were 7.7%, 12.5%, and 30.4%, respectively.CONCLUSIONSThe authors’ preferred multimodal treatment strategy, that of planned incomplete resection and subsequent adjuvant radiosurgery, is a feasible option for the management of patients with large petroclival meningiomas, considering both local tumor control and postoperative quality of life.

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Contribution of Rehabilitation Counsellors in the Rehabilitation of Persons with Acquired Brain Injury

Australian Journal of Rehabilitation Counselling ◽

10.1017/s1323892200100055 ◽

1995 ◽

Vol 1 (1) ◽

pp. 23-32 ◽

Cited By ~ 2

Author(s):

Ross Crisp

Keyword(s):

Brain Injury ◽

Service Delivery ◽

Case Management ◽

Therapeutic Relationship ◽

Systems Approach ◽

Acquired Brain Injury ◽

Rehabilitation Service ◽

Rehabilitation Process ◽

Counselling Practice ◽

Vocational Evaluation

Recent rehabilitation counselling literature has pointed to major developments in the contribution of rehabilitation counsellors to acquired brain injury (ABI) rehabilitation. Rehabilitation counsellors have widened their skill base in case management, vocational evaluation, and in the therapeutic relationship between counsellor and client. It is evident, however, that better methods of ABI rehabilitation service delivery, including those services provided by rehabilitation counsellors, continue to be sought. Strategies needed to ensure the advancement of rehabilitation counselling practice and research in ABI rehabilitation are discussed, and involve the adoption of a systems approach, a shift away from dominant clinical psychological analyses in favour of psychosocial frameworks, and the co-participation of persons with ABI in the rehabilitation process.

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