Pub Date : 2023-12-01Epub Date: 2022-05-30DOI: 10.1017/BrImp.2022.15
Michael Francis Norwood, David Ross Painter, Chelsea Hannah Marsh, Connor Reid, Trevor Hine, Daniel S Harvie, Susan Jones, Kelly Dungey, Ben Chen, Marilia Libera, Leslie Gan, Julie Bernhardt, Elizabeth Kendall, Heidi Zeeman
Background: Deficits in visuospatial attention, known as neglect, are common following brain injury, but underdiagnosed and poorly treated, resulting in long-term cognitive disability. In clinical settings, neglect is often assessed using simple pen-and-paper tests. While convenient, these cannot characterise the full spectrum of neglect. This protocol reports a research programme that compares traditional neglect assessments with a novel virtual reality attention assessment platform: The Attention Atlas (AA).
Methods/design: The AA was codesigned by researchers and clinicians to meet the clinical need for improved neglect assessment. The AA uses a visual search paradigm to map the attended space in three dimensions and seeks to identify the optimal parameters that best distinguish neglect from non-neglect, and the spectrum of neglect, by providing near-time feedback to clinicians on system-level behavioural performance. A series of experiments will address procedural, scientific, patient, and clinical feasibility domains.
Results: Analyses focuses on descriptive measures of reaction time, accuracy data for target localisation, and histogram-based raycast attentional mapping analysis; which measures the individual's orientation in space, and inter- and intra-individual variation of visuospatial attention. We will compare neglect and control data using parametric between-subjects analyses. We present example individual-level results produced in near-time during visual search.
Conclusions: The development and validation of the AA is part of a new generation of translational neuroscience that exploits the latest advances in technology and brain science, including technology repurposed from the consumer gaming market. This approach to rehabilitation has the potential for highly accurate, highly engaging, personalised care.
{"title":"The attention atlas virtual reality platform maps three-dimensional (3D) attention in unilateral spatial neglect patients: a protocol.","authors":"Michael Francis Norwood, David Ross Painter, Chelsea Hannah Marsh, Connor Reid, Trevor Hine, Daniel S Harvie, Susan Jones, Kelly Dungey, Ben Chen, Marilia Libera, Leslie Gan, Julie Bernhardt, Elizabeth Kendall, Heidi Zeeman","doi":"10.1017/BrImp.2022.15","DOIUrl":"10.1017/BrImp.2022.15","url":null,"abstract":"<p><strong>Background: </strong>Deficits in visuospatial attention, known as neglect, are common following brain injury, but underdiagnosed and poorly treated, resulting in long-term cognitive disability. In clinical settings, neglect is often assessed using simple pen-and-paper tests. While convenient, these cannot characterise the full spectrum of neglect. This protocol reports a research programme that compares traditional neglect assessments with a novel virtual reality attention assessment platform: <i>The Attention Atlas (AA).</i></p><p><strong>Methods/design: </strong>The AA was codesigned by researchers and clinicians to meet the clinical need for improved neglect assessment. The AA uses a visual search paradigm to map the attended space in three dimensions and seeks to identify the optimal parameters that best distinguish neglect from non-neglect, and the spectrum of neglect, by providing near-time feedback to clinicians on system-level behavioural performance. A series of experiments will address procedural, scientific, patient, and clinical feasibility domains.</p><p><strong>Results: </strong>Analyses focuses on descriptive measures of reaction time, accuracy data for target localisation, and histogram-based raycast attentional mapping analysis; which measures the individual's orientation in space, and inter- and intra-individual variation of visuospatial attention. We will compare neglect and control data using parametric between-subjects analyses. We present example individual-level results produced in near-time during visual search.</p><p><strong>Conclusions: </strong>The development and validation of the AA is part of a new generation of translational neuroscience that exploits the latest advances in technology and brain science, including technology repurposed from the consumer gaming market. This approach to rehabilitation has the potential for highly accurate, highly engaging, personalised care.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78795279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2022-05-31DOI: 10.1017/BrImp.2022.12
Marthe E Ford, Gert J Geurtsen, Ben Schmand, Erny Groet, Coen A M Van Bennekom, Eus J W Van Someren
Purpose: Sleep is essential for our overall health and wellbeing. Unfortunately, stroke often induces insomnia, which has been shown to impede rehabilitation and recovery of function. Cognitive behavioral therapy for insomnia (CBT-I) is the treatment of choice for insomnia in the general population and is efficacious both when delivered face-to-face or online. The primary aim of this study was to evaluate efficacy of blended CBT-I (eCBT-I) in five poststroke participants with insomnia according to DSM-5 criteria.
Methods: A randomized multiple baseline design was used to evaluate improvements in total sleep time, sleep onset latency, sleep efficiency, nocturnal awakenings and sleep quality. The intervention included six weeks of eCBT-I combined with two face-to-face sessions.
Results: All participants completed the intervention. One participant stopped using the diary, while the other four completed it fully. All five sleep diary measures improved, significantly so for nocturnal awakenings. Moreover, after completion of the treatment, four out of five participants no longer fulfilled DSM-5 criteria for insomnia disorder.
Conclusions: This is the first study to show that blended CBT-I is potentially effective in participants with post-stroke insomnia. The findings justify extension to a randomized controlled trial.
{"title":"Can people with poststroke insomnia benefit from blended cognitive behavioral therapy? A single case experimental design.","authors":"Marthe E Ford, Gert J Geurtsen, Ben Schmand, Erny Groet, Coen A M Van Bennekom, Eus J W Van Someren","doi":"10.1017/BrImp.2022.12","DOIUrl":"10.1017/BrImp.2022.12","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep is essential for our overall health and wellbeing. Unfortunately, stroke often induces insomnia, which has been shown to impede rehabilitation and recovery of function. Cognitive behavioral therapy for insomnia (CBT-I) is the treatment of choice for insomnia in the general population and is efficacious both when delivered face-to-face or online. The primary aim of this study was to evaluate efficacy of blended CBT-I (eCBT-I) in five poststroke participants with insomnia according to DSM-5 criteria.</p><p><strong>Methods: </strong>A randomized multiple baseline design was used to evaluate improvements in total sleep time, sleep onset latency, sleep efficiency, nocturnal awakenings and sleep quality. The intervention included six weeks of eCBT-I combined with two face-to-face sessions.</p><p><strong>Results: </strong>All participants completed the intervention. One participant stopped using the diary, while the other four completed it fully. All five sleep diary measures improved, significantly so for nocturnal awakenings. Moreover, after completion of the treatment, four out of five participants no longer fulfilled DSM-5 criteria for insomnia disorder.</p><p><strong>Conclusions: </strong>This is the first study to show that blended CBT-I is potentially effective in participants with post-stroke insomnia. The findings justify extension to a randomized controlled trial.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75778360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2022-12-23DOI: 10.1017/BrImp.2022.34
Rebecca El-Helou, Jeffrey M Rogers, Brooke Ryan, Dianne L Marsden, Ann Winkler, Andrew Baillie, Ian Kneebone
Mood problems are common after stroke, and screening is recommended. Training may support staff knowledge and implementation of screening, but the feasibility of training programmes in the Australian healthcare system has not been formally established. This study aimed to assess the feasibility of a mood screening training for a multidisciplinary team (MDT) of stroke clinicians working in a post-acute inpatient rehabilitation service.Twelve staff from a rehabilitation service at a major hospital in Sydney, Australia participated in a 3-h interactive training session. The feasibility of running the course, assessment of knowledge gained via a consolidation exercise and quiz and acceptability of the training were assessed via focus groups.The in-person modality of the training hindered recruitment and assessment of participants' knowledge, though the actual measures themselves appeared appropriate. Nine participants provided feedback in two focus groups. Thematic analysis identified positive reactions to the training. However, low self-efficacy persisted and organisational/socio-cultural barriers to implementation emerged. Following training, the medical officers of the MDT had successfully implemented routine screening.Overall, the training appeared acceptable and to foster knowledge in staff. However, limitations to recruitment and administering evaluations were identified. The development of flexible online training may improve future evaluations of screening training programmes/pathways.
{"title":"Evaluating the feasibility and acceptability of the Mood Assessment Post-Stroke (MAPS) mood screening training.","authors":"Rebecca El-Helou, Jeffrey M Rogers, Brooke Ryan, Dianne L Marsden, Ann Winkler, Andrew Baillie, Ian Kneebone","doi":"10.1017/BrImp.2022.34","DOIUrl":"10.1017/BrImp.2022.34","url":null,"abstract":"<p><p>Mood problems are common after stroke, and screening is recommended. Training may support staff knowledge and implementation of screening, but the feasibility of training programmes in the Australian healthcare system has not been formally established. This study aimed to assess the feasibility of a mood screening training for a multidisciplinary team (MDT) of stroke clinicians working in a post-acute inpatient rehabilitation service.Twelve staff from a rehabilitation service at a major hospital in Sydney, Australia participated in a 3-h interactive training session. The feasibility of running the course, assessment of knowledge gained via a consolidation exercise and quiz and acceptability of the training were assessed via focus groups.The in-person modality of the training hindered recruitment and assessment of participants' knowledge, though the actual measures themselves appeared appropriate. Nine participants provided feedback in two focus groups. Thematic analysis identified positive reactions to the training. However, low self-efficacy persisted and organisational/socio-cultural barriers to implementation emerged. Following training, the medical officers of the MDT had successfully implemented routine screening.Overall, the training appeared acceptable and to foster knowledge in staff. However, limitations to recruitment and administering evaluations were identified. The development of flexible online training may improve future evaluations of screening training programmes/pathways.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75262153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-01-05DOI: 10.1017/BrImp.2022.36
Anthony Pak-Hin Kong, Dustin Kai-Yan Lau, Daisy Ho-Ying Lai
Objective: Discourse analysis is one of the clinical methods commonly used to assess the language ability of individuals with traumatic brain injury (TBI). However, the majority of published analytic frameworks are not geared for highlighting the pragmatic aspect of discourse deficits in acquired language disorders, except for those designed for quantifying conversational samples. This study aimed to examine how pragmatic competence is impaired and reflected in spoken monologues in Chinese speakers with TBI.
Methods: Discourse samples of five tasks (personal narrative, storytelling, procedural, single- and sequential picture description) were elicited from ten TBI survivors and their controls. Each discourse sample was measured using 16 indices (e.g., number of informative words, percentage of local/global coherence errors, repeated words or phrases) that corresponded to the four Gricean maxims. Twenty-five naïve Chinese speakers were also recruited to perform perceptual rating of the quality of all 50 TBI audio files (five discourse samples per TBI participant), in terms of erroneous/inaccurate information, adequacy of amount of information given, as well as degree of organization and clarity.
Results: The maxim of quantity best predicted TBI's pragmatic impairments. Naïve listeners' perception of pragmatics deficits correlated to measures on total and informative words, as well as number and length of terminable units. Clinically, personal narrative and storytelling tasks could better elicit violations in pragmatics.
Conclusion: Applying Gricean maxims in monologic oral narratives could capture the hallmark underlying pragmatic problems in TBI. This may help provide an additional approach of clinically assessing social communications in and subsequent management of TBI.
{"title":"Measuring pragmatic competence of discourse output among Chinese-speaking individuals with traumatic brain injury.","authors":"Anthony Pak-Hin Kong, Dustin Kai-Yan Lau, Daisy Ho-Ying Lai","doi":"10.1017/BrImp.2022.36","DOIUrl":"10.1017/BrImp.2022.36","url":null,"abstract":"<p><strong>Objective: </strong>Discourse analysis is one of the clinical methods commonly used to assess the language ability of individuals with traumatic brain injury (TBI). However, the majority of published analytic frameworks are not geared for highlighting the pragmatic aspect of discourse deficits in acquired language disorders, except for those designed for quantifying conversational samples. This study aimed to examine how pragmatic competence is impaired and reflected in spoken monologues in Chinese speakers with TBI.</p><p><strong>Methods: </strong>Discourse samples of five tasks (personal narrative, storytelling, procedural, single- and sequential picture description) were elicited from ten TBI survivors and their controls. Each discourse sample was measured using 16 indices (e.g., number of informative words, percentage of local/global coherence errors, repeated words or phrases) that corresponded to the four Gricean maxims. Twenty-five naïve Chinese speakers were also recruited to perform perceptual rating of the quality of all 50 TBI audio files (five discourse samples per TBI participant), in terms of erroneous/inaccurate information, adequacy of amount of information given, as well as degree of organization and clarity.</p><p><strong>Results: </strong>The maxim of quantity best predicted TBI's pragmatic impairments. Naïve listeners' perception of pragmatics deficits correlated to measures on total and informative words, as well as number and length of terminable units. Clinically, personal narrative and storytelling tasks could better elicit violations in pragmatics.</p><p><strong>Conclusion: </strong>Applying Gricean maxims in monologic oral narratives could capture the hallmark underlying pragmatic problems in TBI. This may help provide an additional approach of clinically assessing social communications in and subsequent management of TBI.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89481718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2022-06-01DOI: 10.1017/BrImp.2022.10
Em Bould, Sue Sloan, Libby Callaway
Background and objectives: People with acquired brain injury (ABI) may experience behaviours of concern that require therapy services, including behaviour support. In Australia, the implementation of a National Disability Insurance Scheme (NDIS) and development of the NDIS Quality and Safeguards Commission, has led to significant changes to behaviour support workforce processes, and the way behaviour support is funded, regulated and delivered to people with ABI who are Scheme participants. The aim of this study was to explore the current and future provider market of professionals providing behaviour supports to Scheme participants who experience ABI.
Method: An anonymous survey was designed and distributed via social media channels, an email listserv and professional association newsletters to professionals working within the NDIS in Australia. Data were analysed using descriptive statistics and content analysis.
Results: One hundred and two surveys responses were analysed. A majority of professionals had an average understanding of the NDIS Quality and Safeguard Commission rules and policies on behaviour support. Responses to current and future registration as an NDIS Practitioner indicated the workforce gap could increase by between 17 and 26%. Respondents also raised concerns about the lack of training and experience of allied health professional students and graduates in addressing behaviours of concern. Responses to the open-ended question highlighted additional issues in the provision of behaviour support within the NDIS.
Conclusions: This research highlighted the need for an NDIS behaviour support workforce strategy and supply-side market intervention to ensure a viable and sustainable workforce for people with ABI who need behaviour support.
{"title":"Behaviour support for people with acquired brain injury within the National Disability Insurance Scheme: an Australian survey of the provider market.","authors":"Em Bould, Sue Sloan, Libby Callaway","doi":"10.1017/BrImp.2022.10","DOIUrl":"10.1017/BrImp.2022.10","url":null,"abstract":"<p><strong>Background and objectives: </strong>People with acquired brain injury (ABI) may experience behaviours of concern that require therapy services, including behaviour support. In Australia, the implementation of a National Disability Insurance Scheme (NDIS) and development of the NDIS Quality and Safeguards Commission, has led to significant changes to behaviour support workforce processes, and the way behaviour support is funded, regulated and delivered to people with ABI who are Scheme participants. The aim of this study was to explore the current and future provider market of professionals providing behaviour supports to Scheme participants who experience ABI.</p><p><strong>Method: </strong>An anonymous survey was designed and distributed via social media channels, an email listserv and professional association newsletters to professionals working within the NDIS in Australia. Data were analysed using descriptive statistics and content analysis.</p><p><strong>Results: </strong>One hundred and two surveys responses were analysed. A majority of professionals had an average understanding of the NDIS Quality and Safeguard Commission rules and policies on behaviour support. Responses to current and future registration as an NDIS Practitioner indicated the workforce gap could increase by between 17 and 26%. Respondents also raised concerns about the lack of training and experience of allied health professional students and graduates in addressing behaviours of concern. Responses to the open-ended question highlighted additional issues in the provision of behaviour support within the NDIS.</p><p><strong>Conclusions: </strong>This research highlighted the need for an NDIS behaviour support workforce strategy and supply-side market intervention to ensure a viable and sustainable workforce for people with ABI who need behaviour support.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88487713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2022-11-17DOI: 10.1017/BrImp.2022.26
Anne Henning, Michael Linden, Beate Muschalla
Objective: The purpose of this study was to compare the self- and observer ratings of capacity limitations in patients with neurological conditions. Research on this topic is relevant for assessing the patients' ability to participate in work and social life and improving collaborative patient-clinician relationships.
Method: The self- and observer ratings of capacity limitations in a sample of N = 245 patients with neurological conditions from a rehabilitation facility were compared and assessed using the short rating of activity limitations and participation restrictions in mental disorders according to the International Classification of Functioning, Disability and Health (Mini-ICF-APP) and the equivalent self-rating questionnaire (Mini-ICF-APP-S).
Results: Paired-samples t-tests revealed significant differences between the self- and observer ratings for six out of 13 capacity dimensions. On average, the patients rated the capacity dimensions adherence to regulations, planning and structuring of tasks, professional competency and endurance as significantly less limited, in comparison to the observers (small to medium effect sizes). The self-ratings for limitation of contact with others and self-care were only marginally higher than the observer ratings.
Conclusions: The findings show that psychological capacity limitations occur in patients with neurological conditions. In clinical practice, limitations in each capacity dimension and discrepancies in patient- and clinician-ratings should be thoroughly assessed. This is especially relevant in patients with neurological conditions who have a potential tendency to underestimate or deny their disability.
研究目的本研究旨在比较神经系统疾病患者自我和观察者对能力限制的评价。有关这一主题的研究对于评估患者参与工作和社会生活的能力以及改善患者与医生之间的合作关系具有重要意义:方法:使用《国际功能、残疾和健康分类》(Mini-ICF-APP)中的精神障碍活动限制和参与限制简易评分法(Mini-ICF-APP-S)以及等效的自我评分问卷(Mini-ICF-APP-S),对来自康复机构的 N = 245 名神经系统疾病患者的能力限制自我评分和观察者评分进行比较和评估:在 13 个能力维度中,有 6 个维度的自我评分与观察者评分存在显著差异。平均而言,与观察者相比,患者对遵守规章制度、计划和安排任务、专业能力和耐力等能力维度的评分明显较低(小至中等效应大小)。在与他人接触的限制和自我照顾方面,患者的自我评分仅略高于观察者的评分:研究结果表明,神经系统疾病患者会出现心理能力限制。在临床实践中,应全面评估每个能力维度的限制以及患者和临床医生评分之间的差异。这一点对神经系统疾病患者尤为重要,因为他们可能会低估或否认自己的残疾。
{"title":"Self- and observer ratings of capacity limitations in patients with neurological conditions.","authors":"Anne Henning, Michael Linden, Beate Muschalla","doi":"10.1017/BrImp.2022.26","DOIUrl":"10.1017/BrImp.2022.26","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to compare the self- and observer ratings of capacity limitations in patients with neurological conditions. Research on this topic is relevant for assessing the patients' ability to participate in work and social life and improving collaborative patient-clinician relationships.</p><p><strong>Method: </strong>The self- and observer ratings of capacity limitations in a sample of <i>N</i> = 245 patients with neurological conditions from a rehabilitation facility were compared and assessed using the short rating of activity limitations and participation restrictions in mental disorders according to the International Classification of Functioning, Disability and Health (Mini-ICF-APP) and the equivalent self-rating questionnaire (Mini-ICF-APP-S).</p><p><strong>Results: </strong>Paired-samples <i>t</i>-tests revealed significant differences between the self- and observer ratings for six out of 13 capacity dimensions. On average, the patients rated the capacity dimensions <i>adherence to regulations</i>, <i>planning and structuring of tasks</i>, <i>professional competency</i> and <i>endurance</i> as significantly less limited, in comparison to the observers (small to medium effect sizes). The self-ratings for limitation of <i>contact with others</i> and <i>self-care</i> were only marginally higher than the observer ratings.</p><p><strong>Conclusions: </strong>The findings show that psychological capacity limitations occur in patients with neurological conditions. In clinical practice, limitations in each capacity dimension and discrepancies in patient- and clinician-ratings should be thoroughly assessed. This is especially relevant in patients with neurological conditions who have a potential tendency to underestimate or deny their disability.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91108509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-02-15DOI: 10.1017/BrImp.2023.3
Carmen May, Katlyn Bieber, Debbie Chow, W Ben Mortenson, Julia Schmidt
Purpose: Peer-support groups for stroke survivors are often organized and facilitated by health authorities and disability related organizations within rehabilitation programs. However, the benefits of peer-led, peer-support groups have not yet been evaluated. The purpose of this study was to explore participants' experiences in a community-based, peer-led, peer-support group for stroke survivors.
Materials and methods: Semi-structured interviews were conducted and analyzed following constructivist grounded theory with 11 participants who attended a peer-led, peer-support group for people with stroke. The data were also complemented with one quantitative rating question regarding their experience attending the group.
Results: Three themes were identified. Meeting unmet needs after stroke captured how the group was created by stroke survivors to address life in the community post-stroke. Buddies helping buddies highlighted that stroke recovery is a shared process at the group, where members help and encourage each other to contribute what they can. Creating authentic friendships revealed how people experienced social connection and developed relationships in the peer-led, peer-support group.
Conclusions: Peer-led, peer-support groups may provide opportunities for stroke survivors to connect with like-minded people in their community to have fun while exploring their abilities.
{"title":"Experiences of adults with stroke attending a peer-led peer-support group.","authors":"Carmen May, Katlyn Bieber, Debbie Chow, W Ben Mortenson, Julia Schmidt","doi":"10.1017/BrImp.2023.3","DOIUrl":"10.1017/BrImp.2023.3","url":null,"abstract":"<p><strong>Purpose: </strong>Peer-support groups for stroke survivors are often organized and facilitated by health authorities and disability related organizations within rehabilitation programs. However, the benefits of peer-led, peer-support groups have not yet been evaluated. The purpose of this study was to explore participants' experiences in a community-based, peer-led, peer-support group for stroke survivors.</p><p><strong>Materials and methods: </strong>Semi-structured interviews were conducted and analyzed following constructivist grounded theory with 11 participants who attended a peer-led, peer-support group for people with stroke. The data were also complemented with one quantitative rating question regarding their experience attending the group.</p><p><strong>Results: </strong>Three themes were identified. <i>Meeting unmet needs after stroke</i> captured how the group was created by stroke survivors to address life in the community post-stroke. <i>Buddies helping buddies</i> highlighted that stroke recovery is a shared process at the group, where members help and encourage each other to contribute what they can. <i>Creating authentic friendships</i> revealed how people experienced social connection and developed relationships in the peer-led, peer-support group.</p><p><strong>Conclusions: </strong>Peer-led, peer-support groups may provide opportunities for stroke survivors to connect with like-minded people in their community to have fun while exploring their abilities.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74830895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Individuals living in residential aged care facilities with cognitive decline are at risk of social isolation and decreased wellbeing. These risks may be exacerbated by decline in communication skills. There is growing awareness that group singing may improve sense of wellbeing for individuals with dementia. However, to date few studies have examined broader rehabilitative effects on skills such as communication of individuals with dementia.
Aims: To determine the feasibility and acceptability of the MuSic to Connect (MuSiCON) choir and language/communication assessment protocol in people with cognitive impairment living in non-high-care wards of a residential facility.
Methods: Six individuals with mild-moderate cognitive impairment participated (age range 55-91 years, five female, one male). A mixed method approach was used. Quantitative outcomes included attendance rates, quality of life and communication measures. The qualitative measure was a brief survey of experience completed by participants and carers post-intervention.
Results: Overall, MuSiCON was perceived as positive and beneficial, with high attendance, perception of improved daily functioning and high therapeutic benefit without harmful effects. While there was no reliable change in communication skills over the course of the six-week intervention, most participants successfully engaged in the conversational task, suggesting it is a suitable and ecologically valid method for data collection.
Conclusions: The MuSiCON protocol demonstrated feasibility and was well received by participants and staff at the residential facility. A co-design approach is recommended to improve upon feasibility, acceptability and validity of the assessment protocol prior to Phase II testing.
背景:居住在养老院中的认知能力下降者面临着社会隔离和幸福感下降的风险。沟通能力的下降可能会加剧这些风险。越来越多的人意识到,集体歌唱可以提高痴呆症患者的幸福感。目的:确定 "MuSic to Connect"(MuSiCON)合唱团和语言/交流评估方案在居住在养老院非高度护理病房的认知障碍患者中的可行性和可接受性:六名轻度-中度认知障碍患者(年龄在 55-91 岁之间,五名女性,一名男性)参加了此次活动。采用了混合方法。定量研究结果包括出勤率、生活质量和沟通能力。定性测量是由参与者和照护者在干预后完成的简短体验调查:总的来说,MuSiCON 被认为是积极有益的,参加率很高,认为日常功能得到了改善,治疗效果很好,没有产生有害影响。虽然在为期六周的干预过程中,沟通技能没有发生可靠的变化,但大多数参与者都成功地完成了对话任务,这表明这是一种合适且符合生态学原理的数据收集方法:MuSiCON方案证明了其可行性,并受到了参与者和住宿设施工作人员的欢迎。建议在第二阶段测试之前,采用共同设计的方法来提高评估方案的可行性、可接受性和有效性。
{"title":"Phase I trial of the MuSic to CONnect (MuSiCON) protocol: feasibility and effect of choir participation for individuals with cognitive impairment.","authors":"Penelope Monroe, Mark Halaki, Georgina Luscombe, Fiona Kumfor, Kirrie J Ballard","doi":"10.1017/BrImp.2022.32","DOIUrl":"10.1017/BrImp.2022.32","url":null,"abstract":"<p><strong>Background: </strong>Individuals living in residential aged care facilities with cognitive decline are at risk of social isolation and decreased wellbeing. These risks may be exacerbated by decline in communication skills. There is growing awareness that group singing may improve sense of wellbeing for individuals with dementia. However, to date few studies have examined broader rehabilitative effects on skills such as communication of individuals with dementia.</p><p><strong>Aims: </strong>To determine the feasibility and acceptability of the MuSic to Connect (MuSiCON) choir and language/communication assessment protocol in people with cognitive impairment living in non-high-care wards of a residential facility.</p><p><strong>Methods: </strong>Six individuals with mild-moderate cognitive impairment participated (age range 55-91 years, five female, one male). A mixed method approach was used. Quantitative outcomes included attendance rates, quality of life and communication measures. The qualitative measure was a brief survey of experience completed by participants and carers post-intervention.</p><p><strong>Results: </strong>Overall, MuSiCON was perceived as positive and beneficial, with high attendance, perception of improved daily functioning and high therapeutic benefit without harmful effects. While there was no reliable change in communication skills over the course of the six-week intervention, most participants successfully engaged in the conversational task, suggesting it is a suitable and ecologically valid method for data collection.</p><p><strong>Conclusions: </strong>The MuSiCON protocol demonstrated feasibility and was well received by participants and staff at the residential facility. A co-design approach is recommended to improve upon feasibility, acceptability and validity of the assessment protocol prior to Phase II testing.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90475164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-01-06DOI: 10.1017/BrImp.2022.35
Bojana Šarkić, Jacinta M Douglas, Andrea Simpson
Objective: This study explored non-specialist audiological clinical practice in the context of traumatic brain injury (TBI), and whether such practices incorporated considerations of TBI-related complexities pertaining to identification, diagnosis and management of associated auditory and vestibular disturbances.
Design: A cross-sectional online survey exploring clinical practice, TBI-related training and information provision was distributed to audiologists across Australia via Audiology Australia and social media. Fifty audiologists, 80% female and 20% male, participated in this study. Years of professional practice ranged from new graduate to more than 20 years of experience.
Results: Clear gaps of accuracy in knowledge and practice across all survey domains relating to the identification, diagnosis and management of patients with auditory and/or vestibular deficits following TBI were evident. Further, of the surveyed audiologists working in auditory and vestibular settings, 91% and 86%, respectively, reported not receiving professional development for the diagnosis and management of post-traumatic audio-vestibular deficits.
Conclusion: Inadequate resources, equipment availability and TBI-related training may have contributed to the gaps in service provision, influencing audiological management of patients with TBI. A tailored TBI approach to identification, diagnosis and management of post-traumatic auditory and vestibular disturbances is needed.
{"title":"A cross-sectional survey of non-specialist Australian audio-vestibular clinical practice for traumatic brain injury and rehabilitation.","authors":"Bojana Šarkić, Jacinta M Douglas, Andrea Simpson","doi":"10.1017/BrImp.2022.35","DOIUrl":"10.1017/BrImp.2022.35","url":null,"abstract":"<p><strong>Objective: </strong>This study explored non-specialist audiological clinical practice in the context of traumatic brain injury (TBI), and whether such practices incorporated considerations of TBI-related complexities pertaining to identification, diagnosis and management of associated auditory and vestibular disturbances.</p><p><strong>Design: </strong>A cross-sectional online survey exploring clinical practice, TBI-related training and information provision was distributed to audiologists across Australia via Audiology Australia and social media. Fifty audiologists, 80% female and 20% male, participated in this study. Years of professional practice ranged from new graduate to more than 20 years of experience.</p><p><strong>Results: </strong>Clear gaps of accuracy in knowledge and practice across all survey domains relating to the identification, diagnosis and management of patients with auditory and/or vestibular deficits following TBI were evident. Further, of the surveyed audiologists working in auditory and vestibular settings, 91% and 86%, respectively, reported not receiving professional development for the diagnosis and management of post-traumatic audio-vestibular deficits.</p><p><strong>Conclusion: </strong>Inadequate resources, equipment availability and TBI-related training may have contributed to the gaps in service provision, influencing audiological management of patients with TBI. A tailored TBI approach to identification, diagnosis and management of post-traumatic auditory and vestibular disturbances is needed.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90560757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2022-12-20DOI: 10.1017/BrImp.2022.31
Melanie Hoyle, Pamela Meredith, Tamara Ownsworth, Asaduzzaman Khan, Louise Gustafsson
Purpose: To examine associations between post-stroke participation and personal factors, including demographic characteristics, self- and threat appraisals, and personality variables.
Methods: An exploratory cross-sectional study with purpose-designed survey was completed online or via mail. The survey was comprised of demographic and health-related questions and multiple questionnaires, including the Stroke Impact Scale Version 3.0 (SISv3) (participation/perceived recovery), Community Integration Questionnaire (CIQ) (participation), Head Injury Semantic Differential III (pre- vs post-stroke self-concept/self-discrepancy), Appraisal of Threat and Avoidance Questionnaire (threat appraisal), Life Orientation Test - Revised (optimism) and Relationships Questionnaire (adult attachment style) that measured variables of interest. Sixty-two participants, aged 24-96 years who had experienced a stroke (one or multiple events) and had returned to community living, completed the survey. Associations were examined using correlations, and univariate and multiple linear regression analyses.
Results: Regression analysis showed that greater participation, measured using the CIQ, was associated with younger age, female gender, lower self-discrepancy and higher perceived recovery, explaining 69% of the variability in CIQ participation. Further, greater participation on the SISv3 was associated with lower self-discrepancy and higher perceived recovery, explaining 64% of the variability in SISv3 participation.
Conclusions: Results indicate that personal factors, particularly self-appraisals like self-concept/self-discrepancy, in combination with perceived recovery may be important in explaining a large portion of variance in post-stroke participation. Specifically, findings highlight the interrelatedness of self-concept change, perceived recovery and post-stroke participation. Further longitudinal research is needed to clarify the directionality of these associations throughout the hospital-to-home transition.
{"title":"Associations between participation and personal factors in community-dwelling adults post-stroke.","authors":"Melanie Hoyle, Pamela Meredith, Tamara Ownsworth, Asaduzzaman Khan, Louise Gustafsson","doi":"10.1017/BrImp.2022.31","DOIUrl":"10.1017/BrImp.2022.31","url":null,"abstract":"<p><strong>Purpose: </strong>To examine associations between post-stroke participation and personal factors, including demographic characteristics, self- and threat appraisals, and personality variables.</p><p><strong>Methods: </strong>An exploratory cross-sectional study with purpose-designed survey was completed online or via mail. The survey was comprised of demographic and health-related questions and multiple questionnaires, including the Stroke Impact Scale Version 3.0 (SISv3) (participation/perceived recovery), Community Integration Questionnaire (CIQ) (participation), Head Injury Semantic Differential III (pre- vs post-stroke self-concept/self-discrepancy), Appraisal of Threat and Avoidance Questionnaire (threat appraisal), Life Orientation Test - Revised (optimism) and Relationships Questionnaire (adult attachment style) that measured variables of interest. Sixty-two participants, aged 24-96 years who had experienced a stroke (one or multiple events) and had returned to community living, completed the survey. Associations were examined using correlations, and univariate and multiple linear regression analyses.</p><p><strong>Results: </strong>Regression analysis showed that greater participation, measured using the CIQ, was associated with younger age, female gender, lower self-discrepancy and higher perceived recovery, explaining 69% of the variability in CIQ participation. Further, greater participation on the SISv3 was associated with lower self-discrepancy and higher perceived recovery, explaining 64% of the variability in SISv3 participation.</p><p><strong>Conclusions: </strong>Results indicate that personal factors, particularly self-appraisals like self-concept/self-discrepancy, in combination with perceived recovery may be important in explaining a large portion of variance in post-stroke participation. Specifically, findings highlight the interrelatedness of self-concept change, perceived recovery and post-stroke participation. Further longitudinal research is needed to clarify the directionality of these associations throughout the hospital-to-home transition.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91139431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}