Insight vs readiness: Factors affecting engagement in therapy from the perspectives of adults with TBI and their significant others

O'Callaghan, A. M.; McAllister, Lindy; Wilson, Lindsay

doi:10.3109/02699052.2012.698788

Cited by 32 publications

(37 citation statements)

References 36 publications

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“…First, traditional thematic analysis involving coding and categorising into higher-order themes was undertaken, and saturation of themes was achieved in the 17 interviews. The five themes arising from this analysis have been reported previously by our group (O'Callaghan et al, 2012). Second, three transcripts illustrating very different healthcare journeys were selected and analysed using narrative analysis approaches (Josselson, 2006; Sandelowski, 1991).…”

Section: Methodsmentioning

confidence: 58%

“…This study was conducted with the approval of the Charles Sturt University Ethics in Human Research Committee (protocol: 2007/071), the Royal Melbourne Hospital Human Research Ethics Committee (protocol: 2007/175) and the Alfred Hospitals Research and Ethics Unit (approval number: 170/07). The methodology used in the larger study (O'Callaghan et al, 2009, 2010, 2011, 2012) from which these three case narratives are derived is described, followed by description of the development of the case narratives presented in this paper.…”

Section: Methodsmentioning

confidence: 99%

“…O'Callaghan, McAllister, and Wilson (2009, 2010, 2011, 2012) analysed 386 surveys and 17 in-depth interviews to identify the experiences of Victorian healthcare consumers when accessing care after an acute brain injury. This study employed mixed methods and reflected on the experiences of 202 adults with a moderate to severe brain injury and 184 significant others.…”

Section: Introductionmentioning

confidence: 99%

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Healthcare Consumers' Need for Brain-injury Services: The Critical Importance of Timing in Planning Future Services

O'Callaghan¹,

McAllister

Wilson³

2012

Brain Impairment

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Developing an awareness of the preferences of healthcare consumers is essential in determining the 'reality' of service provision, in planning the provision of brain-injury services and in service evaluation. Consumers should be given the opportunity to express satisfaction or dissatisfaction with the services they receive, offering their perceptions of barriers to service access, which could be removed once known. This article presents narratives of the healthcare journeys of three adults with a moderate to severe brain injury. The experiences of these participants were elicited through in-depth interviews. The aim of this article is to convey how the needs and experiences of adults with brain injury change throughout time, affecting their ability to access care over time. Previous research by the authors of this paper identified five factors that affect consumers' experiences of care: acceptance and readiness, support, advocacy, the right service at the right time and mismatched expectations. The fluidity and interaction of these factors through time is demonstrated in this article as facilitating and impeding access to services. The implications for clinicians in considering these factors when planning services for adults with moderate to severe brain injuries are explored.

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Section: Methodsmentioning

confidence: 58%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Healthcare Consumers' Need for Brain-injury Services: The Critical Importance of Timing in Planning Future Services

O'Callaghan¹,

McAllister

Wilson³

2012

Brain Impairment

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“…There is evidence that executive functioning is the best predictor of functional performance in older adults living in the community (13) and predicts progress during acute TBI rehabilitation (14). Lack of insight is generally associated with poorer functional recovery and worse rehabilitation and employment outcomes (15)(16)(17). It has been proposed that adequate IADL performance post TBI depends on both the individual's cognitive status and their self-awareness (18,19).…”

Section: Traumatic Brain Injury; Brain Injury; Activities Of Daily LImentioning

confidence: 99%

The interrelationship of functional skills in individuals living in the community, following moderate to severe traumatic brain injury

Giles

Clark-Wilson²,

Baxter³

et al. 2018

Brain Injury

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Objective: The Adaptive Behaviour and Community Competency Scale was used to investigate the interrelationship of 22 basic and instrumental activities of daily living (ADL/IADL) in individuals with moderate to severe traumatic brain injury (TBI). The relationship of self-awareness to task performance was also investigated. Research design: Prospective descriptive study. Method: The profiles of 100 community dwelling individuals were used to compare the degree to which independence in each ADL/IADL was associated with independence in every other ADL/IADL. The interrelationship of these skills was further explored in a factor analysis, and comparisons made between the degree of self-awareness of those who could and could not complete IADL independently. Results: We found evidence of a hierarchy of skills: individuals who were independent in IADL were more able to perform ADL, than vice versa. Factor analysis supported a two-factor solution distinguishing ADL and IADL. Self-awareness was more strongly associated with IADL than with ADL independence. Conclusions: A subset of individuals with moderate to severe TBI are able to perform a range of IADL. This group appears to have higher levels of self-awareness than those who are limited to performing only ADL skills. Implications for the applications of functional retraining interventions are discussed.

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“…Difficulties with poor insight/reduced self-awareness are associated with poorer rehabilitation outcomes (O'Callaghan et al, 2012), increased carer burden (Ergh et al, 2002) and is a risk factor for behavioural disturbance (Bach and David, 2006).…”

Section: Loss Of Insightmentioning

confidence: 99%

How is ABI assessed and responded to in non-specialist settings? Is specialist education required for all social care professionals?

Holloway¹

2014

Social Care and Neurodisability

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Mark Holloway is a Brain Injury Case Manager, based at Head First, Hawkhurst, UK. AbstractPurpose -The purpose of this paper is to examine the research into prevalence of acquired brain injury in non-ABI specialist services, the impact of the invisible aspects of executive impairment and loss of insight upon functioning and to question how this is assessed and managed by generalist services. Design/methodology/approach -A literature search was undertaken to identify where people with an ABI may come in to contact with services that are not specifically designed to meet their needs. Findings -ABI is prevalent amongst users of a variety of community, inpatient and criminal justice services. The common albeit invisible consequences of ABI complicate assessment, service use and or treatment particularly in the context of a lack of under pinning knowledge and experience amongst the staff in non-specialist ABI services. As a consequence risks to children and adults are increased, opportunities for rehabilitation and growth are lost and human potential squandered. Addressing the first stage in this process, developing knowledge of the consequences of ABI and how to assess need, is a pre-requisite for change. Practical implications -An absence of basic underlying knowledge of the consequences of ABI impacts upon assessment and so limits the effectiveness of services. A consequence of this is manifest in the over-representation of people with an ABI to be found in non-specialist settings. Originality/value -Little research is undertaken from a social and community perspective into the impact of ABI over the longer term for those who have no contact with specialist services and yet, quite clearly by their use of other services, have unidentified, unrecognised and un-responded to needs. Keywords Acquired brain injury, Assessment of need, Executive impairment, Loss of insight, Social work, Non-ABI specialist services Paper type Viewpoint As those working in the field of social care our assessments and the knowledge that underpins and informs those assessments are key to our roles. My professional practice as a social work qualified brain injury case manager leads me to question how we develop that knowledge when it sits outside of what we (or our employers) may expect? If our knowledge excludes factors that have a major impact upon what we are assessing can we Safeguard children for example?In this paper I outline the prevalence and impact of acquired brain injury and the likelihood that such injuries are a daily feature of social work and social care practice, whatever our chosen field of endeavour. I argue that the impact of acquired brain injury is a fact of our professional lives, one which many individuals and services seem structurally ill-equipped to deal with, starting with a very basic absence of knowledge of the impact of acquired brain injury.

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Insight vs readiness: Factors affecting engagement in therapy from the perspectives of adults with TBI and their significant others

Cited by 32 publications

References 36 publications

Healthcare Consumers' Need for Brain-injury Services: The Critical Importance of Timing in Planning Future Services

Healthcare Consumers' Need for Brain-injury Services: The Critical Importance of Timing in Planning Future Services

The interrelationship of functional skills in individuals living in the community, following moderate to severe traumatic brain injury

How is ABI assessed and responded to in non-specialist settings? Is specialist education required for all social care professionals?

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