An Exploration of the Psychosocial Health of Individuals with Acquired Brain Injury Receiving Interdisciplinary Services

Research Objectives: To explore the psychosocial health of individuals with acquired brain injury (ABI) receiving interdisciplinary rehabilitation services.

Design: Exploratory mixed methods study using survey, interview, and focus group.

Setting: A private, outpatient, interdisciplinary, neurological rehabilitation clinic.

Participants: Individuals were eligible to participate if they were 18 years or older and either (1) have an ABI and are a client receiving at least two services from the neurological rehabilitation clinic or (2) provide clinical services at the neurological rehabilitation clinic. Clinicians identified potential client participants through professional referral sampling. Eight clients participated, ages 31-70 years, all white. The client participants included five men, two women, and one unspecified gender. Seven client participants experienced stroke and one experienced traumatic brain injury. Additionally, all clinicians providing services at the neurological rehabilitation clinic were invited and, through volunteer sampling, four clinicians participated. The clinician participants were ages 21-70​ years, all women​, and all white​. One clinician was an occupational therapist, two clinicians were physical therapists, and one clinician was a speech language pathologist.

Interventions: Not applicable.

Main Outcome Measures: Client participants completed two surveys from the Quality of Life in Neurological Disorders Measurement System: the Positive Affect and Well-Being (PAW) and the Ability to Participate in Social Roles and Activities (APSRA) tools. Client participants also engaged in semi-structured interviews designed by researchers to explore clients' psychosocial health and the role of the interdisciplinary team. Clinicians participated in a virtual focus group designed by researchers to explore how the interdisciplinary team attends to the psychosocial health of their clients.

Results: Clients' PAW scores of 50.01 ± 7.79 were within normal limits for the general population. APSRA scores of 44.10 ± 8.42 indicated mild functional impairment for the general population. Narratives were analyzed via open and axial coding which yielded three themes: therapist approach, client experience, and environment. ​Subthemes of the therapist approach included therapeutic rapport, self regulation, carryover, functional progress, collaboration, celebration, encouragement, and holistic approaches. Subthemes of the client experience included situational feelings, increase in positive feelings, and no mental health change. Subthemes related to the environment included positive community and design of the physical environment.

Conclusions: Clients with ABI were found to have normal to mildly impaired psychosocial health compared to the general population. Clinicians were found to intentionally address the psychosocial health of their clients. Additional research is recommended to study best practices for addressing psychosocial health of clients receiving rehabilitation services.

Author(s) Disclosures: There are no conflicts of interest to disclose.