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Title: Evaluation of a multidisciplinary transitional and community rehabilitation intervention for adults with severe acquired brain injury : a case series exploring community integration
Author: Thomas, Clare Diana
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2018
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INTRODUCTION: Healthcare policy in the United Kingdom supports community placement following acquired brain injury (ABI). Evidence supports the efficacy of multidisciplinary neurorehabilitation for this group but is limited for programmes supporting community integration in adults with severe disability. This study describes the development and initial evaluation of a transitional and community intervention in this area. METHODS: The study comprised five repeated measures single case studies as well as semi structured interviews with four of the participants’ relatives or friends. Outcomes measures used were the Community Integration Measure, UK Functional Independence Measure/ Functional Assessment Measure and Mayo Portland Adaptability Inventory. Clinical validity was measured using Goal Attainment Scaling. RESULTS: All participants returned to living in the community with significantly improved functional independence and good goal attainment. One participant reported improved community integration but four did not. Reasons for this include: the impact of insight and anxiety on self-report of community integration; ongoing challenges with independence; and outcome choice. Key successful elements of the intervention were identified including: consistent rehabilitation routines; use of trained support workers; and appropriate use of risk assessment to support independence. The participants’ relatives expressed satisfaction with the intervention and the professional support provided. Concerns raised related to communication of goals and discharge planning, intensity of therapy and the environment of the Transitional Unit. CONCLUSIONS: This study provides an initial positive evaluation of the intervention but indicates the need to complete further evaluation and with additional outcome measures for community integration. Key learning points from the case studies can be replicated in other services, including the use of goal setting protocols, support worker training and protocols for assessment of capacity and risk.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available