Brain Impairment

This report provides the theory, method and practice of culturally secure translation and knowledge exchange in the Healing Right Way Clinical Trial (2017–2022), outlining activities to date.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

Behaviour change is common and distressing after acquired brain injury (ABI); however, clinicians report a lack of training to address this. An intervention guidebook and podcast series were co-designed as training resources in PBS+PLUS, a behaviour support intervention. Participants with ABI, family members, and clinicians reported on many benefits of being involved in this co-design process and on the high utility of co-designed PBS+PLUS resources. Findings highlight the importance of involving stakeholders when implementing research into clinical settings.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

While goal setting with children and their families is considered best practice during rehabilitation following acquired brain injury, its successful implementation in an interdisciplinary team is not straightforward. This paper describes the application of a theoretical framework to understand factors influencing goal setting with children and their families in a large interdisciplinary rehabilitation team.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

This paper details the adaptation process forTeachABI-Australia, a nationwide digital resource for educators addressing acquired brain injury (ABI)-related learning needs. Australian educators found TeachABI acceptable but recommended modifications to improve cultural and environmental fit, highlighting the importance of tailoring professional development resources to local contexts.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

Despite evidence supporting skills retraining during post-traumatic amnesia (PTA) following traumatic brain injury (TBI), utilisation of this intervention in clinical practice in Australia is unclear. Following training in the intervention, occupational therapists reported improved confidence and competencies, and 2 years later, a key facilitator of implementing the intervention into clinical practice was the benefit to the patients. Despite this, barriers such as time and resourcing require consideration to facilitate best-practice rehabilitation for individuals in PTA.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

Regular exercise can greatly benefit those with Parkinson’s disease, and our pilot study shows that a tailored mobile app can help. By participating in a home exercise program using the app for 2 weeks, patients saw a notable increase in activity and an enhancement in their overall well-being. This approach could offer a supportive step toward improved health management for those with Parkinson’s disease.

Going home after a stroke is a significant milestone in the stroke recovery journey; however, stroke survivors have unmet needs in relation to discharge planning processes. Our survey found that healthcare professionals working in stroke care experience challenges in coordinating care between services, resulting in inconsistent practice. Our study suggests that clearer guidance and support is needed to improve communication between hospital-based clinicians and primary and community care providers, which will benefit outcomes for stroke survivors.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

People with aphasia after stroke can have difficulty with conversations, healthcare decisions, relationships and returning to work. Aphasia can have negative impacts on psychological and mental health, such as depression and anxiety. Stroke clinicians report a lack of knowledge and skills in how to best support communication and psychological care needs. Consumers with lived experience of aphasia and expert clinicians contributed to the identification of a preliminary list of clinical competencies to guide clinician skill development.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

Stroke survivors often disagree with others (e.g. clinicians) regarding the nature and extent of their post-stroke impairments – a phenomenon termed ‘impaired self-awareness’ (ISA). Using 45 stroke survivors, this study examined biological, psychological and social factors associated with ISA at two time points during rehabilitation. ISA was associated with a number of biopsychosocial markers of poorer outcomes across the rehabilitation journey. Results highlighted the clinical importance of ISA and suggested there may be value in biopsychosocial-informed assessment and management approaches.

A needs analysis of 103 providers of cognitive rehabilitation services to people with brain injury in Queensland indicated a need for further training in this complex area of practice. Respondents perceived a need for further training on the management of complex impairments such as in executive function, self-awareness and functional cognition. There was a preference for flexible delivery of training with support from the workplace to overcome barriers associated with time constraints and affordability.

Children and young people with acquired brain injury (CYP-ABI) and their families experience long-term impact on their well-being and participation in activities at home, school and in their community. They have substantial unmet needs and face multiple barriers, with a lack of awareness and understanding, support for parents and cross-sector collaboration being key. The findings are informing intervention development and recommendations for improving service provision to ensure the needs of CYP-ABI and their families are met and they experience improved health and well-being.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

Although people with acquired brain injury (ABI) may be vulnerable to online scams, there are no existing ways of assessing cyberscam risks or the effectiveness of interventions for people with ABI. A screening tool (‘The CyberABIlity Scale’) was developed and revised based on feedback from clinicians and people with ABI. The CyberABIlity Scale was found to be accessible and relevant, and has the potential to be an effective tool for identifying online vulnerability for people with ABI.

Helping patients navigate changes in sexual functioning and wellbeing after traumatic brain injury is an important aspect of recovery often overlooked in health care. This study tackles the hesitancy around discussing sexuality by identifying barriers and enablers and co-designing solutions with a healthcare team. This exploration revealed the importance of addressing institutional and environmental barriers to tackle the discomfort in addressing sexuality and to achieve sustainable behavioural change within healthcare teams.

This article belongs to the Collection Clinical Implementation to Optimise Outcomes.

Cognitive impairment is common after stroke and can have an ongoing negative impact on the everyday lives of stroke survivors. However, little is known about cognitive outcomes following different treatments for ischaemic stroke. We found that treatment with clot retrieval was associated with better performance on a measure of cognitive screening in the days following a stroke, indicating that clot retrieval may improve cognitive outcomes in addition to its established benefit in reducing the degree of disability in treated patients.

This study explored the experiences of people with an acoustic neuroma in New Zealand. We asked about changes to quality of life and the provision of information, support and services. We concluded that there are negative impacts of acoustic neuroma for New Zealanders and gaps in person‐centred care, such as provision of information, education, and access to formal and informal support. There is a need for practical information, education and support during diagnosis, treatment and post‐treatment.

Traumatic brain injury (TBI) is associated with lifelong consequences. The potential for long-term negative consequences from multiple TBIs has inspired discussion about how to measure Lifetime TBI Exposure (LTE). This pilot study applied an online version of the Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID) for LTE screening in the general adult population in Australia. Results indicated that the online OSU TBI-ID is a feasible and valid measure for assessing LTE. This method could assist in identifying TBIs that have previously gone unrecognised, unreported, or untreated.

There are more than 400 000 Australians living with dementia and an estimated 200 000 family or friends providing care to them. While the carer’s experience can be a positive one, it can also be very stressful. This study shows that an online carer support program was received well and can be helpful in improving mood. Support should be offered to all carers of people living with dementia.

Symptoms associated with concussion (e.g. headaches, tiredness) are experienced in the absence of concussion such that it’s important to understand how symptoms are experienced among people without concussion. We asked adults without a brain injury how they experience concussion-like symptoms and found that people with higher levels of worry about illness and negative feelings tended to experience greater symptom severity. These findings highlight the importance of interpreting symptom experience in concussion populations in the context of a broader clinical picture.

Understanding how Australian speech-language pathologists (SLPs) assess cognitive-communication disorders in children and adolescents with traumatic brain injuries (TBIs) is crucial for improving paediatric care. In a survey of 111 SLPs, although professional optimism was high, results found diverse measurement practices and feelings of nervousness and difficulty among clinicians. These insights highlight the need for standardized practices and enhanced training to ensure accurate and consistent assessments to ultimately improve outcomes for children and adolescents recovering from TBIs.

Communication difficulties following traumatic brain injury (TBI) can affect both the individual and the family following the injury.  This paper reviews the specific nature of attention-related difficulties following TBI on the family through qualitative analysis of interviews.  Families were found to adapt their social lives and implement specific strategies to improve the ability of their loved ones to interact and participate in conversations.

Scientific conferences are a common way for researchers to share their findings, but the impact of conference participation on clinical and research practice is not well understood. In our survey of clinicians, researchers and students who attended a stroke conference, participants reported that conferences are more influential in changing clinical practice than journal articles. This suggests that conference presentations can be a useful method for enhancing evidence‐based practice.

Despite the name, people with minor stroke can experience debilitating long‐term consequences post‐stroke that impact on multiple areas of everyday life. Our study found that a new multicomponent treatment can improve wellbeing in people with a minor stroke but did not fully meet all their unmet needs. Further research is required; however, the new treatment has the potential to provide a service pathway for people with minor stroke that could be used by other health services.

Fatigue is one of the biggest problems for everyday life following a brain injury. There are some treatment approaches that have positive effects but these do not adopt the team approach that is promoted for brain injury rehabilitation. The findings highlight  that further research is needed to develop, evaluate, and implement a team approach to fatigue that can reduce the impacts on everyday life. 

There is a high occurrence of brain injuries in offenders within the justice sector. This study interviewed staff working in the justice sector about how brain injuries are currently identified and managed. It was found that a national standard for screening for brain injuries, addressing factors affecting reporting of new injuries, provision of clear healthcare pathways and improved communication would help to improve how people are supported following brain injury in the justice sector.

Individualised housing has the potential to enable people with disability to realise their right to choose where and with whom they live. Understanding the experience of moving into individualised housing is critical to informing effective policy and the disability housing market. This study contributes new knowledge about the transition experience from the perspective of people with neurological disability and highlights the need for investment in transtion-specific policy and support models to better prepare and support people through the transition process.

This qualitative study examines how healthcare practitioners talk about life after stroke with people in inpatient stroke services.

Young adults (aged 18–65) with acquired disability and complex needs are at risk of being stuck in hospital or discharged to nursing homes. This study focused on improving hospital discharge for young adults with acquired disability and complex needs. It found that effective discharge involves coordinated care, involving people and their families in planning, and collaboratively arranging community support and housing. Better communication and early arrangements for support are key to successful transitions from hospital to community.