Client experiences with holistic neuropsychological rehabilitation: “It is an ongoing process”

Abstract

The effectiveness of holistic neuropsychological rehabilitation for people with acquired brain injury has previously been demonstrated by means of standardized and routinely administered outcome measures. However, the most important outcomes from the perspective of former clients are largely unknown. This study explored the experience of participating in a holistic neuropsychological rehabilitation programme by conducting three focus groups with twelve former clients who had sustained a brain injury. Data were transcribed verbatim and analysed using thematic analysis. "It is an ongoing process" emerged as the overarching theme for the experience of recovery from brain injury. Four subthemes, or phases, were identified. Participants went through (1) a phase of confrontation, after which they (2) trained their skills and strategies, and (3) experimented with these in daily life. In the end, clients reached a phase of (4) coming to terms with their injury. Participants described increased levels of selfesteem, sense of competence, and adaptation as the most important outcomes of the programme, as these factors helped them regain a sense of identity. The results indicate that including these factors in outcome evaluations of complex interventions after brain injury may be important as they appear essential for capturing the client's perspective on change.

Disrupción biográfica y discapacidad cognitiva en el daño cerebral adquirido. Visibilización narrativa

“…Globalmente, el DCA corresponde a una de las principales causas de discapacidad en ascenso, con impactos negativos en la calidad de vida (Fernández-Sánchez et al, 2022;Quezada García, 2020;Verdugo et al, 2019Verdugo et al, , 2021. Se incluyen en sus etiologías las lesiones cerebrales por enfermedad cerebrovascular, tumores cerebrales, traumatismos craneoencefálicos, anoxias cerebrales, encefalopatías hipóxico-isquémicas, infecciones cerebrales, desórdenes metabólicos e intoxicaciones por inhalación o ingesta; siendo una entidad distinta a la discapacidad intelectual en el neurodesarrollo y a la discapacidad psicosocial relacionada con trastorno mental grave y prolongado (Climent López et al, 2022;Department of Health & Social Care, 2022;Domensino et al, 2021;Wilson et al, 2017).…”

Neuropsychological disorders after COVID-19. Urgent need for research and clinical practice

“…Cognitive difficulties can persist over two years after the hypoxic event, regardless of the patient’s emotional state [ 26 ]. Neuro-psychological deficits following hypoxia typically require long-term neuropsychological rehabilitation and can present various intensity and scope, from severe, generalized to selective, cognitive deficits [ 27 ]. Similar cognitive impairments and emotional disorders are currently observed in patients in the early phase and up to 3 months after severe respiratory disorders due to COVID-19 [ 28 ].…”

“…Importantly, many indications point out to neuropsychological deficits being underdiagnosed even in hospitalized patients. It is, after all, strongly emphasized in case of encephalopathy or stroke victims that the fact that they do not present any visible deficits, being capable of “walking and talking” at the time of discharge from the hospital, does not necessarily translate into their neuropsychological functioning being fully intact [ 29 , 36 ].…”

Time from injury and age interact in relationship with perceived quality of life outcomes following vocation-focused neuropsychological rehabilitation

“…Several studies have addressed the efficacy of community-based neuropsychological rehabilitation interventions with a vocational focus (Diller and Ben-Yishay, 2020;Domensino et al, 2021). Overall, such programs appear to be beneficial, not only with respect to general functioning and employment status but also in terms of subjective life satisfaction (Shany-Ur et al, 2020).…”