“It does not always need to be staff choosing the agenda”: Interviewing people with traumatic brain injury about their experiences of communicating with rehabilitation staff.

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PURPOSE: The communicative interaction between people with traumatic brain injury (TBI) and staff can be challenging, and there is emerging evidence that communication partner training (CPT) can improve this communicative interaction in hospital-based in- and outpatient rehabilitation. While staff perspectives on the specific communication issues in the rehabilitation context have been stated recurrently, the perspectives of people with TBI remain underreported. Therefore, the aim of this study was to explore people with TBI’s experiences of communicating with rehabilitation staff. METHOD: Design: Qualitative interview study. Individual semi-structured interviews were conducted with nine individuals with moderate to severe TBI (three females, six males). Participants were aged between 22 and 61 years (median = 33), and were between 7 to 168 months post-injury (median = 37). All participants had current or recent experience of hospital-based rehabilitation (inpatient and outpatient). Interviewing people with TBI is methodologically challenging due to the cognitive and communicative disorders within this population. To provide participants with opportunities to express their personal experiences, stimulus materials (i.e. video recording, pictures, and keywords) were developed to support the verbally presented interview questions. Interviews were video-recorded, transcribed, and analyzed through an inductive reflexive thematic analysis. To maximize trustworthiness, the study design and reporting followed the COREQ Checklist. RESULTS: Three themes with seven subthemes were generated from the analysis: (1) Communicating with staff is challenging (Struggling with information processing, Lack of possibilities to express oneself): “It is nice when staff sometimes lean back. Then I have to take the initiative, come up with the topic, and hold the responsibility. It gives me confidence… It does not always need to be staff choosing the agenda”. (2) Relationships with staff are established through communication (Inappropriate communication style in staff, The power balance is skewed, Staff as humans vs. functions): “Some were a little harsh in their tone... Maybe I need it to be structured, but it was the way, it was said that did not have to be that way… I felt reduced and that is not a nice feeling at all”. (3) People with TBI want individualized communication (Staff should tailor their approach, Being seen as a human): ”She just sits there, focused. Focused and engaged, and she just remembers what person I am”. DISCUSSION AND CONCLUSION: The use of stimulus materials elicited valuable reflections in participants though the use of communicative support introduced more structure to the interviews. Participants shared experiences of how staff providing communicative support were able to improve the interaction, whereas staff not attending to the communicative challenges of individuals with TBI could limit the communicative success. Participants’ perspectives are crucial to tailor CPT programs to the specific communication issues in the rehabilitation context.
Original languageEnglish
Publication dateMar 2023
Publication statusPublished - Mar 2023
EventInternational Brain Injury Association's 14th International Conference on Brain Injury - Dublin, Ireland
Duration: 29 Mar 20231 Apr 2023

Conference

ConferenceInternational Brain Injury Association's 14th International Conference on Brain Injury
CountryIreland
CityDublin
Period29/03/202301/04/2023

ID: 337351788