Determining client cognitive status following mild traumatic brain injury
- Authors: Hobson, Elizabeth , Lannin, Natasha , Taylor, Amelia , Farquhar, Michelle , Morarty, Jacqui , Unsworth, Carolyn
- Date: 2016
- Type: Text , Journal article
- Relation: Scandinavian Journal of Occupational Therapy Vol. 23, no. 2 (2016), p. 138-146
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- Description: Background People with mild traumatic brain injury (mTBI) commonly experience cognitive impairments. Occupational therapists working in acute general hospitals in Australia routinely access client Glasgow Coma Scale (GCS) scores, and assess cognitive status using standardized tools and by observing basic activity of daily living (ADL) performance. However, limited evidence exists to identify the best assessment(s) to determine client cognitive status. Aim/objectives To determine whether cognitive status assessed by GCS score and the Cognistat are predictive of basic ADL performance among clients with mTBI in an acute general hospital and make inferences concerning the clinical utility of these assessment tools. Material and methods Retrospective analysis of medical record data on demographics, Cognistat, GCS, and modified Barthel Index (MBI) using descriptive statistics, chi-square tests and linear regression. Results Data analysis of 166 participants demonstrated that no associations exist between GCS and Cognistat scores, or Cognistat scores and MBI dependency level. The presence of co-morbid multi-trauma injuries and length of stay were the only variables that significantly predicted MBI dependency level. Conclusion and significance While the MBI scores are of value in identifying clients with difficulty in basic ADLs, Cognistat and GCS scores are of limited use in differentiating client levels of cognitive impairment and the authors caution against the routine administration of the Cognistat following mTBI. Further research is required to identify more suitable assessments for use with a mTBI population. © 2015 Taylor & Francis.
Engaging patients with moderate to severe acquired brain injury in goal setting
- Authors: D’Cruz, Kate , Unsworth, Carolyn , Roberts, Karen , Morarty, Jacqui , Turner-Stokes, Lynne
- Date: 2016
- Type: Text , Journal article
- Relation: International Journal of Therapy and Rehabilitation Vol. 23, no. 1 (2016), p. 20-31
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- Description: Background/Aims: An exploratory study of a novel approach to using the Goal Engagement Scale to examine patients’, families’ and health professionals’ perceptions of patient engagement in goal setting. Methods: This mixed methods study was conducted from September 2013 to April 2014 in both inpatient trauma and rehabilitation units at an Australian health care service. Participants were 22triads (patients with moderate to severe traumatic brain injury or stroke, their family member(s) and a treating health professional) participating in routine goal setting interviews. Goal setting interviews were audio recorded, transcribed and thematically analysed, drawing upon an iterative process of qualitative data analysis, while the Goal Engagement Scale scores were analysed descriptively, drawing comparison between triad participant findings. Findings: Perception of patient’s level of engagement in goal setting differed between health professionals, patients and families. Health professionals’ views dominated the goal setting process. Goal setting interview data revealed four main themes, highlighting the importance of reflective listening skills to build a trusting relationship with patients and families to support engagement in goal setting. Conclusions: The findings of this exploratory study both affirm the suitability of future research into goal setting engagement and provide clinically useful strategies to support engagement of patients and families in goal setting. © 2016 MA Healthcare Ltd. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Carolyn Unsworth” is provided in this record**