The Feasibility and Efficacy of providing early rehabilitation to patients: following mild traumatic brain injury

Killington M1, Fyfe D2 , Patching A2 , Habib P2 , Kochiyil V3, Kay R 4 and Crotty M5  

1 South Australia Brain Injury Rehabilitation Services, CALHN, SA Health, 2 South Australia Health Consumer Advisory Council, 3 Aged Care, Rehabilitation & Palliative Care, NALHN, SA Health, 4 Allied Health Reform, Royal Adelaide Hospital, CALHN, South Australia, 5Division Rehabilitation, Aged & Palliative Care, SALHN, SA Health and Flinders University, South Australia

 

Background and aim: It is widely believed that light, colour, access to gardens and stimulation affect recovery.  Little research has reported consumer opinions of the key physical and environmental aspects of rehabilitation buildings. The aim was to describe patient and family views of the essential environmental components which promote engagement and recovery during inpatient rehabilitation.

Method: The project was co-created with consumers (one from each of the 3 South Australian metropolitan health networks). In-depth interviews were undertaken with 54 current or recent rehabilitation patients and 23 informal carers of rehabilitation patients and focus groups conducted with 90 clinical staff. Interviews and focus groups were audiotaped and transcribed verbatim. Discrepancies were adjusted following “member checking” and then qualitative thematic analysis undertaken with the assistance of NVivo 11 qualitative data analysis software package to identify major themes (first via open coding, followed by axial and then selective coding).

Results: The four major themes were: 1) Choice can be an illusion in a rehabilitation ward. 2) Access to outside areas is a priority and affects well- being 3) Socialisation can be facilitated by the environment. 4) Ward configuration should align with the model of care.

Conclusion: Consumers prioritised features which allowed choice and control. Empathic design for rehabilitation facilities can be achieved if architects strive for a more human-centred approach and ensure facilities promote a sense of wellbeing while facilitating meaningful restorative activity. More research is required to link environmental features with clinical outcomes.


Maggie Killington

Maggie Killington works as the Coordinator of Research for SA Brain Injury Rehabilitation services and is a senior lecturer at Flinders University in College of Nursing and Health Sciences. She is currently working on a number of grant funded research projects within SABIRS.  She has recently worked as research manager at Flinders Medical Centre where she undertook a study with consumers investigating the optimum environments in which to receive rehabilitation.

Dean Fyfe

Dean Fyfe is a consumer representative on the CALHN executive quality and governance committee.  He is a consumer advisor for the design of services move  to Repatriation precinct. He was a principal investigator for the Rehabilitation Environments research undertaken across all three health networks.

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