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Day Hospital Project

Description:
A research intervention to enhance the well-being and psychosocial outcomes of people with acquired brain injury attending day hospital

Rationale:
In view of the persistent, and often severe, cognitive and social difficulties experienced by individuals with ABI, it may be seen as a particularly environmentally sensitive disability

Many interventions are developed atheoretically

The International Classification of Functioning Disability and Health highlights the need to develop interventions that consider the impact of the environment in rehabilitation

Participants:
People with acquired brain injury attending Day Hospital, their significant others as well as Day Hospital Staff

Key features:
Explore how patients, families and staff perceive environmental factors impacting on the rehabilitation of people with ABI

Develop an intervention based on the International Classification of Functioning, Disability and Health (ICF)(WHO, 2001) that recognises and incorporates the ICF concept of environmental influences on the rehabilitation of people with acquired brain injury

Evaluate the effectiveness of the intervention for improving the well-being and psychosocial outcomes of people with acquired brain injury attending day hospital

Funding:
Externally funded with the support of the Princess Alexandra Hospital Research Foundation

Conducted in association the University of Queensland, Department of Occupational Therapy, the Centre of National Research on Disability and Rehabilitation Medicine (CONROD) and the Day Hospital Rehabilitation Team at the Princess Alexandra Hospital

Research / Evaluation Strategies:
4 stage cumulative mixed methodology study

Stage 1 involved a quality review with Day Hospital staff to discuss the key principles of the ICF environment dimension that staff considered to be of most importance in Day Hospital

Stage 2 involved in depth qualitative interviews with patients and families to identify important aspects of
environment as well as the administration of a range of outcome measures taken at two stages

Stage 3 involved using the data from Stages 1 and 2 to develop a 6-week intervention for patients to enhance their environment during the Day Hospital phase of rehabilitation.

Stage 4 involved implementation of the intervention with groups of patients and comparison with participant's data from Stage 2 of the study on pre-,post-intervention and follow up measures. 

Outputs and Outcomes:
Environment factors influence both the process and outcome of rehabilitation for clients, families and staff

Development of the PEER (Personal Environments Enhancing Rehabilitation) program targeting  influence and use of environment in day hospital rehabilitation

Qualitative analysis of in-depth semi-structured

Interviews identified that participants found the PEER program more valuable than individual rehabilitation because of the ability to share experiences and understand environmental influences

Quantitative evaluation suggested PEER group had lower depression and higher community integration following intervention

Publications:
Kuipers, P., Foster, M., Smith, S., & Flemming, J. (2009). Using ICF-Environment factors to enhance the continuum of outpatient ABI rehabilitation: An exploratory study. Disability and Rehabilitation, 31(2), 144-151.

Fleming, J., Kuipers, P., Foster, M., Smith, S., & Doig, E. (2009)Evaluation of an outpatient, peer group intervention for people with acquired brain injury based on the ICF 'Environment' dimension. Disability and Rehabilitation, 31(20), 1666-1675



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Last updated: 7 September 2017