Early rehabilitation of patients with severe acquired brain injury: Strategies to promote participation

Abstract

Purpose: The aim of this study was to explore the experiences of professional specialists in early rehabilitation who face demanding pedagogical challenges in facilitating and promoting participation of the severe acquired brain injury patient. Method: In a qualitative study, using phenomenological philosophy and thinking, the experiences of specialist professional experts were investigated. Data were generated in five individual interviews and one focus-group interview. The interview questions were grounded in a preliminary field study. In a four-step phenomenological analysis, empirical themes were identified, using the computer program N-Vivo10; they were structured and organized, and the results were theoretically stated and supported. Results: Important practice knowledge emerged in this study that led to the proposal of a determined, client-centred approach when facilitating the promotion of severe acquired brain injury patients’ participation in early rehabilitation. Four factors are important in this approach: (i) gain contact, (ii) register responses, (iii) intentional interaction, (iv) partial participation. Together they constitute the elements in a proposal for a new model: the GRIP model. Conclusion: The four factors that shape the GRIP model can enrich neurorehabilitation services and support professional experts in early rehabilitation interventions with severe acquired brain injury patients regaining participation and functioning in everyday life.

Key words:

• participation
• learning
• interdisciplinary teamwork
• early strategy
• early rehabilitation
• consciousness
• bodily communication

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Acknowledgements

A special thank you goes to the patients, their families, and the health professionals who took the time and trouble to participate in this research. Funding: The study was funded by Hammel Neurorehabilitation and Research Centre and was supported by the Danish Physiotherapists’ Research Fund and the Danish Association of Occupational Therapists.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.