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How Do People with Brain Injury Reintegrate into Their Communities on Return Home from In-Patient Rehabilitation

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Thesis(4.18 MB)

Date

2023

Authors

Armstrong, Jonathan

Supervisor

Kayes, Nicola
Bright, Felicity

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Degree name

Doctor of Health Science

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Publisher

Auckland University of Technology

Abstract

Community integration is widely acknowledged as a primary goal of rehabilitation following acquired brain injury (ABI). Although there are frameworks that help to describe certain components of community integration, these frameworks are not congruent with research that explores lived experience of community integration for those recovering from ABI. Further, literature relating to community integration frameworks and lived experience does not appear to be translating into clinical practice, service organisation, or health policy. Using Interpretive Descriptive methodology, eight people, who had recently been discharged from in-patient rehabilitation following ABI, were interviewed to explore the question: How do people with brain injury reintegrate into their communities on return home from in-patient rehabilitation? Interviews were transcribed and data analysed using a four-stage process of comprehending, synthesising, theorising, and reconceptualising. From this analysis four interconnecting themes were developed: Growing into a new way of community living, Living up to expectations, (Re)Building social connections, and Engaging in meaningful occupations. Growing into a new way of community living was a four-stage process that offers insights into the dynamic, iterative, and temporal aspects of community integration. Each stage builds on the previous, with a range of practical and emotional experiences reported by participants. Living up to expectations incorporates expectations from a variety of sources: self-expectations; and expectations of significant others, life roles, and those of society in general. These expectations either facilitate or challenge people’s reintegration. (Re)Building social connections highlights the importance of various types of social networks providing a range of support through which people with ABI are able to increase their connections and continue to build their community engagement. Engaging in meaningful occupations assists people with ABI to measure their progress, motivate themselves through ongoing achievements, reduce dependence on others, and stay occupied to distract them from negative thoughts and feelings. These findings have generated a number of recommendations that can be integrated into rehabilitation service delivery to facilitate community integration for people with ABI. Most importantly, rehabilitation programmes should support the person with ABI to engage in meaningful shared occupations that create opportunities for social connection and lead to a sense of belonging in the community. With shared occupation and social connection being significant factors in community integration, the concept of relationship-centred rehabilitation is proposed as an approach that could further promote community integration.

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http://hdl.handle.net/10292/16917

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