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Behavioral and neural effects of intensive cognitive and communication rehabilitation in young college-bound adults with acquired brain injury
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Translation and Linguistic Validation of Outcome Instruments for Traumatic Brain Injury Research and Clinical Practice: A Step-by-Step Approach within the Observational CENTER-TBI Study. ...
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Speech-Language Pathologists as Expert Witnesses in Court Cases
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In: Theses (2021)
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Speech Language Pathologists (SLPs) Enactment of Dysphagia Education and Counselling in TBI Inpatient Rehabilitation.
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In: Electronic Thesis and Dissertation Repository (2021)
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Abstract:
Abstract Background Traumatic brain injury (TBI) incidence rates are rising significantly across all age groups, often requiring complex and expensive medical care. Common causes of TBI include motor-vehicle accidents, violence, sport injuries and falls. For some individuals, inpatient rehabilitation (IPR) is used as a care pathway to provide intervention(s) for the physiological, psychological, neurobehavioural and cognitive-communication sequelae of a TBI.Many patients with a TBI will also experience dysphagia, an impairment or disorder of deglutition (swallowing). Dysphagia affects hydration, nutritional intake, respiration and can significantly impact an individual’s quality of life. It has been identified as a contributing factor in the mortality and morbidity of patients in many hospital care settings. In the Province of Ontario, patients with dysphagia concomitant with a TBI often receive inpatient rehabilitative care by a Speech-Language Pathologist (SLP). Successful outcomes for dysphagia are best achieved when the patient, independently whenever possible, and the family when it is not possible, have been educated and counselled to know which foods they can and cannot safely consume and why this is important. This requires that the SLP enact education and counselling with the patient who has a cognitive-communication disorder related to the TBI and their family in an effective way to provide critical and understandable information about the assessment results and the risks and benefits of the various management choices under consideration. It is also considered part of the SLP’s scope of practice to ensure that all members of the interdisciplinary IPR team are aware and understand the assessment results, management recommendations and know how to recognize and respond to signs and symptoms that reflect a risk of harm. As a Speech-Language Pathologist (SLP) working in an IPR setting for over 20 years with patients who have a TBI and dysphagia,I have recognized that there is a lack of accessible, evidence-based, comprehensive methods that are patient and family-focused for SLPs to use to enact education and counselling within this practice context. Therefore the objectives of this thesis were to: (1) conduct a scoping review of the literature to better understand how SLPs enact education and counselling with patients who have dysphagia and a TBI, especially within the context of inpatient rehabilitation settings; and (2) use qualitative hermeneutic inquiry to understand how SLPs enact dysphagia education and counselling with patients who have a TBI and are in inpatient rehabilitation settings in Ontario. Methods This research started with a scoping review of the literature followed by a qualitative study using a philosophical hermeneutical perspective and semi-structured interviews with twelve SLPs working in IPR settings with individuals who have dysphagia and a TBI. Participants also provided for consideration the materials they used when enacting education and counselling with their patients. Results The scoping literature review helped to reveal important parts of the enactment of education and counselling, especially as it relates to the numerous people and groups of people within the inpatient practice context who must be part of the education and counselling conversations. The results of the hermeneutic inquiry revealed important information about the complexities and constraints of practice and provided evidence of how SLPs continually try to mitigate the risks within this environment to keep their patients safe. These important conversations also revealed that SLPs generated practice-based knowledge and used innovation(s) around education and counselling primarily due to the lack of guidance around education and counselling currently available within guideline documents. Conclusion This thesis project provided a useful framework for examining the individual accounts of the SLPs and bringing these together in a thematic manner to generate important information for SLPs, educators, policy makers, and health care administrators. It advanced our understanding of how SLPs enact dysphagia education and counselling for patients with a TBI within IPR settings in Ontario.
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Keyword:
dysphagia; Education; Hermeneutics; Inpatient Rehabilitation; Practice Based Research; Speech Language Pathology; Speech Pathology and Audiology; Swallowing; Traumatic Brain Injury
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URL: https://ir.lib.uwo.ca/cgi/viewcontent.cgi?article=10463&context=etd
https://ir.lib.uwo.ca/etd/8029
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Blast exposure in the military and its effects on sensory and cognitive auditory processing
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Time to Follow Commands, Duration of Post-Traumatic Amnesia, and Total Duration of Impaired Consciousness as Predictors of Outcome Following Pediatric Traumatic Brain Injury
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In: http://rave.ohiolink.edu/etdc/view?acc_num=osu1587156828071613 (2020)
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Behavioral Regulation Changes in Adolescents with Mild Traumatic Brain Injury
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In: http://rave.ohiolink.edu/etdc/view?acc_num=case1592550397348451 (2020)
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Association of Traumatic Brain Injury with Vestibular Dysfunction and Dizziness in Post-9/11 Veterans
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In: ETSU Faculty Works (2020)
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Cortical function in acute severe traumatic brain injury and at recovery: A longitudinal fMRI case study
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In: Brain and Mind Institute Researchers' Publications (2020)
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El daño cerebral en el traumatismo craneoencefálico severo: estudio de un caso de intervención neuropsicológica
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Identification des facteurs de risque de développer une démence de type Alzheimer à la suite d’un traumatisme craniocérébral et caractérisation des profils neuropsychologiques
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Linguistic and Cultural Acceptability of a Spanish Translation of the Ohio State University Traumatic Brain Injury Identification Method Among Community-Dwelling Spanish-Dominant Older Adults.
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In: Archives of rehabilitation research and clinical translation, vol 1, iss 3-4 (2019)
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General practitioners’ perceptions of their communication with Australian Aboriginal patients with acquired neurogenic communication disorders
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In: Research outputs 2014 to 2021 (2019)
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A Case Study Examing Student-Athletes Returning to the Classroom After Suffering a Concussion/Mild Traumatic Brain Injury
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In: Doctoral Dissertations and Projects (2019)
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A Single Case Narrative of Spirituality Following Aphasia from Traumatic Brain Injury: Findings about Forgiveness and Freedom Using WELLHEAD and SHALOM
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In: Religions ; Volume 10 ; Issue 5 (2019)
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General practitioners' perceptions of their communication with Australian Aboriginal patients with acquired neurogenic communication disorders
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Enhancing Cognitive and Linguistic Processes of Individuals with a History of TBI
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In: Doctoral Dissertations (2019)
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Content Analysis of Tweets by People with Traumatic Brain Injury (TBI): Implications for Rehabilitation and Social Media Goals
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Assessment of social cognition in interaction situations in traumatic brain injury ; Évaluation de la cognition sociale en situation d’interaction dans le traumatisme crânien
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In: https://hal.archives-ouvertes.fr/tel-03549684 ; Linguistique. Aix-Marseille Université, 2018. Français (2018)
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Microlinguistic and Fluency Characteristics of Narrative and Expository Discourse in Adolescents with Traumatic Brain Injury
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In: http://rave.ohiolink.edu/etdc/view?acc_num=osu1522867732273912 (2018)
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