Occupation

Abstracts Wednesday 29 June 2016
References
Gill-Thwaites H and Munday R (2008) SMART manual Version 2:
a tool for the assessment and treatment of the brain damaged
patient in a vegetative or minimally conscious state. London:
Royal Hospital for Neuro-disability.
Royal College of Physicians (2013) Prolonged Disorders of
Consciousness: National Clinical Guidelines. London: RCP.
Keywords
Neurological practice, Practice development, Innovative practice
Contact E-mail Addresses
ginniegarlick@gmail.com
Author Biographies
Ginnie Garlick is a Senior II Occupational Therapist specialising
in neurology. She currently works in the Brain Injury Service at
the Royal Hospital for Neuro-disability. She is a qualified Sensory
Modality and Rehabilitation Technique (SMART) assessor and
at present she works primarily with patients with a prolonged
disorder of consciousness. A large component of her role
involves carrying out detailed assessment of these patients,
along with the inter-disciplinary team, to contribute to diagnosis
and establish any potential for function.
Trauma and Orthopaedics Annual Conference
Session 31.1
A new conceptual framework to facilitate return to
paid work following a brain injury
Beaulieu K, University of Northampton
Introduction: In Western industrialised societies paid work is
valued and it is accepted that being employed is good for an
individual’s health. Only one third of the brain injury population
currently return to paid work. Those that do return, do so at a
lower level, on fewer hours and most for less pay. Due to current
poor return to paid work success rates in England and the social
and financial consequences for these individuals this warranted
exploration. This PhD research aimed to improve return to paid
work following a brain injury.
Method: Following NHS ethical approval, a qualitative,
descriptive phenomenological research approach was used to
collect interview data from sixteen brain injured participants
who had returned to paid work and eleven employers who had
been involved in return to paid work of brain injured individuals
in England (Giorgi 2000). Descriptive phenomenological analysis
of their lived experience data established a general situated
structure of the phenomenon and its deeper meaning.
Findings and conclusion: Four themes emerged occupational
needs, experiencing loss, grief and adjustment, self-identity
and social inclusion and return to the workplace. A conceptual
framework to facilitate return to paid work of individuals
following a brain injury was developed from evaluation of the
findings. This framework concluded the research and provides
a new evidence based approach to enable brain injured
individuals, employers and professionals to manage return to
paid work.
Future impact on service users: The use of this new conceptual
framework by professionals will facilitate a more successful
return to paid work experience for service users and their
employers.
Implications for occupational therapy: Rehabilitation needs
to include essential brain injury information, assessment of
occupational needs, grief counselling and coping strategies to
better inform employers and these individuals how to manage
adjustment and a changing identity in the workplace.
References
Giorgi A (2000) The status of Husserlian phenomenology in
caring research. Scandinavian Journal of Caring Sciences. 14(1),
3–10.
Keywords
Neurological practice, Research, Occupational science
Contact E-mail Addresses
karen.beaulieu@northampton.ac.uk
Author Biographies
Karen Beaulieu is completing her PhD looking at return to work
following a brain injury. She programme leads the MSc OT
pathway at The University of Northampton.
Session 31.2
Evaluating an early traumatic brain injury vocational
rehabilitation training package
Holmes J, Phillips J, Morris R, Radford K, University of
Nottingham
Background: Early Specialist Traumatic Brain Injury Vocational
Rehabilitation (ESTVR), was translated into a training package
(manual, module, mentoring) for use in a feasibility randomised
controlled trial (Radford et al, 2015). The aim of this study was
to explore the acceptability and usefulness of the training from
the perspective of Occupational Therapists (OTs) trained to
deliver it.
Methods: A training package to equip OTs with the necessary
acumen to deliver ESTVR was developed by ‘experts’ in
vocational rehabilitation and traumatic brain injury, including
service users. Six trainers delivered training and four mentored
OTs. All those trained were interviewed by telephone by an
independent researcher using a topic guide. Data were analysed
by the author using Framework Analysis (Srivastava A and
Thomson SB, 2009) and externally validated by the wider study
team who discussed and agreed themes.
Results: Five OTs were trained and four delivered ESTVR and
received mentoring (one left). Six major themes emerged: (1) OTs
motivations to participate in research (2) impact of the learning
environment (3) changing confidence levels over time (4)
growing appreciation of complexities with the intervention (5)
the acceptability of the training package to therapists (6) lessons
for future implementation. Across themes OTs reflected how
mentoring was important in delivering ESTVR.
Conclusions: Engaging OTs in research should emphasise
prospects for self-development and altruism. Training requires
detailed descriptions of interventions to inform implementation
(Scott SD et al., 2012). Adequate resources should be allocated.
OTs value training materials but require prompts to use and
adapt them to local contexts. OTs’ confidence to implement
interventions in research should be addressed by researchers.
Mentoring supports implementation fidelity in research trials.
Impact: Training packages that include mentoring help OTs gain
confidence and competence to provide evidence based care.
References
Radford KA, P. J., Jones T, Gibson A, Sutton C, Watkins C,
Sach T, Duley L, Walker M, ummond A, Hoffman K, O’Connor,
Forshaw D, Shakespeare D (2015) Facilitating return to work
through early specialist health-based interventions (FRESH):
protocol for a feasibility randomised controlled trial. Pilot and
Feasibility Studies 1(24).
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