Hostname: page-component-848d4c4894-8bljj Total loading time: 0 Render date: 2024-06-22T05:39:06.927Z Has data issue: false hasContentIssue false
  • English
  • Français

Identifying Current Practices and Supports in Behaviour Management Following ABI in South Australian Community Settings: A Delphi Study

Published online by Cambridge University Press:  02 February 2017

Alinka Fisher ,
Michelle Bellon ,
Sharon Lawn  and
Sheila Lennon
Alinka Fisher*
Affiliation:
Department of Disability and Community Inclusion, School of Health Sciences, Flinders University, Adelaide, Australia
Michelle Bellon
Affiliation:
Department of Disability and Community Inclusion, School of Health Sciences, Flinders University, Adelaide, Australia
Sharon Lawn
Affiliation:
Department of Psychiatry, School of Health Sciences, Flinders University, Adelaide, Australia
Sheila Lennon
Affiliation:
Repatriation General Hospital, School of Health Sciences, Flinders University, Adelaide, Australia
*
Address for correspondence: Department of Disability and Community Inclusion, School of Health Sciences, Flinders University, Adelaide, Australia. E-mail: Alinka.Fisher@flinders.edu.au, Ph: 08) 82 015 956
Get access

Abstract

Objectives: To consider the strategies currently used by family care givers to manage challenging behaviour in the community following ABI, and to identify what supports are available that support family care givers in addressing this issue.

Research design: Delphi study.

Methods: Service providers (n = 8) and family care givers (n = 3) completed a three-round Delphi process with the aim of reaching consensus (75% agreement) regarding research objectives. Round 1 consisted of an open-ended questionnaire in which items were identified; these items were then rated in Round 2 and 3 using a Likert scale. Statistical aggregation then allowed for quantitative analysis.

Results: The findings suggest a number of behaviour management approaches are being used by family care givers, including basic antecedent strategies, agreeing with the person's demands, and medication. Consensus was reached that only two services in SA provide specific support to family care givers regarding behaviour management in the community: Families4Families Inc. (a peer support network) and Private Specialists (e.g., [neuro]psychologists and [neuro]psychiatrists).

Conclusions: Findings emphasise the need for more specialised services specific to educating and supporting family care givers in the management of challenging behaviours following ABI. These services should be accessible, centralised, and easy for family care givers to navigate.

Keywords

behaviourfamilycommunityacquired brain injuryservices
Type
Articles
Information
Brain Impairment , Volume 18 , Issue 2 , September 2017 , pp. 211 - 225
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

AIHW. (2007). Disability in Australia: Acquired brain injury. Australian Institute of Health and Welfare, 55, 1–27, Retrieved August 16, 2016, from www.aihw.gov.au.Google Scholar
Alderman, N. (2003). Contemporary approaches to the management of irritability and aggression following traumatic brain injury. Neuropsychological Rehabilitation, 13 (1/2), 211–240.Google Scholar
Allen, M.H., Currier, G.W., Hughes, D.H., Docherty, J.P., Carpenter, D., & Ross, R. (2003). Treatment of behavioral emergencies: A summary of the expert consensus guidelines. Journal of Psychiatric Practice, 9 (1), 16–38.Google Scholar
Anderson, M.I., Parmenter, T.R., & Mok, M. (2002). The relationship between neurobehavioural problems of severe traumatic brain injury (TBI), famiy funcitoning and the psychological well-being of the spouse/caregiver: Path model analysis. Brain Injury, 16 (9), 743–757.Google Scholar
Arco, L., & Bishop, J. (2009). Single participant studies in positive behaviour support for parents of individuals with brain injuries. Brain Impairment, 10, 307–319.Google Scholar
Borgmeier, C. & Rodriguez, B. J. (2015). Consequence strategies to change behavior. In Brown, F., Anderson, J.L. & De Pry, R.L. (Eds.), Individual positive behavior supports: a standards; based guide to practices in school and community settings. Baltimore, Maryland: Paul H. Brookes Publishing Co., Inc, 145–179.Google Scholar
Brain Injury SA. (2016). Brain Injury South Australia. Retrieved from http://braininjurysa.org.au/.Google Scholar
Braine, M.E. (2011). The experience of living with a family member with challenging behavior post acquired brain injury. Journal of Neuroscience Nursing, 43 (3), 156–164.Google Scholar
British Society of Rehabilitation Medicine (2003). National guidelines for rehabilitation following acquired brain injury. London: BSRM.Google Scholar
Carnevale, G.J., Anselmi, V., Busichio, K., & Millis, S.R. (2002). Changes in ratings of caregiver burden following a community-based behavior management program for persons with traumatic brain injury. Journal of Head Trauma Rehabilitation, 17 (2), 83–95.Google Scholar
Carnevale, G.J., Anselmi, V., Johnston, M.V., Busichio, K., & Walsh, V. (2006). A natural setting behavior management program for persons with acquired brain injury: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 87, 1289–1297.Google Scholar
Carnevale, G.K. (1996). Natural-setting behavior management for individuals with traumatic brain injury: Results of a three-year caregiver training program. Journal of Head Trauma Rehabilitation, 11 (1), 27–38.Google Scholar
Cattelani, R., Zettin, M., & Zoccolotti, P. (2010). Rehabilitation treatments for adults with behavioral and psychosocial disorders following acquired brain injury: A systematic review. Neuropsychology Review, 20, 52–85.Google Scholar
Currier, G.W., & Allen, M.H. (2000). Physical and chemical restrain in the psychiatric emergency service. Psychiatric Services, 51 (6), 717–719.CrossRefGoogle Scholar
Damasio, A. R. (1994). Descartes' error: emotion, reason, and the human brain. New York: Putnam.Google Scholar
de Koning, M.E., Spikman, J.M., Coers, A., Schoenherr, M.C., & van der Naalt, J. (2015). Pathways of care the first year after moderate and severe traumatic brain injury-discharge destinations and outpatient follow-up. Brain Injury, 29 (4), 423–429.Google Scholar
Denscombe, M. (2010). The good research guide for small-scale social research projects (4th ed.). England, UK: Open University Press.Google Scholar
Department of Health (2012). Acquired brain injury model of rehabilitation for South Australia. Adelaide: Government of South Australia.Google Scholar
Disability SA (2016). Office of the senior practitioner: Restrictive practices. Department of Communities and Scoial Inclusion, Government of South Australia. Retrieved August 16 from https://www.dcsi.sa.gov.au/services/disability-sa/office-of-the-senior-practitioner.Google Scholar
Disability Services. (2013). Adult specialist services intervention and positive behaviour support team. Retrieved from http://www.dcsi.sa.gov.au/services/disability-services/adult-specialist-services-intervention-assist Google Scholar
Dyer, K.W., Bell, R., McCann, J., & Rauch, R. (2006). Aggression after traumatic brain injury: Analysing socially desirable responses and the nature of aggressive traits. Brain Injury, 20 (11), 1163–1173.Google Scholar
Ergh, T.C., Hanks, R.A., Rapport, L.J., & Coleman, R.D. (2003). Social support moderates caregiver life satisfaction following traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 25 (8), 1090–1101.CrossRefGoogle ScholarPubMed
Ergh, T.C., Rapport, L.J., Coleman, R.D., & Hanks, R.A. (2002). Predictors of caregiver and family functioning following traumatic brain injury: Social support moderates caregiver distress. Journal of Head Trauma Rehabilitation, 17 (2), 155–174.Google Scholar
Families4Families Inc. (2011). Families4Families ABI Support Network. Retrieved from http://families4families.org.au/.Google Scholar
Feeney, T., & Ylvisaker, M. (1995). Choice and routine: Antecedent behavioural interventions for adolescents with severe traumatic brain injury. Journal of Head Trauma Rehabilitation, 10 (3), 71–86.Google Scholar
Feeney, T.J., & Ylvisaker, M. (2003). Context-sensitive behavioral supports for young children with TBI: Short-term effects and long-term outcome. Journal of Head Trauma Rehabilitation, 18 (1), 33–51.Google Scholar
Feeney, T.J., & Ylvisaker, M. (2006). Context sensitive behavioral supports for young children with brain injury: A replication. Brain Injury, 20, 629–646.Google Scholar
Feeney, T.J., & Ylvisaker, M. (2008). Context-sensitive cognitive-behavioral supports for young children with brain injury: A second replication. Journal of Positive Behaviour Support Intervention, 10, 115–128.Google Scholar
Feeney, T.J., Ylvisaker, M., Rosen, B.H., & Greene, P. (2001). Community supports for individuals with challenging behavior after brain injury: An analysis of the New York state behavioral resource project. Journal of Head Trauma Rehabilitation, 16 (1), 61–75.Google Scholar
Fink, A., & Kosecoff, J. (1985). How to conduct surveys: A step-by-step guide. London, UK: Sage Publications.Google Scholar
Fisher, A., Lennon, S., Bellon, M., & Lawn, S. (2015). Family involvement in behaviour management following acquired brain injury (ABI) in community settings: A systematic review. Brain Injury, 29 (6), 661–675.CrossRefGoogle ScholarPubMed
Fleming, J., Sampson, J., Cornwell, P., Turner, B., & Griffin, J. (2012). Brain injury rehabilitation: The lived experience of inpatients and their family caregivers. Scandinavian Journal of Occupational Therapy, 19 (2), 184–193.Google Scholar
Fleminger, S., Greenwood, R.R.J., & Oliver, D.L. (2008). Pharmacological management for agitation and aggression in people with acquired brain injury (Review). Cochrane Database of Systematic Reviews, 4, 1–28.Google Scholar
Flinders University. (2015). Community Re-entry Program. Retrieved from http://www.flinders.edu.au/sohs/sites/disability-studies/associated-programs/community-re-entry-program/.Google Scholar
Forsyth, R. (2002). Rehabilitation after brain injury. Current Paediatrics, 12, 275–278.Google Scholar
Gelber, D.A., & Callahan, C.D. (2010). Neurologic examination of the patient with traumatic brain injury. In Ashley, M.J. (Ed.), Traumatic brain injury: Rehabilitation, treatment, and case management (3rd ed., pp. 3–27). Broca Raton, FL: CRC Press.Google Scholar
Green, J. & Thorogood, N. (2014). Qualitative Methods for Health Research. London, UK: SAGE Publications LTD.Google Scholar
Iqbal, S., & Pipon-Young, L. (2009). The delphi method. The Psychologist, 22, 598–600.Google Scholar
Jacobs, H.E. (1995). Behaviour analysis guidelines and brain injury rehabilitation. Maryland: Aspen Publications, Inc.Google Scholar
Johnson, R., & Balleny, H. (1996). Behaviour problems after brain injury: incidence and need for treatment. Clinical Rehabilitation, 10, 173–181.Google Scholar
Jumisko, E., Lexell, J., & Soederberg, S. (2007). Living with moderate or severe traumatic brain injury: The meaning of family members' experiences. Journal of Family Nursing, 13 (3), 353–369.Google Scholar
Kant, R., Duffy, J.D., & Pivovarnik, A. (1998). Prevalence of apathy following head injury. Brain Injury, 12 (1), 87–92.Google Scholar
Keeney, S., Hasson, F., & McKenna, H.P. (2006). Consulting the oracle: ten lessons from using the Delphi technique in nursing research. Journal of Advanced Nursing, 53 (2), 205–212.CrossRefGoogle ScholarPubMed
Keeney, S., Hasson, F., & McKenna, H. (2011). The delphi technique in nursing and health research. Hoboken: Wiley.Google Scholar
Kelly, G., Brown, S., Todd, J., & Kremer, P. (2008). Challenging behaviour profiles of people with acquired brain injury living in community settings. Brain Injury, 22 (6), 457–470.Google Scholar
Kitter, B., & Sharman, R. (2015). Caregivers' support needs and factors promoting resiliency after brain injury. Brain Injury, 29 (9), 1082–1093.Google Scholar
Lefebvre, H., Cloutier, G., & Levert, M.J. (2008). Perspectives of survivors of traumatic brain injury and their caregivers on long-term social integration. Brain Injury, 22 (7–8), 535–543.Google Scholar
Littlefield, L., Stokes, D., Bardenhagen, F., & Collins, L. (2012). Government funded clinical neuropsychological services. Retrieved from http://www.psychology.org.au/Assets/Files/Government-Funded-Clinical-Neuropsychological-Services-Feb2012.pdf.Google Scholar
Manchester, D., Hodgkinson, A., & Casey, T. (1997). Prolonged, severe behavioural disturbance following traumatic brain injury: What can be done? Brain Injury, 11 (8), 605–617.Google Scholar
Manchester, D., Hodgkinson, A., Pfaff, A., & Nguyen, G. (1997). A non-aversive approach to reducing hospital absconding in a head-injured adolescent boy. Brain Injury, 11 (4), 271–277.Google Scholar
Marsh, N. V., Kersel, D. A., Havill, J. H., & Sleigh, J. W. (1998). Caregiver burden at 1 year following severe traumatic brain injury. Brain Injury, 12 (12), 1045–1059.Google Scholar
Masel, B.E., & DeWitt, D.S. (2010). Traumatic brain injury: A disease process, not an event. Journal Neurotrauma, 27, 1529–1540.Google Scholar
McDermott, G.L., & McDonnell, A.M. (2014). Acquired brain injury services in the Republic of Ireland: Experiences and perceptions of families and professionals. Brain Injury, 28 (1), 81–91.Google Scholar
Munce, S.E.P., Laan, R.V., Levy, C., Parsons, D., & Jaglal, S.B. (2014). Systems analysis of community and health services for acquired brain injury in Ontario, Canada. Brain Injury, 28 (8), 1042– 1051.Google Scholar
Murray, H.M., Maslany, G.W., & Jeffery, B. (2006). Assessment of family needs following acquired brain injury in Saskatchewan. Brain Injury, 20 (6), 575–585.Google Scholar
National Disability Insurance Scheme. (2016). Australian Department of Human Services, South Australia. Retrieved August 16 from https://myplace.ndis.gov.au/ndisstorefront/about-us/our-sites/sa.html Google Scholar
New Zealand Guidelines Group Inc (NZGG). (2006). Traumatic brain injury: Diagnosis, acutes management and rehabilitation. Evidence-Based Best Practice Guidelines. ACC, New Zealand.Google Scholar
Oddy, M., & Herbert, C. (2003). Intervention with families following brain injury: Evidence-based practice. Neuropsychological Rehabilitation, 13 (1/2), 259–273.Google Scholar
Okoli, C., & Pawlowski, S.D. (2004). The delphi method as a research tool: An exmple, design considerations and applications. Information & Management, 42 (1), 15–29.Google Scholar
Perkes, I., Schofield, P.W., Butler, T., & Hollis. (2011). Traumatic brain injury rates and sequaelae: A comparison of prisoners with a matched community sample in Australia. Brain Injury, 25 (2), 131–141.Google Scholar
Ponsford, J.L., Downing, M.G., Olver, J., Ponsford, M., Acher, R., Carty, M., & Spitz, G. (2014). Longitudinal follow-up of patients with traumatic brain injury: Outcome at two, five, and ten years post-injury. Journal of Neurotrauma, 31 (1), 64–77.Google Scholar
Ponsford, J., Sloan, S., & Snow, P. (Eds.). (2013). Traumatic brain injury: Rehabilitation for everyday adaptive living (2nd ed.). Hove, East Sussex: Psychology Press.Google Scholar
Powell, C. (2003). The Delphi technique: Myths and realities. Journal of Advanced Nursing, 41 (4), 376–382.Google Scholar
Prigatano, G.P. (1992). Personality disturbances associated with traumatic brain injury. Journal of Consulting and Clinical Psychology, 60 (3), 360–368.Google Scholar
Rolls, E.T. (2002). In Stuss, D.T. & Knight, R.T. (Eds), The functions of the orbitogrontal cortex, in Principles of Frontal Lobe Function, (pp. 354–375). New York: Oxford University Press.Google Scholar
Rowe, G., & Wright, G. (1999). The Delphi technique as a forecasting tool: Issues and analysis. International Journal of Forecasting, 15, 353–375.Google Scholar
SA Health. (2015). Brain Injury Rehabilitation Services. Retrieved from https://www.rah.sa.gov.au/hampstead/brain.php Google Scholar
Sabaz, M., Simpson, G.K., Walker, A.J., & Roger, J.M. (2014). Prevalence, comorbidities, and correlates of challenging behavior among community-dweling adults with severe traumatic brain injury: A multicenter study. Journal of Head Trauma Rehabilitation, 29 (2), E19–E30.Google Scholar
Sander, A.M., Caroseli, J.S., High, W.M., Becker, C., Neese, L., & Scheibel, R. (2000). Relationship between family functioning and patients' progress in post-acute TBI rehabilitation. Journal of the International Neuropsychological Society, 6, 649–657.Google Scholar
Sander, A.M., Maestas, K.L., Sherer, M., Malec, J.F., & Nakase-Richardson, R. (2012). Relationship of caregiver and family functioning to participation outcomes following post-acute rehabilitation for traumatic brain injury: A multicenter investigation. Archives of Physical Medicine and Rehabilitation, 93, 842–848.Google Scholar
Saout, V., Gambart, G., Leguay, D., Ferrapie, A.-L., Launay, C., & Richard, I. (2011). Aggressive behavior after traumatic brain injury. Annals of Physical and Rehabilitation Medicine, 54, 259–269.Google Scholar
Schlund, M.W. (2002). Effects of acquired brain injury on adaptive choice and the role of reduced sensitivity to contingencies. Brain Injury, 16, 527–535.Google Scholar
Schofield, P.W., Butler, T.G., Hollis, S.J., Smith, N.E., Lee, S.J., & Kelso, W.M. (2006). Traumatic brain injury among Australian prisoners: Rates, recurrence and sequelae. Brain Injury, 20 (5), 499–506.Google Scholar
Simpson, G., Blaszczynski, A., & Hodgkinson, A. (1999). Sex offending as a psychosocial sequela of traumatic brain injury. Journal of Head Trauma Rehabilitation, 14 (6), 567–580.Google Scholar
Simpson, G., Sabaz, M., Daher, M., Gordon, R., & Strettles, B. (2014). Challenging behaviours, co-morbidities, service utilisation and service access among community-dwelling adults with severe traumatic brain injury: A multicentre study. Brain Impairment, 15 (1), 28–42.Google Scholar
Skulmoski, G.J., Hartman, F.T., & Krahn, J. (2007). The delphi method for graduate research. Journal of Information Technology Education, 6, 1–21.Google Scholar
Stewart, I., & Alderman, N. (2010). Active versus passive management of post-acquired brain injury challenging behaviour: A case study analysis of multiple operant procedures in the treatment of challenging behaviour maintained by negative reinforcement. Brain Injury, 24 (13–14), 1616–1627.Google Scholar
SurveyMonkey Inc. (2016). Survey Monkey. Palo Alto, California, USA. Retrieved August 14 from www.surveymonkey.com.Google Scholar
Tam, S., McKay, A., Sloan, S., & Ponsford, J. (2015). The experience of challenging behaviours following severe TBI: A family perspective. Brain Injury, Early Online, 1–9.Google ScholarPubMed
Todd, J., Loewy, J., & Kelly, G. (2004). Managing challenging behaviours: Getting interventions to work in nonspecialised community settings. Brain Impairment, 5 (1), 42–52.Google Scholar
Uniting Communities. (2016). Take Five in home and community based support. Retrieved from http://www.unitingcommunities.org/find-a-service/services/take-five/ Google Scholar
Willis, T.J., & LaVigna, G.W. (2003). The safe management of physical aggression using multi-element positive practices in community settings. Journal of Head Trauma Rehabilitation, 18 (1), 75–87.Google Scholar
Winkler, D., Sloan, S., & Callaway, L. (2010). People under 50 with acquired brain injury living in residential aged care. Brain Impairment, 11 (3), 299–312.Google Scholar
Wood, R.L., & Alderman, N. (2011). Applications of operant learning theory to the management of challenging behavior after traumatic brain injury. Journal of Head Trauma Rehabilitation, 26 (3), 202–211.Google Scholar
Ylvisaker, M., & Feeney, T. J. (1998). Collaborative Brain Injury Intervention: Positive Everyday Routines. Canada: Thomson Learning.Google Scholar
Ylvisaker, M., Jacobs, H.E., & Feeney, T. (2003). Positive supports for people who experience behavioral and cognitive disability after brain injury: A review. Journal of Head Trauma Rehabilitation, 18 (1), 7–32.Google Scholar
Ylvisaker, M., Turkstra, L.S., & Coelho, C. (2005). Behavioral and social interventions for individuals with traumatic brain injury: A summary of the research with clinical implications. Behavioral and Social Intervention, 26 (4), 256–267.Google Scholar