Team-based rehabilitation after traumatic brain injury: a qualitative synthesis of evidence of experiences of the rehabilitation process

Abstract

Objective: To synthesize and explore experiences of the rehabilitation process for adults with traumatic brain injury receiving team-based rehabilitation. Data sources: A qualitative evidence synthesis was conducted according to the “Enhancing transparency in reporting the synthesis of qualitative research” (ENTREQ) Guidelines, of qualitative studies published in 5 databases in 2000–21. Study selection and data extraction: Screening, selection of relevant studies, assessment of methodological limitations, systematic qualitative content analysis and assessment of confidence with Grading of Recommendations Assessment, Development, and Evaluation- Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) were carried out by independent researchers. Data synthesis: The 10 included studies revealed how people with traumatic brain injury perceived that they struggled on their own for a long time to adapt their daily life. They experienced that access to team-based rehabilitation was scarce and that the interventions offered were neither individually tailored nor coordinated. A respectful attitude from professionals and individually adapted information facilitated their rehabilitation process. Conclusion: This qualitative evidence synthesis indicates areas for improvement and a need to develop person-centred team-based rehabilitation for adults with traumatic brain injury, in terms of accessibility, coordination, continuity, content and participation. Given the limited opportunities for team-based rehabilitation after hospital discharge, further research is needed to understand how rehabilitation can support the adaptation of everyday life. Lay abstract The aim of this study was to review scientific publications about experiences of the rehabilitation process from the perspective of adults with traumatic brain injury who had received team-based rehabilitation. Several established databases were searched, yielding 10 relevant qualitative studies. The experiences described in these studies overlapped, and showed that people with traumatic brain injury struggled on their own over a long period of time to adapt to their new situation in everyday life. They experienced that access to team-based rehabilitation was limited and not adapted to their needs at different time-points. As many people with traumatic brain injury had limited experience of team-based rehabilitation after hospital discharge, this study indicates a need to develop person-centred team-based rehabilitation over a longer period of time. Further research is needed regarding experiences of how rehabilitation can support adaptation in everyday life after traumatic brain injury.

Keywords

• brain injury
• evidence-based practice
• rehabilitation
• review
• qualitative research
• qualitative evidence synthesis