Community reintegration needs following paediatric brain injury: perspectives of caregivers and service providers. Issue 19 (11th September 2022)

• Record Type: Journal Article
• Authors: Diener, Marissa L.; Kirby, Anne V.; Sumsion, Felicia; Canary, Heather E.; Green, Michael M.
• Is Part Of: Disability and rehabilitation. Volume 44:Issue 19(2022)
• Page Start: 5592
• Page End: 5602
• Publication Date: 2022-09-11
• Subjects: Paediatric -- brain injury -- family support -- community reintegration -- social services; People with disabilities -- Periodicals; Rehabilitation -- Periodicals; 617.03
• DOI: 10.1080/09638288.2021.1946176
• Languages: English
• ISSNs: 0963-8288

Abstract

Abstract: Purpose: To explore the processes of community reintegration of children and families at least one year following a paediatric brain injury from the perspective of caregivers and outpatient/community service providers. Materials and methods: A qualitative analysis of semi-structured interviews from outpatient or community service providers ( N = 14; occupational, physical, and speech and language therapists, neuropsychologists, school counsellors, recreational providers) and caregivers of six children ( N = 8) at least one year after their injury. Interviews were transcribed and thematically coded using deductive (employing Bronfenbrenner's ecological systems theory) and inductive approaches. Results: Themes from both providers and caregivers indicated additional supports needed at all levels of Bronfenbrenner's ecological systems theory (i.e., individual, microsystem, mesosystem/exosystem, macrosystem, chronosystem). Participants felt that several characteristics would be needed in an ideal service system following paediatric brain injury including: community solutions ("it takes a village"), long-term approaches to care, and new financial approaches. Conclusions: The results suggest that children and families have substantial community reintegration needs following paediatric brain injury. Multi-system interventions are needed to support long-term community reintegration, especially those that increase communication and support transitions. There is also a strong need for alternative funding to support these efforts. Implications for Rehabilitation: Families with a child with a moderate to severe brain injury face challenges with community reintegration a year or more after their child's injury. Effort should be put into helping families navigate the complex medical, insurance, and school systems with a navigator service and step-down care to ensure a continuum of care and to support community reintegration. Special support should be provided during transitions, such as transitions from hospital care to outpatient care, and across school transitions.