Self-identified goals and the ability to set realistic goals following acquired brain injury: a classification framework.

OBJECTIVE: To develop a framework for classifying the nature of goals identified by people with acquired brain injury (ABI) and explore the extent to which goals and the ability to set realistic goals vary over time and according to stage of recovery. METHODS: Participants included 60 people with ABI comprising two subgroups: a post-acute subgroup (n = 28, mean time since injury = 1.1 years, SD = 0.5) and a long-term subgroup (n = 32, mean time since injury = 4.9 years, SD = 3.0). Participants completed the Self-Awareness of Deficits Interview, which includes a goal-setting component, at an initial assessment and at 12-month follow-up assessment. Data generated from the interviewing process were analysed using a combination of qualitative and quantitative methods. RESULTS: Through an inductive analysis, a classification framework was developed consisting of the following goal categories: 'relationships', 'work and education', 'injury/rehabilitation', 'health and leisure', 'daily life management' and 'general life/personal goals'. Each of these categories comprised several subcategories of goals. Overall, the post-acute subgroup identified more goals in the improve function/rehabilitation subcategory than the long-term subgroup (P = 0.002), whereas the nature of other life goals remained consistent over time. The ability to set realistic goals improved over time for the entire sample (P = 0.013). CONCLUSION: The findings provide therapists with greater insight into the goals most commonly identified by individuals with ABI. The classification framework may assist therapists to elicit client goals and tailor rehabilitation accordingly.

The transition from hospital to home for individuals with acquired brain injury: a literature review and research recommendations.

PURPOSE: To review the literature relating to the transition from hospital to home for individuals with acquired brain injury (ABI) and make recommendations concerning the future direction of transition-specific research. METHOD: Relevant research articles were identified through searching existing database systems and by reviewing the reference lists of identified articles. Only articles in which the results directly related to individuals with ABI from the time of discharge to 1 year post-discharge were included in the review. RESULTS/DISCUSSION: A total of 50 articles were identified as meeting the criteria for inclusion in the review. The methodological quality of included articles was evaluated using a set of specific criteria. The articles were classified into the following categories: (i) The perspectives of individuals with ABI and their caregivers; (ii) outcomes for individuals with ABI following transition; (iii) post-discharge services; and (iv) transitional living services/programmes. The majority of articles were based on samples of individuals with stroke, typically aged over 65 years. A common theme identified in the review was that the transition from hospital to home is typically perceived as an exciting yet difficult period for individuals and their families and as such, post-discharge support is critical. CONCLUSION: Further ABI transition-specific research is necessary in order to: (i) Develop a comprehensive theoretical framework of the transition phase; and (ii) facilitate both the validation of current intervention strategies and the development of innovative/tailored intervention approaches.