CONFERENCE PROGRAMME AUSTRALASIAN SOCIETY FOR THE STUDY OF BRAIN IMPAIRMENT NEW ZEALAND REHABILITATION ASSOCIATION - and Shed 6, Queens Wharf ...
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
AUSTRALASIAN SOCIETY FOR THE STUDY OF BRAIN IMPAIRMENT and NEW ZEALAND REHABILITATION ASSOCIATION CONFERENCE PROGRAMME Shed 6, Queens Wharf, Jervois Quay Wellington, New Zealand 2nd – 4th May 2019
Plan of Shed 6 Room 4 Room 1 Room 2 Room 3 Posters Prep Room Posters Reg Desk Room 1 Room 3 Workshops 1 and 3 Concurrent Sessions 3, 6, 8, 11, 14, 17 Talk by Dr Shankar Sankaran NZRA AGM Plenary 1, 2, 3, 6 Concurrent Sessions 1, 4, 9, 12, 15 Room 4 Awards and Conference Close Morning tea Room 2 Lunch Afternoon Tea Workshops 2 and 4 Datablitz Posters Concurrent Sessions 2, 5, 7, 10, 13, 16 ASSBI Executive Meeting Prep Room ASSBI AGM Speakers preparation room, access via Room 4 Student Workshop Arcade Exhibitors in Arcade Posters Accident Compensation Corporation (ACC) Registration Desk Australasian Society for the Study of Brain Toilets Impairment (ASSBI) Exhibitors – in Room 4 Drake Medox ABI Rehabilitation NZ Centre for Person Centred Research Medilink Australia Rehabilitation Teaching and Research Unit Laura Fergusson New Zealand
Connecting and Collaborating in Rehabilitation THURSDAY 2nd May 8.00-9.00 Registration at Registration Desk 9.00 – 4.00 Workshops 9.00-12.00 Workshop 1 9.00-12.00 Workshop 2 Venue: Room 1 Venue: Room 2 Chair: Nicola Kayes Chair: William Levack Prof Fiona Jones Prof Fary Khan and Dr Bhasker Amatya Integrating self-management support in a brain Neurorehabilitation Research - All you need to know injury service: lessons learnt and secrets of success to start Fiona is brought to you by Drake Medox This workshop is brought to you by Laura Fergusson New Zealand 10.30-10.45 Morning Tea 12.00-1.00 Lunch for delegates attending TWO workshops 12.30-1.00 Registration at Registration Desk 1.00-4.00 Workshop 3 1.00-4.00 Workshop 4 Venue: Room 1 Venue: Room 2 Chair: Jonathan Armstrong Chair: Andrew Clarkson Prof Jonathan Evans Dr Matire Harwood Rehabilitation of memory and executive functions Rehabilitation research and service development: after brain injury meeting the rights of Indigenous people 2.30-2.45 Afternoon Tea 4.00 Workshops CLOSE 4.15 – 6.00 ASSBI Executive Meeting- Room 2 6.30: Mihi whakatau/welcome from mana whenua (the people of Te Whanganui-a-Tara/Wellington) 7.00: Dr Shankar Sankaran, Consultant Geriatrician: ACC Falls prevention & recognition of concussion 7.30-9.30 Welcome Reception in the Arcade and Room 4
FRIDAY 3rd May 7.00 – 8.30 Put Posters up 8.30 –10.45 PLENARY 1 Venue: Room 1 Chair: William Levack 8.30 – 8.45 Welcome – William Levack 8.45 – 9.45 International Keynote Speaker: Fiona Jones ‘Feeling less alone’: co-producing self-management support following traumatic brain injury 9.45 – 10.30 Panel Discussion: Run by William Upscaling rehabilitation: policy, practice, and politics Speakers: Dr Kathie Irwin – Head of Maori and Cultural Capability, ACC; Anne Hawker – Principal Disability Adviser, Ministry of Social Development and Prof Katherine McPherson – Chief Executive, Health Research Council of New Zealand Fiona is brought to you by Drake Medox and Kathie is brought to you by ACC 10.30 – 11.00 Morning Tea 11.00 – 12.30 CONCURRENT SESSIONS 1 – 3 Session 1: 90 minutes Session 2: 90 minutes Session 3: 90 minutes Venue: Room 1 Venue: Room 2 Venue: Room 3 Chair: Rachelle Martin Chair: Suzie Mudge Chair: Felicity Bright Focus on family Emotions and cognition Understanding experiences of recovery 11.00 Penny Analytis 11.00 Skye McDonald 11.00 Lee Cubis The Experience of Attending a What causes impaired empathy Use of social identity mapping to Camp for Families with a Child after traumatic brain injury? understand the impact of brain with Acquired Brain Injury: Trialing an emotional Stroop task tumour on social groups and Perspectives of Young People with 11.15 Barbra Zupan identity: A qualitative study Acquired Brain Injury and Siblings What is the relationship between 11.15 Tenelle Hodson 11.15 Margaret Pozzebon empathic responses and emotion A journey of ambiguity – The The spousal experience of Primary recognition following brain injury? healthcare experiences of people Progressive Aphasia 11.30 Michelle Kelly with mild stroke 11.30 Libby Callaway Changes in social and emotional 11.30 Kate O’Reilly Family and Traumatic Brain Injury: functioning in the early stages of Tarnished Dreams - Australian An Investigation using the Family dementia women’s experience of traumatic Outcome Measure 11.45 Rachael Rietdijk brain injury 11.45 Nic Ward Self-reported quality of life 11.45 Kate D’Cruz Meeting Unmet Needs: Education outcomes after in-person and Humanising healthcare: and Support for Adult Family telehealth social communication understanding the potential of Members of Individuals with Brain skills training for people with narrative storytelling Injury traumatic brain injury 12.00 Margaret Mealings. The 12.00 Emily Trimmer 12.00 Anneli Cassel student journey: Living and Carers’ Way Ahead: A resource for Protocol, process, and progress on learning following traumatic brain families caring for someone with a feasibility RCT targeting social injury brain injury cognitive impairments after 12.15 Ronelle Hewetson 12.15 Narelle Higson acquired brain injury Exploring social network Taking Action to Support Sexual 12.15 Jennie Ponsford maintenance and quality of life in Expression Using a Team Cognitive Reserve and age predict people with social cognition Approach: The Recognition Model cognitive recovery following TBI impairment post right hemisphere stroke 12.30 – 1.45 Lunch 12.30 – 1.45 Room 2: ASSBI AGM & Room 3: NZRA AGM
1.45 – 3.15 CONCURRENT SESSIONS 4 – 6 Session 4: 90 mins Session 5: 90 mins Session 6: 90 mins Venue: Room 1 Venue: Room 2 Venue: Room 3 Chair: Jonathan Armstrong Chair: Debbie Snell Chair: Janet Wagland Knowledge translation in Culture & equity Service delivery in rehabilitation rehabilitation 1.45 Dana Wong 1.45 Ngawairongoa Herewini 1.45 Suzanne Barker-Collo Evaluating the impact of the Maori cultural support: A unique Stroke and Traumatic Brain Injury BRAINSPaN clinician and role within brain rehabilitation in New Zealand: Contrasting researcher network on 2.00 Beth Armstrong incidence, and mood functioning multidisciplinary collaboration and Aboriginal Australian experiences across two epidemiological studies knowledge translation in the brain of brain injury and ways forward in 2.00 Lynne Turner-Stokes impairment field culturally secure rehabilitation Estimated life-time savings in the 2.00 Elisa Lavelle Wijohn 2.15 Natalie Ciccone cost of on-going care following Community–Academic Partnership Yarning together: Developing a specialist rehabilitation for severe as an effective methodology for culturally secure rehabilitation traumatic brain injury (TBI) in the research which can benefit approach for Aboriginal UK participants, contribute to Australians after brain injury 2.15 Areti Kennedy knowledge and impact policy 2.30 Frances Simmonds Preliminary Evidence from Action: 2.15 William Levack Does New Zealand’s geographical First year outcomes of the Almost 1 in 10 Cochrane reviews and cultural challenges impact Acquired Brain Injury Transitional are on rehabilitation patient access to inpatient Rehabilitation Service Pilot Project interventions: findings from a rehabilitation services – a study 2.30 Kate Gould Cochrane Rehabilitation review using five years of AROC data Hoarding and ABI: An overview ‘tagging’ project and Case Study 2:30 Laura De Lacy Datablitz 2.45 Jacinta Douglas Using knowledge translation to 2.45 Saravana Kumar Enabling Hospitals to be more develop a sensory modulation Meeting the needs of people who Inclusive and Responsive to People pathway within acquired brain have sustained very serious with Cognitive Disabilities injury rehabilitation lifelong injuries in South Australia: 3.00 Nicola Kayes 2.45 Christine Cummins A multi-method research project Measuring connection and Creating opportunities for (DB1) collaboration in rehabilitation: knowledge brokers to capitalise on 2.50 Emma Finch developing a measure of the relational aspects of Exploring the unmet needs of therapeutic relationship knowledge translation minor stroke survivors (DB2) 3.00 Jean Hay-Smith 2.55 Rebecca Andrews From systematic review of Supporting persons with ABI and rehabilitation exercise to clinical communication impairment to practice: a knowledge translation access the legal system: A case ‘call to action’ study review (DB3) 3.00 Katie Hodge Long-term follow-up of moderate- to-severe traumatic brain injury in the Canterbury region (DB4) 3.05 Danielle Sansonetti Early intervention for social skills impairment following acquired brain injury: Promoting self- awareness to optimise community integration (DB5) 3.10 Elizabeth Beadle Gaps in occupational participation following severe TBI: associations with cognition, mood, and psychosocial function (DB6)
3.15 – 3.45 Poster Session 1 and Afternoon Tea 3.45 – 5.00 PLENARY 2 Venue: Room 1 Chair: Jacinta Douglas 3.45 – 4.15 National Keynote Speaker: Prof Fary Khan Fatigue Management in Neurorehabilitation 4.15 – 4.30 Dr Alison Drewry (brought to you by ACC) Reducing the incidence and impact of brain injury in New Zealand 4.30 – 4.40 Information on the 2020 Conference in Perth 4.40 – 4.50 ASSBI Fellowship presentation 4.50 – 5.20 ASSBI Presidential Address: Prof Robyn Tate Measuring outcomes and monitoring progress in the era of evidence-based clinical practice 5.30 – 6.30 Brain Impairment Editorial Board Meeting – Room 2 5.30 – 7.00 Student Networking Drinks – Mac’s Brewbar, 4 Taranaki St 7.15 Conference Dinner - Cable Room, Harbourside Function Venue, 4 Taranaki St
Poster # Name Title Young People’s Experience of the Sibling Relationship When One Sibling 1 Analytis, Penny Has an Acquired Brain Injury Concussion Essentials: Piloting a clinical trial to reduce persisting 2 Anderson, Vicki symptoms following child concussion Support for Community Integration after Brain Injury within New 3 Armstrong, Jonathan Zealand Health Policy Combined rehabilitation and glycosominoglycan treatment improves 4 Barwick, Deanna forelimb function following motor cortex stroke in mice Standardising the Management of Behaviours of Concern in the Acute 5 Block, Heather Phase of Traumatic Brain Injury A Systematic Review of the Evidence Relating the Management of 6 Block, Heather Behaviours of Concern in Acute Traumatic Brain Injury The complexities of enacting person-centred practice in stroke 7 Bright, Felicity rehabilitation Review and selection of outcome measurement within a complex model 8 Brosnan, Nicky of neurodisability provision 9 Brunner, Melissa What’s it like to use Twitter after a Traumatic Brain Injury? A New Innovation: The Benefits of the Aphasia New Zealand (AphasiaNZ) Charitable Trust’s Community Aphasia Advisor (CAA) 10 Castle, Emma Service Intervening to improve quality of life several years after traumatic brain 11 Caukill, Kathryn injury More than meets the eyes: Cerebellar white matter changes and 12 Chen, Yu contributions to cognitive dysfunction in frontotemporal dementia An economic evaluation of constraint-induced movement therapy 13 Christie, Lauren implementation: The ACTIveARM Project Environmental enrichment following prefrontal cortex stroke: good or 14 Clarkson, Andrew bad? Evaluating a falls reduction intervention in older persons’ inpatient 15 Dickie, Benn rehabilitation: does it work in a new context? Clinical Perspectives on Training and Delivering a Positive Behaviour Support Intervention for People with Acquired Brain Injury: A 16 Gould, Kate Qualitative Study Post-traumatic Parkinsonism following severe traumatic brain injury: A 17 Gozdzikowska, Kristin case report Physical outcomes for people admitted to an adult Brain Injury 18 Hassett, Leanne Rehabilitation Unit: a cohort study “I just let it ring now”: Maintaining friends after a right hemisphere 19 Hewetson, Ronelle stroke 20 Kumfor, Fiona Prevalence and neurocognitive basis of delusions in dementia Development of an English-language version of a Japanese iPad application to enhance person-centred goal setting in rehabilitation – 21 Levack, William with implications for indigenous communities 22 Lister, Helena The future of bariatric Care in TBI: Can we cope with the load?
SATURDAY 4th May 7.00 – 9.00 Put Posters up 7.30-8.30 Breakfast “How to”: Sessions 7 – 8 Session 7: 60 mins Session 8: 60 mins Venue: Room 2 Venue: Room 3 Chair: Jenny Fleming Chair: Libby Callaway Lynne Turner-Stokes Libby Callaway How to set structured goals for management of Identifying and mitigating risks when providing patients on Prolonged Disorders of Consciousness therapy services to people with Acquired Brain Injury (PDOC) in the National Disability Insurance Scheme 9.00 – 10.30 PLENARY 3 Venue: Room 1 Chair: Nicola Kayes 9.00 – 10.00 International Keynote Speaker: Jonathan Evans Music, mindfulness and positive psychotherapy after brain injury 10.00-10.30 National Keynote Speaker: Matire Harwood Mana Tū: Indigenous people ‘taking charge’ of living with long term conditions 10.30 – 11.00 Poster Session 2 and Morning Tea 11.00 – 12.30 CONCURRENT SESSIONS 9 – 11 Session 9: 90 mins Session 10: 90 mins Session 11: 90 mins Venue: Room 1 Venue: Room 2 Venue: Room 3 Chair: Jean Hay-Smith Chair: Dana Wong Chair: Leanne Togher Paediatric rehabilitation Technology in rehabilitation Communication 11.00 Sarah Badger 11.00 Leanne Hassett 11.00 Kellie Stagg Short term outcomes of children Patient reported outcomes of Communication impairment and with abusive head trauma two- usability and enjoyment of using the working alliance in stroke years post-injury: A retrospective digital devices in rehabilitation as rehabilitation review part of the AMOUNT (Activity and 11.15 Joanne Steel 11.15 MObility UsiNg Technology) Social communication assessment randomised controlled trial for clinical practice: A review of 11.30 Therese Mulligan 11.15 Tamara Ownsworth innovative standardised tools and ‘You only get one brain’: An Perspectives on the use of discourse assessment methods exploratory retrospective study on telerehabilitation for delivering 11.30 Elise Elbourn life after adolescent traumatic community-based support to Recommendations to support brain injury individuals with an acquired brain cognitive-communication recovery 11.45 Owen Lloyd injury during subacute and early Impaired Self-Awareness after 11.30 Renerus Stolwyk community rehabilitation Paediatric Traumatic Brain Injury: Utilising telehealth to deliver following severe Traumatic Brain Liability or Protective Factor? neuropsychological rehabilitation Injury (TBI) 12.00 Jesse Shapiro services to rural patients with 11.45 Anna Copley No diffusion imaging correlate of stroke: development and Remediation of cognitive- paediatric post-concussion evaluation of a novel pilot communication disorders following syndrome: a TBSS study program acquired brain injury using 12.15 Rachelle Martin 11.45 Vanessa Rausa telerehabilitation: A pilot study Using a single-case experimental Delivering concussion evidence to design to evaluate the the community: A digital solution Datablitz effectiveness of therapeutic horse 12.00 Robyn Gibson riding for children and young Datablitz What do SLTs think about aphasia people experiencing disability 12.00 Melissa Brunner therapy? (DB13) What Role does Social Media have 12.05 Salma Charania in Rehabilitation after a Traumatic The Lived Experience of Brain Injury? (DB7) Communication Changes Caused
12.05 Duncan Babbage by MND in People with MND and Person Centred Approaches to their Family and Friends: A Scoping Future Technology for Review (DB14) Rehabilitation (DB8) 12.10 Elise Elbourn 12.10 Lucy Arthur Objective clinical methods for The Application of Wearable evaluating the severity of Technology to Guide Therapy and discourse disorders and predicting to Refine Interpretation of Non- psychosocial outcomes following verbal Communication in a Non- severe Traumatic Brain Injury (TBI) speaking client Illustrated by a (DB15) case study: James (DB9) 12.15 Brooke-Mai Whelan 12.15 Vanessa Rausa Telerehabilitation and acquired Development of a Concussion brain injury (ABI): An online high- Digital Health Tool: HeadCheck intensity behavioural speech (DB10) intervention using real-time 12.20 Di Winkler videoconferencing and store and Integrated apartments for people forward functionality (DB16) with disability: Individual 12.20 Nikki-Anne Wilson experience and outcomes (DB11) Social Simulation: A Cognitive 12.25 Elizabeth Beadle Mechanism Associated with The integration of telehealth in to Impaired Social Knowledge in the a community based Behavioural-Variant of interdisciplinary brain injury Frontotemporal Dementia (DB17) service (DB12) 12.25 Crystal Kelly Managing adults with cognitive- communication disorders following traumatic brain injury in community settings across Australia and New Zealand (DB18) 12.30 – 1.45 Lunch 12.45-1.40 Venue: Room 2 An informal lunchtime workshop for students entitled Utilising Positive Behaviour Support (PBS) to help people improve quality of life and self-regulate behaviour after acquired brain injury (ABI). Chair: Student Co-ordinator Speaker: Dr Kate Gould (Clinical Neuropsychologist & Research Fellow) Guest Speakers: 1.45 – 2.45 CONCURRENT SESSIONS 12 – 14 How to Session 12: 60mins How to Session 13: 60mins How to Session 14: 60mins Venue: Room 1 Venue: Room 2 Venue: Room 3 Chair: Lucy Knox Chair: Debbie Snell Chair: Felicity Bright 1.45 Cathy Bucolo 1.45 Elizabeth Pritchard, Caroline 1.45 Johnny Bourke, Joanne Participant Led Videos: supporting Fisher and Toni Withiel Nunnerley and Hamish Ramsden people with cognitive- Answering to the call for action How to build capacity for communication changes following from practitioners in response to meaningful consumer engagement acquired brain injury to ‘voice’ family violence: A ‘how to’ in rehabilitation research their goals, express their needs workshop. and desires in their own words and lead the creation of a training video for their support workers. 2.45 – 3.15 AFTERNOON TEA
3.15 – 4.15 CONCURRENT SESSIONS 15 – 17 Session 15: 60 mins Session 16: 60 mins Session 17: 60 mins Venue: Room 1 Venue: Room 2 Venue: Room 3 Chair: Jacinta Douglas Chair: Skye McDonald Chair: Jennie Ponsford Collaborative approaches Intervention implementation Diverse perspectives 3.15 Di Winkler 3.15 Lauren Christie 3.15 Cynthia Honan Co-design, pilot and evaluation of Implementation of constraint- Cognitive fatigue in chronic fatigue participant led videos to train induced movement therapy in syndrome: Comparisons with support workers public health: The ACTIveARM individuals with multiple sclerosis 3.30 Eleanor Jackson Project and healthy individuals Peer support following traumatic 3.30 Jai Carmichael 3.30 Felicity Bright brain injury: Efficacy and impact of Readiness of Community ABI Recalibrating hope in the year client-led group programmes Therapists to Learn and Implement after stroke: A call to move beyond 3.45 Lucy Knox Positive Behaviour Support: A ‘realistic’ hope “If there’s an official term called Mixed-Methods Study supported decision making, I have 3.45 Matt Thomas Datablitz no clue”: Experiences of CIRCuiTS cognitive remediation 3.45 Chelsea Nicol community-based rehabilitation trial in Orange, NSW The impact of primary brain professionals in supporting tumour on subjective cognitive decision-making participation for Datablitz functioning and associations with adults after ABI 4.00 Travis Wearne psychological distress (DB22) 4.00 Liz Williams Regulating emotion following 3.50 “I really try to plug into the traumatic brain injury: Results (DB23) person”: Strategies used by from a repeated biofeedback 3.55 Lisa Rapport clinicians to build and nurture the treatment study (DB19) Selection Bias Associated with therapeutic alliance in community 4.05 Elly Williams Eyetracking Research in Traumatic brain injury rehabilitation Community rehabilitation: Brain Injury (DB24) Increasing independence 4.00 Kerrin Watter regardless of time since acquired Early intervention for cognitive- brain injury (DB20) communication reading 4.10 Deborah Snell comprehension deficits after ABI: ‘Listening in’ for uncertainty during initial results (DB25) recovery from mild traumatic brain 4.05 Freyr Patterson injury: a mixed methods study Interactions during occupational (DB21) therapy brain injury rehabilitation groups: a descriptive video analysis (DB26) 4.15 – 5.00 AWARDS AND CONFERENCE CLOSE Venue: Room 1 Chair Robyn Tate 4.15 – 4.30 Thanks to Convenor, Committees and Sponsors 4.30 – 5.30 ASSBI Early Career Clinical Innovation Award ASSBI Douglas Tate Award ASSBI Student Awards Kevin Walsh Award Luria Award Travel Award NZRA Student Awards Mindlink Brightwater Award for Interdisciplinary Presentation
Poster # Name Title A longitudinal investigation of dysarthria recovery over two years 1 Lu, Sheree following severe traumatic brain injury Theoretical model development explaining how peer support improves health outcomes for people with spinal cord impairment: a 2 Martin, Rachelle realist approach Positive participation, therapeutic landscapes and personal agency as active ingredients in rehabilitation interventions: therapeutic 3 Martin, Rachelle horse riding as an example Improving functional independence and quality of life for clients with an acquired brain injury undergoing community rehabilitation using 4 Martini, Angelita assistive devices for toileting Early Action Appraised: Stakeholders’ perspectives on early pilot ABI 5 Nielsen, Mandy transitional rehabilitation in Queensland, Australia Developing a Video Resource for Pressure Injury Prevention 6 Nunnerley, Joanne Education in Spinal Cord Injury 7 Ricciardi, Manjula Spasticity Management: Challenge and Experience Application of generalisation principles in rehabilitation following 8 Sansonetti, Danielle brain injury 9 Shendyapina, Maria Stroke education as a part of rehabilitation process Using CIRCuiTS cognitive remediation therapy to improve the 10 Thomas, Matt functioning of adults with schizophrenia The Impact of Sleep and Fatigue on Social Cognition in Multiple 11 Turner, Jason Sclerosis VanSolkema, Attention and communication following TBI: Making the connection 12 Maegan through a meta-narrative systematic review VanSolkema, Hypoxic brain injury post-intensive rehabilitation: Are clients and 13 Maegan families ready for discharge? A series of single-case experiments evaluating a novel massage 14 Verhagen, Heidie therapy for chronic lower back pain Interdisciplinary goal planning in early rehabilitation: Exploring 15 Watter, Kerrin three different techniques 16 White, Brid Veterans Rehabilitation Strategy 17 Wiingaard, Signe Adjusting to changes in sense of self after traumatic brain injury 18 Williams, Katherine Dysphagia following moderate-to-severe traumatic brain injury Establishing a framework to better understand and manage client and families’ perception and expectation of recovery after an Acquired Brain Injury within a community based residential 19 Yap, Adelene rehabilitation setting 20 Young, Tony TBI at ABI: Trends over the past three years 21 Young, Tony Visual care plans to enhance communication and efficiency 22 Young, Tony Enhancing early engagement for transitions to community Zhavoronkova, Dual-tasking training improves cognitive functions in patients with 23 Ludmila mild traumatic brain injury 24 Zupan, Barbra Sex Differences in Emotional Self-Awareness and Emotional Clarity
THURSDAY ABSTRACTS conducting quantitative and/or qualitative research, and acknowledging and incorporating Workshop 1 values and preferences in clinical decision making. The workshop will feature: ‘Integrating self-management support in a brain • Lectures from the experts: general issues in injury service: lessons learnt and secrets of planning, executing, and evaluating research success’ projects Jones, Fiona1 • Interactive sessions, with free discussion 1 St George's University of London, London, UK including challenges and gaps in research in rehabilitation settings This workshop will explore what is meant by • Group activities and discussion in which ‘supported self-management’ in the context of participants will critically appraise papers, integrating self-management support into a brain and develop case-based studies. injury service. Using findings from recent projects Participants will receive critical appraisal tools working across major trauma centres in London, and guidelines, examples of different types of community and voluntary services attendees will studies (e.g. systematic reviews, RCTs, critically reflect on the unifying components of observational studies), and useful links to supported self-management and how they can background and additional readings. By the end utilise key principles and best evidence in of this workshop the participants will have everyday practice. learned how to: • Formulate clear research questions During the course of the workshop attendees will • Understand literature searching strategies work together to explore ways to promote and be familiar with different resources problem solving, facilitate self-discovery, goal (both primary and secondary database setting, use of resources and create knowledge searches) together about the best ways to support self- • Understand different study designs management which is authentic and person (qualitative, quantitative) centred. The workshop will also include • How to write an academic manuscript examples of evaluating impact and sustaining a • Undertake critical appraisal of research culture of self-management support within brain The workshop will be facilitated by Prof Fary injury rehabilitation teams. Attendees will work Khan and Dr Bhasker Amatya, who have together to create a shared understanding of the extensive experience in research in rehabilitation secrets to success that can be implemented into settings (combined publication of over 400 peer- their practice the next day. reviewed articles) and are practising/teaching evidence-based practice and conducting research Workshop 2 at sites across Australia and Asia. Neurorehabilitation Research - All you need to Workshop 3 know to start Khan, Fary1 and Amatya, Bhasker1 Rehabilitation of memory and executive 1 Department of Medicine (Royal Melbourne functions after brain injury Hospital), The University of Melbourne, Evans, Jonathan1 Department of Rehabilitation Medicine and 1 University of Glasgow, UK Australian Rehabilitation Research Centre, Royal Melbourne Hospital, Parkville, VIC. Australia In this workshop Jon will update participants on Workshop structure the evidence base for the rehabilitation of This intensive and interactive workshop is memory and executive functions after brain designed for healthcare professionals who wish injury. A particular focus will be on prospective to develop their knowledge and skills in memory and goal management, which rely on conducting research and in evidence-based the integration of memory, attention and practice. Further, it will help participants to executive functions. Current developments in the advance their skills in searching and critically use of reminding technology will be discussed appraising the literature, designing and including ApplTree, a reminding app designed
with, and for, people with brain injury; fall, then taking action to get them the help & interactive voice-based guidance, and the use of support they need. If an older person has augmented reality. indicated they have had a slip, trip or fallen in the At the end of this workshop participants will last year then they are potentially at risk of • Be up-to-date on the current evidence having a (another) fall and will benefit from the relating to the rehabilitation of memory and Live Strong for Longer programme. executive deficits after brain injury. Further; falls are the leading cause of brain injury • Understand how digital health technology in NZ; accounting 38% of all brain may be used to assist memory and executive injury. Concussion is caused by a blow to the functions in everyday life after brain injury head or body that could result in any shaking of • Be aware of ongoing developments in the brain and a person does not have to be technology that may assist memory and knocked out to be concussed. Early recognition executive functioning in the future. and management is essential to minimise the severity of the injury and decrease the risk of Workshop 4 having prolonged symptoms. Keeping Older people Independent & well living the life they Rehabilitation research and service want to live – ultimate outcome. development: meeting the rights of Indigenous people’ FRIDAY ABSTRACTS Harwood, Matire1 1 University of Auckland, New Zealand Plenary 1 Three outcomes for the workshop: ‘Feeling less alone’: co-producing self- a. An understanding of the UN Declaration on management support following traumatic brain the Rights of Indigenous peoples and its injury application to rehabilitation services and Jones, Fiona1 research 1 St George's University of London, London, UK b. Pathways to inequities c. How to address the ‘Responsiveness to People with Acquired Brain Injury (ABI) can Indigenous peoples’ question/s in business experience long-term cognitive, psychological, case or funding applications emotional and social effects, frequently resulting in ‘hidden disability’. Likewise, families navigate a ACC Falls prevention & recognition of complex, changing situation that may include concussion mood disturbances associated with their Dr Shankar Sankaran relative’s injury and shifts in family relationships. Consultant Geriatrician Self-management programmes have traditionally been used for people with long-term chronic NZ has a growing ageing population. With age the conditions and have shown impact on clinical, risk of having a fall increases, those over 65 have psychological and social outcomes. There are a 1 in 3 chance of having a fall and for those over challenges in providing self-management support 80 it’s 1 in 2, falls can be prevented. ACC, the for people with ABI and their families, which Ministry of Health, Health Quality & Safety traditionally focus on behaviour change methods Commission, DHBs, GPs, health professionals, and require cognitive abilities. The range of home carers and community groups, all deliver complex issues experienced by people with ABI services to older people. Working together we'll added to the perceptions of healthcare staff better coordinate our efforts and create a system particularly in the acute settings, means that self- that is easy to use and helps to reduce the management approaches which start early after incidence and severity of falls and fractures. This injury are relatively rare. approach has been the catalyst for the creation of the Live Stronger for Longer movement the This keynote lecture will explore co-production unifying brand that aims to unite the falls and methodology and a staged approach to co- fracture system in NZ. Falls can be prevented by designing a new self-management approach. identifying when an older person is at risk of a Using participatory methods we harnessed the
knowledge, experiences, and power of a group of with ABI and their families from the perspective 14 people with ABI and their families and of young people with ABI and siblings. developed a shared approach to self- Method: Semi-structured interviews were management support across an acute conducted with seven young people with ABI and neuroscience pathway. 110 staff in a major 11 siblings. London trauma centre learned how to integrate Results: Using thematic analysis, four themes self-management support strategies and patients were identified: Accepting ABI; Camp friendships; with ABI and their families used new self- Personal mentoring; Escape from daily life. management books. The co-designed books Participants experienced camp as an embodied a person-centred approach to self- environment where ABI was understood and management with stories, ideas and reflections accepted, and they felt relieved of the pressure on life after ABI, and space for recording, hopes, to explain their family’s situation. This targets, successes and strategies. The books had acceptance provided the background to camp a ‘natural fit’ with patients and families and friendships and to having fun. By interacting with provided staff with a shared mechanism to others in similar situations, participants felt they implement self-management strategies within understood ABI better, and for some, this shaped their everyday work. their values and future career choices. Whilst There were clear benefits to taking part in a camp was viewed as an escape from daily life, for process of authentic co-design and these will be some participants, negative experiences such as discussed through the reflections of people with family conflict crept into the camp experience. ABI, their families, healthcare staff and the project Conclusions: Condition-specific camps may team. Finally, there will be a summary of lessons provide young people with ABI and siblings with learnt and advice for those who seek to engage opportunities to better understand ABI and its and involve people with ABI and their families in impact on the individual and the family. Camps research and enhancing service provision. may also provide opportunities to have fun and to make friends, providing a buffer against Panel Discussion challenges faced by families with a child with ABI. As such, camps may provide an important allied Concurrent Session 1 health support service. Correspondence: Penelope Analytis; The Experience of Attending a Camp for Families penelope.analytis@monash.edu with a Child with Acquired Brain Injury: Perspectives of Young People with Acquired The spousal experience of Primary Progressive Brain Injury and Siblings Aphasia Analytis, Penelope1,2; Warren, Narelle3 and Pozzebon, Margaret1,2; Douglas, Jacinta1,3 and Ponsford, Jennie1,2 Ames, David4 1 Monash-Epworth Rehabilitation Research 1 School of Allied Health, La Trobe University, Centre, Monash University, Melbourne, Australia Melbourne, Australia 2 Monash Institute of Cognitive and Clinical 2 Speech Pathology Department, Royal Melbourne Neurosciences, School of Psychological Sciences, Hospital, Melbourne, Australia Monash University, Melbourne, Australia 3 Summer Foundation, Melbourne, Australia 3 School of Social Sciences, Faculty of Arts, 4 Academic Unit for Psychiatry of Old Age, Monash University, Melbourne, Australia University of Melbourne, Melbourne, Australia Background and Objectives: Paediatric acquired brain injury (ABI) is associated with long-term Background and aims: Primary Progressive negative sequelae, and families must continually Aphasia (PPA) is a neurocognitive-degenerative adapt to meet the changing needs of the child disorder, characterised by early and ongoing with ABI and family members. Interventions decline of language-communication-cognitive which provide enriching educational abilities. Despite the pivotal role that spouses opportunities, such as condition-specific camps, play in supporting their partner diagnosed with may support families following ABI. This study PPA, little is known about how they deal with and explored the experience of a camp for children face the challenges associated with this progressive condition. The aim of this qualitative
research project was to gain an understanding of members and the relative with brain injury. This the personal experiences of spouses living with study aimed to produce a profile (positive and this condition. negative) of families supporting relatives with Method: Thirteen spouses whose partners were traumatic brain injury (TBI) who experience high diagnosed with PPA participated in 1:1 semi support needs. structured, in-depth interviews to explore their Methods: A cross-sectional survey-based pilot lived experiences of this illness. Using a study was undertaken with thirty-eight dyads. constructivist grounded theory approach, Dyads consisted of a family member and relative analysis moved through a process of data-driven with TBI and high daily support needs (median open and focused coding, for the identification of Care and Needs Scale (CANS) score of 7, emergent categories, themes and subthemes indicating near 24-hour per day care that captured the lived experiences of spouses requirements). The survey examined supporting partners with PPA. demographic and clinical characteristics of the Results: A constructivist grounded theory relative with TBI and the family member; and the analysis of the interview data revealed an CANS; Health of the Nation Outcome Scale– overarching theme of ‘facing the challenges of Acquired Brain Injury; and Role Checklist for the PPA’ that captured the overall experiences of person with TBI. Non-parametric bivariate spouses. Four interdependent and overlapping analyses were conducted. themes that sat within this overarching theme Results: Independence of the FOM-40 domains included: acknowledging disconnect in the was confirmed. Place of residence (supported spousal relationship, living the decline, re- accommodation/family home) was an important adjusting sense of self, and getting on with living. predictor variable. Supported accommodation Each of these core themes revealed how spouses was strongly associated with lower levels of dealt with the ongoing and evolving challenges of burden reported in families. Family home was PPA, particularly concerning changing relational strongly associated with better adjustment of the dynamics with their partner and adjusting their relative with TBI. Family resilience was positively own self-conceptualisation. associated with sustainability of support and Conclusions: The findings highlight the comorbidity in the relative with TBI. importance of addressing the relational Conclusions: Family outcomes were associated consequences of PPA for spouses, specifically to with a variety of demographic and clinical manage their changing emotional-relational characteristics of the relative with TBI including connectivity within self, their partner and social residence, behaviour and mental health world. symptoms. The results provide meaningful Correspondence: Margaret Pozzebon; evidence for service providers given the margaret.pozzebon@mh.org.au increasing investment in housing and support options for people with disabilities, and the Family and Traumatic Brain Injury: An ongoing reliance on families to provide informal Investigation using the Family Outcome support after TBI. Measure Correspondence: Christine Migliorini; Migliorini, Christine1; Callaway, Libby1,2; Moore, christine.migliorini@monash.edu Sophie1; and Simpson, Grahame K3,4 1 Department of Occupational Therapy, Monash Meeting Unmet Needs: Education and Support University, Frankston, VIC, Australia for Adult Family Members of Individuals with 2 Neuroskills Pty Ltd, Sandringham, VIC, Australia Brain Injury 3 Brain Injury Rehabilitation Research Group, Ward, Nic1; Naidu, Nalita1; Palmer, Siobhan1 and Ingham Institute of Applied Medical Research, Gozdzikowska, Kristin1 Sydney, NSW, Australia 1 Laura Fergusson Trust, Christchurch, New 4 Liverpool Brain Injury Rehabilitation Unit, Zealand Sydney, NSW, Australia Background and Objectives: Traumatic brain Background and Objectives: The Family Outcome injury (TBI) has adverse, long-term impacts on Measure (FOM-40) captures multidimensional not only survivors, but on family members as data about wellbeing and capacity of family well. Family members often have critical
supporting roles in the recovery process; individual with a brain injury and are often the research has identified relationships between cause of increased stress and poor quality of life family member well-being and survivor outcome. in both the person with brain injury and their However, there is a gap in translating this families and social networks. Often access to research to clinical practice due to limited intervention and support is limited for many provision for funded interventions for family families, especially those living in rural areas. The members. However, there has been a recent shift aim of this programme was to develop an easily in policy with Accident Compensation accessible online resource for families to help Corporation (ACC) TBI Strategy and Action Plan them understand and support their family (2017 – 2021) stating clearly a goal “to improve member with challenging behaviours. services that extend to whānau, taking a more Method: Eight family members of a person with holistic approach.” brain injury completed the pilot trial of the Method: Group programmes to educate and Carers’ Way Ahead programme. The programme support adult family members were was developed by six clinicians and targets the implemented over an 18-month period. This most common types of challenging behaviours presentation will review the rationale, identified by family members in 7 modules. intervention content, implementation process, Participants of the trial completed a number of and pre-/post-outcome measures of these measures before and after completing the services to date. programme and were also asked to provide Results: Wilcoxon signed-rank test revealed a feedback on the feasibility and acceptability of significant median decrease in self-ratings of the programme. perceived stress following group intervention, as Results: Overall, feedback from families suggests compared to pre-treatment self-ratings (z = - the programme “Carers’ Way Ahead” is both 2.070, p = 0.038). All participants reported they feasible and acceptable. All family members would recommend the programme. Qualitative identified the need for support, especially those data highlighted self-reported themes of in rural areas. Responses from families indicated increased ability to cope, increased that an online programme is both easily understanding of the individual with TBI, as well accessible and convenient to those with time as benefits of peer-support. constraints. Conclusions: Professionally-led family/whānau Conclusions: This project aims to address a support and education appears integral for significant gap in resources for families trying to individual and family systems’ optimal recovery manage challenging behaviour post brain injury. and outcome after moderate to severe TBI. Correspondence: Emily Trimmer; Understanding the importance of whānau emily.trimmer@gmail.com contributions to recovery is also fundamental to understanding Māori health and whānau ora, or Taking Action to Support Sexual Expression supporting Māori families in collectively Using a Team Approach: The Recognition Model achieving optimal wellbeing. Higson, Narelle1 Correspondence: Kristin Gozdzikowska; 1 Outside the Square OT Solutions, Perth, Western Kristin@lftcant.co.nz Australia Carers’ Way Ahead: A resource for families Although it is generally agreed among health care caring for someone with brain injury professionals that engaging in activities related to Trimmer, Emily1; McDonald, Skye1; Newby, Jill1; sexual expression may be an important part of Grant, Samantha2; Gertler, Paul2 and Simpson, health and wellness for people of all ages, Graham3 abilities and cultural backgrounds, there often 1 School of Psychology, University of New South remains a theory/practice when it comes to Wales, Sydney, NSW, Australia addressing the area in rehabilitation and 2 Private practice community settings. Research suggests that 3 Ingham Institute of Applied Medical Research many healthcare workers do not feel adequately equipped to address sexual concerns in a Background: Challenging behaviours can have a competent, safe and supported manner. major impact on family members caring for an
This presentation will outline the steps of The expression or a neutral face. Measures of Recognition Model, a useful framework for team- empathy and emotion recognition were taken. based practice published in 2010 by UK Results: People with TBI were slower than occupational therapist Lorna Couldrick, which controls overall. They did, however, demonstrate may be used to assist both individual a similar magnitude Stroop effect on incongruent practitioners and health teams in a variety of trials. Stroop performance was not related to work settings to positively support sexual emotion perception accuracy of self-reported expression. The presentation will identify empathy. potential challenges health conditions and Conclusion. This study found that rapid disability may present to engaging in sexual conceptual processing of emotional faces was expression, outline potential barriers to including preserved in people with TBI, despite sexual expression in practice in a safe, respectful substantially slowed processing speed. There was and inclusive way and identify practical strategies no evidence that this conceptual processing of which may be used to assist in increasing emotional faces plays a role in the ability to confidence, comfort and competence when recognise or to resonate with the emotions of addressing this area. Resources and avenues of others after a TBI or in healthy controls. support to foster further learning will also be Correspondence: Skye McDonald; identified. s.mmcdonald@unsw.edu.au Correspondence: Narelle Higson; narelle@otsots.com.au What is the relationship between empathic responses and emotion recognition following Concurrent Session 2 brain injury? Zupan, Barbra1 and Neumann, Dawn2 What causes impaired empathy after traumatic 1 Central Queensland University, Rockhampton, brain injury: Trialling an Emotional Stroop Task Australia McDonald, Skye1; Osborne-Crowley, Katie1; 2 Indiana University School of Medicine, Wilson, Emily1; De Blasio, Frances; Wearne, Travis Department of Physical Medicine and and Rushby, Jacqueline1 Rehabilitation, Indianapolis, United States 1 School of Psychology, UNSW, Sydney, Australia Background and Objectives: Recognising Background and Objectives: Emotional empathy emotions and empathising with others’ feelings allows the observer to share, or ‘resonate’ with, contribute to positive psychosocial outcomes but the emotional state of others. People with the relationship between them is not well traumatic brain injury (TBI) often have a reduced understood. This study aimed to compare the ability to resonate with the emotions of others association between emotion recognition and but there is little research into the mechanisms empathic responses to film clips in people with for this. The perception-action model (PAM) of and without TBI. empathy proposes a mechanism whereby, when Method: 60 adults with moderate to severe TBI an observer pays attention to another’s and 60 age and sex-matched healthy controls emotional state, all relevant conceptual (HC) participated. Participants viewed affective representations relating to the observed film clips, reported the character’s expressed emotional experience are rapidly and emotions, and their own emotional responses to automatically activated providing access to the the clips. Responses were considered empathic if meaning in the stimuli. This study aimed to participants reported feeling the same emotion determine whether people with TBI are also they had identified the character in the clip to be rapidly accessing parallel emotional information, feeling. making them susceptible to incongruity in an Results: Participants with TBI were significantly Emotional Stroop task. less accurate than HCs at emotion recognition, Method: 26 people with TBI and 30 matched t=.2.74, p=.007 and less likely to experience an control participants were presented with 105 empathic response, χ2=14.33, p
and empathically responded to the characters’ correlated with stress, and negatively correlated emotions more frequently, (78% versus 65% for with quality of the relationship (p
with a significant effect of time for the TH group attendance. Three cases will be illustrated to only (p=.001). There were no significant convey the breadth of treatment responses: 1) interactions, or time or group effects for other reliable and clinical improvements; 2) no change QOLIBRI scales. post-treatment with delayed improvement; and Conclusions: TBIconneCT participants reported 3) non-response. improved QOL in social relationships. TH Conclusions: Challenges arising from the research participants reported improved QOL in cognition, process will be discussed, including difficulties whereas IP participants did not. with potential participant identification and Correspondence: Rachael Rietdijk; maintaining group allocation. The case rman7827@uni.sydney.edu.au illustrations will be reflected upon to consider possible mediating factors to treatment Protocol, process, and progress on a feasibility response. RCT targeting social cognitive impairments after Correspondence: Anneli Cassel; acquired brain injury anneli.cassel@unsw.edu.au Cassel, Anneli1,2; McDonald, Skye1,2 and Kelly, Michelle2,3 Cognitive Reserve and Age Predict Cognitive 1 School of Psychology, University of New South Recovery Following TBI Wales, Sydney, Australia Ponsford, Jennie1,2; Fraser, Elinor1,2; Biernacki, 2 Moving Ahead Centre of Research Excellence in Kathryn2,3; McKenzie, Dean2 and Downing, Brain Recovery, University of New South Wales, Marina1,2 Sydney, Australia 1 School of Psychological Sciences, Monash 3 School of Psychology, University of Newcastle, Institute of Cognitive and Clinical Neuroscience, Newcastle, Australia Monash University, Clayton, Victoria, Australia 2 Monash Epworth rehabilitation research Centre, Background and Objectives: Social cognitive Epworth Healthcare, Richmond, Victoria, impairments are common after acquired brain Australia injury (ABI) and detrimentally impact on social 3 Centre for Molecular and Behavioral relationships. Despite this, few have treated Neuroscience, Rutgers University, Newark, USA social cognitive deficits in this population. This study aims to establish the feasibility of a novel Background and Objectives: Cognitive social cognition group treatment (‘SIFT IT’) for impairments are common and disabling after TBI. people with ABI. Little is known of factors associated with Method: The SIFT IT study is a multi-site RCT. cognitive recovery. This longitudinal study Recruitment commenced mid-2017 at three NSW examined the association of age, IQ and PTA brain injury rehabilitation services and the duration with cognitive recovery 2-5 years community. Eligible participants are randomly following TBI. allocated into SIFT IT or Waitlist Control (WLC). Methods: 107 individuals with mild to severe TBI, SIFT IT runs in small groups for 14 weekly 90- Mage 44.38 years, Meduc 14.04 years, MPTA = 21.66 minute sessions, delivered by a Clinical days and MIQ 109 were assessed early post-injury Psychologist. The program covers: emotional self- and reassessed an average 44.65 months post- awareness, emotion perception, perspective injury. A matched healthy control group (n=63) taking, and choosing social responses. Feasibility, with Mage 46.92 years, Meduc 13.34 years, and MIQ qualitative, and quantitative outcomes are 107.21 completed measures once. Measures monitored. Measures are administered at three included the NART (premorbid IQ), Digit Symbol time-points: T1 (eligibility); T2 (post-SIFT IT); and Coding (DSCT) (processing speed), RAVLT T3 (post-waitlist SIFT IT/3-month follow-up). (memory) and Trail Making Test Part B (TMT-B) Results: The study is ongoing with 23 participants (executive function). Regression analyses eligible thus far: 12 randomly allocated to SIFT IT examined predictors of cognitive performance. and 11 to WLC. Half of the recruitment waves are Results: Participants with TBI performed complete, with four programs finished. By T3, significantly worse than controls on all measures retention has been 91% with excellent group (all p
in the TBI group at follow-up. Premorbid IQ was networks. “Continuation and stability” was associated with gains on all measures, after characterised by long lasting and supportive accounting for initial performance (β = 0.35, p < social networks which helped to maintain self- .001), RAVLT (β = 0.22, p < .05), and TMT-B (β = – identity. “Maintenance and expansion” depicted 0.43, p < .001). Age was associated with gains on the experience of both retaining pre-existing DSCT (β = –0.35, p < .001) and TMT-B (β = 0.28, p networks and forming new ones, and learning to < .05). PTA duration was not significantly assimilate old and new identities. “Loss and associated with cognitive recovery on any disconnection” reflected the loss of social groups measure. without forming new connections and an ongoing Conclusions: Findings support the contention struggle to rebuild one’s self-identity. “Loss and that cognitive reserve and to a lesser extent age rebuilding” was characterised by disruption of determine degree of long-term cognitive social groups, with new connections forming over recovery following TBI. time to support a reconstituted self-identity. Correspondence: Jennie Ponsford; Conclusions: Social networks can be substantially jennie.ponsford@monash.edu altered following a brain tumour diagnosis. Individuals who are able to maintain, expand or Concurrent Session 3 rebuild their social networks typically experience greater continuity or positive shifts in their self- Use of social identity mapping to understand identity. The implications for psychosocial the impact of brain tumour on social groups and interventions will be discussed. identity: A qualitative study Correspondence: Lee Cubis; Cubis, Lee1,2; Ownsworth, Tamara1,2; Pinkham, lee.cubis@griffithuni.edu.au Mark3,4; Foote, Matthew3,4 and Chambers, Suzanne1,2,5 A journey of ambiguity – The healthcare 1 School of Applied Psychology, Griffith University, experiences of people with mild stroke Mount Gravatt, Australia Hodson, Tenelle1; Gustafsson, Louise2 and 2 Menzies Health Institute Queensland, Griffith Cornwell, Petrea2 University, Gold Coast, Australia 1 School of Health & Rehabilitation Sciences, 3 School of Medicine, University of Queensland, University of Queensland, Brisbane, Australia Brisbane, Australia 2 School of Allied Health Sciences, Griffith 4 Department of Radiation Oncology, Princess University, Brisbane, Australia Alexandra Hospital, Woolloongabba, Australia 5 Cancer Council Queensland, Fortitude Valley, Background and Objectives: Whilst it has Australia recently been acknowledged that people with mild stroke experience ongoing issues following Background and objectives: Confidence in hospital discharge, mild stroke-specific services support has been found to buffer the adverse are lacking internationally. Consequently, the effects of brain tumour on psychological well- ability to understand how this population being. This study aimed to explore individuals’ experiences health services is restricted, halting experience of changes in social networks and the advancement in the area. It is imperative that the impacts on self-identity after brain tumour. views of this population are sought in regards to Method: A purposive sample of 20 adults with health services to address their needs and reduce primary brain tumour (35% benign; 15% low the impact of ongoing issues. For this reason, this grade; 50% high grade) participated in two semi- study aimed to answer the question: “How do structured interviews over three months. A visual people with mild stroke perceive their experience social map was used during the interviews to of stroke-related services?” characterise members of their social network and Method: Qualitative investigation using an their function, importance and meaning. Guided interpretative phenomenological analysis. Five by phenomenology, interview transcripts and participants were interviewed at 1-, 3-, and 6- social maps were analysed to identify major months post discharge. Visual Analogue Scale themes. scores that measured satisfaction with health Results: Four themes depicted patterns of loss, services were used for triangulation. stability, growth and expansion of social
You can also read