Communicative interaction between rehabilitation staff and people with TBI: An interview study.

Title: Communicative interaction between rehabilitation staff and people with TBI: An interview study.

Background and objectives:
The communicative interaction between people with traumatic brain injury (TBI) and rehabilitation staff can be challenging, and there is emerging evidence that communication partner training (CPT) can improve this interaction. However, to tailor CPT programs to the variable contexts of rehabilitation, more knowledge is needed about the experiences of the communicative interactions taking place in rehabilitation. Thus, the aim of this study was: 1) to explore rehabilitation staff’s experiences of their communication with people with TBI. 2) To investigate rehabilitation managers’ perspectives on the communicative interactions between staff and people with TBI. 3) To explore people with TBI’s experiences of communicating with rehabilitation staff.

Method:
Individual semi-structured interviews were conducted with twenty-two staff members, four managers, and nine people with TBI. All participants were recruited from six Danish facilities offering in- and outpatient rehabilitation to people with moderate to severe TBI. Interviews were transcribed verbatim and analyzed through reflexive inductive thematic analysis. Data from interviews with people with TBI was analyzed independently. The study design and reporting were guided by reporting checklists to maximize trustworthiness.

Results: For interviews with rehabilitation staff and managers, the analysis generated four main themes: 1) Cognitive-communication disorders challenge interaction. 2) Staff struggle in communication. 3) Communication context is crucial. 4) Staff want communication knowledge and skills. For interviews with people with TBI, three main themes were generated: 1) Communicating with staff is challenging. 2) Relationships with staff are established through communication. 3) People with TBI want individualized communication.

Conclusion:
Staff and managers generally perceived communication with people with TBI as highly demanding, but there were noteworthy differences related to staff’s workplace, disciplines, and years of work experience. People with TBI also shared experiences of communicative challenges and emphasized how staff’s communicative support could improve the interaction, whereas staff not attending to the communicative needs of people with TBI could limit the communicative success. Overall, the participants’ perspectives are crucial to tailoring future CPT programs to the specific communicative interactions in the rehabilitation context.
Corresponding author: Iben Christensen at [email protected]