Feasibility study undertaken on young adults following an Acquired Brain Injury (ABI)
A feasibility research study funded by the RCN Foundation, in partnership with SameYou, and undertaken by the YARNS Transition team at the University of Edinburgh
The purpose of the study was to co-design and preliminarily test a nurse-led, holistic, neurological rehabilitation intervention which supports the psychosocial rehabilitation and survivorship of young adults following an Acquired Brain Injury (ABI).
Laura was appointed as Research Fellow to undertake the study. Speaking of the experience, she said "working with the YARNS Transitions team has enhanced my competency on conducting research at a post-doctoral standard. It has allowed me to pursue similar areas of interest first explored in my PhD, with the added experience of working primarily with nurses and nursing academics."
What is the research about?
The research sought to identify how best to support young adults following an acute brain injury (ABI). The first YARNS study, which looked at online messages, revealed the kinds of problems young adults faced when recovering from ABI.
This suggested that work was needed to develop something new that could be offered, especially when they left hospital and returned home.
The approach that was taken in this study is termed a realist evaluation. This involves looking at what published evidence exists and testing this out with people who have experienced ABI or with health professionals who understand the challenges that might be involved. The team were especially interested in emotional and social wellbeing (termed psychosocial support) as this was mentioned as important in the first YARNS study.
What did they do?
The work was divided the work into three parts (or work packages). The first involved a thorough search of the published literature on this topic, choosing the most relevant and most robust studies and summarised what they said. In the second work package, findings from the first step were used to create a logic model (a diagram summarising essential steps of the rehabilitation approach being proposed). Young adults with experience of ABI, and some health professionals who are experts in this area, were invited to review and strengthen the logic model by considering whether it might work, when and for whom.
A separate study was also undertaken as part of the research during this second work package. This was an MSc dissertation undertaken at Edinburgh University, funded as part of this grant, exploring the role of the nurse in post-ABI rehabilitation and support. This provided new insights into the key role played by the nurse and their capacity to co-ordinate care across a multi-professional group. It also developed a young researcher’s skills in research.
The final work package took the logic model a step further by subjecting it to scrutiny in co-design workshops where participants refined the logic model using creative thinking activities and prioritisation exercises based on their lived experiences, either as experts by experience or as service providers. Five workshops were conducted for participants to confirm, challenge and refine the logic model and the aim of the intervention it represents. Essentially this means what more needs to be done to better support young adults post ABI.
What were the findings?
The work resulted in the SPARK model - Supporting the PsychosociAl Rehabilitation needs of young adults with acquired brain injury and stroKe.
SPARK is a new approach to shape young adults’ psychosocial needs post-ABI when they return home. The SPARK intervention works on personal priorities, including whether face-to-face or hybrid meetings are preferred, as well as timings, going at the young person’s pace. SPARK promotes an interdisciplinary team approach and ensures that young adults can be referred to other health and social care teams and services as required. The opportunity for face to face or hybrid delivery acknowledges potential challenges related to transportation, mobility and accessibility.
What happens next?
The findings will be published and shared with professionals and other stakeholder at meetings and conferences. The SPARK model now needs to be tested in the real world and evaluated by young people post ABI and professionals and others supporting them. Only then can it be determined how effective this model can be in practice. It has been created from published evidence and built by the views of those with experience, and the team believe their voice has been key to this project.