ABSTRACT

Challenging behaviours are common following moderate to severe acquired brain injury (ABI). These behaviours cause relationship and community participation difficulties and are a significant source of stress for many individuals with ABI and their close others (COs). A Positive Behaviour Support intervention, PBS + PLUS, was implemented to assist individuals with ABI to collaboratively build meaningful lives and self-regulate their behaviour. This study explored the perspectives of individuals with ABI and COs (family members, friends, and carers) who had completed an individualized 12-month PBS + PLUS intervention. Fifty-two individuals participated in semi-structured interviews, and a thematic analysis of interview transcripts identified the interrelated themes of Openness to Change, Embeddedness, Clinician Connection, and Preparedness for the Future. Participant perceptions of, and engagement with, PBS + PLUS were influenced by an attitude of openness to new ideas and by the intervention itself. Achieving contextual relevance allowed the intervention to become embedded in participants’ lives, and the client–clinician relationship was central to participants’ positive experiences. While most participants felt better equipped to cope with the future, some experienced difficulties transitioning to post-intervention life. These results suggest PBS + PLUS may assist individuals with ABI to lead meaningful lives and more confidently overcome behavioural challenges, while encouraging supportive and empowered COs.

摘要

具有挑战性的行为在中度至重度获得性脑损伤 (ABI) 后很常见。这些行为会导致人际关系和社区参与困难，并且是许多 ABI 患者及其亲密他人 (CO) 的重要压力源。实施积极行为支持干预 PBS + PLUS 以帮助患有 ABI 的个人协作建立有意义的生活并自我调节他们的行为。本研究探讨了患有 ABI 和 CO（家庭成员、朋友和照顾者）的个人的观点，他们已经完成了为期 12 个月的个性化 PBS + PLUS 干预。52 人参加了半结构化访谈，对访谈记录的主题分析确定了开放性、嵌入性、临床医生联系、和未来的准备。参与者对 PBS + PLUS 的看法和参与受到对新思想的开放态度和干预本身的影响。实现情境相关性允许干预融入参与者的生活，而客户-临床医生关系是参与者积极体验的核心。虽然大多数参与者感觉能够更好地应对未来，但一些人在过渡到干预后的生活时遇到了困难。这些结果表明 PBS + PLUS 可以帮助患有 ABI 的人过上有意义的生活并更自信地克服行为挑战，同时鼓励支持和授权的 CO。实现情境相关性允许干预融入参与者的生活，而客户-临床医生关系是参与者积极体验的核心。虽然大多数参与者感觉能够更好地应对未来，但一些人在过渡到干预后的生活时遇到了困难。这些结果表明 PBS + PLUS 可以帮助患有 ABI 的人过上有意义的生活并更自信地克服行为挑战，同时鼓励支持和授权的 CO。实现情境相关性允许干预融入参与者的生活，而客户-临床医生关系是参与者积极体验的核心。虽然大多数参与者感觉能够更好地应对未来，但一些人在过渡到干预后的生活时遇到了困难。这些结果表明 PBS + PLUS 可以帮助患有 ABI 的人过上有意义的生活并更自信地克服行为挑战，同时鼓励支持和授权的 CO。