Abstract
Background In a feasibility randomised controlled trial, training was developed to equip occupational therapists to deliver early specialised traumatic brain injury vocational rehabilitation in the English National Health Service (NHS). Method The package was developed by experts in vocational rehabilitation and traumatic brain injury, and included a manual, direct instruction by six trainers and opportunity for mentorship by four therapists. Following training, therapists were interviewed regarding the effectiveness and ease of use of the package. Interviews were analysed using the framework approach. Results Five trained therapists were interviewed regarding the package. Results were organised into six categories: (1) motivation to participate in research; (2) impact of the learning environment; (3) changing confidence levels over time; (4) growing appreciation of complexities about the intervention; (5) acceptability of the training package; and (6) lessons for future implementation. Conclusion The therapists reported acquiring the knowledge necessary to implement the intervention. The data indicate that the training packages require detailed descriptions of the interventions being taught for local implementation in the NHS and for future research. The training materials are valued by therapists but require time for familiarisation, and reminders from mentors help put training into practice. The therapists have concerns about implementing the interventions within a research context, which researchers should address.
Highlights
TBI is a major cause of long term disability (Saltychev et al, 2013)
The purpose of the study was to explore the following questions: (1) Could the complex intervention, Early Specialist TBI VR (ESTVR), be translated into a training manual, direct teaching and mentoring package for Occupational Therapists (OTs) working in the FRESH trial?; (2) Did the OTs find the training package effective in preparing them to deliver the intervention?; (3) How did the OTs describe the package’s "ease of use"?
The training package was delivered to OTs working in the FRESH trial
Summary
People who incur severe TBI are likely to sustain permanent neurological damage, which has a lasting impact on the ability to resume former occupations. Vocational Rehabilitation (VR) is defined as, “a multiprofessional approach that is provided to individuals of working age with health-related impairments, limitations, or restrictions with work functioning and whose primary aim is to optimise work participation” (Escorpizo et al, 2011). In the UK health system rehabilitation commissioning is patchy resulting in the delivery of VR meeting less than 10% of the estimated need for people with TBI (Playford et al, 2011). In a feasibility randomised controlled trial, training was developed to equip Occupational Therapists to deliver Early Specialised Traumatic Brain Injury Vocational Rehabilitation in the English National Health Service
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