What environmental factors irritate people with acquired brain injury?

Abstract

Purpose: This study aims to determine the environmental factors nurses identify as being irritating to people with acquired brain injury.Method: This was a qualitative study. An experienced interviewer used the Critical Decision Method to interview 28 nurses working in 10 inpatient brain injury rehabilitation units in Australia on a one to one basis for 1 – 1.5 h on two consecutive days. Transcripts of interviews were analysed using thematic analysis.Results: Nurses identified five groups of irritants that acted as triggers for aggression:too much stimulation, e.g., overcrowding, too much noisetoo many restrictions, e.g., locked doors, lack of space, lack of privacy, lack of choice, lack of freedominteraction with staff, e.g., staff with an inflexible approach, setting limits, communication style of staff, inappropriate interaction by staff, inexperienced staff, rotation of staff, lack of staff expertiseinteraction with other patientsinteraction with family and visitors, e.g., families expecting too much, patients being treated like children, fights with partners.Conclusion: The nurses in this study identified many environmental factors that irritate people with acquired brain injury. Some irritants appeared unavoidable but others could be addressed by staff expertise.