Are we giving them what they need in care conferences? Perspectives from caregivers in Inpatient Brain Injury Rehabilitation
Bibliographic record
Abstract
Are we giving them what they need in care conferences? Perspectives from caregivers in Inpatient Brain Injury RehabilitationAnna Yuen OT Reg. (Ont.), MScOT, Toronto Rehab, UHNDebbie Hebert OT Reg. (Ont.), MSc, Principal Investigator, Practice Lead, Occupational Therapy, Toronto Rehab, UHN; Clinic Lead, Rocket Family Upper Extremity Clinic, Toronto Rehab, UHN; Associate Professor, Dept. OS & OT, University of TorontoEdith Ng OT Reg. (Ont.), BScOT, MSc, Co-Investigator, Advanced Practice Leader, Toronto Rehab, UHN; Lecturer status-only University of TorontoAbstractBackground / AimsCare conferences, also known as family conferences, are recommended in the Ontario NeuroTrauma Foundation (INESSS-ONF) Clinical Practice Guideline to be regularly offered to individuals with traumatic brain injury in inpatient rehabilitation. Care conferences are typically offered for patients and caregivers to meet with the interprofessional teams to discuss progress, provide education, and address discharge planning. However, there is limited research to guide the delivery of care conferences with people with acquired brain injury (ABI) and their caregivers. The aims of this study are: (1) understand the needs and expectations of patients with ABI and their caregivers in inpatient rehabilitation; (2) determine if their needs and expectations were met; and (3) identify opportunities to better shape care conferences in both format and content. Findings gathered on caregivers will be shared at this conference.MethodsIn this mixed methods study, quantitative and qualitative data was obtained through semi-structured interviews using open and closed-ended questions, which were co-designed with patient partners and the interprofessional teams. Interviews were conducted within one week after their care conferences. Qualitative data from caregiver interviews have been analyzed using a thematic analysis approach as described by Braun and Clarke (2006) to code and theme the data. Quantitative data is being analyzed using descriptive statistics. ResultsFour themes emerged to characterize caregiver needs and expectations: Feeling informed, being prepared, sharing information, and team involvement. Care conferences offer the opportunity for caregivers to ask questions and receive information to feel informed. Not only did they value the face-to-face opportunity to meet and liaise with the interprofessional teams to support their loved ones, the importance of preparing them on what to expect prior to the care conference was also expressed. All caregivers interviewed found care conference provided an effective opportunity for education, progress update, and discharge planning. Opportunities to improve their care conference experiences were also identified, including: improving caregiversu2019 preparation prior to the care conference, providing adequate time and opportunities for questions, and ensuring all pertinent members were present for the discussion. ConclusionsUsing thematic analysis, an enriched understanding of caregiver needs and expectations emerged, and care conferences were found to play an important role in the individualsu2019 inpatient rehabilitation journey. Findings from this study can provide insights to guide the design of care conferences in ABI inpatient rehabilitation services to more effectively and consistently meet the needs of caregivers. Patientsu2019 feedback will be analyzed and compared with that of the caregivers as a next step. As care conferences are regularly used to facilitate discharge planning, improving care conferences may also improve discharge transitions and community integration. Learnings may also guide the delivery of care conferences beyond the inpatient ABI rehabilitation setting.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.039 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.021 | 0.007 |
| Scholarly communication | 0.009 | 0.009 |
| Open science | 0.002 | 0.009 |
| Research integrity | 0.003 | 0.009 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".