Therapists’ and patients’ experiences and perceptions of sleep difficulties after head injury

Gardani, M., McMillan, T. and Gibbons, L. (2014) Therapists’ and patients’ experiences and perceptions of sleep difficulties after head injury. Brain Injury, 28(5-6), p. 773. (doi:10.3109/02699052.2014.892379)

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Abstract

<i>Objectives:</i> Head injury (HI) patients report frequent problems with memory, concentration, fatigue, irritability, temper, dizziness and headaches. Sleep problems are reported in up to 70% of patients after head injury and insomnia symptoms can be found in up to 30% of HI patients; these rates are significantly higher than those found in the general population. This study has conducted the first qualitative analysis on the impact of sleep difficulties in the quality-of-life of HI patients.<p></p> <i>Methods:</i> Two groups of therapists (n = 16) participated in focus group discussions. The groups included speech therapists, neuropsychologists, assistant psychologist, nurses and support workers that have been working in two local rehabilitation centres for at least 6 months prior to the study. Community patients were recruited from a local HI supporting network (Headway) and were invited to participate in the study. Three groups of community patients (n = 4 per group) with severe HI were facilitated to discuss their sleep problems after the injury in a group setting. Group discussions lasted ∼45–60 minutes per group until saturation was achieved. Thematic analysis was used to qualitatively explore the beliefs, experiences and expectations associated with sleep disturbances following head injury.<p></p> <i>Results:</i> Therapists and support staff reported that sleep difficulties are common in HI patients and that in most cases sleep disturbance is related not only to the HI itself but also to mental health or environmental factors. Staff felt that little attention is routinely paid to these problems during rehabilitation unless specifically linked to challenging behaviour. Fatigue was thought to be highly relevant and to have a negative effect on engagement and participation in rehabilitation. Patients thought that sleep problems became persistent after injury and the areas that emerged as being more affected were: mood, cognition, everyday functioning, physical health, concentration and cognition. Most patients reported severe insomnia symptoms associated with worry about life and family during the night.<p></p> <i>Conclusions:</i> To provide better management and improve their rehabilitation it is essential to understand the therapists’ and patients’ expectations and perceptions of sleep difficulties after head injury. Qualitative analysis shows that sleep difficulties have a significant impact on the cognitive, affective and behavioural difficulties that many patients experience following a head injury.

Item Type:Articles (Other)
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gibbons, Mr Liam and McMillan, Professor Thomas and Gardani, Dr Maria
Authors: Gardani, M., McMillan, T., and Gibbons, L.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
Journal Name:Brain Injury
Publisher:Informa Healthcare
ISSN:0269-9052
ISSN (Online):1362-301X

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