Caroline Ellis-Hill

Using water as a treatment (hydrotherapy) can be traced back to ancient times with treatments for both physical and psychological illnesses [1]. Immersion in warm or cold water can have an effect o...

Introduction Traumatic brain injury (TBI) brings about inevitable and significant changes for family members. Mental health effects for family members are well documented but there are significant gaps in support options across services. Here, we describe our protocol for a study that seeks to investigate the potential for a narrative, creative approach, the ‘Life Threads’ approach, as a low intensity, accessible means of support that can be applied across service contexts. Methods We will recruit 20 family members of someone who sustained a TBI from services in an area of the UK with a diverse demographic. Family members will be provided with the ‘Life Threads’ approach materials and guided in their use. The study is planned to run from March 2023 to July 2024. Analysis Collection of data on potential usefulness, feasibility and acceptability will be through focus groups and individual interviews. Transcripts will be analysed using reflexive thematic analysis, conducted within a relativist, constructivist orientation. Ethics and dissemination Ethical approvals have been sought and gained (Nottingham 1 Research Ethics Committee, 23/EM/0185, 4 September 2023), and the study has been registered with ISRCTN. As a research team, we are guided by our own personal, professional and research experiences of TBI which we will consider reflexively throughout the research process. Results will be disseminated in collaboration with our patient and public involvement group through open peer-reviewed journal publication and scientific conference, with lay summaries shared via recruitment sites. Trial registration number ISRCTN17392794.

Aim: To explore the experiences of older adults (65+) living with acquired brain injury regarding their sense of well‐being during physical rehabilitation within the Greek Healthcare System.Background: With the increasing ageing population and the life‐changing effects of acquired brain injury, there is a need to focus on care for older people and their potential to live well. Rehabilitation systems deserve greater attention, especially in improving the well‐being of those who are using them.Design: A qualitative study design with a hermeneutic phenomenological approach was used.Methods: Fourteen older adults living with acquired brain injury and undergoing physical rehabilitation in Greece were purposively sampled. Semi‐structured interviews were conducted to collect data and were thematically analysed using van Manen's and Clarke and Braun's methods. The COREQ checklist was followed.Results: Four themes emerged from the analysis: (1) Challenges of new life situation, (2) Seeking emotional and practical support through social interaction, (3) Identifying contextual processes of rehabilitation, (4) Realising the new self.Conclusions: The subjective experiences, intersubjective relations and contextual conditions influence the sense of well‐being among older adults living with acquired brain injury, thus impacting the realisation of their new self. The study makes the notion of well‐being a more tangible concept by relating it to the degree of adaptation to the new situation and the potential for older adults to create a future whilst living with acquired brain injury.Relevance for Clinical Practice: Identifying the factors that impact older adults' sense of well‐being during rehabilitation can guide healthcare professionals in enhancing the quality of care offered and providing more dignified and humanising care.Patient or Public Contribution: Older adults living with acquired brain injury were involved in the study as participants providing the research data.

This paper presents qualitative research findings from the evaluation of a Parkinson’s Dance well-being venture in the UK. Qualitative data was gathered to see how bespoke dancing sessions helped people with Parkinson’s (PwP) to manage their conditions and improve their lives and prospects. Principles of a participatory approach were incorporated and methods included semi-structured interviewing, researchers participant observation and an elicitation-based activity. Nineteen PwP, six carers, four dance artists and seven helpers participated in the study. Participating in Parkinson’s Dance sessions meant that PwP could experience the possibilities to dance, develop a “can do” attitude, experience fun, enjoyment, social connection, exercise, movement to music, improvement and/or maintenance of their balance, suppleness, coordination and confidence with movement, symptoms being pushed back and ability to learn new things. Our findings add to the evidence-base about the benefits of dance for people experiencing Parkinson’s and through novel application of the Life-world based well-being framework of K. T. Galvin and Todres (2011) we propose a theoretical basis for Parkinson’s Dance as a resource for well-being. There is scope to consider application of the well-being framework to other arts activities and as the basis of an arts and well-being evaluation tool.

A sense of control is important for supporting older people living with frailty to develop adaptive functioning to optimize wellbeing. This scoping review examined the literature on the sense of control and wellbeing in older people living with frailty within their everyday life and care service use. Nine databases were searched using the timeframe 2000 to 2021 to identify key ideas regarding control and wellbeing in older people with frailty. The review highlighted three major themes: a) Control as conveyed in bodily expressions and daily activities, b) Sense of control and influence of place of residence, and c) Control within health and social care relationships. Maintaining a sense of control is not only an internal feeling but is impacted by physical and social environments. Greater focus is needed on the nature of relationships between older people living with frailty and those who work alongside them, which support control and wellbeing.

Aims: To acquire an in‐depth understanding of how older individuals diagnosed with acquired brain injury (ABI) experience their well‐being and care when undergoing physical rehabilitation.Design: Systematic literature review.Data sources: The electronic databases of PubMed, CINAHL, APA PsycInfo, ASSIA and SCOPUS were searched from 2005 to 2020. Extensive reference checking was also conducted.Review methods: A systematic review was conducted following PRISMA guidelines, including predominantly qualitative studies. Studies’ quality was appraised using the critical apraisal skills programme (CASP) tool.Results: Seventeen studies met the inclusion criteria. Following methods of thematic synthesis, four overarching interpretive themes were identified: (a) Rehabilitation processes and their impact on older individuals’ well‐being; (b) Identity and embodiment concerns of older individuals during rehabilitation; (c) Institutional factors affecting older individuals’ care and well‐being experiences; and (d) Older individuals’ participation in creative activities as part of rehabilitation.Conclusion: Organizational and structural care deficiencies as well as health disparities can adversely impact older individuals’ autonomous decision‐making and goal‐setting potentials. The discrepancy between older individuals’ expectations and the reality of returning home along with the illusionary wish to return to a perceived normality, can further negatively affect older individuals’ sense of well‐being. Constructive communication, emotional support, family involvement in rehabilitation and creating a stimulating, enriching social environment can humanize and facilitate older individuals’ adjustment to their new reality following ABI.Impact: There is a lack of qualitative research on older individuals’ ABI rehabilitation experiences, especially traumatic brain injury incidents. Further study should consider patients’ concerns over their involvement in decision‐making and goal setting about their care. Overall, this review reveals the need to examine further the significance of humanizing care and the factors that affect older individuals’ sense of well‐being.

Background: The need for dignity and compassion in healthcare is enshrined in policy, but is often difficult to enact in practice and what is precisely meant by these concepts is unclear. In this paper, we have explored theoretical underpinnings which form the basis of a lifeworld‐led approach which was used in a research study to support the humanity of service providers and users alike.Aim: In this article, we share our analysis of what we have learnt after undertaking an innovative appreciative action research project with patients and staff in a stroke ward with the aim of exploring if a novel phenomenologically driven and philosophically derived humanising framework could be applied in health care. Following the research, we wanted to develop a theoretical understanding of the processes occurring during the research in order to provide a framework and language which could be used to support practical lifeworld developments in the future. We analysed the approach through Participatory and Appreciative Action Reflection.Findings: As researchers, we found that the approach was underpinned by four key existential principles. The first principle was recognising a mutually arising reality rather than a reality ‘out there’. The second was recognising a reality which was constantly changing rather than ‘fixed’. The third was recognising that we needed to work from within, as part of a human living system rather than trying to control reality from the ‘outside’. Finally, we recognised that this reality could only be accessed through human knowing, including embodied knowing rather than intellectual knowing alone. These principles challenged many of the usual ways of thinking and working within research and healthcare contexts.Conclusion: Understanding the processes and reality in this way gave new perspectives; enhancing our understandings and views of ourselves, what is important and most importantly what is possible in caring systems.