Keith Redpath, Director. Acquired Brain Injury Service. Training Report

Transcription

1 Keith Redpath, Director Acquired Brain Injury Service Training Report

2 Contents 1. Introduction 2. Development of Training Sessions 3. Training Workshops 4. Evaluation 5. Conferences & Poster Presentations 6. Key Findings 7. Future Steps 8. Actions Appendices A. Acquired Brain Injury Training Evaluation Form Before and After Brain Injury Knowledge Questionnaire B. Brain Injury & Sport Questionnaire C. Joined up thinking: a model for long term rehabilitation after return home. Poster Presentation, IBIA 9 th World Congress on Brain Injury. D. Getting your Head around Brain Injury Promotional Flyer E. A Holistic Person Centred Model of Community Based Rehabilitation. Poster Presentation. NHS Scotland Fringe Event

3 1. Introduction Throughout 2011 and 2012 the Acquired Brain Injury Service continued to provide training to a variety of service-users, carers and professionals in the West Dunbartonshire area. There were five distinct types of training sessions offered: Individualised Person Centred Service User Training Overcoming Barriers to Rehabilitation Brain Injury and Alcohol Quick Guide to Community Rehabilitation for Acquired Brain Injury Brain Injury, Physical Activity and Sport These sessions were delivered in response to identified training needs and developed from the service s rolling programme of acquired brain injury awareness training that has been in operation since An additional consultation with independent service user group the Brain Injury Experience Network (BIEN) was conducted in March 2011 continuing to apply a co-production model to further training. It was recognised that training sessions can help contribute to continued professional development and provide useful practical advice for supporting a person with a brain injury and their families, as well as promoting the confidence of those affected by the present and future consequences of acquired brain injury. It was additionally recognised that it was essential to demonstrate the work of the Acquired Brain Injury Service and independent service user group BIEN at a number of leading conferences that were to be held over the period 2011/ 2012 including Huntercombe Rehabilitation Event, February 2011, Glasgow, U.K The International Brain Injury Association s Ninth World Congress on Brain Injury, March , Edinburgh, U.K. Scottish Head Injury Information Forum, What s new in the care and treatment of brain injury? April , Edinburgh, U.K. 3

4 Head Injury Information Day, May 2011 and 2012, Glasgow, U.K. NHS Scotland Event, Driving Quality Through Innovation, June , Glasgow, U.K. Good Practice Presentations, West Dunbartonshire CHCP Care Inspectorate, June 2012, Glasgow, U.K. Third International Conference on Sport and Society, July , Cambridge, UK. The central themes of training and presentations to be delivered included: The benefits of adopting a co-productive model of working The benefits of working in partnership utilising personcentred approaches, social circles and collaborative goalsetting Recognition as survivors not victims The benefits of working within a health and care partnership The importance of identifying and recognising cognitive factors in rehabilitation The need for ongoing community care 2 years in hospital, 50 years in the community The West Dunbartonshire ABI Service received funding from the West Dunbartonshire Community Health Partnership (CHP) in 2009 for a Public Engagement Project. The aim of the project was to promote an understanding of Acquired Brain Injury; in keeping with the role of the ABI Service, i.e. not only providing assessment, intervention and social rehabilitation but also in guiding service development and providing education, emphasising care pathways, utilising an interdisciplinary approach and service user journeys as essential components for establishing effective integrated services. Whilst all of the originally planned local GP and AHP training was completed in , the follow up ABI and sports training in , which had been requested by the service-user group and developed with them to meet their aims, was incorporated within the project. 4

5 2. Development of Training Sessions Evaluation and consideration of further training needs was undertaken in February 2011 by the Acquired Brain Injury Service. Team members noted the individualistic nature of Acquired Brain Injury with service users having an array of specific difficulties and individual personal circumstances. It was agreed that there was a need for individuals with acquired brain injury, family and support workers to not only gain an understanding of brain injury but a very specific insight into their own/ their significant other s difficulties. It was decided that individualised educational sessions centring on individual neuropsychological assessments and brain scanning results, identifying day to day challenges and arising difficulties, would be offered to service users and their families. It was additionally recognised that a number of service user specific tailored sessions would be held with support organisations to aid in day to day working and individual quality of life. Service User Consultation March 2011 A consultation was conducted in March 2011 with BIEN the Brain Injury Experience Network. This is an independent service-user group with all members having experienced an acquired brain injury. This consultation highlighted a need for further local training in brain injury due to the experiences of service-users where they have not felt that their difficulties and needs were appropriately understood and managed. BIEN identified the local sports and leisure centres as a central service for those returning home after hospital, rehabilitation and those reengaging in community activities. This service was targeted as part of the Acquired Brain Injury Service, Public Engagement Project for a rolling programme of training so as to aid all Brain Injury survivors in engaging in physical activity and to enable West Dunbartonshire sport and leisure staff to more easily recognise the social and functional impact of acquired brain injury alongside cognitive difficulties. 5

6 Based on the evaluation of previously held training sessions as outlined in the Acquired Brain Injury Service, Training Report 2010/2011, it was decided to continue to provide previously designed training sessions to a variety of service users, carers and support workers: Overcoming Barriers to Rehabilitation Brain Injury and Alcohol Quick Guide to Community Rehabilitation for Acquired Brain Injury Ongoing consideration of training and the identification of specific aims and central themes were continually monitored and evaluation undertaken through quarterly meetings of the Public Engagement Project. This is a joint project developed by the Acquired Brain Injury Service, WD CHCP and individuals with acquired brain injury to raise awareness of the complex issues for people with Acquired Brain Injury living within their communities. 6

7 3. Training Workshops Individual Specific Training One-to-one training was provided for a number of individuals where there were challenges, including behaviour, or additional problems which were leading to difficulty in ongoing support and care. These training sessions centred on the individual s neuropsychological assessment, their specific rehabilitation needs and personal goals as identified collaboratively with them. Sessions involved working with carers and support workers to develop greater insight and education into that individual s needs and issues, and to offer advice/ tips on how to more successfully work with and support that specific individual. As these individuals are faced with a number of social and familial barriers which constantly affect their quality of life and overall wellbeing, time was spent in each session to look at problem solving. Feedback of the difficulties from each individual, carer and support organisation was incorporated within the assessment and intervention work of the support team and care plan. Overcoming Barriers to Rehabilitation This group training session was designed to be specific for a local support organisation due to ongoing difficulties in supporting an individual with Acquired Brain Injury. This training focused on behaviour that can be interpreted as challenging and on overcoming barriers to rehabilitation. The session was structured around the individual with brain injury s own goals and the difficulties they face as identified from their neuropsychological assessment. Education was offered on causes of acquired brain injury and resulting difficulties, an introduction to neuropsychological assessment, and tips and advice on working with or around deficits. Additional time was spent looking at stress and anger for both the service-user and workers. The final part of this training session focused on problem solving and the developing of better ways of working with people with ABI and this specific person. 7

8 Brain Injury & Alcohol This training offered an introduction to Acquired Brain Injury with a specific focus on the role of alcohol in cause, recovery, rehabilitation and lifelong management. The session was three hours in length and consisted of a mix of talks, case discussions and activities. The first period of the session focused on understanding Acquired Brain Injury and the difficulties that arise. The second section focused on Alcohol Related Brain Damage and the increased day to day risks for an individual with ABI due to alcohol intake seizures, medication management, worsening of symptoms. The last section of the session was spent looking at deficits and needs of a specific ABI service user with those involved in his direct care. This section focused on problem solving and education on specific deficits e.g. dyslexia This training pack was developed by the ABI Service, with the Community Addictions Service (CAT) providing further training development at the session itself, to offer an addictions worker s perspective. A CAT trainer attended the session and contributed insight into working with individuals with addictions and the method of motivational interviewing. Quick Guide to Community Rehabilitation for Acquired Brain Injury This training was provided in June 2011 at the What Is Brain Injury Conference? organised by Headway Glasgow. This was a full day conference for carers, survivors of acquired brain injury and local carer services. Full details of the conference can be found on the Headway Glasgow website This training was designed to provide an overview of Acquired Brain Injury and the work of the West Dunbartonshire Acquired Brain Injury Service. This training was an adapted version of the previously used Quick Guide to Brain Injury as outlined in the ABI Service Training Report of

9 Training focused on type, cause and effects of Acquired Brain Injury and the current difficulties and myths faced in providing support. Education was offered on recognising Brain Injury and an insight was offered into the role of Neuropsychology and Rehabilitation. Brain Injury, Physical Activity & Sport This training was undertaken over four sessions in the local West Dunbartonshire sports and leisure facilities: Meadow Centre, Dumbarton Vale of Leven Pool, Alexandria Playdrome, Clydebank Training provided an overview of brain injury alongside an introduction to the relationship between concussion, brain damage and physical activity. The session also focused on hints, tips and assessment to aid identification of deficits and activities to recognise best practice and specific needs of those with ABI. All participants were provided with handouts on completion detailing services, assessment tools and additional reading. 9

10 4. Evaluation Individual Specific Training This training was not formally assessed due to its individualistic nature and the ongoing contact with those involved as feedback was incorporated into service-user specific rehabilitation goals and planning. It is estimated that 14 service users, 9 significant others/ family members and 4 members of support teams/ personal assistants or paid carers (excluding the larger sessions discussed below) received direct training. Additionally educational materials, advice and information were provided to West Dunbartonshire CHCP staff from alternative services in relation to cases where staff were working with individuals with Acquired Brain Injury but ABI was not the primary cause of disability. Many of these sessions were informal in nature. Positive feedback on the benefits of a person centred approach considering day to day activities was received. This form of training will be considered and incorporated into forthcoming pilot projects focusing on Quality of Life and collaborative Goal Setting. Overcoming Barriers to Rehabilitation This training was provided in July 2011 to a combination of support staff and management from Cornerstone Community Care who have direct involvement with ABI service users. 7 direct members of the support team attended. The session was developed by discussing with the service-user his support needs and perception of supports. Collaboratively goal setting and combining these with Neuropsychology assessment to inform workers of specific deficits and ways to compensate for those in order to more effectively support and rehabilitate. Due to the ongoing nature of work with these attendees a formal evaluation form was not completed. The session concluded on future goal setting and plans for future joint working. Cornerstone 10

11 staff reported that the training had been a good opportunity for the support team to meet and discuss concerns. This was additionally felt by the ABI Service contributing to a fuller assessment of ongoing issues, as workers provided much more detailed information and feed back on difficulties faced when supporting this individual than had previously been available. Support staff reported that a more structured focused approach informing of specific individual ABI difficulties could benefit working and quality of life of this particular service-user. At the conclusion of the session support staff and the present members of the ABI team reported being much better informed in relation to the specific needs and problems this service-user faces. All feedback was incorporated into the ABI team s assessment of ongoing care. Brain Injury & Alcohol This training was provided in April 2011 to a combination of support staff and management from the Richmond Fellowship alongside West Dunbartonshire Council Community Addictions Workers (CAT). 13 individuals attended this session. Completed Evaluation Forms (Appendix A): Did training meet expectations: All 11 participants that completed evaluation forms responded that training met expectations What have you learned that you can apply to your job: 18% 18% 18% 28% 18% Better Understanding Differences between ABI and ARBD Brain Functions Intro to Motivational Interviewing Advice on Supporting Individuals Figure 1. Responses to question 2 - what can be applied to your job? 11

12 Appropriateness: 10/11 responded yes that material had been appropriate Length: 9/11 responded yes. One individual stated training could have been longer Possible Improvements: It was suggested that dates/ contact details for further training could have been included Further Training: 10/11 stated they would like to attend further training. One suggestion was made on training focusing on different types of injury. Quotes of attendees: I had no knowledge of ABI prior to attending in particular effects and use of alcohol! I feel more aware of how staffs approach, lack of knowledge/ skills affect the people we support Additional feedback was received from staff working directly with the client. They reported that individualised training had been very helpful as it allowed for clearer understanding and made it easier to draw on information and tips. It was felt that this was an effective way of training and that similar sessions should again be considered in the future. Quick Guide to Community Rehabilitation for Acquired Brain Injury As noted above this training was provided as one of many drop in sessions at the What Is Brain Injury Conference? organised by Headway Glasgow. Due to the drop in nature of sessions, it is estimated that approximately 20 individual attended with 11 opting to complete related questionnaires. 12

13 Attendees were asked to complete a Before and After Brain Injury Knowledge Questionnaire (Appendix B) Correct Answers Before Training Correct Answers After Training Percentage Increase in Accuracy How many patients with a 5/11 (45.5%) 10/11 (91%) 45.5% head injury, does a GP have on his/ her practice list? When and where should the 4/11 (36.4%) 8/11 (73%) 36.6% Glasgow Coma Scale be Used? Effectiveness of Rehab? 6/11 (55.5%) 11/11 (100%) 44.5% How does the brain compensate for damage? Helping someone with a brain injury? 4/11 (36.4%) 8/11 (73%) 36.6% 8/11 (73%) 9/11 (82%) 9% Table 1 - Responses to "Before & After Brain Injury Knowledge Questionnaire" Attendees responded with greater knowledge in all sections after training. Attendees responded that training had been useful in highlighting the benefits of a local Brain Injury Team and the role of neuropsychology in brain injury rehabilitation. Brain Injury, Physical Activity & Sport Four training sessions were held in total with 38 attendees. Formal feedback was taken with the use of the Acquired Brain Injury Training Evaluation Form (Appendix A) at all group sessions. In some instances individuals later discussed their training with the team and their comments have been included. 13

14 Completed Evaluation Forms (Appendix A): Did the training meet expectations All 38 participants responded yes. What have you learned today that you can apply to your job? 2% 2%2% 2%2% 25% Awareness of What to Look Out For Understanding, Knowledge & Ideas The need for a slightly different service - patience & reiteration Consideration of Concussion 34% Long term effects of ABI How to adapt What questions to ask 31% Assessment tools Figure 2. Responses to question 2 what can be applied to your job? Some attendees identified more than one theme. Appropriateness: 36 individuals reported yes, one participant did not respond while one participant felt the handouts should have been in a larger font with more space for notes. Participants noted the benefit of the handout pack so as they could use materials again. Length: 37 participants responded yes, one participant did not respond. 8 respondents attended shorter 1hr30mins training. It was deemed to have delivered the most important information. 3 participants suggested a second session to further advance knowledge. Possible Improvements: 22 attendees reported they had nothing to add, 10 individuals did not respond. The following suggestions were made: Role play, good versus bad practice x2 (added after pilot) Case Studies of direct work with clients (added after pilot) Focus on the different areas of the brain and side effects of damage to different areas (individual made aware that this was an additional training session we offered). 14

15 Further Training: Participants were allowed to select as many courses as sought Selected Further Training Management of Pain & Chronic Fatigue Epilepsy & Brain Injury Challenging Behaviour Visibility & Brain Injury Stres of Being A Carer 0 Coping with Loss Figure 3. Selected Further Training Do you think it is worthwhile to continue this line of training for coaches/ gym/ instructors: 36 participants reported yes, two participants left back page blank Additional comments were made this would be an excellent teaching session for general gym instructors who have a wide client base to deal with on a day to day basis will help destroy apprehension when dealing with patients I think it is worthwhile as training had never been covered before Yes, feel it would be beneficial for all staff. Reception for example will be the first to meet and greet and could set off on the correct foot if properly trained Attendees at this training additionally completed a before and after questionnaire on Head Injury & Sport (Appendix C). An increase in knowledge in all areas measured was identified. See Appendix C for breakdown. 15

16 This questionnaire additionally identified familiarity with brain injury across those working in Sport & Leisure facilities: 3% 15% 9% 3% 33% I have never come across someone with a brain injury I have no knowledge of brain injury I have a general idea of what happens after a brain injury I work with/ know individuals with brain injury 37% I have received training on working with individuals with brain injury I feel comfortable and confident in working with individuals with brain injury Figure 4. Familiarity with Acquired Brain Injury Of note more than half of those trained identified a knowledge of people attending their service with acquired brain injury, however only 3% had received training in relation to brain injury and/or cognition. Individuals reported that they had never previously considered a need for this type of training but felt that it had been extremely worthwhile. 16

17 5. Conferences and Poster Presentations Huntercombe Group Rehabilitation Event, Back to the Future: 20 years of Brain Injury Rehabilitation in Scotland, February 2011, Glasgow, UK. This conference took a retrospective look at developments in the field of brain injury rehabilitation over the last twenty years. The ABI Service s Co-ordinator took part in a session focusing on the role of social work services. This presentation highlighted the benefits of working in a Health and Care Partnership and the need for informed long term community care for those affected by acquired brain injury. The International Brain Injury Association s Ninth World Congress on Brain Injury, March , Edinburgh, UK. This conference had 1,300 delegates from 40 countries exploring a variety of topics relating to brain injury. The Acquired Brain Injury Service presented a poster titled Joined up thinking: a model for long-term rehabilitation after return home (Appendix D). This poster provides an overview of acquired brain injury needs in West Dunbartonshire alongside an overview and rationale behind services and model offered by the Acquired Brain Injury Service. Scottish Head Injury Information Forum, What s new in the care and treatment of brain injury? April , Edinburgh, UK. This conference aimed to debate, relay and pass on information that had been discussed/ presented at the International World Congress to a wider audience. The Consultant Clinical Neuropsychologist, Acquired Brain Injury Service, West Dunbartonshire CHCP presented a short talk on what she had learned at the conference focusing on endocrine concerns, mild TBI and concussion. The above noted poster was also presented (Appendix D). 17

18 Head Injury Information Day, May 2011 and 2012, Glasgow, UK. This conference was organised by the Brain Injury Network Group (BING) as an opportunity for those affected by acquired brain injury and their families/ friends to receive up to date and accurate information in relation to ABI and available services. The conference was divided into a presentation hall in which the ABI team held a stall and separate rooms in which presentations and DVDs were shown. The Chair & Secretary of the Brain Injury Experience Network (BIEN) introduced and showed a ten minute version of Getting your Head around Brain Injury, an educational DVD resource currently in production. A trailer for this resource can be found at: Promotional Flyer Appendix E NHS Scotland Event 2012, Driving Quality through Innovation, June , Glasgow, UK. The annual NHS Scotland Event is the leading health event in Scotland. It provides an opportunity for individuals working in, and with, NHS Scotland to consider and discuss some of the important challenges for health and social care now and in the future. The Acquired Brain Injury Service entered a poster A holistic person-centred model of community based rehabilitation (Appendix F) which was displayed at the Fringe event on the 21 st June. This poster focused on the benefits and effectiveness of a person centred approach and how this model is applied in West Dunbartonshire. 18

19 Good Practice Presentations, West Dunbartonshire CHCP Care Inspectorate, June 2012, Glasgow The Acquired Brain Injury Service and the Brain Injury Experience Network were selected as exemplar services to be presented to the Care Inspectorate to highlight the innovative and sector leading practice of West Dunbartonshire CHCP. The Acquired Brain Injury Service Coordinator and the Secretary of BIEN gave a presentation on a co-productive model of working using the forthcoming education DVD resource as a resulting positive example. Third International Conference on Sport and Society, July , Cambridge, UK. This conference explored the relationship of sports participation to physical, mental, or emotional health and wellbeing. The Consultant Clinical Neuropsychologist & Assistant Psychologist presented a session Overcoming the barriers to participation in organised sport for people with cognitive difficulties due to acquired brain damage. This session provided an overview of the training that had been provided to sport and leisure staff throughout the year. 19

20 6. Key Findings The Acquired Brain Injury Service provided consistent training throughout the year at an individual, familial, societal and professional level. There was a recognised need at all sessions for education on brain injury and additionally cognitive difficulties. The majority of those who were trained reported that they would like to receive further training. Training evaluations suggest that local workers and carers have knowledge that individuals they support have experienced brain injury and as a result can experience a number of different difficulties. However, trainees came into sessions unsure about what these difficulties are or how they can be managed. The individualistic nature of Acquired Brain Injury and the need for a person centred model of support with informed self care was additionally noted with recognition of the need for service user specific tailored sessions. Individuals, families and support organisations who received this training reported that it was extremely beneficial. Information and learning from these sessions was incorporated into Individual Care Plans and Rehabilitation Goals. The benefits of awareness across social circles leading to a clearer understanding alongside realistic expectations of recovery by all involved were identified as important factors in raising individual and familial quality of life. 20

21 Figure 5. The WDC holistic model of community support based rehabilitation and training. A circle of positive impact Building trust, relationships and value, making better use of each other s assets and resources to achieve better outcomes and improved efficiency The consultation process with the Brain Injury Experience Network was identified as invaluable in developing training as it lead to a range of experience based suggestions. Training in areas identified by BIEN made a direct impact on service users day to day life and aided in the provision of appropriate services to those with acquired brain injury. All central themes The benefits of adopting a co-productive model of working The benefits of working in partnership utilising personcentred approaches, social circles and collaborative goalsetting Recognition as survivors not victims The benefits of working within a health and care partnership The importance of identifying and recognising cognitive factors in rehabilitation The need for ongoing community care 2 years in hospital, 50 years in the community were delivered across a number of conferences with this being recognised as a worthwhile method of delivering wider messages and impacting greater change. At two events members of the Brain Injury Experience Network (BIEN) presented their experiences of acquired brain injury, incorporating their new educational DVD resource Getting your Head around Brain Injury. BIEN members identified their 21

22 participation in these educational sessions as extremely rewarding. Attendees of training noted the impact and strong benefits of an individual with brain injury telling their own experiences and discussing life after the hospital and what happened when they came home. This was especially noted at carer and family events. 7. Future Steps Initially future training will focus on the use and dissemination of Getting your Head around Brain Injury, the recently developed educational DVD resource. This will commence after the official launch of the DVD in September As the Brain Injury, Physical Activity & Sport Training Project has now been completed, a further Training Consultation session will 22

23 be held with BIEN and the local Managed Care Network to identify other possible targets for training alongside dissemination projects for the DVD. Encouraged by the positive feedback received on the strong impact for both service users and those receiving training, serviceusers will continue to develop their training skills and the coproduction model will continue to be employed. Funding has been accessed through Awards For All to develop service-user training and presentation skills and opportunities, and this will be supported and developed throughout The successful feedback of formalised individualised person centred training has been noted and this method of training will be continued. To offer an insight into the benefits of this training and the overall work of the Acquired Brain Injury Service a Quality of Life Pilot Project is now underway. This project is person centred, monitoring each service users quality of life at six month intervals. This allows the service and the service user to work together on identifying changing difficulties and the impact of everyday life, leading to the collaborative setting of appropriate rehabilitation focused goals. The vast causes and multiple and/or varying difficulties experienced after an acquired brain injury alongside individual circumstances suggest that we cannot easily compare survivors of acquired brain injury to one another. This method of working will allow individuals to compare their own quality of life at different periods of time in response to changes in their own lives and health. This avoids individuals being grouped inappropriately or compared to others with very different needs. This will not only aid in the identifying of appropriate individual training but allow us to monitor if an impact has been made. Benefits of presenting at international and local conferences have included increased sharing of information and knowledge; stronger links to both mainstream and specialist services which has lead to increased networking and partnership working. Additionally presentations have resulted in a greater awareness of both the Acquired Brain Injury Service and the Brain Injury Experience Network. This work will be continued in the coming year and incorporated into the dissemination plans for the forthcoming DVD. 23

24 8. Actions This training report will be available in a variety of formats and will be posted onto the CHCP website within the Acquired Brain Injury training section. The report will be presented to the national ABI Managed Clinical Network to support the work of the MCN education sub-group and to share good practice in the development of ABI educational resources across Scotland The report findings will be considered and discussed with BIEN and the local Managed Care Network within Training Consultation Events to guide future training. 24

25 Appendix A The Acquired Brain Injury Team Training Evaluation Form Date The Acquired Brain Injury Team would like to thank you for coming to our training today. We ask if you could fill out this evaluation form in order for us to identify areas we can improve on. Did the training today meet your expectations? What have you learned today that you can apply to your job? Did you feel the training material was appropriate? Did you feel that the length of the training was adequate? 25

26 Is there anything you feel that should have been included in the training that was not? Do you think you will attend any of the other training being offered by the Acquired Brain Injury Team? If yes, which areas are of interest? Do you have any suggestions on how we could improve the training? 26

27 Appendix B Please tick the answer/s to the following questions 1. How many patients with a head injury, does a GP have on his/her practice list? One Five Ten Twenty 2. When & Where should the Glasgow Coma Scale be used At the scene of an accident On a general ward While in intensive care In a GP s clinic 3. Rehabilitation is still effective after 1 year 5 years 10 years 20 years 4. How does the brain compensate for damage Cells re-grow Brain cells make new connections Functions/ tasks are taken over by new areas New pathways are formed 5. Which of the following would help someone with a brain injury when attending an appointment with their GP Double appointment times Being provided with written information about what was discussed Receiving a reminder about the details of the appointment 27

28 Working in more than words Please tick the answer/s to the following questions 6. How many patients with a head injury, does a GP have on his/her practice list? One Five Ten Twenty 7. When & Where should the Glasgow Coma Scale be used At the scene of an accident On a general ward While in intensive care In a GP s clinic 8. Rehabilitation is still effective after 1 year 5 years 10 years 20 years 9. How does the brain compensate for damage Cells re-grow Brain cells make new connections Functions/ tasks are taken over by new areas New pathways are formed 10. Which of the following would help someone with a brain injury when attending an appointment with their GP Double appointment times Being provided with written information about what was discussed Receiving a reminder about the details of the appointment Working in more than words 28

29 Appendix C Head Injury & Sport Please tick the answer/s to the following questions: How familiar are you with brain I have never come across someone with a brain injury I have no knowledge of brain injury I have a general idea of what happens after a brain injury I work with/ know individuals with brain injury I have received training on working with individuals with brain injury I feel comfortable and confident in working with individuals with brain injury General Knowledge 1. How many patients with a head injury, does a GP have on his/ her practice list? One Five Ten Twenty 2. Concussion only occurs if you are knocked unconscious True False 3. Rehabilitation is still effective after 1 year 5 years 10 years 20 years 4. Being unconscious for several minutes is a medical emergency True False 29

30 5. Having one brain injury makes you four times more susceptible to having an additional brain injury True False 6. It is not harmful to head the ball True False 7. How does the brain compensate for damage Cells re-grow Brain cells make new connections Functions/ tasks are taken over by new areas New pathways are formed 8. More severe brain damage occurs when you are unconscious True False 9. Brain Injury is not linked to dementia in later life True False 10. Which of the following would help someone with a brain injury when attending an appointment Double appointment times Being provided with written information about what was discussed Receiving a reminder about the details of the appointment Working in more than words 11. It takes ten days to recover from uncomplicated concussion True False 30

31 Appendix D 31

32 32

33 Appendix E Getting your Head around Brain Injury Promotional Flyer 33

34 Appendix F 34

35 35