RESUMO
INTRODUCTION: The sequelae of moderate-severe acquired brain injury (ABI) encompass motor, cognitive, sensory, emotional and behavioural areas that affect meaningful occupational participation and quality of life, with a high prevalence of associated mental disorders. When the patient returns to community life after discharge from the hospital, specialised care is generally insufficient due to the lack of consideration of the dual condition of mental disorder and ABI. Since there is a negative impact on competence and thus on occupational participation, occupational therapy represents a convenient way of intervention. On these assumptions, a community-based occupational therapy protocol on mental health for people with moderate/severe acquired brain injury (COT-MHABI) is presented. It is focused on meaningful occupational participation and looks for improvement in the quality of life. METHODS AND ANALYSIS: This study aims: (i) to design a protocol to evaluate the effectiveness of a community occupational therapy intervention based on MOHO for patients with a dual (mental health/ABI) for improving quality of life and self-perceived occupational performance; (ii) to analyse the outcomes of occupational and social variables (occupational balance, participation level, satisfaction with occupation and performed roles and community integration) after the COT-MHABI process; (iii) to analyse the impact of quality of life on satisfaction with occupations performed by this population. A non-randomised controlled clinical trial will be performed. Patients assigned to the experimental group will receive over one year of on-site and telematic occupational therapy sessions, 16 sessions on average. Variables such as quality of life, community integration or satisfaction with occupational performance will be collected at baseline, 6, and 12 months. DISCUSSION: The needs for the dual mental/ABI population in their reintegration into the community are related to the associated deficits and to the absence of specialised services for the complexity of this patient profile. Few studies consider the coexistence of mental health and ABI issues. The COT-MHABI protocol is proposed to provide continuity to the community needs of this population, conceptualised from occupational participation, person-centred and focused on meaningful activities. CLINICAL TRIAL REGISTRATION: Trial identifier and registry name ClinicalTrials.gov ID: NCT04586842 https://clinicaltrials.gov/ct2/show/NCT04586842?term=252136&draw=2&rank=1; Pre-results; Community-based Occupational Therapy Intervention on Mental Health for People With Acquired Brain Injury (COT-MHABI).
Assuntos
Lesões Encefálicas , Terapia Ocupacional , Lesões Encefálicas/complicações , Lesões Encefálicas/terapia , Humanos , Saúde Mental , Satisfação Pessoal , Qualidade de VidaRESUMO
El daño cerebral adquirido ocasiona frecuentemente dificultades físicas, cognitivas y sociales que generan deprivación ocupacional. Un gran número de personas afectadas manifiestan alteraciones conductuales y emocionales, ya sea a causa de trastornos mentales previos, del manejo de la situación o por la aparición de un trastorno neurocognitivo posterior u otros asociados. Desde el equipo EASE del Institut Guttmann, se implementa un programa de intervención domiciliaria, con una perspectiva comunitaria en salud mental y daño cerebral adquirido, con el objetivo de favorecer la mejora de la calidad de vida y de la participación ocupacional de las personas con daño cerebral adquirido y sus familias
Acquired brain injury often causes physical, cognitive and social difficulties that lead to occupational deprivation. A great number of affected people show behavioral and emotional disorders, either because of previous psychiatric problems, coping with the situation, or because of the appearance of a later neurocognitive disorder or other associates. From the Institut Guttmann's EASE team, a program of home intervention is developed, with a community perspective in mental health and acquired brain injury. The aim is the improvement of the quality of life and occupational participation of people with acquired brain injury and their families
