None listed
Conditions
Brief summary
Post-traumatic Amnesia (PTA) is a state of confusion after someone experiences a TBI. Speech Pathologists (SPs) currently undertake a range of practices for patients with PTA but what they do is under-reported and requires further investigation (Steel et al., 2013). It is common practice that when patients are in PTA, direct therapy is kept to a minimum in case activities lead to agitation. However recent studies have demonstrated that patients in PTA can participate in some therapies such as physiotherapy or occupational therapy. Cognitive-communication deficits are a common sequelae of Traumatic Brain Injury (TBI) with 80–100% experiencing this type of communication impairment (MacDonald & Wiseman-Hakes, 2010). Part of this cognitive-communication profile is the ability to structure verbal narration of an event or a series of events (i.e. narrative discourse). This research project aims to investigate the feasibility of conducting structured narrative discourse therapy with people in PTA in order to improve their cognitive-communication skills. It is hypothesised that patients will tolerate participating in this specialised novel therapy program without any adverse effects and we expect to see improvement in their narrative discourse skills. We also hypothesise that people in PTA will have impaired narrative discourses.
Interventions
Participants will partake in a 30-minute 1:1 therapy sessions five times a week, aimed at developing narrative discourse skills, until they are deemed out of PTA (scoring 12 for 3 consecutive days on the Westmead PTA scale) or up to 10 sessions (whichever occurs first). The intervention will be delivered face-to-face. on our Acquired Brain Injury ward.
The therapy will be conducted by a member of the speech pathology team. The speech pathology team at Epworth HealthCare is experienced in cogni
Participants will partake in a 30-minute 1:1 therapy sessions five times a week, aimed at developing narrative discourse skills, until they are deemed out of PTA (scoring 12 for 3 consecutive days on the Westmead PTA scale) or up to 10 sessions (whichever occurs first). The intervention will be delivered face-to-face. on our Acquired Brain Injury ward. The therapy will be conducted by a member of the speech pathology team. The speech pathology team at Epworth HealthCare is experienced in cognitive-communication therapy and brain injury but will receive additional training and support. Training will occur through use of the manual and by the two Epworth Speech Pathologists involved in the study. The manual has been designed specifically for this study. Clinicians who will be administering the intervention will participate in 1x 60 minute face-to-face training session at least 2 weeks prior to delivering the first intervention. Each treatment session will consist of the elements described below: Part 1: Narrative discourse task with picture prompts The participant will be shown a narrative picture sequence and then supported by the clinician to describe all the story elements. The participant will then be asked to tell the story from start to finish without any prompting, to see if they are able to retain the narrative structure and include the story elements. Note: participants will be shown a different narrative pictures sequence during each session. Part 2: Narrative generation task The participant will then be asked to tell the clinician a personal anecdote describing a time where they have had a similar experience to the story they just described. The clinician will document whether the patient included the same story elements as they were supported to do in the first task. Where the intervention has been delivered by a clinician outside of the research team, a member of the research team will check-in with the clinician to ensure all measures have been completed accurately and respond to any queries from the clinician. In addition to formal outcome measure for monitor tolerance and participation in the intervention by tracking the duration of each session and number of sessions attended.
Sponsors
Epworth Healthcare
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Has a next of kin who can provide consent to participate Adequate communication to participate in structure therapy targeting narrative skills as determined by their treating speech pathologist Ability to participate in a structured therapy session as determined by the clinician who is screening the patient English speaking Maximum score on The Westmead Post-Traumatic Amnesia Scale (WPTAS) <11 within 24 hours of admission Adult (i.e. over 18 years old)
Exclusion criteria
Previously diagnosed dementia or conditions impacting communication Visual impairments which cannot be compensated for to see picture stimuli Inability to sustain alertness for sufficient period of time to participate in the intervention Medically unstable as determined by treating medical team
Outcome results
None listed