Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Vic. 3800, Australia; and Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Vic. 3121, Australia.
Brain Impair. 2024 Apr;25. doi: 10.1071/IB23060.
Background Challenging behaviours are often a significant difficulty faced following acquired brain injury (ABI), for which PBS+PLUS (a Positive Behaviour Support framework) is an effective intervention. Clinicians report experiencing a range of barriers to supporting behaviour change for individuals with ABI and require tailored resources to support the implementation of PBS+PLUS. This study aimed to describe the process of co-designing a PBS+PLUS intervention guidebook and podcast series together with individuals with ABI, close-others, and clinicians, and qualitatively examine co-design experiences. Methods The Knowledge-To-Action Framework was followed to support the translation of PBS+PLUS into clinical practice. Participants with ABI (n = 4), close-others (n = 7), and clinicians (n = 3) participated in focus groups contributing to the development of a PBS+PLUS intervention guidebook and podcast series. Following completion of the groups, qualitative interviews were conducted to understand participants' perspectives of the co-design experience. Transcripts were analysed using reflexive thematic analysis. Results Co-design processes are described, and participants provided practical suggestions for co-design and the dissemination of developed resources. Two core themes encapsulating four sub-themes were identified. Firstly, 'Esteeming Experiences ' described the person-driven approach of co-design whereby participants felt supported and connected with other contributors and facilitators through sharing their perspectives. Secondly, 'Empowerment ' reflected participants' increased confidence and skills in applying PBS+PLUS. Conclusions Overall, participants endorsed the therapeutic benefits of co-design engagement and high utility of PBS+PLUS resources. This study adds to the growing literature supporting the use of co-design methodology within clinical implementation, and is inclusive of individuals with ABI, close-others, and clinicians.
背景 获得性脑损伤（ABI）后，挑战性行为通常是一个重大的困难，而 PBS+PLUS（积极行为支持框架）是一种有效的干预措施。临床医生报告说，他们在支持 ABI 患者的行为改变方面面临着一系列障碍，需要有针对性的资源来支持 PBS+PLUS 的实施。本研究旨在描述与 ABI 患者、密切相关者和临床医生共同设计 PBS+PLUS 干预指南和播客系列的过程，并对共同设计经验进行定性研究。
方法 遵循知识转化框架，以支持 PBS+PLUS 转化为临床实践。ABI 患者（n=4）、密切相关者（n=7）和临床医生（n=3）参加了焦点小组，为 PBS+PLUS 干预指南和播客系列的开发做出了贡献。在小组完成后，进行了定性访谈，以了解参与者对共同设计经验的看法。使用反思性主题分析对转录本进行分析。
结果 描述了共同设计过程，参与者提供了关于共同设计和开发资源传播的实用建议。包含四个子主题的两个核心主题被确定。首先，“尊重体验”描述了共同设计的以人为本的方法，通过分享他们的观点，参与者感到受到支持和与其他贡献者和促进者建立联系。其次，“赋权”反映了参与者在应用 PBS+PLUS 方面增强了信心和技能。
结论 总体而言，参与者认可共同设计参与的治疗益处和 PBS+PLUS 资源的高度实用性。这项研究增加了越来越多的支持在临床实施中使用共同设计方法的文献，并包括 ABI 患者、密切相关者和临床医生。
