"Going under the radar": barriers to continuity in the rehabilitation trajectories of adults with acquired brain injury in North Norway.

Abstract

Acquired Brain Injury (ABI) is a major cause of disability, but rehabilitation services for adults with ABI discharged home remains deficient. This study explores barriers to continuity in the rehabilitation trajectories of this population in North Norway. Data were generated from focus groups consisting of individuals with ABI and family caregivers (<i>n</i> = 5) and healthcare professionals (<i>n</i> = 14). Purposeful sampling of participants (total <i>n</i> = 19) ensured diverse perspectives. A reflexive thematic analytical approach was applied to identify recurring themes. This study reveals significant misalignment between the support needs of home-dwelling adults with ABI and the existing healthcare system in North Norway. Four themes were identified: (1) A lack of awareness of patient rehabilitation needs in hospitals, (2) individuals with ABI slipping through the cracks during transitions, (3) constraints in municipal healthcare services' capacity, and (4) unclear rehabilitation pathways for individuals with ABI. Individuals with ABI need assistance navigating complex healthcare systems, gaining insight into their functional problems, and expressing needs and goals. The findings support calls for a paradigm shift in ABI rehabilitation, advocating for a transition from impairment-focused to reengagement-oriented practices as individuals with ABI transition from inpatient to home settings with increasingly stable residual impairments.