Cognitive rehabilitation following Traumatic Brain Injury: an international survey of current clinician practice.

Abstract

Clinicians were surveyed internationally to explore their cognitive rehabilitation practices including approaches, training and resource utilisation. 606 clinicians of various disciplines and years of experience, from 45 countries, completed an online survey regarding their current cognitive rehabilitation practice. Data were analysed utilising descriptive statistics and qualitatively <i>via</i> content analysis. Clinicians most frequently employed external compensatory strategies (86%) and environmental adaptations and restructuring (87% using often/always) within cognitive rehabilitation. Beyond repetition, restorative approaches were utilised less frequently. Common components of cognitive rehabilitation included assessment, goal setting, psychoeducation, and progress monitoring. Occupational therapy and speech pathology were most routinely involved in cognitive rehabilitation. Practice occurred most frequently in inpatient settings, followed by the community noted to promote real-world integration. Less than half of clinicians (44%) deemed formal training sufficient in preparing them to provide cognitive rehabilitation. Whilst awareness of clinical practice guidelines and other resources was high, usage was relatively infrequent. A preference for compensatory strategies highlights current practice trends in cognitive rehabilitation. Gaps in training and infrequent use of clinical practice guidelines underscore the need for targeted training and development of required evidence to promote best practice of evidence-based care and outcomes following TBI.