The pervasive and unyielding impacts of cognitive-communication changes following traumatic brain injury

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Kelly, Crystal
Cornwell, Petrea
Hewetson, Ronelle
Copley, Anna
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2023
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Abstract

Background: Cognitive-communication disorders (CCDs) are common in the traumatic brain injury (TBI) population. Despite this, there has been limited research that explores the long-term impacts of reduced cognitive-communication functioning on daily life for this population. Aims: To identify the long-term impacts of cognitive-communication impairment as reported by adults with TBI and their significant others. Methods & Procedures: A qualitative descriptive approach grounded in phenomenology was used. Semi-structured, one-on-one interviews were conducted with adults with CCDs following TBI (n = 16) and their significant others (n = 12) to explore their lived experiences. Outcomes & Results: Reflexive thematic analysis revealed an overarching theme of ‘The pervasive and unyielding impacts of cognitive-communication changes on daily life following TBI’. Within this overarching theme, three subthemes were identified: (1) self-awareness of communication changes; (2) fatigue; and (3) self-identity and life roles. Conclusion & Implications: The findings from this study highlight the long-term negative impacts of reduced cognitive-communication functioning on daily life. Health professionals supporting this population should consider ways to reduce the significant impact CCDs have on the lives of adults following TBI and their significant others. In addition, the findings highlight the importance of long-term rehabilitation services following TBI, with further research needed that explores how these services can be optimised. What this paper adds: What is already known on this subject Cognitive-communication disorders (CCDs) affect the majority of adults who experience moderate to severe traumatic brain injury (TBI) and encompass any component of communication that is affected by cognition. The hallmark characteristic of CCDs are breakdowns that affect social communication skills as well as cognitive-linguistic deficits. Combined, these can have dramatic implications for a person's quality of life, their level of independence, employment opportunities and social participation. There has been limited research to date that explores the long-term impacts of CCDs on the lives of adults following TBI. Further research that explores these impacts is needed to improve the support services and rehabilitation models of care available for this population. What this study adds The overarching theme was ‘The pervasive and unyielding impacts of communication changes on daily life following TBI’ with subthemes including changed communication, self-awareness of communication changes, fatigue and self-identity and life roles. The findings from this study highlight the long-term negative impacts of reduced cognitive-communication functioning on everyday functioning and quality of life as well as the importance of long-term rehabilitation services following TBI. What are the clinical implications of this work? Speech-language therapists and other health professionals working with this clinical population should consider how to address the significant and long-lasting impacts of CCDs. Due to the complex nature of the barriers experienced by this clinical population, an interdisciplinary targeted approach is advised wherever possible when providing rehabilitation services.

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International Journal of Language & Communication Disorders

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This is the peer reviewed version of the following article: Kelly, C., Cornwell, P., Hewetson, R. & Copley, A. (2023) The pervasive and unyielding impacts of cognitive-communication changes following traumatic brain injury. International Journal of Language & Communication Disorders, which has been published in final form at https://doi.org/10.1111/1460-6984.12923. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

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This publication has been entered in Griffith Research Online as an advanced online version.

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Clinical sciences

Allied health and rehabilitation science

Linguistics

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Social Sciences

Life Sciences & Biomedicine

Audiology & Speech-Language Pathology

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Kelly, C; Cornwell, P; Hewetson, R; Copley, A, The pervasive and unyielding impacts of cognitive-communication changes following traumatic brain injury, International Journal of Language & Communication Disorders, 2023

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