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Better guidelines needed to help those with behavior changes after brain injury

brain injury
Credit: Pixabay/CC0 Public Domain

Managing people's altered behavior after a traumatic brain injury needs more specific attention and better guidelines, according to new research from Flinders University's College of Nursing and Health Sciences.

An estimated 69 million individuals worldwide sustain a traumatic brain injury each year, and up to 70% of the 22,710 patients hospitalized in Australia each year experience behavioral changes while in hospital that include agitation, irritability, aggression, inappropriate sexual behavior, perseveration, wandering or absconding, and apathy.

However, a systematic review of treatments shows that optimal clinical practice guideline recommendations to best manage these patients in hospital and inpatient rehabilitation settings are sparse.

The Flinders Caring Futures Institute study is looking at ways to improve management of behavior changes after traumatic brain injury in the acute hospital setting. The study is led by Occupational Therapist and Ph.D. candidate, Heather Block with her supervisory team, Professor Stacey George, Associate Professor Michelle Bellon and Dr. Sarah Hunter.

"We aimed to identify high-quality recommendations that can be applied in hospital and rehabilitation settings," says Ms. Block.

Assessment of Clinical Practice Guideline (CPG) quality was based on adequately addressing four of the six domains measured by the AGREE II evaluation instrument. Seven CPGs out of 408 identified records met the inclusion criteria, and only two CPGs were deemed high-quality.

"High-quality guideline recommendations with the strongest supporting evidence for non-pharmacological treatment include behavior management plans considering precipitating factors, antecedents and reinforcing events," says Ms. Block. "Recommendations with the strongest supporting evidence for pharmacological management include for aggression in traumatic brain injury."

However, the researchers found few guidelines that provide comprehensive detail on the implementation of recommendations into , which may limit their adoption into more hospital and rehabilitation settings.

The research findings—"Clinical practice guideline recommendations for the management of challenging behaviors after traumatic injury in acute hospital and inpatient rehabilitation settings: a ," by Heather Block, Maria Paul, Eimear Muir-Cochrane, Michelle Bellon, Stacey George and Sarah Hunter—have been published in Disability and Rehabilitation.

Ms. Block says further research is now needed to rigorously evaluate behavior management programs, investigation of evidence-practice gaps, and implementation strategies for adopting Clinical Practice Guideline recommendations into practice.

More information: Heather Block et al, Clinical practice guideline recommendations for the management of challenging behaviours after traumatic brain injury in acute hospital and inpatient rehabilitation settings: a systematic review, Disability and Rehabilitation (2023). DOI: 10.1080/09638288.2023.2169769

Citation: Better guidelines needed to help those with behavior changes after brain injury (2023, February 7) retrieved 29 March 2024 from https://medicalxpress.com/news/2023-02-guidelines-behavior-brain-injury.html
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