Measuring outcomes from a peer-led social communication skills intervention for adults following brain injury

获得性脑损伤是全世界终身残疾的主要原因。慢性认知和沟通问题可能伴随着伤害，对以前的关系和建立新关系的能力产生不利影响。社会接受度降低和社会孤立是常见的问题。社会沟通技能的干预被建议作为康复方案的实践标准，但从更传统的干预模式中获益的证据是混合的。特别是，不能假设在培训环境中学到的技能会自动转移到日常生活中。重新融入社区意味着能够独立于家庭成员和专业人员与其他人建立关系。为了扮演一个有价值的社会角色，这个人需要能够在谈话中作为平等的伙伴参与，并有能力代表自己说话。我的博士研究开发并调查了一种新方法的有效性，训练一个患有严重ABI的同龄人，以促进专家讨论组中的沟通。结果与对照组（传统的工作人员领导的社会活动组严重ABI的个人）进行比较。现有的结果测量工具的目的是评估在配对的对话，而不是组的变化，所以一个新的数字测量工具（INT）的开发和测试，使用社会网络的方法，定量测量随着时间的推移，群体社会参与的变化，结果表明，训练有素的同行可以成功地促进群体互动，没有直接的支持，从一个神经典型的通信伙伴。随着时间的推移，干预组的社会联系和协作参与能力有所提高。相反，在工作人员领导的小组中，没有随时间发生变化。总体而言，这些发现显示了在复杂的遭遇中以及在与多个沟通伙伴的新社交网络中建立独立关系的好处的初步证据，符合日常生活的沟通需求。这项博士研究的发现有可能为临床实践提供信息通过以下方式。它符合当前针对现实环境中沟通需求的新干预措施的建议，现在需要进行一项全面的研究来增加对这些初步发现的信心。该研究金的一个关键目标是为多中心试验提出赠款申请。测量群体社会互动的变化是一个新的调查领域，INT符合目前对测量社会参与结果的新工具的建议。我的第一位导师，约瑟夫·德夫林教授，作为创新和企业的副院长，能够很好地为我提供关于网络机会和制定联系计划以开发INT的建议。该措施还需要验证，以证明数据量增加时的可靠性和响应能力，并测试其在更广泛的临床背景和群体中的应用。我的二级导师，约书亚斯托特博士，带来了管理痴呆症和精神健康状况的赠款资助项目的经验

Acquired brain injury is a principal cause of life-long disability worldwide. Chronic cognitive and communication problems can follow injury, adversely impacting previous relationships and the ability to build new ones. Reduced social acceptance and social isolation are commonly reported problems. Intervention for social communication skills is recommended as a practice standard in programmes of rehabilitation, but the evidence of gain from more traditional models of intervention is mixed. In particular, automatic transfer of skills learned in the training setting to everyday life cannot be assumed. Community re-integration entails the ability to build relationships with other people independently of family members and professionals. In order to play a valued social role, the person needs to be able to engage as an equal partner in conversation, and have an ability to speak on their own behalf.My PhD research developed and investigated the efficacy of a new approach, training a peer with a severe ABI to facilitate communication in an expert discussion group. Outcomes were compared to a control group (a traditional staff-led social activity group for individuals with severe ABI). Existing outcome measurement tools are designed to evaluate change in paired conversations rather than groups, so a new digital measurement tool (the INT) was developed and tested, using social network methodologies, to quantitatively measure change in group social participation over time.Results showed that a trained peer can successfully facilitate group interaction without direct support from a neurotypical communication partner. The intervention group showed an improved ability to socially connect and participate collaboratively over time. Conversely, there was no change over time in the staff-led group. Overall, these findings show initial evidence of benefit in independent relationship-building within complex encounters and in new social networks with multiple communication partners, consistent with the communication demands of everyday life.Developing findings from this PhD research has the potential to inform clinical practice in the following ways. It meets current recommendations for new interventions that address communication needs in real-world environments and a fully powered study is now required to increase confidence in these initial findings. A key objective for this fellowship is to produce a grant application for a multi-centre trial. Measurement of change in group social interaction is a new field of investigation and the INT meets current recommendations for new tools to measure social participation outcomes. My first mentor, Professor Joseph Devlin, as Vice Dean of Innovation and Enterprise is well placed to advise me on networking opportunities and the formulation of a contact plan to develop the INT. The measure also requires validation to demonstrate reliability and responsiveness with increased volumes of data, and to test its application to wider clinical contexts and groups. My secondary mentor, Dr Joshua Stott, brings experience of managing grant funded projects in dementia and mental health conditions