Older adults' lived experiences of physical rehabilitation for acquired brain injury and their perceptions of well-being: A qualitative phenomenological study

Abstract Aim To explore the experiences of older adults (65+) living with acquired brain injury regarding their sense of well-being during physical rehabilitation within the Greek Healthcare System. Background With the increasing ageing population and the life-changing effects of acquired brain injury, there is a need to focus on care for older people and their potential to live well. Rehabilitation systems deserve greater attention, especially in improving the well-being of those who are using them. Design A qualitative study design with a hermeneutic phenomenological approach was used. Methods Fourteen older adults living with acquired brain injury and undergoing physical rehabilitation in Greece were purposively sampled. Semi-structured interviews were conducted to collect data and were thematically analysed using van Manen's and Clarke and Braun's methods. The COREQ checklist was followed. Results Four themes emerged from the analysis: (1) Challenges of new life situation, (2) Seeking emotional and practical support through social interaction, (3) Identifying contextual processes of rehabilitation, (4) Realising the new self. Conclusions The subjective experiences, intersubjective relations and contextual conditions influence the sense of well-being among older adults living with acquired brain injury, thus impacting the realisation of their new self. The study makes the notion of well-being a more tangible concept by relating it to the degree of adaptation to the new situation and the potential for older adults to create a future whilst living with acquired brain injury. Relevance for Clinical Practice Identifying the factors that impact older adults' sense of well-being during rehabilitation can guide healthcare professionals in enhancing the quality of care offered and providing more dignified and humanising care. Patient or Public Contribution Older adults living with acquired brain injury were involved in the study as participants providing the research data

A systematic review of the qualitative literature on older individuals’ experiences of care and well-being during physical rehabilitation for acquired brain injury

Abstract Aims: To acquire an in-depth understanding of how older individuals diagnosed with acquired brain injury (ABI) experience their well-being and care when undergoing physical rehabilitation. Design: Systematic literature review. Data sources: The electronic databases of PubMed, CINAHL, APA PsycInfo, ASSIA and SCOPUS were searched from 2005 to 2020. Extensive reference checking was also conducted. Review methods: A systematic review was conducted following PRISMA guidelines, including predominantly qualitative studies. Studies’ quality was appraised using the critical apraisal skills programme (CASP) tool. Results: Seventeen studies met the inclusion criteria. Following methods of thematic synthesis, four overarching interpretive themes were identified: (a) Rehabilitation processes and their impact on older individuals’ well-being; (b) Identity and embodiment concerns of older individuals during rehabilitation; (c) Institutional factors affecting older individuals’ care and well-being experiences; and (d) Older individuals’ participation in creative activities as part of rehabilitation. Conclusion: Organizational and structural care deficiencies as well as health disparities can adversely impact older individuals’ autonomous decision-making and goal-setting potentials. The discrepancy between older individuals’ expectations and the reality of returning home along with the illusionary wish to return to a perceived normality, can further negatively affect older individuals’ sense of well-being. Constructive communication, emotional support, family involvement in rehabilitation and creating a stimulating, enriching social environment can humanize and facilitate older individuals’ adjustment to their new reality following ABI. Impact: There is a lack of qualitative research on older individuals’ ABI rehabilitation experiences, especially traumatic brain injury incidents. Further study should consider patients concerns over their involvement in decision-making and goal setting about their care. Overall, this review reveals the need to examine further the significance of humanizing care and the factors that affect older individuals’sense of well-being

The Experience of Gender in Spousal Caregiving: A Phenomenological Psychological Study (Greece)

Purpose/Objective: To explore how spousal caregivers of older people undergoing rehabilitation experience gender within the Greek community. Research method/Design: A psychological phenomenological design and analysis were used to illuminate the unique meanings eleven spousal caregivers attribute to their experience of gender by gathering qualitative data via interviews. Results: The data provided an insight into the structure of the experience of gender for the spousal caregivers as a normative diachronic identity in a succession of phases: normative constitution, alienation, and reparation. Conclusions/ Implications: The findings highlight the influence of gender stereotypes on spousal caregivers' self-concept, agency, caregiving evaluations, and practices, emphasizing the importance of adopting an intersectional perspective in future research and interventions, considering various factors such as ethnicity, gender, sexuality, age, power dynamics, and cultural norms. Spousal caregivers experience alienation on entering the caregiving journey, with gender-related vulnerabilities affecting their psychological well-being. Addressing these vulnerabilities can improve caregivers' mental health and foster effective coping strategies. The study emphasizes the moral aspect of caregiving, highlighting the relationship between a sense of obligation, feelings of guilt, gender norms, and motivations calling for challenging self-sacrificial morals and societal norms associated with them to empower caregivers to prioritize their well-being while maintaining their caregiving motivations. This shift in perspective can lead to a more positive and fulfilling caregiving experience

Nitrogen Interstitial Alloying of CoCrFeMnNi High Entropy Alloy through Reactive Powder Milling

The present work is focused on the synthesis of CoCrFeMnNi high entropy alloy (HEA) interstitially alloyed with nitrogen via powder metallurgy routes. Using a simple method, nitrogen was introduced to the HEA from the protective N2 gas atmosphere during mechanical alloying (MA) processing. The lattice parameter and amount of nitrogen in HEA were observed to be linearly proportional to the milling duration. The limited solubility of nitrogen in the main face centered cubic (FCC) phase resulted in the in-situ formation of nitrides and, accordingly, significant increase in the hardness values. It has been shown that fabrication of such nitrogen-doped HEA bulk materials can be conveniently achieved by a simple combination of MA + spark plasma sintering processes, without the need for adding nitrogen from other source

Influence of Ti on the Tensile Properties of the High-Strength Powder Metallurgy High Entropy Alloys

The focus of this study is the evaluation of the influence of Ti concentration on the tensile properties of powder metallurgy high entropy alloys. Three Ni1.5Co1.5CrFeTiX alloys with X = 0.3; 0.5 and 0.7 were produced by mechanical alloying and spark plasma sintering. Additional annealing heat treatment at 1100 °C was utilized to obtain homogenous single-phase face centered cubic (FCC) microstructures, with minor oxide inclusions. The results show that Ti increases the strength of the alloys by increasing the average atomic size misfit i.e., solid solution strengthening. An excellent combination of mechanical properties can be obtained by the proposed method. For instance, annealed Ni1,5Co1,5CrFeTi0.7 alloy possessed the ultimate tensile strength as high as ~1600 MPa at a tensile ductility of ~9%, despite the oxide contamination. The presented results may serve as a guideline for future alloy design of novel, inclusion-tolerant materials for sustainable metallurg

Theoretical analysis of neutron scattering results for quasi-two dimensional ferromagnets

A theoretical study has been carried out to analyse the available results from the inelastic neutron scattering experiment performed on a quasi-two dimensional spin-1/2 ferromagnetic material $K_2CuF_4$. Our formalism is based on a conventional semi-classical like treatment involving a model of an ideal gas of vortices/anti-vortices corresponding to an anisotropic XY Heisenberg ferromagnet on a square lattice. The results for dynamical structure functions for our model corresponding to spin-1/2, show occurrence of negative values in a large range of energy transfer even encompassing the experimental range, when convoluted with a realistic spectral window function. This result indicates failure of the conventional theoretical framework to be applicable to the experimental situation corresponding to low spin systems. A full quantum formalism seems essential for treating such systems.Comment: 16 pages, 6 figures, 1 Table Submitted for publicatio

The Formation of Cosmic Structures in a Light Gravitino Dominated Universe

We analyse the formation of cosmic structures in models where the dark matter is dominated by light gravitinos with mass of $100$ eV -- 1 keV, as predicted by gauge-mediated supersymmetry (SUSY) breaking models. After evaluating the number of degrees of freedom at the gravitinos decoupling ($g_*$), we compute the transfer function for matter fluctuations and show that gravitinos behave like warm dark matter (WDM) with free-streaming scale comparable to the galaxy mass scale. We consider different low-density variants of the WDM model, both with and without cosmological constant, and compare the predictions on the abundances of neutral hydrogen within high-redshift damped Ly--$\alpha$ systems and on the number density of local galaxy clusters with the corresponding observational constraints. We find that none of the models satisfies both constraints at the same time, unless a rather small $\Omega_0$ value (\mincir 0.4) and a rather large Hubble parameter (\magcir 0.9) is assumed. Furthermore, in a model with warm + hot dark matter, with hot component provided by massive neutrinos, the strong suppression of fluctuation on scales of \sim 1\hm precludes the formation of high-redshift objects, when the low--$z$ cluster abundance is required. We conclude that all different variants of a light gravitino DM dominated model show strong difficulties for what concerns cosmic structure formation. This gives a severe cosmological constraint on the gauge-mediated SUSY breaking scheme.Comment: 28 pages,Latex, submitted for publication to Phys.Rev.