Brain-In-Hand technology for adults with acquired brain injury: A convergence of mixed methods findings

Jade Kettlewell; Asha Ward; Roshan das Nair; Kate Radford

doi:10.1177/20556683221117759

Brain-In-Hand technology for adults with acquired brain injury: A convergence of mixed methods findings

J Rehabil Assist Technol Eng. 2022 Sep 8:9:20556683221117759. doi: 10.1177/20556683221117759. eCollection 2022 Jan-Dec.

Authors

Jade Kettlewell¹, Asha Ward², Roshan das Nair^{3

4}, Kate Radford²

Affiliations

¹ Centre for Academic Primary Care, Applied Health Research Building, University of Nottingham School of Medicine, Nottingham, UK.
² Centre for Rehabilitation & Ageing Research Injury, Inflammation and Recovery Sciences, School of Medicine University of Nottingham, Nottingham, UK.
³ Division of Psychiatry & Applied Psychology, University of Nottingham, Nottingham, UK.
⁴ Institute of Mental Health, Nottinghamshire University Hospitals NHS Foundation Trust, Nottingham, UK.

Abstract

Introduction: Individuals with acquired brain injury may find it difficult to self-manage and live independently. Brain-in-Hand is a smartphone app designed to support psychological problems and encourage behaviour change, comprised of a structured diary, reminders, agreed solutions, and traffic light monitoring system.

Aim: To evaluate the potential use and effectiveness of Brain-in-Hand for self-management in adults with acquired brain injury.

Methods: A-B mixed-methods case-study design. Individuals with acquired brain injury (n = 10) received Brain-in-Hand for up to 12 months. Measures of mood, independence, quality of life, cognition, fatigue, goal attainment, participation administered at baseline, 6 and 12 months. Semi-structured interviews conducted with acquired brain injury participants (n = 9) and healthcare workers (n = 3) at 6 months.

Results: Significant increase in goal attainment after 6 months use (t(7) = 4.20, p = .004). No significant improvement in other outcomes. Qualitative data suggested improvement in anxiety management. Contextual (personal/environmental) factors were key in influencing the use and effectiveness of Brain-in-Hand. Having sufficient insight, appropriate support and motivation facilitated use.

Conclusions: Brain-in-Hand shows potential to support acquired brain injury, but further work is required to determine its effectiveness. Context played a pivotal role in the effectiveness and sustained use of Brain-in-Hand, and needs to be explored to support implementation.

Keywords: assistive technology; brain injury; independent living; rehabilitation; self-management; smart technology; smartphone app.