The objective of evidence-based practice is to assess, evaluate, and subsequently develop comprehensive care and intervention plan that will help manage the behaviors of the patient and offer therapeutic and medical care plans. The people who suffer from traumatic brain disorder (TBI) tend to show signs of cognitive, emotional, and physical impairments that make it difficult to reintegrate into the community. For the individual to integrate successfully into the community and return to productive activities, it requires that they modify the maladaptive behaviors associated with the injury. In most cases, TBI has a bearing on different behavioral interventions such as disinhibition, aggression, and difficulty in forging functional relationships with others. It is worth noting that a complete reversal of the behavior may not be possible, meaning that a realistic objective would be to try to modify the behavior of the TBI patient (Kinoshita, 2017). A range of therapeutic interventions exists that help a TBI patient deal with the problem and integrate successfully into the community.
Interventions and Care Plan for TBI Patient
The nurse of the fare provider should develop trusting relationships with the patient. The formulation and the maintenance of the trusting relationship mostly occur during the rehabilitation phase, meaning that the nurse or the care provider should prove to the patient that he or she understands what is important to the patient (Maas et al., 2017). The trust will mainly exist if the patient understands that the individual providing the care and recommendations for care is doing so in good faith and that he or she means well. Furthermore, the patient needs to understand that the care activities aim at achieving the intended care goals. It is imperative to note that trust mainly stems from caring, honest, and consistent interactions. It is more helpful for the care provider to create a non-judgmental and comfortable atmosphere that encourages the patient to discuss their concerns and preferences freely, even if the interests may appear illogical. The knowledge gained from such a discussion is helpful, whether structured or not because they help in the development of a sound behavioral plan and ensuring an effective and efficient treatment plan (Aries et al., 2012). Building a functional relationship should go beyond the professionals, and the patients since people with TBI may feel isolated. Therefore, the support network should include family, friends, professionals, and other people that might have had similar experiences.
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The key to caring for a patient with TBI is to understand their behavior. It requires an understanding of problematic behavior. It includes antecedents, precipitating factors, and triggers that may precede the impulsive behaviors. It is worth noting that triggers that lead to behavior may be internal or external. Internal factors may include fatigue, hunger, and know self-esteem. In contrast, the external factors may include interaction with individuals, routine or change of routine, and improved levels of interaction with a certain class of individuals (Roozenbeek, Maas & Menon, 2013). An understanding of the possible cause of the maladaptive behavior and what happens after the occurrence of the behavior since such may reinforce or even maintain the behavior. For instance, if the patent shows a positive behavior with a degree of consistency, then it would be advisable for the care professionals to reward him or her with the increased attention that has the propensity of improving the frequency of the attention.
During care, professionals need to recognize and subsequently respond to precursors. Towards this end, it is important to note both the verbal and non-verbal cues that precede the display of behavior of concern. An individual's behavior change may be a representation of the negative internal state. It means that the patient may show signs of fidgeting and pacing, the face may be become flushed, and he or she may have a hard time initiating and maintaining eye contact (Babcock et al., 2014). Besides, the patient may also show signs such as muttering and diminished attention to the task. The care provider needs to understand the sudden, albeit subtle, changes in the patient's behavior and the response accordingly. Early detection and intervention in the sequence of the patient's behavior is a significant step that defines the most effective strategies.
Personalized Care for Mr. Nowak
Mr. Nowak requires interventions to modify his behavior and help in improving his memory. Various therapeutic interventions exist that are important in modifying the behavior of the patient with TBI, such as Mr. Nowak. The first one is insight-oriented psychotherapy, which mainly entails the processes and interventions for gaining in-depth awareness of the patient's behaviors, feelings, and thoughts. Insight oriented psychotherapy helps in guiding the care professionals in determining the behavior of the patient with TBI and then helps formulate the strategies to change their behavioral patterns (Vavilala et al., 2014). It requires the patient to attend to tasks, maintain a rational thought process, recall events, apply reason, and then develop insights. The method is ideal in handling various problems associated with TBI, such as thought organization, memory loss, abstract processing, attention, and abstract processing, meaning that it is ideal for Mr. Nowak's case. The method is mainly ideal for individuals with moderate and mild debilitating effects.
Cognitive-behavioral therapy is the most ideal for patients with TBI, such as Mr. Nowak, due to its specific nature that targets the interpretation and perception of experience. It helps the patient in understanding the connection between behavior, feelings, thoughts, and beliefs. It means that certain assumptions, whether real or abstract, tend to have a connection with the underlying ideas and have a bearing on the behavioral patterns (Maas et al., 2013). The patient's belief patterns that were present before the injury and the ones that the patient acquired after the injury tend to affect the progress of the rehabilitation process. Cognitive-behavioral therapy requires the individual to analyze the maladaptive behavior in correlation to underlying beliefs that may be unrealistic, untrue, and counterproductive in ensuring the meeting of basic needs. The method is beneficial in that it permits the alteration of behavior in that it reconciles the belief of the patient with the thought process. For instance, Mr. Nowak will solve crossword puzzles.
The effectiveness and efficiency of cognitive-behavioral therapy depend on the patient's degree of cognitive functioning. Rational Emotive Behavioral Therapy (REBT), which is a form of cognitive-behavioral therapy, depends on various factors. The factors include, but not limited to, flexibility, the capability of withstanding frustration, self-direction, self-acceptance, and the ability to take charge o one's emotional disturbances. An additional goal is to accord the patient the opportunity to challenge self-defeatist thoughts and feelings and to make them remain focused (Haddad & Arabi, 2012). Discussions aimed at correcting Mr. Nowak's cognitive abilities will be less directive and more collaborative and flexible. The therapist will have to adapt to the needs of the individual and not the individual changing to the REBT provisions. When applied to patients with brain injury, REBT will be exceedingly structured, including role-play, and repetitive. REBT will mainly be successful when reliant on procedural learning.
Evaluation Strategy for the Effectiveness of Personalized Care
The evaluation strategy for the effectiveness of the interventions for Mr. Nowak will certainly entail various parameters. The first parameter will be the accessibility of care. As noted before, Mr. Nowak accessed care, and that means that the personalized engagements were effective. Secondly, the fact that the family accepted care will undoubtedly improve the confidence of the care provider and, therefore, efficiency. The cost-effective nature of the chose interventions also means that patients will afford and get regular care. Finally, improvement of memory and cognitive abilities, as depicted by the patient's ability to solve simple tasks such as crossword puzzles, will be the hallmark of improvement in his mental skills.
Conclusion
As demonstrated, several therapeutic approaches exist that can help patients with TBI in developing adaptive behaviors. The ideal therapy in this regard is cognitive behavioral therapy, which allows the patient to understand the connection between behavior, feelings, thoughts, and beliefs. It means that certain assumptions, whether real or abstract, tend to have a relationship with the underlying thoughts and have a bearing on the behavioral patterns. The goal is to reconcile the patients' attitudes, feelings, and beliefs with their behavior.
References
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