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Item Client satisfaction at the Midcentral Health and Massey University concussion clinic : a thesis presented in partial fulfilment of the requirements for the degree of Masters of Arts in Psychology at Massey University(Massey University, 2003) Leach, Roxanne MarieThe present study intended to evaluate the quality of the service provided by the Midcentral Health and Massey University Concussion Clinic. In doing so, the study first considered the nature of Mild Traumatic Brain Injury and concussion injury and rehabilitation and investigated different methods of measuring quality and weighed up the pros and cons of each method to chose the most appropriate method for this setting. As a result, the present study surveyed service satisfaction at the Concussion Clinic. A standardised measure (the Service Satisfaction Survey – 30) was chosen to counter previous methodological problems common to other studies of satisfaction. The main objective of this study was to provide feedback to the Concussion Clinic regarding satisfaction with aspects of their services and to simultaneously investigate relationships with satisfaction. On a whole, participants were generally satisfied with the Concussion Clinic service; conversely some aspects of the service that could be improved were identified. However caution has to be taken in analysing the results especially when inferring results to the whole population, due to this low response rate (twenty of the seventy-nine clients surveyed returned the survey). The second objective of the study was to evaluate the use of this method of evaluation, and the measure chosen, with this type of service. The measure chosen (the Service Satisfaction Scale –30) proved inappropriate for this service setting due to the length and irrelevant questions. Moreover the use of client satisfaction as a method to evaluate this service, even though it provided some data on satisfaction with services, also may not be justified for the reason that the clients were generally only seen once and the nature of outcome in this setting was unclear. This study demonstrated the need for more research in the area of service satisfaction in the health arena, in particular this type of setting; suggestions for this research are included in this study.Item Brain injury and discrimination : the effects of visibility and perceptions of dangerousness and responsibility : this thesis is submitted as a partial fulfilment of the requirements for the degree of doctorate of Clinical Psychology, [Massey University, Wellington, New Zealand](Massey University, 2012) Foster, Lynette AThe aim of the research outlined in the following pages was to examine the impact that the visible signs of brain injury and perceptions of dangerousness and responsibility have on participants’ willingness to socialise with adolescent survivors of brain injury. The research has two articles, and Article Two has two studies. In Article One, participants were shown a picture of either an adolescent male or female, with or without a head scar, with a brief vignette advising that the adolescent had sustained a brain injury. Participants reported that others would be more willing to socialise with the adolescents with a scar, than the adolescents with no scar, and female participants reported that others would be more willing to socialise with the female adolescent, than the male adolescent. Article Two used a similar paradigm to Article One. Study one of Article Two replicated Article One and added an additional factor, knowledge about how to interact, as a factor influencing willingness to socialise. Results showed that participants with more knowledge about how to interact with survivors were more willing to socialise, than participants with less knowledge. Study two examined whether describing the adolescents as dangerous or responsible for contributing to, or causing their brain injury, would influence willingness to socialise. Results showed strong support for a danger model, where perceptions of dangerousness were mediated by fear. When the adolescents’ were described as dangerous, fear increased and subsequent willingness to socialise decreased. To a lesser extent, support was found for a responsibility model. Perceptions of being responsible (falling and sustaining a significant injury to the head after drinking too much alcohol) increased anger but anger in turn did not impact willingness to socialise. Being described as not responsible (as a result of a brain tumour) increased pity, but again there was no relationship between pity and willingness to socialise. This information is useful for rehabilitation professionals assisting adolescents’ re-integration back into the community post injury. Informing survivors that people’s attitudes may change once visible signs of injury heal may be relevant when managing expectations of how others may treat them. It may also be useful to discuss how others may perceive them when they have contributed to causing their current condition or are perceived as dangerous. Finally, knowledge about how to interact may be useful for policy makers when designing campaigns to reduce discrimination.Item Family preparedness for life with a traumatically brain injured relative : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Management at Massey University, Palmerston North, New Zealand(Massey University, 2001) Winthrop, Rachel C.The numbers of people surviving traumatic brain injury are increasing, as medical technology and crisis management systems improve. The demand for rehabilitation and support services outstrips supply and typically it is the families of individuals with brain injury who step in to meet the shortfall in services. Yet families are rarely prepared for the changes traumatic brain injury brings. It was a premise of this study that well prepared families would be more likely to understand what was required to effectively facilitate their injured relative's recovery, and be more capable of doing so, than families that were not well prepared. Using an evolving methodology, this three-phase mixed method study set out to investigate family preparation for life with a brain injured relative, focusing on the period where the injured relative was an inpatient at a rehabilitation facility in the Manawatu, New Zealand. Semi structured interviews and a self-administered mail questionnaire were employed to examine the roles performed by family members following their relative's brain injury, and their perceptions of the preparation they received for these roles and for the effects of role performance on their own lives, while their relative was an inpatient at the Rehabilitation Centre. The study found that family members often played a critical part in their relative's recovery from injury, assuming one or more of the roles of caregiver, case manager and therapist. Consistent with the literature, many family members considered they had not been adequately prepared for these roles during the period of inpatient treatment and suggested many changes were required to the way in which the process of family preparation was approached. From the experiences reported by family members, an evidence-based model of family preparation was developed to guide family preparation initiatives during the period of inpatient rehabilitation. The model is based on the premise that each family has unique preparation needs, reflecting the different capabilities of their brain injured relative, the family's social capital, and the range of professional and lay services available to the injured relative and the family at any given time. The changes to family preparation proposed in the study include enhanced collaboration between families, practitioners and agencies, greater inclusion of families in the inpatient phase by practitioners, and the adoption of a more planned approach to family preparation. These changes are largely achievable within existing resource constraints.