E-Thesis 163 views 360 downloads
Enhancing Neurorehabilitation for Adults with Acquired Brain Injury: Integrating Wellbeing Science for Whole Health / KATIE GIBBS
Swansea University Author: KATIE GIBBS
DOI (Published version): 10.23889/SUThesis.70831
Abstract
Living with acquired brain injury necessitates significant personal adjustment. While holistic neurorehabilitation aims to support recovery, clinical practice remains largely deficit-focussed, prioritising recovery and functional gains as opposed to promoting wellbeing in its fullest sense. Current...
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Swansea
2025
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| Institution: | Swansea University |
| Degree level: | Doctoral |
| Degree name: | Ph.D |
| Supervisor: | Kemp, A. and Fisher, Z. |
| URI: | https://cronfa.swan.ac.uk/Record/cronfa70831 |
| Abstract: |
Living with acquired brain injury necessitates significant personal adjustment. While holistic neurorehabilitation aims to support recovery, clinical practice remains largely deficit-focussed, prioritising recovery and functional gains as opposed to promoting wellbeing in its fullest sense. Current interventions often focus on isolated aspects of health rather than addressing them integrally, compounded by a lack of transdisciplinary frameworks to guide intervention design. Through the systematic application of the transdisciplinary, metatheoretical GENIAL framework, this thesis highlights how wellbeing science may add value to holistic neurorehabilitation by building foundations for wellbeing at multiple levels of scale.Using primarily qualitative methodologies and reflexive thematic analysis situated within a critical realist perspective, this work unpacks interview and focus group data from 75 participants (aged 18-86 years old) involved in group-based interventions delivered byholistic neurorehabilitation units in South Wales. Interventions included an adapted-Acceptance and Commitment Therapy programme designed to foster psychological adjustment, and, in partnership with community interest companies, an immersive, nature-based surf therapy programme and a sustainable construction ecotherapy programme that promoted meaningful environmental engagement. Using the GENIAL framework as an analytical lens through which participant insights were critically unpacked, this thesis retrospectively evaluates the potential of each intervention to support wellbeing across individual, social, and environmental domains, offering a nuanced understanding of the mechanisms through which wellbeing can be facilitated in clinical practice.The results illustrate how holistic neurorehabilitation can synergistically build foundations for wellbeing by supporting connection across multiple levels, including to the self (enhancing self-connectedness through emotional regulation and identity reconstruction), others (fostering social connections through shared experiences, group identification andbelonging), and the environment (promoting nature connectedness and pro-environmental attitudes through meaningful environmental engagement). This work exemplifies how rehabilitation, informed by wellbeing science, can transcend beyond domain-specific deficit reduction and instead cultivate the conditions to support individuals, community and planetary wellbeing. |
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| Keywords: |
Wellbeing, Acquired Brain Injury, Holistic Neurorehabilitation, Nature-based Interventions |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
The Regional Neuropsychology and Community Brain Injury Service |