Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Date of Graduation

Spring 2015

Document Type


Degree Name

Doctor of Philosophy (PhD)


Department of Communication Sciences and Disorders


Cynthia R. O'Donoghue

Cara Meixner


The mixed methods explanatory design study examined specific constructs of Post Hospital Interdisciplinary Brain Injury Rehabilitation – Residential (PHIDBIR-R) programs that positively influenced gains in function. The investigation involved exploring the phenomenon of individuals’ experiences while participating in a PHIDBIR-R program as part of recovery from brain injury. The study’ primary purpose was to understand individuals who make the greatest gains in function while participating in these programs, as measured by the Mayo-Portland Adaptability Inventory-4 (MPAI-4) change scores from admission to discharge and what are the components of these programs that may contribute to individuals’ gains in function.

Data were collected via repeated measurement of the MPAI-4 to determine top performers and characteristics of those performers, and to understand which components of the MPAI-4’s 29 areas of measurement most contributed to their change scores. Next, semi-structured interviews with 10 of the top performers was completed. Inclusion criteria included: sustained a traumatic brain injury; aged 18 or older; be identified as one of the top performers; agree to participate. Numerous procedures enhanced trustworthiness, including peer reviewers, member checking, and memo-writing.

Data were analyzed using constant comparison procedures. Thirteen themes within four major categories were reflected in the data. Themes reflect participants’ understanding of crisis, crisis counseling, crisis supervision, and clinical supervision. The results provided a cogent framework for PHIDBIR-R program development, stakeholder program selection and advocate and legislator consideration for program in inclusion for optimal outcome. Contributions to the literature and future research recommendations are also explored.



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