gms | German Medical Science

Background: Over one million people live with the long-term consequences of acquired brain injury (ABI). Many smart technologies exist to aid rehabilitation, but technology to support self-management is limited. Brain-in-Hand (BiH) is a smartphone app designed to support psychological problems and encourage behaviour change.

Aim: To evaluate the experiences/perspectives of ABI patients and healthcare professionals (HCPs) after using BiH.

Method: Semi-structured interviews were conducted with ABI participants (n=9) and HCPs (n=3) at 6 months. Data were collected on the acceptability of BiH and barriers/facilitators to use. Interviews were thematically analysed using a framework informed by the International Classification of Functioning, Disability and Health and Behaviour Change Wheel, then triangulated with stakeholders for validity.

Results/findings: Context (personal/environmental factors) was the key determinant influencing BiH use and effectiveness. Key themes were: insight and self-awareness; patient and therapist support/training; motivation for use; technology barriers/facilitators. Having appropriate, on-going support, ability to self-monitor, set realistic goals and motivation facilitated BiH use.

Discussion and conclusions: BiH and the context for its use must be considered as part of the same system (technology+context = whole system). Although simple to use, effectiveness was dependent on relevant rehabilitation goals, user insight and support from people familiar with the technology. Investment and training in the whole system seems fundamental to success.

BiH has the potential to be a valuable tool in community rehabilitation. Early identification of barriers/facilitators can guide implementation. Further research should focus on user attributes important for success and its wider applicability to other long-term conditions.