A multi-tiered intervention to address behavioural and cognitive changes after diagnosis of primary brain tumour: a feasibility study.
OBJECTIVE
Untreated behavioural and cognitive changes after primary brain tumour (PBT) can result in challenging behaviours (CBs), with limited documentation on treatment approaches. This study explored the feasibility of employing a Behavioural Consultancy approach to manage CBs, targeting individuals with PBT, family and treating staff.


METHODS
Participants were patients and families of two hospitals and health professionals from cancer/neurological services. A single-case experimental design piloted skill-based training and environmental changes in managing socio-behavioural impairments in a person with a low grade astrocytoma. A half-day workshop to train family members (n = 7) in compensatory strategy use to manage CBs after PBT was piloted. Finally, a 1-day workshop was provided to 43 health professionals in managing CBs after PBT. For both workshops, a pre-post impact evaluation was conducted employing a purpose-designed Strategies Use Measure.


RESULTS
All three interventions demonstrated positive results. The single case showed a 71% decrease in the target behaviour (time spent talking) post-intervention. Some attrition to these gains was observed at two follow-up time points (3 and 5 months). Participants from both workshops demonstrated significant post-intervention increases in perceived knowledge of Strategy Use (family members z = 2.03, p < 0.05; health professionals z = 4.95, p < 0.00; Wilcoxon signed-rank test).


CONCLUSIONS
These initial studies highlight the potential of employing an integrated multi-tiered intervention based on a Behavioural Consultancy model to manage CBs after PBT.
Brain Injury Rehabilitation Unit, Liverpool Hospital, Sydney, Australia. diane.whiting@sswahs.nsw.gov.au
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D001254:Astrocytoma / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D001291:Attitude of Health Personnel; D001932:Brain Neoplasms / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005190:Family / Q000523:psychology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D010865:Pilot Projects; D013315:Stress, Psychological / Q000209:etiology*