Healthcare professional experiences of family expectations in inpatient neurorehabilitation

Families of individuals who require inpatient neurorehabilitation following brain injury often have expectations of recovery that differ from treating healthcare professionals. This can hinder collaboration and create tension. This study aimed to explore healthcare professionals’ experiences of family expectations and identify ways to improve practice. Semi-structured interviews were conducted with healthcare professionals at a Level 1 neurorehabilitation unit in England. This National Health Service unit is commissioned to see patients with highly complex needs following a brain injury. Data were analyzed using reflexive thematic analysis. Eighteen healthcare professionals from a range of disciplines participated, with physiotherapists most highly represented (n = 5). Analysis generated three key themes: ‘the promise of rehabilitation,’ ‘confidence with complexity,’ and ‘developing mutual understanding.’ Participants described differing expectations as a common and emotionally demanding aspect of their work, often complicated by prognostic uncertainty. Healthcare professionals recognized hope as a valid and often protective response to a life-altering brain injury. Improved mutual understanding may require a multi-component intervention to aid communication pre-admission, identify family support needs, support patients requiring disability management, provide emotional support to HCPs, and to address uncertainty. It is critical to first deepen understanding of family and patient perspectives on this topic.