Identifying key components for psychosocial interventions in neurorehabilitation: a realist evaluation on young adults with an acquired brain injury

BACKGROUND: Acquired brain injuries (ABIs), including stroke, lead to younger adults exhibiting a range of psychosocial challenges such as isolation or diminished quality of life. Healthcare services including multidisciplinary teams and nurses play a pivotal role in helping individuals navigate a post-ABI world, but the mechanisms underlying psychosocial support in a younger population remain largely unknown. METHODS: This realist evaluation explores ten initial programme theories derived from a realist review literature. Realist interviews were also conducted to refine these programme theories and clarify which causal and contextual factors are most important for intervention development, as guided by the Six steps in Quality Intervention Development (6SQuID). Six young adults with experience of ABI and seventeen service providers from across the four countries of the UK participated in this theory refinement. RESULTS: The co-construction refinement process with the participants focusing on psychosocial support to people with ABI resulted in three refined programme theories expressed as context, mechanism, outcome configurations: (1) "Engaging the Individual;" (2) "Empowering the Community," and (3) "Equipping the Professionals." CONCLUSION: This realist interview evaluation highlights crucial elements that both experts by experience and service providers identify as necessary to be incorporated into future psychosocial interventions.