Introduction: In light of the COVID-19 pandemic, digital healthcare has become a rapidly increasing area of research interest. Digital cognitive assessments, which can be completed remotely, without supervision, are being developed and used in both research and clinical contexts with multiple populations. However, very little is known about the way in which these digital assessments are perceived and experienced by survivors of traumatic brain injury (TBI), despite this being a population who commonly undergo cognitive assessment. This study aimed to address this gap by exploring how TBI survivors experience a digital cognitive assessment.
Method: Participants who self-reported sustaining a TBI at some point during their life were asked to complete an online digital cognitive test battery (ACS). An adjusted think-aloud protocol was used to encourage participants to share their ‘in the moment’ thought and reactions during the cognitive assessment, they then engaged in a brief retrospective semi-structured interview about their experiences. Data were analysed using reflexive thematic analysis.
Results: Analysis identified three core themes which focused on 1. Previous experiences which impact how the cognitive assessment is experienced; 2. In the moment experiences: emotions, thoughts and reactions during the cognitive assessment and interview; 3. The use of remote cognitive testing for TBI in the future. Within the core themes, nine subthemes were identified and a detailed narrative description of each theme is provided.
Discussion: Key findings are discussed within the context of the surrounding literature, including the perceived benefits and limitations of utilising digital cognitive assessments, and specifically remote digital assessments with TBI survivors; the in the moment emotional experiences of participants, such as anger, sadness and grief, and factors which were perceived to impact these; and the importance of balancing probable distress with the potential benefits of cognitive assessment. Subsequent recommendations for practice and research are also discussed.
