Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-23T16:38:45.807Z Has data issue: false hasContentIssue false
  • English
  • Français

Transitions and Brain Injury: A Qualitative Study Exploring the Journey of People with Traumatic Brain Injury

Published online by Cambridge University Press:  14 June 2012

Anne Louise Conneeley
Anne Louise Conneeley*
Affiliation:
Coventry University, United Kingdom
*
Address for correspondence: Anne Louise Conneeley, Coventry University, Faculty of Health and Life Sciences, Priory Street, Coventry, Warwickshire, CV1 5FBUnited Kingdom. E-mail address: [email protected]
Get access

Abstract

This qualitative study aimed to explore transitions from hospital to the home over a period of one year.

Methods and procedures: A longitudinal, phenomenological approach was employed and 18 individuals with severe traumatic brain injury, their family members and rehabilitation professionals were interviewed using semistructured interviews, when the person with brain injury was discharged from the ward, after 6 months and again after one year.

Results: Themes identified within the data included returning home, getting back to normal, moving forward and the role of rehabilitation in the transitional period. Further subthemes were also identified including issues of life-course disruption, self-identity, status and reconstruction.

Conclusions: Data suggested that access to rehabilitation programs employing individualised, contextual interventions following discharge to the home were integral in enabling the transition through to autonomy and independence. Consideration of issues of identity and status can enable a different and potentially important perspective on the experience of transitions for those with brain injury. Reclaiming personal autonomy and control appeared to be central to the reconstruction of a coherent sense of self, enabling a meaningful life after brain injury.

Keywords

Traumatic brain injurytransitionsoccupationidentityrehabilitationqualitative research
Type
Articles
Information
Brain Impairment , Volume 13 , Issue 1: Transition to Community Living after Acquired Brain Injury , July 2012 , pp. 72 - 84
Copyright
Copyright © The Authors 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agnihotri, S., Lynn Keightley, M., Colantonio, A., Cameron, D., & Polatajko, H. (2010). Community interventions for youth with acquired brain injuries. Developmental Neuro-Rehabilitation, 13 (5), 369–382.Google ScholarPubMed
Arber, A. (2006). Reflexivity: A challenge for the researcher as practitioner? Journal of Research in Nursing, 11 (2), 147–157.CrossRefGoogle Scholar
Arber, S., & Cooper, H. (2000). Chapter 5. Gender and inequalities in health across the life-course: In E. Annandale & K. Hunt (Eds.), Gender inequalities in health (pp.). Buckingham, Philadelphia: Open University Press, 123–149.Google Scholar
Bach, L., & David, A. (2006). Self-awareness after acquired and traumatic brain injury. Neuropsychological Rehabilitation, 16 (4), 397–414.CrossRefGoogle ScholarPubMed
Bandura, A. (1977). Self-efficacy: Towards a unifying theory of behavioural change. Psychological Review, 84, 191–215.CrossRefGoogle Scholar
Banja, J.D. (1994). Risk assessment and patient autonomy. Journal of Head Trauma Rehabilitation, 9 (4), 70–72.CrossRefGoogle Scholar
Braun, V., & Clarke, E. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.CrossRefGoogle Scholar
Bury, M. (1982). Chronic illness as biographical disruption. Sociology of Health and Illness, 4 (2), 167–182.CrossRefGoogle ScholarPubMed
Carpenter, C., & Suto, M. (2008). Qualitative research for occupational and physical therapists. Oxford: Blackwell Publishing.Google Scholar
Chew-Graham, C.A., May, C.R., & Perry, M.S. (2002). Qualitative research and the problem of judgement. Lessons from interviewing fellow professionals. Family Practice, 19 (3), 185–189.CrossRefGoogle ScholarPubMed
Conneeley, A.L. (2002a). Methodological issues in qualitative research for the researcher/practitioner. British Journal of Occupational Therapy, 65 (4), 185–190.CrossRefGoogle Scholar
Conneeley, A.L. (2003). Quality of life and traumatic brain injury. A longitudinal qualitative study. British Journal of Occupational Therapy, 66 (10), 440–446.CrossRefGoogle Scholar
Conneeley, A.L. (2004). Interdisciplinary collaborative goal-planning in a post-acute neurological setting: A qualitative study. British Journal of Occupational Therapy, 67 (6), 248–255.CrossRefGoogle Scholar
Caplan, A.L. (1988). Informed consent and provider–patient relationships in rehabilitation medicine. Archives of Physical Medicine and Rehabilitation, 69 (5), 312–317.Google ScholarPubMed
Doig, E., Fleming, J., & Tooth, L. (2001). Patterns of community integration 2–5 years post-discharge from brain injury rehabilitation. Brain Injury, 15, 747–762.CrossRefGoogle ScholarPubMed
Exley, C., & Letherby, G. (2001). Managing a disrupted life-course: Issues of identity and emotion work. Health, 5 (1), 112–131.CrossRefGoogle Scholar
Finlay, L., & Gough, B. (2003). Reflexivity. Oxford: Blackwell Publishing.CrossRefGoogle Scholar
Fleming, J., Winnington, H., McGillivray, A., Tatarevic, B., & Ownsworth, T. (2006). The development of self-awareness and relationship to emotional functioning during early community reintegration after traumatic brain injury. Brain Impairment, 7 (2), 83–94.CrossRefGoogle Scholar
Frass, M.R., & Calvert, M. (2009). The use of narratives to identify characteristics leading to productive life following acquired brain injury. American Journal of Speech-Language Pathology, 18 (11), 315–328.CrossRefGoogle Scholar
Gordon, W.A., Cantor, J., Ashman, T., & Brown, M. (2006). Treatment of post-traumatic brain injury executive dysfunction. Journal of Head Trauma Rehabilitation, 21 (2), 156–167.CrossRefGoogle ScholarPubMed
Giddens, A. (1991). Modernity and self-identity. Self and society in the later modern age. Cambridge: Polity Press.Google Scholar
Griffen, J.A., Hanks, R.A., & Meachen, S. (2010). The reliability and validity of the community integration measure in persons with traumatic brain injury. Rehabilitation Psychology, 5 (3), 292–297.CrossRefGoogle Scholar
Hoogerdijk, B., Runge, U., & Haugboelle, J. (2011). The adaptation process after traumatic brain injury. An individual and ongoing occupational struggle to gain new identity. Scandinavian Journal of Occupational Therapy, 18 (2), 122–132.CrossRefGoogle ScholarPubMed
Hwan, K., & Colantonio, A. (2010). Effectiveness of rehabilitation in enhancing community integration after acute traumatic brain injury. American Journal of Occupational Therapy, 64 (5), 709–719.Google Scholar
Johansen, R.K. (2002). Listening in the silence, seeing in the dark: Reconstructing life after brain injury. Berkeley, CA: University of California Press.CrossRefGoogle Scholar
Kirsh, B., Stergiou-Kita, M., & Gewurtz, R. (2009). From margins to mainstream: What do we know about work integration for persons with brain injury, mental illness and intellectual disability? Work, 32, 391–415.CrossRefGoogle ScholarPubMed
Klinger, L. (2005). Occupational adaptation: Perspectives of people with traumatic brain injury. Journal of Occupational Science, 12 (1), 9–16.CrossRefGoogle Scholar
Lefebvre, L., & Lever, M.J. (2006). Sudden and unexpected health situation: From suffering to resilience. Illness, Crisis and Loss, 14 (4), 337–354.CrossRefGoogle Scholar
Letherby, G. (1999). Other than mothers and mothers as others: The experience of motherhood and non-motherhood in relation to ‘infertility’ and ‘involuntary childlessness’. Women's Studies International Forum, 22 (3), 359–372.CrossRefGoogle Scholar
Levack, W.M.M., Kayes, N.M., & Fadyl, J.K. (2010). Experience of recovery and outcome following traumatic brain injury: A meta-synthesis of qualitative research. Disability and Rehabilitation, 32 (12), 986–999.CrossRefGoogle Scholar
McCabe, P., Lippert, C., Weiser, M., Hilditch, M., Hartridge, C., & Villamere, J. (2007). Community reintegration following acquired brain injury. Brain Injury, 21, 231–257.CrossRefGoogle ScholarPubMed
McColl, M.A., Bickenbach, J., Johnson, J., Nishihama, S., Schumaker, M., Smith, K., & Yelland, B. (2000). Changes in spiritual beliefs after traumatic disability. Archives of Physical Medicine and Rehabilitation, 81 (6), 817–823.CrossRefGoogle ScholarPubMed
McColl, M.A., Carslon, P., Johnson, J., Minnes, P., Shue, K., Davies, D., & Karlovits, T. (1998). The definition of community integration. Perspectives of people with brain injuries. Brain Injury, 12 (1), 15–30.CrossRefGoogle ScholarPubMed
Playford, E.D., Dawson, C., Limbert, V., Smith, M., Ward, C.D., & Wells, R. (2000). Goal-setting in rehabilitation: Report of a workshop to explore professional perceptions of goal setting. Clinical Rehabilitation, 4, 49–496.Google Scholar
Serio, C.D., Kreutzer, J.S., & Witol, A.D. (1997). Family needs after traumatic brain injury. A factor analytic study of the Family Needs Questionnaire. Brain Injury, 11 (1), 1–9.CrossRefGoogle ScholarPubMed
Shaw, L.R., Chan, F., & Lam, C.S. (1997). Development and application of the Family Needs Questionnaire in brain injury rehabilitation. Brain Injury, 11 (3), 219–231.Google ScholarPubMed
Sherer, M., Hart, T., Whyte, J., Nick, T.G., & Yablon, S.A. (2005). Neuroanatomic basis of impaired self-awareness after traumatic brain injury: Findings from an early computed tomography. Journal of Head Trauma Rehabilitation, 20 (4), 287–300.CrossRefGoogle ScholarPubMed
Sloan, S., Calloway, L., Winkler, D., McKinley, K., Ziino, C., & Anson, K. (2009). The community approach to participation: Outcomes following acquired brain injury intervention. Brain Impairment, 10 (3), 282–294.CrossRefGoogle Scholar
Taylor, M.C. (2007). Evidence-based practice for occupational therapists. Oxford: Wiley-Blackwell.Google Scholar
Truelle, J.L., Fayol, P., Montreuil, M., & Chevignard, M. (2010). Community integration after severe traumatic brain injury in adults. Current Opinion in Neurology, 23 (6), 688–694.CrossRefGoogle ScholarPubMed
Turner, B., Fleming, J., Cornwell, P., Worrall, L., Ownsworth, T., Haines, T., & Chenoweth, L. (2007). A qualitative study of the transitions from hospital to home for individuals with acquired brain injury. Brain Injury, 21 (11), 1119–1130.CrossRefGoogle ScholarPubMed
Turner, B., Fleming, J., Cornwell, P., Haines, T., & Ownsworth, T. (2009). Profiling early outcomes during the transition from hospital to home after brain injury. Brain Injury, 23 (1), 51–60.CrossRefGoogle ScholarPubMed
Turner, B., Fleming, J., Parry, J., Vromans, M., Cornwell, P., Gordon, C., & Ownsworth, T. (2010). Caregivers of adults with traumatic brain injury: The emotional impact of transitions from hospital to home. Brain Impairment, 11 (3), 281–292.CrossRefGoogle Scholar
Turner, B., Fleming, J., Ownsworth, T., & Cornwell, P. (2011). Perceptions of recovery during the early transition phase from hospital to home following acquired brain injury: A journey of discovery. Neuropsychological Rehabilitation, 2 (1), 64–91.CrossRefGoogle Scholar
Willemse-van Son, A.H., Ribbers, G.M., Hop, W.C., & Starn, H.J. (2009). Community integration following moderate to severe traumatic brain injury: A longitudinal investigation. Journal Rehabilitation Medicine, 41 (7), 521–527.CrossRefGoogle ScholarPubMed
Willer, B., Rosenthal, M., Kreutzer, J.S., Gordon, W., & Rempel, R. (1993). Assessment of community integration following rehabilitation for traumatic brain injury. Journal of Head Trauma Rehabilitation, 8 (2), 75–87.CrossRefGoogle Scholar
World Health Organization. (2001). International Classification of function, disability and health. Geneva: Author.Google Scholar