1
|
Mamman R, Fleming J, Mortenson WB, Schmidt J. Characterizing post-traumatic growth in individuals with traumatic brain injury according to social participation, self-awareness, and self-identity. Disabil Rehabil 2024:1-8. [PMID: 39340245 DOI: 10.1080/09638288.2024.2405571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/22/2024] [Accepted: 09/13/2024] [Indexed: 09/30/2024]
Abstract
PURPOSE After traumatic brain injury (TBI), individuals may face challenges in their social participation, self-awareness, and self-identity. However, positive life changes can also be experienced (i.e., post-traumatic growth). This study aimed to characterize the social participation, self-awareness, and self-identity of individuals with TBI displaying post-traumatic growth. MATERIALS AND METHODS Fifteen participants (male = 10, mean age = 49.7 years) with moderate to severe TBI (average years post-injury = 15.2) were included in this mixed-methods study. Self-report questionnaires were used to assess social participation, self-awareness, and self-identity. Qualitative data, collected using semi-structured interviews, were used to categorize participants into two groups: higher (n = 8) and lower (n = 7) post-traumatic growth. Descriptive statistics were used to characterize participants in each group in terms of their social participation, self-awareness, and self-identity. RESULTS Participants with higher post-traumatic growth had increased social participation, higher self-awareness, and fewer negative discrepancies between their pre- and post-injury self-identities, compared to participants with lower post-traumatic growth. CONCLUSION This study contributes to a more comprehensive understanding of post-traumatic growth through the use of both qualitative and quantitative data. These findings can inform future research and development of programs to promote post-traumatic growth post-TBI.
Collapse
Affiliation(s)
- Rinni Mamman
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - W Ben Mortenson
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health, Vancouver, British Columbia, Canada
- International Collaboration on Repair Discoveries, Vancouver General Hospital, Vancouver, British Columbia, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Julia Schmidt
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health, Vancouver, British Columbia, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
2
|
Versace J, Tazrin S, O'Connor E, Sekibo J, Morey E, Kasinopoulou A, O'Donoghue D, Simblett SK. The role of spirituality and identity formation in personal recovery from traumatic brain injury: A qualitative analysis through the personal experiences of survivors. Neuropsychol Rehabil 2024; 34:1110-1140. [PMID: 38006578 DOI: 10.1080/09602011.2023.2274624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/04/2023] [Indexed: 11/27/2023]
Abstract
Traumatic brain injury (TBI) is a type of acquired brain injury (ABI) that happens when a sudden, external, physical assault damages the brain. TBI can cause long-term cognitive impairments and other lifestyle changes that may affect psychological wellbeing. Among the psychological challenges people recovering from TBI often face is the subjective loss of their pre-injury identity. Quantitative and qualitative research suggests that spirituality can play a positive role in recovery from TBI, increasing the quality of life and overall mental health. However, thus far, the research into this topic has not directly addressed the relationship between identity and spirituality after TBI. The present study sought to do this by thematically analyzing 22 public podcasts featuring interviews of people recovering from TBI telling their stories. The authors review the spiritual themes discussed in the podcasts and then propose a hypothesis about how, through a sense of connection to something self-transcendent, spirituality may enable people to test new meanings and identities, relatively free from the consequences of discrepancy in meaning and identity after TBI.
Collapse
Affiliation(s)
- J Versace
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S Tazrin
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - E O'Connor
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J Sekibo
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - E Morey
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A Kasinopoulou
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - D O'Donoghue
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S K Simblett
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
3
|
Arroyo P, Wilkie L, Davies E, Fisher Z, Kemp AH. Thriving in the wake of a storm: A systematic qualitative review & meta-synthesis on facilitating post-traumatic growth in patients living with Acquired Brain Injury. Neuropsychol Rehabil 2024:1-27. [PMID: 38870482 DOI: 10.1080/09602011.2024.2356891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 05/10/2024] [Indexed: 06/15/2024]
Abstract
Acquired Brain Injury (ABI) often results in significant challenges, yet it may also facilitate Post-Traumatic Growth (PTG). This review explores a critical question: "What are the main factors contributing to PTG following ABI, and what potential barriers to its development are perceived by ABI survivors?" Here we aim to systematically uncover these contributors and barriers to PTG through a meta-synthesis, involving a comprehensive review of previously published qualitative research on this topic. A literature search was conducted across PsycINFO, CINAHL, and MEDLINE up to December 2022 to identify studies for inclusion. From an initial pool of 1,946 records, eleven articles were selected for inclusion. Reflexive thematic analysis yielded three analytical themes including "Journey to Self-Rediscovery", "Strength in Connection" and "Overcoming Obstacles". Our findings also revealed facilitators and barriers across multiple levels of scale including personal (e.g., acceptance versus resignation), interpersonal (e.g., positive social ties versus difficulties making social connections), and systemic (e.g., new meaning and purpose versus financial constraints) scales. Our research extends existing knowledge in ABI rehabilitation, providing a more nuanced understanding of the dynamics influencing PTG with implications for clinicians seeking to promote wellbeing following brain injury.
Collapse
Affiliation(s)
- Pamela Arroyo
- School of Psychology, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, UK
| | - Lowri Wilkie
- School of Psychology, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, UK
- Regional Neuropsychology and Community Brain Injury Service, Morriston Hospital, Swansea, UK
| | - Elen Davies
- Swansea University Library, Swansea University, Swansea, UK
| | - Zoe Fisher
- Regional Neuropsychology and Community Brain Injury Service, Morriston Hospital, Swansea, UK
- Health and Wellbeing Academy, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, UK
| | - Andrew Haddon Kemp
- School of Psychology, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, UK
- Regional Neuropsychology and Community Brain Injury Service, Morriston Hospital, Swansea, UK
| |
Collapse
|
4
|
Sathananthan N, Morris E, Gillanders D, das Nair R, Knox L, Wong D. Rebuilding the self through valued action and group connections after acquired brain injury: Participant perspectives of the VaLiANT group intervention. Neuropsychol Rehabil 2024:1-29. [PMID: 38838171 DOI: 10.1080/09602011.2024.2359992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/17/2024] [Indexed: 06/07/2024]
Abstract
Effective interventions that facilitate adjustment following acquired brain injury (ABI) are needed to improve long-term outcomes and meaningful reengagement in life. VaLiANT is an 8-week group intervention that combines cognitive rehabilitation with Acceptance and Commitment therapy to improve valued living, wellbeing, and adjustment. This study explored participant experiences of VaLiANT to optimize its ongoing development. This included characterization of individually meaningful treatment outcomes, mechanisms of action, and intervention acceptability. Qualitative interviews and quantitative ratings were collected from 39 ABI survivors (Mage = 52, SD = 15; 54% stroke) following their participation in VaLiANT. Participants reported diverse outcomes which resulted in three themes being generated following reflexive thematic analysis. "A fuller toolkit for life with brain injury" indicated increased strategy usage and better daily functioning; "The value of connection and belonging" captured the importance of social experiences in shaping recovery; and "Finding the me I can be" represented cognitive, behavioural, and emotional aspects of identity reconstruction post-ABI. The content and delivery of the intervention were rated highly but participants desired greater follow-up and tailoring of the intervention. Overall, VaLiANT appears to facilitate adjustment through several mechanisms, but greater intervention individualization and dosage may be required to enhance the treatment impact.
Collapse
Affiliation(s)
- Nick Sathananthan
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Eric Morris
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - David Gillanders
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Roshan das Nair
- Institute of Mental Health, University of Nottingham, Nottingham, UK
- Health Division, SINTEF, Trondheim, Norway
| | - Lucy Knox
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| |
Collapse
|
5
|
Brown A, Barth DC, Leslie AR. "You're Someone Different Now": An Autoethnography on Identity and Occupational Identity Disruption After Traumatic Brain Injury. Am J Occup Ther 2024; 78:7802180110. [PMID: 38502115 DOI: 10.5014/ajot.2024.050411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Abstract
IMPORTANCE Identity disruption and occupational identity disruption are common after traumatic brain injury (TBI), but the relationship between these two phenomena is underexplored. Occupational therapy practitioners should be knowledgeable about identity challenges after TBI and ways to reconstruct a sense of self. OBJECTIVE To sensitize readers to the experience of identity disruption and occupational identity disruption and describe how those two experiences are interrelated and transactional in nature. DESIGN We completed an autoethnography, because this method privileges the insider perspective of participants as members of the research team. We interviewed Andi's family and friends, with textual and nontextual data being reviewed during team meetings that occurred 3 times per month over 3 yr. Data were analyzed by hand-coding transcripts to organize findings until we identified themes and salient text for constructing a narrative. Setting: Community. PARTICIPANTS TBI survivor. RESULTS Identity disruption after TBI occurs because of physiological difficulties, psychological changes, and cognitive deficits. Additionally, survivors face interruptions in occupational participation that affect their identity as doers. Andi experienced identity disruption that was exacerbated by being unable to engage in written expression. When he was able to resume writing and regain his occupational identity, Andi was able to reconstruct his sense of self. CONCLUSIONS AND RELEVANCE Identity is created by occupational engagement. Occupational therapy practitioners can better serve their clients by exploring identity disruption and occupational identity disruption after TBI. Plain-Language Summary: This article describes the lived experience of identity disruption and occupational identity disruption with an emphasis on the transformative nature of occupation. Occupational therapists should work collaboratively with clients to identify key occupations that support their sense of identity.
Collapse
Affiliation(s)
- Andi Brown
- Andi Brown, MS, OTR, is Occupational Therapist, Boston, MA;
| | - Devin C Barth
- Devin C. Barth, MS, OTR, is Occupational Therapist and Doctoral Student, Department of Occupational Therapy, Colorado State University, Fort Collins
| | - Amanda R Leslie
- Amanda R. Leslie, MS, OTR, is Occupational Therapist, San Antonio, TX
| |
Collapse
|
6
|
Nalder E, King G, Hunt AW, Hartman LR, Szigeti Z, Drake E, Shah R, Shahzad M, Resnick M, Pereira G, Lenton E. Indicators of life success from the perspective of individuals with traumatic brain injury: a scoping review. Disabil Rehabil 2023; 45:330-343. [PMID: 35037526 DOI: 10.1080/09638288.2021.2025274] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE The purpose was to synthesize qualitative literature and identify indicators of life success (positive life outcomes and experiences) that can help in understanding resiliency in the context of traumatic brain injury (TBI). METHODS This scoping review involved searching nine online databases for population (TBI) and context (qualitative literature). Searches retrieved 42 852 articles and, after two-stage screening, 76 articles met the inclusion criteria of reporting indicators of life success from the perspective of individuals with TBI. RESULTS Most studies were conducted in North America, Australia, or Europe. Participants were people living with TBI (mild to severe), of all age ranges. Positive life experiences were organized within four domains: understanding of oneself and one's life, social relationships and interaction, doing (engagement in activities, sense of control and accomplishment), and hope for the future. CONCLUSIONS The positive life experiences reflect both processes and outcomes (indicators of success) and highlight the need for a multidimensional approach when seeking to understand resiliency following TBI. The transactional framework of life experiences can be applied in future TBI resiliency research to understand how individuals negotiate adversity through experiences promoting understanding of oneself and the world, social relationships, engagement in activity and hope. Implications for rehabilitationRehabilitation services should consider how to afford opportunities for engagement in activity, social interaction, meaning making (i.e., coming to new understandings), and hope.With respect to engaging in activity and social relationships, having social interaction, being understood, being active and productive, having autonomy, and having accomplishments, reflect important experiences to enable within rehabilitation services.Rehabilitation professionals should consider how providing opportunities for their clients to have positive life experiences may contribute toward an adaptive and empowered mindset.
Collapse
Affiliation(s)
- Emily Nalder
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- March of Dimes Canada, East York, Canada
| | - Gillian King
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Bloorview Research Institute & Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Anne W Hunt
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Laura R Hartman
- Bloorview Research Institute & Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Zara Szigeti
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Bloorview Research Institute & Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Emma Drake
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Riya Shah
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Maryam Shahzad
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Myles Resnick
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Giles Pereira
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Erica Lenton
- Gerstein Science Information Centre, University of Toronto, Toronto, Canada
| |
Collapse
|
7
|
Hindhede AL, Poulsen I. The value of social networks to individuals with a severe traumatic brain injury: a mixed methods approach. Disabil Rehabil 2022; 44:7916-7925. [PMID: 34812660 DOI: 10.1080/09638288.2021.2002442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE In this study, we investigate the nature and strength of the social relations of working-age individuals who have survived a severe traumatic brain injury. MATERIALS AND METHODS Fifty-three survivors diagnosed with severe traumatic brain injury completed the social network analysis questionnaire, enabling us to map their social networks using the software program EgoNet.QF. This was combined with interviews with four survivors and their significant members of their network and constructed narrative cases of the resources gained from their network. RESULTS Half the survivors lost friends because of the brain injury. The most common social network post injury comprised parents followed by spouses. Close relatives experienced a dramatic change in the nature of their relationships with the survivor. They also struggled greatly with the rehabilitation health system, which in many cases affected their own careers. CONCLUSION Persons with severe traumatic brain injury and their close relatives predominantly learn to manage the new situation, with functionality driving social interaction. However, as social networks often are limited to the close family, these individuals are placed in a vulnerable position.IMPLICATIONS FOR REHABILITATIONExisting networks (whether few or many) are of major importance for individuals with traumatic brain injury in the rehabilitation process.Close social relations possess knowledge about the survivor with traumatic brain injury that is important for the rehabilitation process.To support individuals and their families who lack strong resources and social networks, health care professionals should systematically identify these persons from admission to hospital and primary care.When these persons have been identified, individual plans for how to strengthen their network can be developed in collaboration with the individuals and their existing social network.
Collapse
Affiliation(s)
| | - Ingrid Poulsen
- Department of Head Injury Rehabilitation, Copenhagen University Hospital, Hvidovre, Denmark.,Research Unit Nursing and Health Care, Health, Aarhus University Denmark
| |
Collapse
|
8
|
Mamman R, Mortenson WB, Fleming J, Schmidt J. Living in a reshaped reality: Exploring social participation and self-identity after TBI. Neuropsychol Rehabil 2022; 32:2102-2124. [PMID: 35997174 DOI: 10.1080/09602011.2022.2113100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Individuals with a moderate to severe traumatic brain injury (TBI) experience substantial changes in their life. This constructivist grounded theory study aimed to develop an explanatory model that explores the impact of changes in social participation and self-identity after sustaining a TBI. Sixteen participants with moderate to severe TBI (mean age = 49.8, 69% male) were recruited, and were on average 16.4 years post-injury (SD = 10.4). Data from semi-structured interviews were analysed thematically. An overarching theme of "living in a reshaped reality" was identified, which depicted how changes in social participation and self-identity influenced ongoing experiences with TBI. Three main themes were generated: (1) "there's nothing that's the same" highlighted the daily challenges individuals faced post-injury, (2) "rebuilding and restarting" described how individuals with TBI navigated through their unfamiliar reality, and (3) "embrace it and run with it" explored participants' reactions towards life with a TBI. An explanatory model was developed, consisting of the overarching theme ("living in a reshaped reality") with the three integrated themes. Future research and clinical practices can build on this understanding to develop programmes to help individuals address their needs in post-injury life.
Collapse
Affiliation(s)
- Rinni Mamman
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada
| | - W Ben Mortenson
- Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,International Collaboration on Repair Discoveries, Vancouver General Hospital, Vancouver, Canada
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Julia Schmidt
- Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| |
Collapse
|
9
|
Perkins A, Gracey F, Kelly G, Jim J. A new model to guide identity-focused multidisciplinary rehabilitation for children and young people following acquired brain injury: I-FoRM. Neuropsychol Rehabil 2022; 32:1928-1969. [PMID: 35895321 DOI: 10.1080/09602011.2022.2100794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
A complexity of biological, psychological, environmental and systemic factors influences a child's adaption after acquired brain injury (ABI), all of which transform as the child matures. Multidisciplinary rehabilitation teams are challenged by balancing family system needs and the child's needs, whilst promoting the child's functional skills in difficult or unappealing tasks. This paper presents the conceptual basis for a model for use in childhood ABI neurorehabilitation to address these challenges. A non-systematic narrative review of literature pertinent to integrated neurorehabilitation of pediatric ABI was conducted. Contemporary models of adult and pediatric psychosocial adaptation involving identity following ABI were reviewed. Key findings were then synthesized with models of pediatric resilience and self-concept development. The resulting model describes a cyclical adaptation process whereby the child learns experientially about their self and their world after ABI. Processes of identity development play a central role - particularly emotive processes of self-evaluation - by influencing the child's motivation for participation, tolerance for challenge, self-regulation and emerging self-awareness. The model directs clinicians to use the psychosocial processes of identity development to enhance the child's willingness and capacity to engage in the daily challenges of rehabilitation. Further systematic development and evaluation of the model is needed.
Collapse
Affiliation(s)
| | - Fergus Gracey
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK.,Cambridge Centre for Paediatric Neuropsychological Rehabilitation, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | | | - Jenny Jim
- The Children's Trust, Tadworth, UK.,Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| |
Collapse
|
10
|
Glennon C, Watson S, Fisher P, Gracey F. The process of identity change following ABI from the perspectives of adolescents and their mothers: A relational grounded theory approach. Neuropsychol Rehabil 2022; 32:1904-1927. [PMID: 35857657 DOI: 10.1080/09602011.2022.2100796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study explored the process of identity adjustment following adolescent brain injury, within the systemic context of the parent-adolescent dyad. Six young people with an ABI (mean age 16.5 years, range 15-18 years; TBI: n = 3) were individually interviewed, and six respective mothers (mean age 45 years, range 37-50 years). A novel relational qualitative grounded theory approach was used, with analyses of dyads linked in an attempt to capture the shared process of adaptation post-injury for young people and their parents. Shared themes emerged for adolescents and mothers regarding "continuity and change" and "acknowledging or rejecting" experiences of change post injury. Adolescents experienced change as an, at times, distressing sense of being "not normal". While mothers turned towards their child, working hard to try to "fix everything", adolescents sought continuity of identity in the context of peer relationships, withdrawing socially to avoid feeling abnormal, reframing or finding new relationships. Some mothers sought to fill social losses through family or disability-specific activity. This study provides a relational understanding of the process of identity adjustment post adolescent BI. Future research and clinical practice should recognize the significant work of mothers, and significance of social relationships to adolescents' emerging post-injury identity.
Collapse
Affiliation(s)
- Ciara Glennon
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK
| | - Suzanna Watson
- Cambridge Centre for Paediatric Neuropsychological Rehabilitation (CCPNR), Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Paul Fisher
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK
| | - Fergus Gracey
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK.,Cambridge Centre for Paediatric Neuropsychological Rehabilitation (CCPNR), Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| |
Collapse
|
11
|
Sherer M, Clark AN, Sander AM, Struchen MA, Bogaards J, Leon-Novelo L, Ngan E. Relationships of self-awareness and facial affect recognition to social communication ability in persons with traumatic brain injury. Neuropsychol Rehabil 2022; 32:2013-2028. [PMID: 35666684 DOI: 10.1080/09602011.2022.2084118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Traumatic brain injury (TBI) can cause changes to the injured person's physical ability, cognitive functioning, and social interactions. Since these attributes largely determine a person's concept of who they are, TBI poses a threat to sense of self. Due to the importance of social communication skills for community integration, impairment of these skills is a particular threat to sense of self. The present investigation sought to explore characteristics that influence social communication abilities. We hypothesized that both ability to interpret facial affect and self-awareness would be associated with communication ability. We also expected that facial affect recognition would influence self-awareness and that the effect of facial affect recognition on social communication would be partially mediated by self-awareness. For this prospective cohort study, participants were 77 individuals with documented TBI. Of these, 65% were male and 83% sustained severe injuries. The hypothesized association of facial affect recognition with social communication was demonstrated with path analysis as was the effect of facial affect recognition on self-awareness. However, the effect of facial affect recognition on social communication was not mediated by self-awareness. In addition, social communication was associated with employment, social integration, and loneliness. Findings highlighted the importance of social communication after TBI.
Collapse
Affiliation(s)
- Mark Sherer
- Brain Injury Research Center TIRR Memorial Hermann, Houston, TX, USA.,H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
| | - Allison N Clark
- Brain Injury Research Center TIRR Memorial Hermann, Houston, TX, USA.,H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.,Department of Physical Medicine and Rehabilitation, Harris Health System, Houston, TX, USA
| | - Angelle M Sander
- Brain Injury Research Center TIRR Memorial Hermann, Houston, TX, USA.,H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.,Department of Physical Medicine and Rehabilitation, Harris Health System, Houston, TX, USA
| | - Margaret A Struchen
- Center for Rehabilitation Psychology and Neuropsychology, PC, Walnut Creek, CA, USA
| | - Jay Bogaards
- Brain Injury Research Center TIRR Memorial Hermann, Houston, TX, USA
| | - Luis Leon-Novelo
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Esther Ngan
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| |
Collapse
|
12
|
Kakonge L, Charron VP, Vedder J, Wormald K, Turkstra LS. A mapping review of adolescent identity after TBI: what clinicians need to know. Neuropsychol Rehabil 2022; 32:1868-1903. [PMID: 35604405 DOI: 10.1080/09602011.2022.2071299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ABSTRACTAdolescence is a critical period for developing a sense of identity, an iterative process that relies on the development of skills such as self-reflection and self-appraisal. Outcomes of identity development include personal ethics, knowledge of one's strengths and challenges, and, ultimately, independence. Traumatic brain injury (TBI) affects these outcomes in adults, when identity has been established and may need to be redefined; but what happens when an injury occurs while identity is being formed? To answer this question, we used mapping review methodology to explore TBI effects on adolescent identity formation, mapping the evidence onto a biopsychosocial framework for rehabilitation. We reviewed studies on identity in adolescents with mild to severe TBI ages 13-18 years, published from inception to 2021, with a focus on outpatient rehabilitation settings. Key findings of the mapping review noted adolescents post-TBI are likely to: (1) question their identity considering dissonance between the current self and their pre-injury self; and (2) seek to establish new, adaptive meanings and identities. All studies drew conclusions regarding identity and participation of adolescents post-TBI. Results provided insight into the importance of considering individualized rehabilitation interventions for adolescents, given their unique developmental path towards identity formation.
Collapse
Affiliation(s)
- Lisa Kakonge
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, Canada
| | - Victoria P Charron
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, Canada
| | - Janelle Vedder
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, Canada
| | - Kendra Wormald
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, Canada
| | - Lyn S Turkstra
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, Canada
| |
Collapse
|
13
|
Abstract
Abstract
Background and Aims:
Engagement is increasingly recognised as important for maximising rehabilitation outcome following stroke. However, engagement can be challenging when neurological impairment impacts a persons’ ability to activate the regulatory processes necessary for engagement and in the context of a changed self. We explored engagement in stroke rehabilitation from the perspective of people with stroke with a primary focus on identifying key processes that appeared important to engagement in stroke rehabilitation.
Design and Methods:
This study drew on Interpretive Description methodology. Maximum variation and theoretical sampling were used to capture diversity in the sample and access a depth and breadth of perspectives. Data collection included semi-structured interviews with people with stroke (n = 19). Data were analysed through a collaborative and iterative process drawing on range of analytical tools including coding, memoing, diagramming and group discussions.
Findings:
Our findings highlight that engagement is a complex, nuanced, responsive, flexible and inherently two-way process. Developing connections appeared central to engagement with connections taking various forms. The most fundamental was the therapeutic connection between the person with stroke and their practitioner as it provided the foundation on which to build other connections. Connection was made possible through five collaborative processes: Knowing, Entrusting, Adapting, Investing and Reciprocating.
Conclusions:
Engagement is a social and relational process enabled through an inherently person-centred approach and active and ongoing reflexivity – highlighting the importance of a humanising approach to care where aspects of self, care and emotion are evident, for both the person with stroke and their practitioner.
Collapse
|
14
|
Rodríguez-Bailón M, López-González L, Merchán-Baeza JA. Client-centred practice in occupational therapy after stroke: A systematic review. Scand J Occup Ther 2020; 29:89-103. [PMID: 33353470 DOI: 10.1080/11038128.2020.1856181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Client-centred practice aims to involve the person in making decisions during the therapeutic intervention process, giving him or her a central and active role.Objectives: To analyze the effects of client-centred practice in occupational therapy on issues related to occupational performance and participation among people with stroke and traumatic brain injury.Material and methods: A systematic review of randomized clinical trials examining the effects of a client-centred practice carried out by occupational therapists in patients with stroke or traumatic brain injury aged over 18 years was conducted. PubMed, Web of Science, Scopus, OT Seeker, PsycINFO and EBSCO were used to retrieve potentially eligible publications.Results: Eight studies, from 294 identified, were included. The extracted data showed that the application of client-centred practice in occupational therapy improved satisfaction with occupational performance compared to conventional interventions. However, client-centred practice and conventional intervention had similar effects on functionality (Activities of Daily Living), life satisfaction and burden on caregivers.Conclusions and significance: Client-centred practice has the effect of achieving greater satisfaction with occupational performance. This suggests that client-centred practice in occupational therapy helps patients to accept the new limitations on their occupational performance. Further studies are needed to determine the effects of client-centred practice on other aspects.
Collapse
Affiliation(s)
| | | | - Jose Antonio Merchán-Baeza
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, University of Vic - Central University of Catalonia (UVIC-UCC), Vic, Spain
| |
Collapse
|
15
|
Martiniello N, Haririsanati L, Wittich W. Enablers and barriers encountered by working-age and older adults with vision impairment who pursue braille training. Disabil Rehabil 2020; 44:2347-2362. [PMID: 33053313 DOI: 10.1080/09638288.2020.1833253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE We explored the experiences of working-age and older adults with acquired vision impairment who pursued braille rehabilitation training, and the facilitators and barriers they encountered throughout this process. METHODS Semi-structured interviews of up to 90 min in length were conducted with 14 participants from across Canada who learned braille between the ages of 33 and 67 (Mdn = 46). Transcripts were analyzed by two researchers using interpretive phenomenological analysis. RESULTS A variety of personal, social and institutional factors characterize the adult braille learning experience. Among these, participants highlight the role of prior identity and experience, the impact of access to resources and the cost of materials and devices needed to maintain braille skills. Findings also emphasize invisible barriers, including the role of societal perceptions towards braille, the level of support provided by family and friends, and the influence of unconscious biases towards braille and aging held by both adult learners and those around them. CONCLUSIONS These findings provide important context to improve policies and practice in adult braille rehabilitation. As the prevalence of age-related vision impairment continues to increase, it will become imperative to understand the unique needs of working-age and older adults with acquired vision impairment who pursue braille.Implications for REHABILITATIONThis study is one of the first to explore the experiences of working-age and older adults with acquired visual impairment who pursue braille rehabilitation training.Rehabilitation professionals must take into account prior learning and reading experiences which may shape the braille learning process.Family members require greater access to resources and support during the training process.There is a significant need for public education to address societal misconceptions about braille and blindness that can lead to a reluctance to use braille.Interactions with other braille users foster more empowering definitions of braille that align with the social model understanding of disability.
Collapse
Affiliation(s)
- Natalina Martiniello
- School of Optometry, Université de Montréal, Montréal, Canada.,CRIR/Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS Centre-Ouest-de-l'Île-de-Montréal, Montréal, Canada
| | | | - Walter Wittich
- School of Optometry, Université de Montréal, Montréal, Canada.,CRIR/Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS Centre-Ouest-de-l'Île-de-Montréal, Montréal, Canada.,CRIR/Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, Canada
| |
Collapse
|
16
|
Engström Å, Jumisko E, Shahim P, Lehto N, Blennow K, Zetterberg H, Tegner Y. Losing the identity of a hockey player: the long-term effects of concussions. Concussion 2020; 5:CNC74. [PMID: 32509326 PMCID: PMC7270839 DOI: 10.2217/cnc-2019-0014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 03/27/2020] [Indexed: 11/21/2022] Open
Abstract
AIM To describe what suffering multiple concussions meant for former semi-professional or professional hockey players who were forced to end their career. RESULTS Nine former Swedish hockey players, who once played on national or professional teams were interviewed. The interviews were analyzed with reference to hermeneutic phenomenology to interpret and explain their experiences. The theme of losing one's identity as a hockey player was constructed from five subthemes: being limited in everyday life, returning to the hockey stadium as soon as possible, forming a post career identity, lacking understanding and support, and preventing injuries by respecting other players. CONCLUSION The former hockey players struggled with developing their off-the-ice identities and with finding other sources of meaning for their lives.
Collapse
Affiliation(s)
- Åsa Engström
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Eija Jumisko
- Development Manager, Lapland University of Applied Sciences, Rovaniemi, Finland
| | - Pashtun Shahim
- Clinical Neurochemistry Laboratory, Institute of Neuroscience & Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Niklas Lehto
- Division of Medical Sciences, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Kaj Blennow
- Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg & Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg & Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square & UK Dementia Research Institute at UCL, London, UK
| | - Yelverton Tegner
- Division of Medical Sciences, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| |
Collapse
|
17
|
Villa D, Causer H, Riley GA. Experiences that challenge self-identity following traumatic brain injury: a meta-synthesis of qualitative research. Disabil Rehabil 2020; 43:3298-3314. [DOI: 10.1080/09638288.2020.1743773] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Darrelle Villa
- School of Psychology, University of Worcester, Worcester, UK
| | - Hilary Causer
- School of Psychology, University of Worcester, Worcester, UK
| | - Gerard A. Riley
- School of Psychology, University of Birmingham, Birmingham, UK
| |
Collapse
|
18
|
A Qualitative Study on the Transition Support Needs of Indigenous Australians Following Traumatic Brain Injury. BRAIN IMPAIR 2019. [DOI: 10.1017/brimp.2019.24] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjective:A growing body of qualitative literature globally describes post-hospital experiences during early recovery from a traumatic brain injury. For Indigenous Australians, however, little published information is available. This study aimed to understand the lived experiences of Indigenous Australians during the 6 months post-discharge, identify the help and supports accessed during transition and understand the gaps in service provision or difficulties experienced.Methods and Procedure:Semi-structured interviews were conducted at 6 months after hospital discharge to gain an understanding of the needs and lived experiences of 11 Aboriginal and Torres Strait Islander Australians who had suffered traumatic brain injury in Queensland and Northern Territory, Australia. Data were analysed using thematic analysis.Results:Five major themes were identified within the data. These were labelled ‘hospital experiences’, ‘engaging with medical and community-based supports’, ‘health and wellbeing impacts from the injury’, ‘everyday living’ and ‘family adjustments post-injury’.Conclusions:While some of the transition experiences for Indigenous Australians were similar to those found in other populations, the transition period for Indigenous Australians is influenced by additional factors in hospital and during their recovery process. Lack of meaningful interaction with treating clinicians in hospital, challenges managing direct contact with multiple service providers and the injury-related psychological impacts are some of the factors that could prevent Indigenous Australians from receiving the supports they require to achieve their best possible health outcomes in the long term. A holistic approach to care, with an individualised, coordinated transition support, may reduce the risks for re-admission with further head injuries.
Collapse
|
19
|
Re-engaging with places: Understanding bio-geo-graphical disruption and flow in adult brain injury survivors. Soc Sci Med 2019; 231:22-30. [DOI: 10.1016/j.socscimed.2018.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 04/09/2018] [Accepted: 05/03/2018] [Indexed: 11/23/2022]
|
20
|
Large R, Samuel V, Morris R. A changed reality: Experience of an acceptance and commitment therapy (ACT) group after stroke. Neuropsychol Rehabil 2019; 30:1477-1496. [PMID: 30924741 DOI: 10.1080/09602011.2019.1589531] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Copious research on the utility of Acceptance and Commitment Therapy (ACT) in long-term conditions has demonstrated promising results. However, little research has been conducted on ACT within stroke, particularly studies that are qualitative in nature. The aim of this paper was to gain insight into stroke survivors' experiences of ACT and to explore what processes help facilitate adjustment in living with residual disability. Interviews with thirteen stroke survivors following their attendance at a stroke-adapted ACT group were analysed using a grounded theory approach. Stroke survivors varied in age, severity of stroke, limitations and duration since stroke. Interviews revealed a main difficulty of "accepting a changed reality" following stroke. Survivors' narratives regarding their experiences of ACT revealed insight into which processes helped facilitate movement towards accepting symptoms and a changed reality and into helpful and less helpful aspects of the intervention. Stroke survivors find ACT helpful in adjusting to stroke limitations. ACT appears to have potential as a psychological intervention for stroke survivors experiencing psychological distress. Amendments to the format of the intervention to enhance the impact of ACT impact are identified.
Collapse
Affiliation(s)
- Rebecca Large
- Psychology Department, Cardiff University, Cardiff, UK
| | | | - Reg Morris
- Psychology Department, Cardiff University, Cardiff, UK
| |
Collapse
|
21
|
van Ierssel J, Sveistrup H, Marshall S. Identifying the concepts contained within health-related quality of life outcome measures in concussion research using the International Classification of Functioning, Disability, and Health as a reference: a systematic review. Qual Life Res 2018; 27:3071-3086. [PMID: 30030674 DOI: 10.1007/s11136-018-1939-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2018] [Indexed: 01/01/2023]
Abstract
PURPOSE To identify the concepts contained within health-related quality of life (HRQOL) outcome measures used in concussion-specific research using the International Classification of Functioning, Disability, and Health (ICF) as a reference. METHODS Eight electronic databases were searched from January 1, 1992 to March 12, 2017. Gray literature was searched, reference lists scanned, and relevant journals hand-searched. Agreement for inclusion was reached by consensus by two reviewers. A standardized data extraction tool was used to document study design, population, and key findings. Questionnaire items were linked as concepts to the corresponding second-level category of the ICF. Quality of studies was not assessed, as review was exploratory. RESULTS Five outcome measures met the inclusion criteria, including the Perceived Quality of Life Scale, EuroQoL-5 dimensions, Quality of Life after Brain Injury, WHOQOL-100, and WHOQOL-BREF. A total of 373 concepts were extracted. 34 questions were linked to activities and participation (50.7%), 16 questions (23.9%) referred to body functions, and 17 questions (25.4%) were related to the environment. CONCLUSIONS The wide range of concepts covered by different outcome measures demonstrates the complexity of recovery post-concussion and a lack of universal agreement in terms of what should be measured in this population. A working conceptual model of HRQOL post-concussion is proposed. Registration Prospero #CRD42017068241 (June 15, 2017).
Collapse
Affiliation(s)
- Jacquie van Ierssel
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
- School of Rehabilitation Sciences, Faculty of Health Sciences, 200 Lees Avenue (A-122), Ottawa, ON, K1N6N5, Canada.
| | - Heidi Sveistrup
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Shawn Marshall
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
22
|
Roddy C, Rickard N, Tamplin J, Lee YEC, Baker FA. Exploring self-concept, wellbeing and distress in therapeutic songwriting participants following acquired brain injury: A case series analysis. Neuropsychol Rehabil 2018; 30:166-186. [PMID: 29560784 DOI: 10.1080/09602011.2018.1448288] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Acquired brain injury (ABI) presents a significant threat to sense of self and necessitates a complex process of psychosocial adjustment. Self-concept changes remain understudied in the early stages of inpatient rehabilitation. The aim of the current study was to examine changes in self-concept, distress, wellbeing and functional skills for five inpatients undertaking a music therapy intervention within a subacute rehabilitation centre in Victoria, Australia. Participants completed a six-week, 12-session therapeutic songwriting programme to produce past-, current- and future-self-focused songs. A range of self-concept, subjective wellbeing and distress measures were completed pre-, mid- and post-intervention. A descriptive case series approach was applied to determine trends in pre-post scores for five individual cases. Participants showing the greatest gains across self-concept and subjective wellbeing indices also showed the greatest functional gains on the Functional Independence Measure (FIM) from admission to discharge. The current study highlights the importance of examining early changes in self-concept, wellbeing and distress in subacute rehabilitation, and suggests that individualised songwriting programmes warrant further research attention in neurological populations.
Collapse
Affiliation(s)
- Chantal Roddy
- School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Nikki Rickard
- School of Psychological Sciences, Monash University, Clayton, VIC, Australia.,Graduate School of Education, University of Melbourne, Carlton, VIC, Australia
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, The University of Melbourne, Southbank, VIC, Australia.,Royal Talbot Rehabilitation Centre, Austin Health, Melbourne, VIC, Australia
| | - Young-Eun C Lee
- Faculty of Fine Arts and Music, The University of Melbourne, Southbank, VIC, Australia
| | - Felicity Anne Baker
- Faculty of Fine Arts and Music, The University of Melbourne, Southbank, VIC, Australia
| |
Collapse
|
23
|
Living Life After Traumatic Brain Injury: Phase 1 of a Longitudinal Qualitative Study. J Head Trauma Rehabil 2018; 33:E44-E52. [DOI: 10.1097/htr.0000000000000321] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
24
|
Fadyl JK, Theadom A, Channon A, McPherson KM. Recovery and adaptation after traumatic brain injury in New Zealand: Longitudinal qualitative findings over the first two years. Neuropsychol Rehabil 2017; 29:1095-1112. [DOI: 10.1080/09602011.2017.1364653] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Joanna K. Fadyl
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Alice Theadom
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Alexis Channon
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Kathryn M. McPherson
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
- Health Research Council of New Zealand, Auckland, New Zealand
| |
Collapse
|
25
|
D’Cruz K, Douglas J, Serry T. Personal narrative approaches in rehabilitation following traumatic brain injury: A synthesis of qualitative research. Neuropsychol Rehabil 2017; 29:985-1004. [DOI: 10.1080/09602011.2017.1361844] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kate D’Cruz
- Department of Community and Clinical Allied Health, La Trobe University, Melbourne, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia
| | - Jacinta Douglas
- Department of Community and Clinical Allied Health, La Trobe University, Melbourne, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia
- Summer Foundation, Melbourne, Australia
| | - Tanya Serry
- Department of Community and Clinical Allied Health, La Trobe University, Melbourne, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia
| |
Collapse
|
26
|
Prescott S, Fleming J, Doig E. Rehabilitation goal setting with community dwelling adults with acquired brain injury: a theoretical framework derived from clinicians’ reflections on practice. Disabil Rehabil 2017; 40:2388-2399. [DOI: 10.1080/09638288.2017.1336644] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sarah Prescott
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Occupational Therapy Department, Princess Alexandra Hospital and the Centre for Functioning and Health Research, Metro South Health District, Queensland Health, Brisbane, Australia
| | - Emmah Doig
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| |
Collapse
|
27
|
Gelech J, Bayly M, Desjardins M. Constructing robust selves after brain injury: positive identity work among members of a female self-help group. Neuropsychol Rehabil 2017; 29:456-476. [PMID: 28393594 DOI: 10.1080/09602011.2017.1308872] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Despite common experiences of identity damage, decline, and deterioration, many brain injury survivors succeed in reconstructing robust identities in the wake of injury. Yet, while this accomplishment greatly benefits survivors' quality of life, little is known about how positive identity work might be facilitated or enhanced in therapeutic institutions. Drawing on data from a women's self-help group, we argue that an egalitarian, reflective, strength-focused, and gender-segregated environment can provide female ABI (acquired brain injury) survivors with a fertile scene for identity enhancement and offer unique opportunities for collective identity development. Sociolinguistic interactional analysis revealed four types of positive identity work undertaken within the group: constructing competent selves; tempering the threat of loss and impairment; resisting infantilisation and delegitimisation; and asserting a collective gender identity. This identity work was facilitated by specific programme attributes and activities and contributed to the global project of decentring disability and destigmatising impairments and losses. We call for increased attention to identity issues in brain injury rehabilitation and argue that gender-segregated programming can provide a unique space for female survivors to construct empowering individual and collective identities after injury.
Collapse
Affiliation(s)
- Jan Gelech
- a Department of Psychology , University of Saskatchewan , Saskatoon , Canada
| | - Melanie Bayly
- a Department of Psychology , University of Saskatchewan , Saskatoon , Canada
| | - Michel Desjardins
- a Department of Psychology , University of Saskatchewan , Saskatoon , Canada
| |
Collapse
|
28
|
Goldberg G. Toward a Postmodern Pragmatic Discourse Semioethics for Brain Injury Care: Empirically Driven Group Inquiry as a Dialogical Practice in Pursuit of the Peircean Aesthetic Ideal of 'Reasonableness'. Phys Med Rehabil Clin N Am 2017; 28:393-411. [PMID: 28390521 DOI: 10.1016/j.pmr.2016.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A postmodern framework is proposed for conceptualizing the impact of brain injury on the subjective being of the injured person. Semiosis, the 'action of signs,' is argued as necessary for this recovery of subjectivity that escapes the mechanistic materialism and mind-matter dualism of modern science. Ethical dilemmas in brain injury care are best approached through an empirical 'semioethics' implemented as a dialogical practice among a group of selected stakeholders seeking a logical solution that best addresses the criterion of maximizing reasonableness as a tempering of rationality with relational concerns in the face of the constraints imposed by the injury.
Collapse
Affiliation(s)
- Gary Goldberg
- Hunter Holmes McGuire VA Medical Center, Physical Medicine and Rehabilitation Service (117A), 1201 Broad Rock Boulevard, Richmond, VA 23249, USA.
| |
Collapse
|
29
|
Lapadatu I, Morris R. The relationship between stroke survivors' perceived identity and mood, self-esteem and quality of life. Neuropsychol Rehabil 2017; 29:199-213. [PMID: 28075218 DOI: 10.1080/09602011.2016.1272468] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To examine change in identity after stroke and to elucidate its relationship with mood and quality of life. To test Higgins' theory of the impact of identity (self-discrepancy) on anxiety and depression. To examine the role of self-esteem in mediating the relationship between identity and outcomes. METHOD Sixty-five community-living first-time stroke survivors, mean age 61.58 and time since stroke 5.60 years, were recruited from stroke charities. A cross-sectional study used the Head Injury Semantic Differential Scale, the Hospital Anxiety and Depression Scale, the Rosenberg Self-Esteem Scale, the Stroke-Specific Quality of Life Questionnaire (adapted) and the Barthel Index. RESULTS Identity was rated more negatively after stroke than before (t(64) = 6.46, p < .00). Greater discrepancy in identity was associated with anxiety (r = .38, p < .00), depression (r = .59, p < .00), self-esteem (r = -.48, p < .00) and quality of life (r = -.54, p < .00). Overall positivity of identity after stroke predicted outcomes even better than discrepancy. The association between discrepancy and mood and quality of life was mediated by self-esteem (β = .30, p < .01; β = -.24, p < .01, respectively). Specific types of discrepancy defined by Higgins did not show differential relationships with anxiety and depression as predicted. CONCLUSIONS Identity changes after stroke and identity and self-esteem are associated with important outcomes for stroke survivors.
Collapse
Affiliation(s)
- Irina Lapadatu
- a Clinical Psychology, School of Psychology , Cardiff University , Cardiff , UK.,b Cardiff and Vale University Health Board , Cardiff , UK
| | - Reg Morris
- a Clinical Psychology, School of Psychology , Cardiff University , Cardiff , UK.,b Cardiff and Vale University Health Board , Cardiff , UK
| |
Collapse
|
30
|
Snell DL, Martin R, Surgenor LJ, Siegert RJ, Hay-Smith EJC. What’s wrong with me? seeking a coherent understanding of recovery after mild traumatic brain injury. Disabil Rehabil 2016; 39:1968-1975. [DOI: 10.1080/09638288.2016.1213895] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Deborah L. Snell
- Concussion Clinic, Burwood Hospital, Christchurch, New Zealand
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Rachelle Martin
- Rehabilitation Teaching and Research Unit, University of Otago Wellington, Wellington, New Zealand
| | - Lois J. Surgenor
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Richard J. Siegert
- Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand
| | - E. Jean C. Hay-Smith
- Rehabilitation Teaching and Research Unit, University of Otago Wellington, Wellington, New Zealand
| |
Collapse
|
31
|
Knox L, Douglas JM, Bigby C. “I’ve never been a yes person”: Decision-making participation and self-conceptualization after severe traumatic brain injury. Disabil Rehabil 2016; 39:2250-2260. [DOI: 10.1080/09638288.2016.1219925] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Lucy Knox
- Living with Disability Research Center, La Trobe University, Victoria, Australia
- Summer Foundation, Victoria, Australia
| | - Jacinta M. Douglas
- Living with Disability Research Center, La Trobe University, Victoria, Australia
- Summer Foundation, Victoria, Australia
| | - Christine Bigby
- Living with Disability Research Center, La Trobe University, Victoria, Australia
| |
Collapse
|
32
|
Jesus TS, Bright F, Kayes N, Cott CA. Person-centred rehabilitation: what exactly does it mean? Protocol for a scoping review with thematic analysis towards framing the concept and practice of person-centred rehabilitation. BMJ Open 2016; 6:e011959. [PMID: 27436670 PMCID: PMC4964252 DOI: 10.1136/bmjopen-2016-011959] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Person-centredness is a philosophy for organising and delivering healthcare based on patients' needs, preferences and experiences. Although widely endorsed, the concept suffers from a lack of detail and clarification, in turn accounting for ambiguous implementation and outcomes. While a conceptual framework based on a systematic review defines person/patient-centred care components (Scholl et al, 2014), it applies across healthcare contexts and may not be sensitive to the nuances of the rehabilitation of adults with physical impairments. Accordingly, this study aims to build a conceptual framework, based on existing literature, of what person-centredness means in the rehabilitation of adults with physical impairments in the clinical encounter and broader health service delivery. METHODS AND ANALYSIS We will use a scoping review methodology. Searches on relevant databases will be conducted first, combining keywords for 'rehabilitation', 'person-centered' and associated terms (including patient preferences/experiences). Next, snowball searches (citation tracking, references lists) will be performed. Papers will be included if they fall within predefined selection categories (seen as most likely informative on elements pertaining to person-centred rehabilitation) and are written in English, regardless of design (conceptual, qualitative, quantitative). Two reviewers will independently screen titles and abstracts, followed by screening of the full text to determine inclusion. Experts will then be consulted to identify relevant missing papers. This can include elements other than the peer-reviewed literature (eg, book chapters, policy/legal papers). Finally, information that helps to build the concept and practice of person-centred rehabilitation will be abstracted independently by two reviewers and analysed by inductive thematic analysis to build the conceptual framework. DISSEMINATION The resulting framework will aid clarification regarding person-centred rehabilitation, which in turn is expected to conceptually ground and inform its operationalisation (eg, measurement, implementation, improvement). Findings will be disseminated through local, national and international stakeholders, both at the clinical and service organisation levels.
Collapse
Affiliation(s)
- Tiago S Jesus
- Portuguese Ministry of Education. Aggregation of Schools of Escariz, Escariz, Portugal
| | - Felicity Bright
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Nicola Kayes
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Cheryl A Cott
- Faculty of Medicine, Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
33
|
|
34
|
Thomas EJ, Levack WMM, Taylor WJ. Self-Reflective Meaning Making in Troubled Times: Change in Self-Identity After Traumatic Brain Injury. QUALITATIVE HEALTH RESEARCH 2014; 24:1033-1047. [PMID: 25015780 DOI: 10.1177/1049732314542809] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Our aim with this article is to clarify the concept of change in self-identity following traumatic brain injury (TBI). We used concept analysis methodology-predominantly concept clarification. We identified 110 articles using a systematic literature search, and used critical appraisal, content analysis, and analytical questioning to explore attributes and boundaries. A reported change in self-identity is the ultimate expression of a variety of cognitive, psychological, and social sequelae of TBI. We present an integrative model of this process, identifying three potential levels of change: (a) component parts (egocentric self, sociocentric self, and "identity as shared with others"); (b) integral processes (self-awareness and expression via meaningful occupation and narratives); and (c) whole-system disruption. Change in self-identity after TBI is a highly individualistic process. The driver of this process is "self-reflective meaning making," giving a purpose and direction in life, providing motivation and goals for future behavior.
Collapse
|