Experiences that challenge self-identity following traumatic brain injury: a meta-synthesis of qualitative research

Abstract

Experiences that challenge self-identity following traumatic brain injury: a meta-synthesis of qualitative research. Disability and Rehabilitation.

A meta-synthesis of individual, interpersonal, and systemic factors impacting resilience after traumatic brain injury.

“…They further described behavioral and psychological coping strategies that mitigated the impact of TBI symptoms and promoted resilience in connection to their life roles and responsibilities. These findings are consistent with prior quantitative and qualitative systematic reviews (Dijkers, 2004;Holland & Schmidt, 2015;Levack et al, 2010;Villa et al, 2020), and suggest that TBI survivors would benefit from interventions that offer education on TBI symptoms and expected challenges, as well as resources and skills to target cognitive, emotional, and identity-related challenges. Consistent with Social Ecological Models describing TBI and other chronic health concerns (e.g., chronic pain; [Bannon et al, 2020;Meints et al, 2019;Nalder et al, 2019]); clinicians should use therapeutic communication techniques (e.g., empathic responding) to guide expectations surrounding patients' engagement in medical treatment and promote shared decision making.…”

“…Social Ecological models characterize the ways in which individual, interpersonal, and systemic factors dynamically influence physical and mental health over time (Partelow, 2018). Such approaches can be useful for explaining the myriad factors that serve as barriers (i.e., inhibiting factors) and facilitators (i.e., enhancing factors) to resilience after TBI (Atallah et al, 2021; Brodsky & Cattaneo, 2013; Levack et al, 2010; Nalder et al, 2019; Villa et al, 2020). Indeed, there is some quantitative evidence that resilience after TBI is impacted by individual (e.g., healthy lifestyle behaviors, personal outlook), interpersonal (e.g., family functioning, social support), and systemic (e.g., available rehabilitation resources, financial stability) factors (Braaf et al, 2020; Holland & Schmidt, 2015; Lefkovits et al, 2020; Levack et al, 2010).…”

Understanding Loneliness in Brain Injury: Linking the Reaffiliation Motive Model of Loneliness With a Model of Executive Impairment

“…It is well-known that brain injury, and its visible and non-visible sequelae, are poorly understood by people in the community (Code et al, 2016 ). This is often reported by survivors in experiences of feeling different from their previous self (Villa et al, 2021 ), misunderstood (Salas et al, 2018 ) or abnormal (Prigatano, 1999 ). There is also an emerging literature stressing how negative interactions can be internalized by survivors, leading survivors to conceal information about the injury to others (Hagger and Riley, 2017 ).…”

Neuroethics across the Disorders of Consciousness Care Continuum

“…It typically occasions unexpected, sudden, and dramatic diminution in core features of human identity, raising ethically fraught questions about life, death, and suffering. 67 68 69 70 71 Unlike other neurological conditions that emerge gradually and allow patients and families to prepare for signs and symptoms of disease, severe acute brain injury is abrupt, strikes without warning, and is immediately disabling. Ethical challenges in the hyperacute phase of DoC—in the moments immediately following injury until hospital arrival—often hinge on the sudden and unexpected nature of the medical condition.…”