Sleep following traumatic brain injury (TBI): experiences and influencing factors

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

“…Our review also identified 2 subthemes surrounding individual-level facilitators of resilience reported by individuals with TBI, (a) behavioral strategies, and (b) psychological strategies. They described behavioral strategies such as seeking TBI-related information on common symptoms, prognosis, and strategies to promote positive recovery, as well as working to develop new strategies (e.g., breaking down tasks into steps, allowing more time to complete tasks, keeping a memory notebook, and reducing stimuli) to minimize the impact of TBI symptoms (Mumbower et al, 2019; Nalder et al, 2013; Nochi, 2000; Soeker & Pape, 2019). Individuals with TBI also utilized psychological coping strategies that helped them manage emotional distress and promote balanced thinking.…”

“…Individuals with TBI also utilized psychological coping strategies that helped them manage emotional distress and promote balanced thinking. These strategies included adopting a present moment focus and cultivating mindful awareness of daily activities (Douglas, 2013; Kruithof et al, 2018), as well as a number of strategies to promote positive mood (e.g., cultivating gratitude and optimism) (Mumbower et al, 2019; Nalder et al, 2013) and a positive framing of their current challenges and identity (e.g., focusing on values, cultivating acceptance, adopting a growth mindset) (McPherson et al, 2018; Salas et al, 2018). For example, participants described viewing the TBI as a “new beginning” linked to a renewed desire to pursue goals as well as a chance to modify their health behaviors (e.g., sleep, exercise, substance use) to optimize recovery.…”

“…Perceptions of being treated differently were commonly reported by individuals with TBI, particularly being underestimated or ignored by family, friends, and coworkers (Soeker & Pape, 2019). Individuals with TBI also described a fear of burdening others, which led to their withdrawal from social activities and increased loneliness and social isolation (Mumbower et al, 2019). Over time, they noticed that people in their lives were less invested in their relationship (McPherson et al, 2018) and had negative reactions to the symptoms they experienced after TBI (e.g., irritability, memory deficits, physical impairments) (McPherson et al, 2018; Stenberg et al, 2020).…”

“…In addition, the availability of continued support from heathcare providers and health care settings were viewed as a crucial resource to promote resilience (Fadyl et al, 2017; Hux et al, 2010). Specifically, persons with TBI benefited from ongoing rehabilitation support and providers’ willingness to educate informal caregivers on appropriate ways of helping promote recovery after their injury (Fadyl et al, 2017; Mumbower et al, 2019). In recognition of the many financial and employment-related barriers that individuals with TBI experienced, they noted the benefits of programs that aided individuals’ resuming employment, either through specialized training (e.g., coworker models, therapist shadowing) or vocational training to find positions suitable for their current skill level (Muenchberger et al, 2008; Oppermann, 2004; Soeker et al, 2012; Stenberg et al, 2020).…”

“…Participants across studies also underscored the benefits of volunteering to add structure to their day, promote positive self-esteem and gratitude, and allow them to maintain a sense of purpose (Jones & Curtin, 2011; Jumisko et al, 2009). Finally, aspects of individuals’ community and environment also promoted resilience, including living in an environment that was accessible given their current abilities (e.g., the availability of sidewalks, public transportation, and ride services) (Jumisko et al, 2009) and having access to information, programs, and activities that promoted their engagement in healthy lifestyle behaviors, routines, and social connections (Godwin et al, 2014; Mumbower et al, 2019; Soeker & Pape, 2019; Soeker, 2015). Examples described by participants included meal preparation programs that accounted for their current abilities, brain injury support groups, and ongoing wellness activities (e.g., yoga, meditation, walking) (Soeker & Pape, 2019).…”