Investigating the family in Traumatic Brain Injury (TBI)

Nelson, Hannah
Investigating the family in Traumatic Brain Injury (TBI). Doctor of Philosophy thesis, University of Liverpool.

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1:1 Introduction T he research thesis will be outlined to provide a summary of the structure and underlying themes. Un like the two research papers , this introduction is not intended for publication. R eferencing for this section and the concluding section will be in American Psychological Association (APA) format , 6 th e dition . A summary of the subject area will now be provided followed by a breakdown of the thesis sections . Traumat ic brain injury (TBI) belongs to a classification of injury called Acquired Brain Inju ry (ABI). ABIs are brain injuries that have occurred since birth with possible causes including st roke, haemorrhage and infection (Powell, 2004) . TBIs are a result of insults to the brain from external forces. TBI can lead to altered state s of consciousness along with impairment of cognitive, physical, and psychosocial functions (Dawodu, 2011). The current research base has often recruited people with a variety of ABIs . This has been a criticism of the literature as ABIs do not aff ect indi viduals in the same way , with survivors presenting with a wide range of impairments which family members must adapt to (Newby & Groom, 2010) . T his thesis will focus on TBI as a distinct sub - group. Literature referring to TBI will primarily be used. The em pirical study will recruit family members of those specifically with a TBI. The narrative review will review papers primarily derived from TBI literature alongside those that explicitly refer to TBI . Both ABI and TB I have significant psychological consequen ces for the individual and the wider family system ( Panting & Merry, 1972; Lezak, 1986; Carnes & Quinn, 2005; Holm, Schönberger, Poulsen, Caetano , 2009 ; Braine, 2011 ). Research focused on the family in ABI /TBI has advanced in recent years , yet th ere is still much to learn about family functioning post injury , and e qually how research can advance understanding of the best interventions to aid family members (Oddy & Herbert, 200 8 ). This thesis will be divided into three sections and each will have a specific focus. The over arching theme will be consider ing how research and practice in TBI can be understood as a social phenomenon. Bowen, Yeates and Palmer (2010 , p . 304 ) discuss that there is a need to see “ brain - 2 - injury as existing within the spaces b etween people” . A focus on systemic thinking in conceptualising brain injury will first be applied to a narrative review. Section 2: Adult Traumatic Brain Injury (TBI): A narrative review of family therapy as a conceptual model in research with famil y members . This paper is format ted for submission to The Journal of Head Trauma Rehabilitation . R eferencing is in the style of the American Medical Association Manual (AMA). A narrative review enables the collection and summarising of a large volume of literature in a subject area. A narrative method was preferred to a systematic review due to the paucity of empirical studies within this area . T o ensure transparency in identifying papers a systematic review method of searching was selected . T he rationale for the review centred on the relative lack of studies within the TBI and family literature which use underpinning epistemologies or conceptual frameworks to support their inquiries. The review addressed two research questions: • What are th e essential attributes of the model of family therapy when applied to TBI? • How could this model be applied as a conceptual framework in TBI research? The findings will propose that , family therapy could provide a conceptual framework to guide research an d give it greater coherence. A guiding conceptual framework is presented which is then discussed in relation to its implications for research and practice. Section 3: Sense - making through observation and action: A grounded theory study investigating how family members of traumatic brain injury (TBI) patients construct an understanding of injury Following on from the narrative review will be a grounded theory empirical study. The paper is format ted for submission to ‘ Brain Injury ’ . The referencing is Co uncil of Science Editors (CSE) format . The study aim ed to address some of the considerations for future research in the narrati ve review , primarily that there is a greater need “ to have an appreciation of the family as more than a collection of individuals living together in the same physical or psychologica l place” (Leaf, 1993 , p.- 3 - 543 ). Additionally , that current theory is stronger in terms of understanding the consequences of brain injury but relatively lacking in t erms of understanding the fa mil y’s response (Perlesz, Kinsella & Crowe, 1999). The rationale for the study is outlined before the methodology is delineated . An epistemological position of constructivism wa s used to try and investigate a number of aims centring on how family members m ake sense of TBI. The paper will present a model of sense - making that developed from a grounded theory design as set out by Strauss and Corbin (1998). The empirical paper will discuss the findings in terms of their implications for practice and research a longside strengths and limitations of the study. Section 4: Concluding section – Subsections 4:1, 4:2, 4:3. The concluding section will use the APA style. This sectio n is aimed at expanding upon the research papers and providing a more in - depth exploration of the work. It will be split into three sections : 4:2 : Extended discussion The first section will provide a general overview of the empirical study and the narrative review. The methodological considerations of both of these papers will be discussed in relation to process issues, strengths and limitations. There will also be an expanded discussion on the papers ’ relevance for theory, research, and pr actice. 4:3 : Lay summary It is well understood that academic work should be widely shared to be most beneficial . I t needs to be determined how non - specialists can access the work (Rowan, Gale, Whaley & Tovar , 2005). A short lay summary of the empirical research will be provide d that could be used for wider dissemination of the research. This summary is intended for publication in the charity Headwa ys ’ newsletter. - 4 - 4:4 : Research proposal : Dynamic influences in sense - making processes within families of Traumatic Brain Injury (TBI) survivors The research proposal will outline the general background and rationale for the study. The aim will be to address some of the criticisms of the empiric al paper. The main critical point to address will be the empirical paper ’ s focus on individual sense - making as opposed to collaborative sense - making . The methodology of analytic induction ( Znaniecki , 1934) will allow hypotheses from the empirical study t o be investigated. The research questions will be : - How do families interactively make sense of TBI ? - What specific interactional behaviours contribute to the interpretation process? The proposal will outline the hypotheses, methodology , ethical issues a nd the manner of data analys is . This concludes the thesis overview and the sections described will now be presented in order.

Item Type: Thesis (Doctor of Philosophy)
Additional Information: Date: 2013-06 (completed)
Uncontrolled Keywords: Traumatic brain injury, Family, Systems, Grounded theory
Subjects: ?? RC0321 ??
Divisions: Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 19 Feb 2014 11:34
Last Modified: 16 Dec 2022 04:40
DOI: 10.17638/00013935
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