The experience of families following Traumatic Brain Injury in adult populations: A meta-synthesis of narrative structures.

Journal article


Whiffin, Charlotte Jane, Gracey, Fergus and Ellis-Hill, Caroline 2021. The experience of families following Traumatic Brain Injury in adult populations: A meta-synthesis of narrative structures. International Journal of Nursing Studies. https://doi.org/10.1016/j.ijnurstu.2021.104043
AuthorsWhiffin, Charlotte Jane, Gracey, Fergus and Ellis-Hill, Caroline
Abstract

Traumatic brain injury has a significant effect on uninjured family members. Typically, this has been examined with a focus on psychopathological outcomes including stress, depression and anxiety. However, in recent years there has been increasing interest in the subjective experiences of families post-injury leading to a plethora of qualitative studies. Therefore, an in-depth examination and synthesis of this literature is now relevant and timely. To examine the subjective experiences of families following traumatic brain injury in adult populations in the sub/post-acute period through the synthesis of original qualitative research. This paper presents a meta-synthesis using Thomas and Harden’s framework of ‘thematic synthesis’ rooted in a critical realist philosophy. In July 2019 five electronic databases, were searched for the terms ‘traumatic brain injury’, ‘family’ and ‘qualitative’ studies were included if the primary research reported qualitative data about the subjective experiences of family members of adults with traumatic brain injury and had been published in a peer reviewed journal. Studies with mixed brain injury samples, child or adolescent traumatic brain injury or disorders of consciousness were excluded. Hand searching and citation searches were also completed. Two reviewers screened titles, abstracts and full text and reached consensus through critical discussion. Thirty papers were finally agreed for inclusion in this review. Each study was then assessed for relevance, resonance and rigour using the Critical Appraisal Skills Programme (CASP) tool. Line by line coding of the findings in each paper was conducted as the basis for a thematic analysis and synthesis. Descriptive themes were identified followed later by analytical themes. This final stage was informed by a narrative lens and from these, eight narrative functions belonging to four dimensions were identified from the subjective experiences of families post-traumatic brain injury. Specifically, these were: (1) Displacing and Anchoring; (2) Rupturing and Stabilising; (3) Isolating and Connecting; (4) Harming and Healing. The interpretation of the narrative functions revealed the substantial existential work involved in negotiating lives, maintaining family system equilibrium and moving forward. As such, family members have their own unique narrative needs. Despite contemporary service models built around the injured person, service providers are well placed to support families in this everyday narrative work through actively attending to narrative structures and understanding the implications of these for family experience.

KeywordsHead injury; Traumatic brain injury; Family; Qualitative; Meta-synthesis; Narrative
Year2021
JournalInternational Journal of Nursing Studies
PublisherElsevier BV
ISSN0020-7489
Digital Object Identifier (DOI)https://doi.org/10.1016/j.ijnurstu.2021.104043
Web address (URL)http://hdl.handle.net/10545/625923
https://www.elsevier.com/tdm/userlicense/1.0/
http://creativecommons.org/publicdomain/zero/1.0/
hdl:10545/625923
Publication dates21 Jul 2021
Publication process dates
Deposited10 Aug 2021, 08:15
Accepted15 Jul 2021
Rights

CC0 1.0 Universal

ContributorsUniversity of Derby, University of East Anglia and Bournemouth University
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