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Title: Investigating the family in Traumatic Brain Injury (TBI)
Author: Nelson, Hannah
Awarding Body: University of Liverpool
Current Institution: University of Liverpool
Date of Award: 2013
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Traumatic brain injury (TBI) belongs to a classification of injury called Acquired Brain Injury (ABI). ABIs are brain injuries that have occurred since birth with possible causes including stroke, haemorrhage and infection (Powell, 2004). TBIs are a result of insults to the brain from external forces. TBI can lead to altered states 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 affect individuals in the same way, with survivors presenting with a wide range of impairments which family members must adapt to (Newby & Groom, 2010) . This thesis will focus on TBI as a distinct sub-group. Literature referring to TBI will primarily be used. The empirical 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 TBI have significant psychological consequences 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 there is still much to learn about family functioning post injury, and equally how research can advance understanding of the best interventions to aid family members (Oddy & Herbert, 2008). This thesis will be divided into three sections and each will have a specific focus. The overarching theme will be considering 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 between 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 family members. The review addressed two research questions: • What are the 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 and 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. The study aimed to address some of the considerations for future research in the narrative 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 psychological 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 terms of understanding the family’s response (Perlesz, Kinsella & Crowe, 1999). The rationale for the study is outlined before the methodology is delineated. An epistemological position of constructivism was used to try and investigate a number of aims centring on how family members make 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 alongside strengths and limitations of the study.
Supervisor: James, Williams; Wall, Gemma; Mullin, Stephen Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry