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Beyond Broken Bodies and Brains: A Mixed Methods Study of Mental Health and Life Transitions After Brain Injury

Published online by Cambridge University Press:  20 July 2017

Chalotte Glintborg ,
Ane S. Thomsen  and
Tia G.B. Hansen
Chalotte Glintborg*
Affiliation:
Department of Communication and Psychology, Center for Developmental & Applied Psychological Science (CeDAPS), Aalborg University, Aalborg, Denmark
Ane S. Thomsen
Affiliation:
Department of Communication and Psychology, Center for Developmental & Applied Psychological Science (CeDAPS), Aalborg University, Aalborg, Denmark
Tia G.B. Hansen
Affiliation:
Department of Communication and Psychology, Center for Developmental & Applied Psychological Science (CeDAPS), Aalborg University, Aalborg, Denmark
*
*Address for correspondence: Chalotte Glintborg, Center for Developmental & Applied Psychological Science (CeDAPS), Aalborg University, Kroghstræde 3, 9220 Aalborg Ø, Denmark. E-mail: [email protected]
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Abstract

Purpose: Clients with an acquired brain injury (ABI) are at risk of mental health problems and it has been argued that transitions throughout the rehabilitation process are a challenge for rehabilitation practice; however, the link between transitions and psychosocial outcome has been under-researched. Therefore, this study aims to (1) investigate the status of clients with moderate or severe ABI two-year post-discharge on the following outcomes variables: Physical and cognitive function, depression, quality of life, civil and work status, (2) examine correlations between these outcomes and (3) explore through qualitative interviews the subjective experiences of individuals with ABI in order to increase our understanding of clients’ perspectives on this outcome and its relation to life transitions in a two-year period.

Method: 37 individuals aged 18–66 with moderate or severe ABI were interviewed two years after discharge. At this time, they also completed standard measures of depression (MDI), quality of life (WHOQOL-bref) and functional independence (FIM™). Historical data of their FIM™ status at discharge were obtained for comparison.

Results: We found psychological problems two years post-hospitalization, especially depression (35.1%) and decreased psychological QOL (61%). Analysis of interviews found six main factors perceived as important for psychosocial outcome: family relations, return to work, waiting lists, psychological support, fatigue and personal competences.

Conclusions: Clients’ status two years post-hospitalization is often characterized by psychological problems. Based on clients’ accounts, we found a connection between psychosocial outcome and life transition experiences and developed a model of factors that are perceived as helping and hindering positive outcome.

Keywords

Community re-entry/participationpsychiatric/mental health/thought processesmeasurement/psychometricoutcometraumatic brain injurystrokeotherrehabilitation psychology
Type
Articles
Information
Brain Impairment , Volume 19 , Issue 3 , December 2018 , pp. 215 - 227
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2017 

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References

APA, American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text revision (DSM-IV)). Washington, DC: American Psychiatric Association.Google Scholar
Bech, P., Licht, R.W., Stage, K.B., Abildgaard, W., Bech-Andersen, G., Søndergaard, S., & Martiny, K. (2005). Den blå bog – rating scales for affective lidelser. [The blue book – rating scales on affective disorders]. Hillerød, Denmark: Psykiatrisk Forskningsenhed, Psykiatrisk sygehus.Google Scholar
Bech, P., Rasmussen, N.-A., Olsen, L.R., Noerholm, V., & Abildgaard, W. (2001). The sensitivity and specificity of the major depression inventory, using the present state examination as the index of diagnostic validity. Journal of Affective Disorders, 66 (2–3), 159–164.Google Scholar
Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3 (2), 77–101.Google Scholar
Conneeley, A.L. (2012). Transitions and brain injury: A qualitative study exploring the journey of people with traumatic brain injury. Brain Impairment, 13 (1), 72–84.Google Scholar
Creswell, J.W., & Clark, V.L.P. (2011). Designing and conducting mixed methods research (2nd ed.). Thousand Oaks, CA: SAGE Publications.Google Scholar
Dahlberg, C.A., Cusick, C.P., Hawley, L.A., Newman, J.K., Morey, C.E., Harrison-Felix, C.L., & Whiteneck, G.G. (2007). Treatment efficacy of social communication skills training after traumatic brain injury: A randomized treatment and deferred treatment controlled trial. Archives of Physical Medicine and Rehabilitation, 88 (12), 1561–1573.Google Scholar
Ellervik, C., Kvetny, J., Christensen, K.S., Vestergaard, M., & Bech, P. (2014). Prevalence of depression, quality of life and antidepressant treatment in the Danish general suburban population study. Nordic Journal of Psychiatry, 68 (7), 507–512. doi: 10.3109/08039488.2013.877074.Google Scholar
Glintborg, C. (2016). Disabled & not normal. Identity construction of adults following an acquired brain injury. Narrative Inquiry, 25 (1), 1–22.Google Scholar
Greene, J.C., & Caracelli, V.J. (1997). Advances in mixed method evaluation: The challenges and benefits of integrating diverse paradigms. New Directions for Evaluation, 74, 5–17.Google Scholar
Gustafsson, L., & Turpin, M. (2012). Analysis of one stroke survivor's transition into vocational experiences, Brain Impairment, 13 (1), 99–107.Google Scholar
Hall, A., Grohn, B., Nalder, E., Worrall, L., & Fleming, J. (2012). A mixed methods study of the experience of transition to the community of working-aged people with non-traumatic brain injury, Brain Impairment, 13 (1), 85–98.Google Scholar
Hall, K.M., Mann, N., High, W.M., Kreutzer, J.S., & Wood, D. (1996). Functional measures after traumatic brain injury: Ceiling effects of FIM, FIM+FAM, DRS and CIQ. Journal of Head Trauma Rehabilitation, 11 (5), 27–39.Google Scholar
Hoogerdijk, B., Runge, U., & Haugboelle, J. (2011). The adaptation process after traumatic brain injury. An individual and ongoing occupational struggle to gain new identity. Scandinavian Journal of Occupational Therapy, 18 (2), 122–132.Google Scholar
Keith, R.A., Granger, C.V., Hamilton, B.B., & Sherwin, F.S. (1987). The functional independence measure: A new tool for rehabilitation. Advances in Clinical Rehabilitation, 1, 6–18.Google Scholar
Klinger, L. (2005). Occupational adaptation: Perspectives of people with traumatic brain injury. Journal of Occupational Science, 12 (1), 9–16.Google Scholar
Levack, W.M.M., Kayes, N.M., & Fadyl, J.K. (2010). Experience of recovery and outcome following traumatic brain injury: A meta-synthesis of qualitative research. Disability and Rehabilitation, 32 (12), 986–999.Google Scholar
Miles, M.B., Huberman, A.M., & Saldana, J. (2013). Qualitative data analysis: A methods sourcebook (3rd ed.). Thousand Oaks, CA: SAGE Publications.Google Scholar
Morton, M.V., & Wehman, P. (1995). Psychosocial and emotional sequelae of individuals with traumatic brain injury: A literature review and recommendations. Brain Injury, 9 (1), 81–92.Google Scholar
Nalder, E., Fleming, J., Cornwell, P., Shields, C., & Foster, F. (2013). Reflections on life: Experiences of individuals with brain injury during the transition from hospital to home, Brain Injury, 27 (11), 1294–1303, DOI: 10.3109/02699052.2013.823560Google Scholar
Nalder, E., Fleming, J., Foster, M., Cornwell, P., Shields, C., & Khan, A. (2012). Identifying factors associated with perceived success in the transition from hospital to home following brain injury. Journal of Head Trauma Rehabilitation, 27, 143– 153.Google Scholar
Nørholm, V., & Bech, P. (2001). The WHO Quality of Life (WHOQOL) Questionnaire: Danish validation study. Nordic Journal of Psychiatry, 55 (4), 229– 235.Google Scholar
Osborne, J. W. (2006). Bringing balance and technical accuracy to reporting odds ratios and the results of logistic regression analyses. Practical Assessment Research & Evaluation, 11, 1–6. http://pareonline.net/getvn.asp?v=11&n=7.Google Scholar
Parkes, C.M. (1971). Psycho-social transitions: A field for study. Social Science & Medicine, 5 (2), 101–115.Google Scholar
Prigatano, G.P. (1991). Disordered mind, wounded soul: The emerging role of psychotherapy in rehabilitation after brain injury. Journal of Head Trauma Rehabilitation, 6 (4), 1–10.Google Scholar
Prigatano, G.P. (1999). Principles of neuropsychological rehabilitation. New York: Oxford University Press.Google Scholar
Rumble, S. (2013). Transitioning in neurorehabilitation. In Noggle, C.A., Dean, R.S. & Barisa, M.T. (Eds.), Neuropsychological rehabilitation (pp. 291–301). New York: Springer.Google Scholar
Schlossberg, N.K. (1984). Counseling adults in transition: Linking practice with theory. New York: Springer.Google Scholar
Schlossberg, N.K., Waters, E.B., & Goodman, J. (1995). Counseling adults in transition: Linking practice with theory (2nd ed.). New York: Springer.Google Scholar
Teasdale, T. W., & Engberg, A. W. (2004). Psychosocial outcome following traumatic brain injury in adults: A long-term population-based follow up. Brain Injury, 18 (6), 535–545.Google Scholar
Teasdale, T.W., & Engberg, A.W. (2005). Psychosocial consequences of stroke: A long-term population-based follow-up. Brain Injury, 19 (12), 1049– 1058.Google Scholar
Turner, B., Fleming, J., Cornwell, P., Haines, T., & Ownsworth, T. (2009). Profiling early outcomes during the transition from hospital to home after brain injury. Brain Injury, 23 (1), 51–60.Google Scholar
Turner, B., Fleming, J., Ownsworth, T., & Cornwell, P. (2011). Perceptions of recovery during the early transition phase from hospital to home following acquired brain injury: A journey of discovery. Neuropsychological Rehabilitation, 2 (1), 64–91.Google Scholar
Turner, B.J., Fleming, J.M., Ownsworth, T.L., & Cornwell, P.L. (2008). The transition from hospital to home for individuals with acquired brain injury: A literature review and research recommendations. Disability and Rehabilitation, 30 (16), 1153–1176.Google Scholar
Wolf, T.J., Brey, J.K., Baum, C., & Connor, L.T. (2012). Activity participation differences between younger and older individuals with stroke, Brain Impairment, 13 (1), 16–23.Google Scholar
World Health Organization (WHO) (1996). WHOQOL-BREF: Introduction, administration, scoring and generic version of the assessment. Available from: http://www.who.int/mental_health/media/en/76.pdf.Google Scholar
World Health Organization (WHO) (1996/2006). ICD-10 international statistical classification of diseases. Geneva: WHO. (ICD-10. Psykiske lidelser og adfærdsmæssige forstyrrelser. Klassifikation og diagnostiske kriterier. København: Munksgaard).Google Scholar
World Health Organization (WHO) (2001). International classification of functioning, disability and health. Available from: http://www.who.int/icf/icftemplate.cfm.Google Scholar
World Health Organization. (WHO) (1998). Development of the world health organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28 (3), 551–558.Google Scholar
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