Establishing a person-centred framework of self-identity after traumatic brain injury: a grounded theory study to inform measure development

BMJ Open. 2014 May 15;4(5):e004630. doi: 10.1136/bmjopen-2013-004630.

Abstract

Objective: To develop a theoretically sound, client-derived framework to underpin development of a measure reflecting the impact of traumatic brain injury (TBI) on a person's self-identity.

Design: Grounded theory, based on transcription of audio recordings from focus group meetings with people who have experienced TBI, analysed with constant comparative methods.

Setting: 8 different urban and rural communities in New Zealand.

Participants: 49 people (34 men, 15 women), 6 months to 36 years after mild-to-severe TBI.

Results: The central concept emerging from the data was that of desiring to be or having lost a sense of being an integrated and valued person. The three main subthemes were: (1) having a coherent, satisfying and complete sense of oneself, (2) respect, validation and acceptance by others and (3) having a valued place in the world.

Conclusions: This study reinforces the notion that change in self-identity is an important aspect of life after TBI, and provides information on what this concept means to people with TBI. In order to scientifically evaluate relationships between self-identity and other aspects of health (eg, depression, quality of life), and to test the effect of interventions to address problems with self-identity after TBI, a quantitative tool for evaluation of this construct is required. Themes from this research provide a foundation for the development of a measure of self-identity grounded in the language and experience of people with TBI.

Keywords: Lived Experience; Outcome; Qualitative Research; Self-Concept; Self-Identity; Traumatic Brain Injury.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Brain Injuries / psychology*
  • Female
  • Grounded Theory*
  • Humans
  • Male
  • Middle Aged
  • Self Concept*
  • Young Adult