Research Methods OY307 14300951
“Is there a correlation between family functioning and rehabilitative progress for a person with a TBI?”
1) Background & Literature Review:
A traumatic brain injury (TBI) is defined as “an alteration in brain function, or other evidence of brain pathology, caused by an external force” (Menon et al., 2010, p138). Implications of TBI are well outlined in the literature (Sander et al., 2002, Gan & Schuller 2002, Sady et al., 2010, Sander et al., 2012). Temple et al., (2016) highlighted that TBI causes physical (e.g. dizziness, fatigue), cognitive (e.g. memory, attention) and/or emotional (e.g. irritability) symptoms. Aside from symptomology, the disruptive consequences of TBI are also well documented. TBI can result in ‘substantial handicap’ with regard to employment, social/ community integration and financial independence (Sander et al., 2002)
Much of the literature surrounding TBI is based on the effect of TBI on the main caregiver which constitutes usually as a spouse or parent (Sady et al., 2010, Anderson et al., 2016, Temple et al., 2016). Little empirical work has examined the effects of TBI on the family unit. Earlier studies have collected data from the main caregiver (usually the mother/ spouse), and have reported findings as representative of the whole family (Anderson et al., 2002, Gan & Schuller, 2002, Sander et al., 2002). These authors recommend that future research should collect data from all family members, including children (Kreutzer et al., 1994, Gan & Schuller, 2002).
There is evidence that family members experience substantial emotional distress and family dysfunction post TBI (Kreutzer et al., 1996, Anderson et al., 2002, Ponsford & Schoenberger, 2010). Many family problems occur including; role changes, decreased social support and increases in emotional distress and family arguments (Temple et al. 2016). In a mixed population of participants with TBI, Temple and colleagues (2016) found more than 80% of families reported unhealthy family functioning after TBI. Family functioning can be defined as “coping with cultural, environmental, psychosocial, and socioeconomic stresses throughout the family life cycle” (David, 1978, p327).
Family members usually constitute as the main source of support for brain-injured people as they attempt to recover pre-morbid activities. People with TBI refer to their family as critical to their ability to reintegrate into their community and relearn social behaviour (Lefebvre et al. 2008). Despite this, the role of family functioning on outcomes in adults with TBI has scarcely been examined and remains poorly understood (Gan & Schuller, 2002, Temple et al., 2016). However, literature surrounding TBI is increasingly recognising the family unit as the main support system for patients post TBI (Gan & Schuller, 2002).
Three studies compared family functioning to outcomes post rehabilitation (Sander et al., 2010, Sander et al., 2012) and to community integration (Sady et...