Conceptualizing self and maintaining social connection following severe traumatic brain injury.

PRIMARY OBJECTIVE

To explore how adults who have sustained severe traumatic brain injury (TBI) conceptualize self several years after injury.

DESIGN

Self-conceptualization was explored from the perspective of the injured individual within a constructivist Grounded Theory approach using in-depth interviews. Qualitative analysis moved through a process of data-driven open and focused coding, identification of emergent self-related categories and exploration of relations between these categories.

PARTICIPANTS

Sixteen men and four women with severe-very severe injury participated in the study. Severity of injury was indexed by either a Glasgow Coma Scale (GCS) score ≤8 or duration of post-traumatic amnesia (PTA) ≥14 days. At the time of interview, the average age of participants was 35.2 years and a minimum of 5 years had elapsed since injury.

MAIN OUTCOMES AND RESULTS

Three main themes emerged from the data. The first two themes together described a model of self-concept. The third theme captured the insider's perspective on factors that had helped to create and maintain a sense of connection between self and society.

CONCLUSION

Conceptualization of self after brain injury is a dynamic and multi-faceted process. Insight into the process can guide the development of therapeutic endeavours to facilitate the ongoing construction of self after severe TBI.