Syed Hassan Syed Tajuddin, Jamaludin Husna, Abd Raman Rosna, Mohd Riji Haliza, Wan Fei Khaw
Department of Medicine, University of Putra Malaysia, UPM Serdang, Selangor, Malaysia.
Department of Computing Sciences, University of Teknologi MARA, Shah Alam, Selangor, Malaysia.
Trauma Mon. 2013 Sep;18(2):56-61. doi: 10.5812/traumamon.11522. Epub 2013 Aug 11.
As with care giving and rehabilitation in chronic illnesses, the concern with traumatic brain injury (TBI), particularly with diffuse axonal injury (DAI), is that the caregivers are so overwhelmingly involved in caring and rehabilitation of the victim that in the process they become traumatized themselves. This review intends to shed light on the hidden and silent trauma sustained by the caregivers of severe brain injury survivors. Motor vehicle accident (MVA) is the highest contributor of TBI or DAI. The essence of trauma is the infliction of pain and suffering and having to bear the pain (i.e. by the TBI survivor) and the burden of having to take care and manage and rehabilitate the TBI survivor (i.e. by the TBI caregiver). Moreover many caregivers are not trained for their care giving task, thus compounding the stress of care giving and rehabilitating patients. Most research on TBI including DAI, focus on the survivors and not on the caregivers. TBI injury and its effects and impacts remain the core question of most studies, which are largely based on the quantitative approach.
Qualitative research can better assess human sufferings such as in the case of DAI trauma. While quantitative research can measure many psychometric parameters to assess some aspects of trauma conditions, qualitative research is able to fully reveal the meaning, ramification and experience of TBI trauma. Both care giving and rehabilitation are overwhelmingly demanding; hence , they may complicate the caregivers' stress. However, some positive outcomes also exist.
Caregivers involved in caring and rehabilitation of TBI victims may become mentally traumatized. Posttraumatic recovery of the TBI survivor can enhance the entire family's closeness and bonding as well as improve the mental status of the caregiver.
A long-term longitudinal study encompassing integrated research is needed to fully understand the traumatic experiences of caregivers. Unless research on TBI or DAI trauma is given its proper attention, the burden of trauma and injury on societies will continue to exacerbate globally.
与慢性病的护理和康复一样,对于创伤性脑损伤(TBI),尤其是弥漫性轴索损伤(DAI),护理人员过度参与受害者的护理和康复工作,以至于在这个过程中他们自己也受到了创伤。本综述旨在揭示重度脑损伤幸存者的护理人员所遭受的隐藏且无声的创伤。机动车事故(MVA)是TBI或DAI的主要致伤原因。创伤的本质是造成痛苦,并且既要承受痛苦(即由TBI幸存者承受),又要承担照顾、管理和使TBI幸存者康复的负担(即由TBI护理人员承担)。此外,许多护理人员并未接受过护理工作的培训,这使得护理和康复患者的压力进一步增大。大多数关于TBI(包括DAI)的研究都聚焦于幸存者而非护理人员。TBI损伤及其影响仍然是大多数研究的核心问题,这些研究大多基于定量研究方法。
定性研究能够更好地评估人类遭受的痛苦,比如DAI创伤的情况。虽然定量研究可以测量许多心理测量参数来评估创伤状况的某些方面,但定性研究能够充分揭示TBI创伤的意义、后果和经历。护理和康复工作都极其艰巨;因此,它们可能会使护理人员的压力更加复杂。然而,也存在一些积极的结果。
参与TBI受害者护理和康复工作的护理人员可能会受到精神创伤。TBI幸存者的创伤后恢复可以增强整个家庭的亲密感和凝聚力,同时改善护理人员的心理状态。
需要进行一项涵盖综合研究的长期纵向研究,以全面了解护理人员的创伤经历。除非对TBI或DAI创伤的研究得到应有的关注,否则创伤和伤害对全球社会造成的负担将继续加剧。