McPherson Kathryn, Fadyl Joanna, Theadom Alice, Channon Alexis, Levack William, Starkey Nicola, Wilkinson-Meyers Laura, Kayes Nicola
The Health Research Council of New Zealand, Auckland, New Zealand (Dr McPherson); Centre for Person Centred Research, AUT University, Auckland, New Zealand (Drs McPherson, Fadyl, and Kayes and Mrs Channon); Centre for Person Centred Research, National Institute for Stroke and Applied Neuroscience, AUT University, Auckland, New Zealand (DrTheadom); University of Otago, Wellington, New Zealand (Dr Levack); School of Psychology, The University of Waikato, Hamilton, New Zealand (Dr Starkey); and School of Population Health The University of Auckland, Auckland, New Zealand (Dr Wilkinson-Meyers).
J Head Trauma Rehabil. 2018 Jan/Feb;33(1):E44-E52. doi: 10.1097/HTR.0000000000000321.
To explore what helps and hinders recovery and adaptation after disabling traumatic brain injury (TBI) and make recommendations for improving service responsiveness.
A longitudinal qualitative descriptive study across all TBI severities.
Community.
Forty people with TBI, and 22 significant others, 6 to 9 months following a TBI.
Semistructured interviews, analyzed using qualitative description, focused on (a) key areas of importance or concern and (b) strategies or actions that people found helpful or that hindered recovery.
Traumatic brain injury produced a complex set of challenges in keeping up with life, and understanding what having a TBI means for, and to, me. This period encompassed a tangled fit and misfit in life as brain injury did not occur in isolation. People had to actively change some aspects of life and yet allow other changes to happen. Valued supports from others included being looked out for and having someone to help drive the process.
Improved services delivery and better outcomes may result if we respond to the person within his or her context; listen, believe, and acknowledge the person's story through our actions; and avoid assumptions about aspects of life that mean most to people and who/what may help best.
探讨哪些因素有助于或阻碍创伤性脑损伤（TBI）致残后的恢复与适应，并为提高服务响应能力提出建议。
一项针对所有TBI严重程度的纵向定性描述性研究。
社区。
40名脑外伤患者以及22名重要他人，均处于脑外伤后6至9个月。
采用定性描述分析法的半结构化访谈，重点关注（a）重要或令人关注的关键领域，以及（b）人们认为有帮助或阻碍恢复的策略或行动。
创伤性脑损伤在适应生活以及理解脑外伤对“我”意味着什么方面带来了一系列复杂的挑战。这一时期包括生活中的各种纠结与不适应，因为脑损伤并非孤立发生。人们必须积极改变生活的某些方面，同时也允许其他变化发生。来自他人的宝贵支持包括受到关照以及有人帮助推动康复进程。
如果我们在患者所处的背景下对其做出回应；通过行动倾听、相信并认可患者的经历；避免对人们认为最重要的生活方面以及最能提供帮助的人或事物做出假设，可能会带来更好的服务提供和结果。
