RUBRIC (Research Unit on Brain Injury Rehabilitation Copenhagen), Department of Neurorehabilitation, Traumatic Brain Injury Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Learning and Philosophy, Aalborg University, Aalborg, Denmark.
J Clin Nurs. 2019 Jan;28(1-2):289-299. doi: 10.1111/jocn.14598. Epub 2018 Aug 1.
Relative involvement is crucial in rehabilitation when patients are incapable of being involved due to cognitive and functional dysfunction. However, studies have shown that this is complex because of differing understandings of the meaning of involvement as well as diverse needs to be involved.
To explore the experience of the rehabilitation process from the perspectives of relatives of patients with a traumatic brain injury. The aim of the study was, through a theoretical-empirical analysis, to identify relatives' strategies and practices in the rehabilitation process as evidenced in meetings with providers.
A longitudinal study with a qualitative approach, drawing on the theory of Pierre Bourdieu.
Data were generated using participant observation and semi-structured interviews. Participants were eleven relatives of patients with a severe traumatic brain injury, followed through in-patient rehabilitation varying from 9-12 weeks. Analysis was undertaken using both an inductive and deductive approach.
Drawing on Bourdieu's concept of strategy, three relative positions were identified, the warrior, the observer and the hesitant. These positions illustrate how different relative positions and their related dispositions influence the strategies used by relatives of patients with a severe traumatic brain injury evidenced in how they act, participate and relate to both the patient and the providers during the course of rehabilitation.
Acknowledging the relatives' positions during the rehabilitation process enables better understanding and support of the relatives in the rehabilitation process to meet their (and thus the patients') diverse needs.
The findings have practical implications in informing how clinicians meet, interact, communicate and involve relatives of adult patients' with traumatic brain injury in decision-making during rehabilitation.
当患者由于认知和功能障碍而无法参与时，相对参与在康复中至关重要。然而，研究表明，这是复杂的，因为对参与的意义有不同的理解，以及参与的需求也不同。
从创伤性脑损伤患者家属的角度探讨康复过程的体验。该研究的目的是通过理论-实证分析，确定亲属在与提供者会面时在康复过程中所采用的策略和做法。
一项纵向研究，采用定性方法，借鉴皮埃尔·布迪厄的理论。
使用参与观察和半结构化访谈生成数据。参与者是 11 名严重创伤性脑损伤患者的亲属，他们在住院康复期间接受了 9-12 周的康复治疗。分析采用了归纳和演绎的方法。
借鉴布迪厄的策略概念，确定了三种亲属位置，即战士、观察者和犹豫者。这些位置说明了不同的亲属位置及其相关的倾向如何影响严重创伤性脑损伤患者亲属在康复过程中使用的策略，这些策略体现在他们在康复过程中的行为、参与以及与患者和提供者的关系。
在康复过程中承认亲属的位置，可以更好地理解和支持亲属，满足他们（以及患者）在康复过程中的多样化需求。
研究结果对告知临床医生如何在康复期间与成年创伤性脑损伤患者的亲属会面、互动、交流和参与决策具有实际意义。
