University of Wisconsin-Eau Claire.
Moravian University, Bethlehem, PA.
Am J Speech Lang Pathol. 2023 Mar 23;32(2S):848-866. doi: 10.1044/2022_AJSLP-22-00103. Epub 2022 Nov 8.
This study examined the perceptions of health care experiences by individuals with traumatic brain injuries (TBIs) across the recovery continuum, regarding care received by a variety of health care providers following their TBI. It sought to identify whether perceptions differed across mild, moderate, and severe participants, as well as acute, subacute, and chronic recovery.
Eighteen individuals with TBI were interviewed, using the Sydney Psychosocial Reintegration Scale-Second Edition (SPRS-2) and a semistructured interview about health care perceptions. A qualitative investigation employing two methods, interpretive phenomenological analysis (IPA) and Systemic Functional Linguistics (SFL; modality and appraisal analysis), provided a micro and macrolevel discourse analysis.
IPA analyses of SPRS-2 interviews differed across severity levels but included changes to relationships, identity, and changes to social engagement and activity. IPA results revealed three core themes related to the health care experiences across severity that encompassed (a) frustrations with providers and (b) lack of support in the chronic phase, and (c) that finding support is crucial. SFL results provided insight into how individuals appraised such experiences in light of their identity and personal perspectives. Key differences between individuals with mild, moderate, and severe TBI diagnoses were found, with those who experienced a mild TBI expressing the most discontent with services received. Participants were most satisfied with acute care and least satisfied with chronic phase support.
The results of this study have significant implications for health care professionals interacting with individuals who have experienced a TBI. Facilitating improved communication, referrals, increased access to mental health counseling, and resources such as groups to support identity expression could improve the health care experience.
本研究通过对创伤性脑损伤（TBI）患者在整个康复过程中对医疗体验的感知进行调查，研究了他们在 TBI 后接受各种医疗服务提供者的治疗的情况。本研究旨在确定感知是否因轻度、中度和重度参与者以及急性、亚急性和慢性康复而有所不同。
使用悉尼心理社会康复量表第二版（SPRS-2）和半结构化访谈对 18 名 TBI 患者进行访谈，以了解他们对医疗保健的看法。采用两种方法，即解释现象学分析（IPA）和系统功能语言学（SFL；模态和评价分析）进行定性研究，提供了微观和宏观层面的话语分析。
SPRS-2 访谈的 IPA 分析因严重程度而异，但包括人际关系、身份和社会参与和活动的变化。IPA 结果揭示了与严重程度相关的三个核心主题，包括（a）对提供者的不满和（b）慢性阶段缺乏支持，以及（c）寻找支持至关重要。SFL 结果提供了如何根据个人身份和个人观点来评价这些经历的见解。发现轻度、中度和重度 TBI 诊断的个体之间存在显著差异，经历轻度 TBI 的个体对所接受的服务最不满意。参与者对急性护理最满意，对慢性阶段的支持最不满意。
这项研究的结果对与经历过 TBI 的个体互动的医疗保健专业人员具有重要意义。改善沟通、转介、增加心理健康咨询的机会以及提供支持身份表达的资源，如团体，可以改善医疗保健体验。
