Research Reports - Coping and adaptive strategies of traumatic brain injury survivors and primary caregivers

NeuroRehabilitation. 2016 Jun 27. [Epub ahead of print]

Adams D(1,)(2), Dahdah D(3,)(4).

BACKGROUND: Qualitative research methods allowed the investigator to contribute
to the development of new theories and to examine change in processes over time,
which added rich detail to existing knowledge of the use of coping and adaptive
strategies by traumatic brain injury survivors and their primary caregivers
(Ponsford, Sloan, & Snow, 2013). The advantages of phenomenological study were
that it allows flexibility to explore and understand meanings attached by people
to well-studied concepts such as coping, resiliency, and adaptation or
compensation. Phenomenological study was sensitive to contextual factors. It also
permitted the study of in-depth dynamics of coping and adaptive strategies of TBI
survivors and primary caregivers, while understanding the social and
psychological implications of the phenomenon.
OBJECTIVE: To explore the needs and deficits of adult traumatic brain injury
(TBI) survivors and primary caregivers; and to identify their self-initiated
coping and adaptive strategies. Significant to this study was the development of
coping and adaptive strategies by the participants after their discharge from
inpatient and rehabilitation treatment. The compensatory skills taught in
treatment settings did not transfer to the home environment. Therefore, these
strategies developed independently from previous treatment recommendations
contributed to the development of theory related to rehabilitation and
counseling. Distinctive to this study was the similarity of coping and adaptive
strategies developed from both mild and severe traumatic brain injury survivors.
METHODS: This study consisted of eleven with TBI and six primary caregivers
(N = 17), who participated in a series of semi-structured interviews aimed at
discovering the coping and adaptive strategies utilized in dealing with the
effects of brain injury. A Qualitative Phenomenological design was employed.
RESULTS: Patience and understanding, support, and professional help were
identified by TBI survivors and caregivers as being their most relevant needs.
Self-reported deficits included short-term memory loss (STM), fatigue, anger, and
personality changes, and the strategies that TBI survivors and caregivers
identified tended to address their problems with these specific day-to-day
deficits. Problem focused, emotion focused, and avoidant coping were utilized to
some degree in their adjustment to home life and activities of daily living.
Participants offered suggestions for mental health professionals addressing how
to more effectively work with brain injury survivors and their primary
caregivers.
CONCLUSION: TBI survivors and caregivers had multiple self-reported unaddressed
needs following their discharge from facility-based treatment. They reported
spontaneously engaging in various coping and adaptive strategies to address their
needs and deficits. However, further education regarding potential post-TBI
challenges and strategies for addressing them are needed, including a need for
community and mental health resources. 

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