title: [Cranial-cerebral trauma after a traffic accident: perceptions of patients, family, physicians and professionals].
abstract: This is a study of medical care when road accident incidents result in traumatic brain injury (TBI). We investigated the personal perceptions of those involved in acute care episodes and subsequent rehabilitation. We conducted simultaneous semi-structured interviews with individuals who had sustained a TBI (8) and their families (8). We then conducted semi-structured individual interviews with the professionals (22) and physicians (9) who attended them. Results reveal the difficulties encountered by the different people involved, from the standpoint of the rehabilitation of both the person who with the TBI and their families, the relationships among the various actors, and the continuity of care. The results disclose the importance of including the family and the TBI casualty in the care process by endorsing their participation and by setting up suitable structures that prioritize a meaningful partnership among the individuals, families, physicians, professionals and health care organizations and in which each person can play a role as an agent in the care of the person with the TBI. An important element, which came out again in our results, is that the shortage of information provided to the families can jeopardize establishing a relationship of trust among the actors. Furthermore, many of the family members were upset that the health intervention was entirely focussed on the TBI casualty: none of the professionals were concerned with what the families were going through, either during the acute care or rehabilitation. Another major problem is lack of communication, not just amongst the professionals, but also between institutions which seem to function in isolation. Lack of resources, the limited availability of those that are offered, and social policies are also detrimental to the reintegration of the TBI individual into the community. Finally, many of the professionals reported that they had not been trained to assist families in this situation.
authors.affiliation: Faculté des sciences infirmieres Université de Montréal.
authors.forename: Hélène
authors.initials: H
authors.lastname: Lefebvre
authors.forename: Diane
authors.initials: D
authors.lastname: Pelchat
authors.forename: Bonnie
authors.initials: B
authors.lastname: Swaine
authors.forename: Isabelle
authors.initials: I
authors.lastname: Gélinas
authors.forename: Marie Josée
authors.initials: MJ
authors.lastname: Levert
mesh_terms: D000063:Accidents, Traffic / Q000523:psychology*; D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002983:Clinical Competence / Q000592:standards; D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards; D006259:Craniocerebral Trauma / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation; D005190:Family / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D015404:Nursing Methodology Research; D010358:Patient Participation; D010820:Physicians / Q000523:psychology; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D036301:Qualitative Research; D011792:Quebec; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires