title: Self-Reflective Meaning Making in Troubled Times: Change in Self-Identity After Traumatic Brain Injury.
abstract: Our aim with this article is to clarify the concept of change in self-identity following traumatic brain injury (TBI). We used concept analysis methodology-predominantly concept clarification. We identified 110 articles using a systematic literature search, and used critical appraisal, content analysis, and analytical questioning to explore attributes and boundaries. A reported change in self-identity is the ultimate expression of a variety of cognitive, psychological, and social sequelae of TBI. We present an integrative model of this process, identifying three potential levels of change: (a) component parts (egocentric self, sociocentric self, and "identity as shared with others"); (b) integral processes (self-awareness and expression via meaningful occupation and narratives); and (c) whole-system disruption. Change in self-identity after TBI is a highly individualistic process. The driver of this process is "self-reflective meaning making," giving a purpose and direction in life, providing motivation and goals for future behavior.
authors.affiliation: University of Otago, Wellington, New Zealand em@doctors.org.uk.
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Thomas
authors.affiliation: University of Otago, Wellington, New Zealand.
authors.forename: William M M
authors.initials: WM
authors.lastname: Levack
authors.affiliation: University of Otago, Wellington, New Zealand.
authors.forename: William J
authors.initials: WJ
authors.lastname: Taylor
keywords: brain injury; concept analysis; recovery; rehabilitation; self; social identity