title: Exploring the experience of sleep and fatigue in male and female adults over the 2 years following traumatic brain injury: a qualitative descriptive study.
abstract: OBJECTIVE
  To explore the experience of fatigue and sleep difficulties over the first 2 years after traumatic brain injury (TBI).
  
  
  METHODS
  Longitudinal qualitative descriptive analysis of interviews completed as part of a larger longitudinal study of recovery following TBI. Data relating to the experience of fatigue and/or sleep were extracted and coded by two independent researchers.
  
  
  METHODS
  Community-based study in the Hamilton and Auckland regions of New Zealand.
  
  
  METHODS
  30 adult participants who had experienced mild, moderate or severe brain injury within the past 6 months (>16 years of age). 15 participants also nominated significant others to take part. Interviews were completed at 6, 12 and 24 months postinjury.
  
  
  RESULTS
  Participants described feeling unprepared for the intensity, impact and persistent nature of fatigue and sleep difficulties after injury. They struggled to learn how to manage their difficulties by themselves and to adapt strategies in response to changing circumstances over time. Four themes were identified: (1) Making sense of fatigue and sleep after TBI; (2) accepting the need for rest; (3) learning how to rest and; (4) need for rest impacts on ability to engage in life.
  
  
  CONCLUSIONS
  Targeted support to understand, accept and manage the sleep and fatigue difficulties experienced may be crucial to improve recovery and facilitate engagement in everyday life. Advice needs to be timely and revised for relevance over the course of recovery.
authors.affiliation: Person Centred Research Centre, Auckland University of Technology, Auckland, New Zealand National Institute for Stroke and Applied Neuroscience, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Alice
authors.initials: A
authors.lastname: Theadom
authors.affiliation: Person Centred Research Centre, Auckland University of Technology, Auckland, New Zealand National Institute for Stroke and Applied Neuroscience, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Vickie
authors.initials: V
authors.lastname: Rowland
authors.affiliation: Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand.
authors.forename: William
authors.initials: W
authors.lastname: Levack
authors.affiliation: School of Psychology, University of Waikato, Hamilton, New Zealand.
authors.forename: Nicola
authors.initials: N
authors.lastname: Starkey
authors.affiliation: School of Population Health, University of Auckland, Auckland, New Zealand.
authors.forename: Laura
authors.initials: L
authors.lastname: Wilkinson-Meyers
authors.affiliation: Person Centred Research Centre, Auckland University of Technology, Auckland, New Zealand The Health Research Council of New Zealand, Auckland, New Zealand.
authors.forename: Kathryn
authors.initials: K
authors.lastname: McPherson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000070642:Brain Injuries, Traumatic / Q000523:psychology*; D005221:Fatigue / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D036301:Qualitative Research; D012146:Rest; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Brain Injury; Fatigue; Longitudinal; QUALITATIVE RESEARCH