What's wrong with me? seeking a coherent understanding of recovery after mild traumatic brain injury.
Qualitative research examining experiences of recovering from mild traumatic brain injury (MTBI) is limited. Findings from quantitative studies regarding predictors of persisting symptoms are inconsistent with limited attention directed to capturing broad perspectives and priorities of the wider stakeholders. More flexible research approaches may help advance the field. We used a mixed method design to generate patient perspectives of MTBI recovery, integrating these with quantitative investigation to isolate factors that might contribute to divergent MTBI outcomes.



The qualitative component reported here involved semi-structured interviews with selected participants (n = 10) from the quantitative study cohort, sampling both recovered and non-recovered adult MTBI participants. Interviews focused on participants' general description and understandings of their recovery and perceptions of what helped or hindered this. Data were analyzed using general thematic analysis.



Participants regardless of recovery status identified the importance of having a coherent understanding of their injury and recovery. Factors facilitating coherence included social support, validation, reassurance, accessing credible evidence-based information and having a pathway to wellness. Findings suggested that coherence could be a helpful umbrella construct worthy of examination in future MTBI research. This construct appears broad and able to cope with the complexity of individual experiences after injury. Implications for rehabilitation Sense of coherence may be a helpful umbrella construct that can facilitate resilience and positive recovery beliefs and expectations after mild traumatic brain injury. Reassurance, validation, and social support appear important and may facilitate injury recovery. Focus on the experiences of people recovering from mild traumatic brain injury may help to refine recovery models and understandings and thus provide more effective intervention targets.
a Concussion Clinic , Burwood Hospital , Christchurch , New Zealand.|b Department of Orthopaedic Surgery and Musculoskeletal Medicine , University of Otago Christchurch , Christchurch , New Zealand.
Deborah L
DL
Snell
c Rehabilitation Teaching and Research Unit , University of Otago Wellington , Wellington , New Zealand.
Rachelle
R
Martin
d Department of Psychological Medicine , University of Otago Christchurch , Christchurch , New Zealand.
Lois J
LJ
Surgenor
e Faculty of Health and Environmental Studies , AUT University , Auckland , New Zealand.
Richard J
RJ
Siegert
c Rehabilitation Teaching and Research Unit , University of Otago Wellington , Wellington , New Zealand.
E Jean C
EJC
Hay-Smith
D000328:Adult; D000368:Aged; D001924:Brain Concussion / Q000523:psychology* / Q000534:rehabilitation*; D016022:Case-Control Studies; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D060685:Sense of Coherence
MTBI; qualitative analysis; sense of coherence; validation