Changing relationships: Acquired Brain Injury, family functioning and the experiences of significant others.

Ghosh-Cannell, Chloe (2020) Changing relationships: Acquired Brain Injury, family functioning and the experiences of significant others. Doctoral thesis, University of East Anglia.

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Purpose: Acquired Brain Injury (ABI) affects both patients and families. This thesis portfolio aims to increase knowledge exploring post-ABI family life, using contrasting methodologies. Two papers are presented; an exploration of the relationship between post-injury neurobehaviouiral (NB) presentation and family functioning (FF), followed by an analysis of subjective experiences for spouses and partners of ABI patients.

Design: A systematic review is presented exploring the relationship between NB change and FF. Broad search terms were applied across three databases, with fifteen studies reviewed. Data extraction and quality assessments are presented. In contrast, the empirical study adopted Interpretative Phenomenological Analysis (IPA). Nine women, whose significant other had experienced an ABI, took part in semi-structured interviews regarding their experience of realisation of change. Analysis was conducted both within and across accounts, with a reflective journal maintained for transparency.

Results: FF mediated the relationship between NB change and caregiver distress, meaning the distress potentially triggered through NB change can be explained through FF. Within NB, behaviour concerns were most predictive of FF, however the differing degrees of detail within the definition and measurement of
“neurobehavioural change” are considered. The IPA derived four main themes; “pushed apart by brain injury”, “bravery to face lingering awareness and emotions”, “lost and trapped in an unsolvable maze” and “unfolding events leading to new perceptions”. Each included two subthemes.

Conclusions: Post-ABI changes elicit a multitude of experiences, including relational disconnect and feeling trapped. Notably though, distress can also be predicted by quantitative measurement. Clinical applications include keeping the whole family in mind when considering ABI sequelae and promoting longer-term support to couples. Further studies could address specific NB aspects to increase predictive accuracy, while extensions of the empirical study could explore underlying internal processes, potentially using Grounded Theory.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Chris White
Date Deposited: 04 Nov 2020 13:23
Last Modified: 04 Nov 2020 13:23


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