An exploration of family in the context of head injury: a narrative understanding of change

Background: Traumatic brain injury is potentially devastating. Families commonly respond by supporting the injured individual and their recovery. However, family members are at risk of negative psychological outcomes and family functioning has emerged as a key variable post injury. What is less understood are the subjective changes experienced by families and the impact these have post injury.

Method: A longitudinal narrative case study using in-depth narrative qualitative interviews. Data were collected a one, three and 12months post injury. Nine non-injured family members from three families were recruited from an acute neurosurgical ward.

Results/findings: Five interwoven narrative threads were identified: trauma, recovery, autobiographical, suffering and family. The narrative approach emphasized that the first-year post-head injury was a turbulent time for families, who were active agents in the process of change.

Discussion: Families’ stories of illness from a nonpatient perspective need recognition and validation in their own right. Understanding this experience in
terms of biographical narratives helps to recognize the vacillation between change and continuity. Adopting a narrative approach to rehabilitation may
be more positive than adopting a model of loss.

Conclusion: Change is not limited to the injured person and family members need help to understand that they too are changing as a result of their
experiences. In addition, it is proposed that there be a shift in the discourse in research and practice literature away from loss and towards transition, with
greater recognition of the role that uninjured family members play in making sense of change post injury