The psychosocial consequences of severe head injury from the perspective of relatives who care for head-injured persons in the community : a cross-sectional case study approach : a thesis presented in partial fulfilment of the requirements for the degree or Master of Arts in Psychology at Massey University
The primary aim of this research was to gain insight into the "world" of carers of head-injured persons in the community, identify their major areas of stress, and explore support needs. A cross-sectional multiple case study design was chosen. The patient sample had all experienced severe to extremely severe head injuries. They were not interviewed. Semi-structured interviews were conducted with eleven carers of the head-injured persons, all but one being a relative of the patient. A verbally-administered questionnaire was used during the interviews to ensure that standardised questions were asked of all respondents. Many of the questionnaire items were closed, but others were partially or fully open-ended. The questions addressed: historical information, changes in the patient, changes in overall life-style, changes in relationships, carers' personal and practical support needs, and their perceptions of the future. A single quantitative analogue rating scale was used to measure levels of respondents' reported distress. Respondents were encouraged to provide comments freely during the interviews. The obtained data was systematically presented in the form of
frequencies and occasional measures of central
tendency. This data was supplemented by eleven individual case studies.
The main patterns and themes were apparent in the grouped data, but the individual case studies permitted examination of both common and unique responses within a "real life" context. There was thus across-study and within-study investigation. The approach to the research was exploratory and descriptive. No hypotheses were held but some expectations were indicated in the existing literature. The present study found similarities with previous research in that psychosocial changes in the patient were reported more frequently by carers than broadly physical changes, reported stress levels were generally high, and there were complaints by respondents about lack of head injury information, and lack of family counselling. The most notable differences were that respondents in this study considered that
(in terms of reported frequencies) communication, conversation and interactional changes in the patients, together with patients' social restrictions/isolation, were the most distressing changes for the carers. A major area of reported distress by respondents in this study related to insensitivity by others towards the patient. However, a number of positive, optimistic comments were made by respondents. Practical support needs were generally met, as were personal support needs in the form of confidantes and friends. The methodological limitations of the present study were discussed, and theoretical and practical implications examined. Suggestions were made for further research.