ABSTRACT

Primary Objective: To identify how families experience cognitive-communication difficulties following Traumatic Brain Injury (TBI). Experiences of information, training and support for managing communication changes were also explored. Research Design: Qualitative focus group methodology using thematic analysis. Method: 15 family members of individuals with cognitive-communication difficulties following severe TBI participated in the study; four parents, six spouses, three siblings and two offspring. The majority of participants were female (80%, n = 12), with a mean age of 51 (range 19–71). Four focus groups were held with family members at 0–12 months, 12–36 months and 36+ months post-injury. The data were transcribed verbatim and analyzed using NVIVO 12.

Results: Cognitive-communication difficulties were found to impact upon family functioning and psychological wellbeing for several years post-injury. Changes to social cognition, insight and the “filter switch” of the person following TBI were key areas of distress. Participants highlighted the need for information about communication changes to be provided at several time points post-injury. The need for peer support from other families with experience of cognitive-communication difficulties was also identified.

Conclusion: Cognitive-communication difficulties impact upon family functioning for many years following injury with families continuing to have support needs for communication well beyond the acute rehabilitation stage.

摘要

主要目标：确定家庭如何在创伤性脑损伤 (TBI) 后遇到认知沟通困难。还探讨了管理沟通变化的信息、培训和支持方面的经验。研究设计：使用主题分析的定性焦点小组方法。方法：15 名患有严重 TBI 后认知沟通困难的家庭成员参与了研究；四个父母，六个配偶，三个兄弟姐妹和两个后代。大多数参与者是女性（80%，n = 12），平均年龄为 51 岁（19-71 岁）。在受伤后 0-12 个月、12-36 个月和 36 个月以上，与家庭成员举行了四个焦点小组。数据被逐字转录并使用 NVIVO 12 进行分析。

结果：发现认知交流困难会影响受伤后数年的家庭功能和心理健康。TBI 后患者的社会认知、洞察力和“过滤器开关”的变化是困扰的关键领域。参与者强调需要在受伤后的几个时间点提供有关沟通变化的信息。其他有认知沟通困难的家庭也需要同伴支持。

结论：认知交流困难会在受伤后多年影响家庭功能，因为在急性康复阶段之后，家庭仍然有交流支持的需求。