Conceptualizing self and maintaining social connection following severe traumatic brain injury

PRIMARY OBJECTIVE: To explore how adults who have sustained severe traumatic brain injury (TBI) conceptualize self several years after injury. DESIGN: Self-conceptualization was explored from the perspective of the injured individual within a constructivist Grounded Theory approach using in-depth interviews. Qualitative analysis moved through a process of data-driven open and focused coding, identification of emergent self-related categories and exploration of relations between these categories. PARTICIPANTS: Sixteen men and four women with severe-very severe injury participated in the study. Severity of injury was indexed by either a Glasgow Coma Scale (GCS) score ≤8 or duration of post-traumatic amnesia (PTA) ≥14 days. At the time of interview, the average age of participants was 35.2 years and a minimum of 5 years had elapsed since injury. MAIN OUTCOMES AND RESULTS: Three main themes emerged from the data. The first two themes together described a model of self-concept. The third theme captured the insider's perspective on factors that had helped to create and maintain a sense of connection between self and society. CONCLUSION: Conceptualization of self after brain injury is a dynamic and multi-faceted process. Insight into the process can guide the development of therapeutic endeavours to facilitate the ongoing construction of self after severe TBI.