Date Presented 3/30/2017
A phenomenological approach was applied to understand the experiences of three participants with traumatic brain injury (TBI) and visual inefficiencies. Five themes resulted: symptoms that complicated life, negative feelings during occupation, changes in coping, personal relationship impact, and lack of resource education.
Primary Author and Speaker: Suzanne Vetter
Additional Authors and Speakers: Katie Kruger
Contributing Authors: Jan Stube, David Biberdorf
PURPOSE AND RATIONALE: The Centers for Disease Control and Prevention (2010) reported that 2,611,129 individuals visit the emergency room each year due to traumatic brain injury (TBI). Approximately 50% of individuals with TBI report visual inefficiencies (Bulson, Jun, & Hayes, 2012; McKenna, Cooke, Fleming, Jefferson, & Ogden, 2006). There is further need for understanding the experiences of persons post-TBI with visual inefficiencies, including their coping in everyday life. This qualitative research study’s aims were to understand the occupational participation challenges that individuals with TBI and visual inefficiencies (as dual diagnoses) face throughout daily life and to identify common coping strategies used to face these challenges.
DESIGN: A phenomenological research approach was used. After institutional review board approval, a list of adults who met the age and dual diagnosis criteria was obtained from an area optometrist. A purposive sample of three young adults with mild traumatic brain injuries consented to two 1-hr interviews.
METHODOLOGY: Semistructured interview questions were developed. Researchers analyzed the interview transcripts using phenomenological coding methodology to establish themes (Patton, 2002).
RESULTS: Five qualitative themes emerged: symptoms complicate participation and self-esteem, negative feelings arise during occupational participation, changes occur in coping, personal relationships are impacted, and lack of resource education is common. Occupations of driving, education, sports and exercise, and social participation were commonly disrupted, impacted by a variety of symptoms, decreased self-esteem, and negative emotions. TBI with visual inefficiencies also affected personal relationships and support systems and the ability to adapt and cope. Lack of education and resources for TBI and visual inefficiencies predominated.
CONCLUSION: Individuals who have mild TBI with visual changes experience many barriers, including lack of resources, an extended period of disruptive symptoms, and occupational dysfunction. Disruptions occurred in instrumental activities of daily living (e.g., driving), social participation, education, and work. This ultimately impacts the individual’s self-esteem, ability to cope, and social systems.
IMPACT STATEMENT: This qualitative study’s findings suggest that people with mild TBI and visual inefficiencies experience daily occupational challenges. They can benefit from occupational therapy services to improve occupational participation and coping, as well as to promote education and advocacy for receiving needed health care resources.
References
Bulson, R., Jun, W., & Hayes, J. (2012). Visual symptomatology and referral patterns for Operation Iraqi Freedom and Operation Enduring Freedom veterans with traumatic brain injury. Journal of Rehabilitation Research and Development, 49, 1075–1082. https://doi.org/10.1682/JRRD.2011.02.0017
Centers for Disease Control and Prevention. (2010). Injury and prevention control: TBI. Retrieved from http://www.cdc.gov/traumaticbraininjury/data/rates.html
McKenna, K., Cooke, D. M., Fleming, J., Jefferson, A., & Ogden, S. (2006). The incidence of visual perceptual impairments in patients with severe traumatic brain injury. Brain Injury, 20, 507–518. https://doi.org/10.1080/02699050600664368
Patton, M. Q. (2002). Qualitative research and evaluation methods (3rd ed.). Thousand Oaks, CA: Sage.
