Living with a moderate head injury: An interpretative phenomenological analysis of young people’s and their mothers’ lived experiences

Williams, Ian 2020. Living with a moderate head injury: An interpretative phenomenological analysis of young people’s and their mothers’ lived experiences. Cardiff University. Item availability restricted.

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Abstract

Background: Childhood head injuries can be mild, moderate or severe. This severity relates to the degree of injury to the brain, which can have a direct effect on their lived experiences. Moderate head injuries in children and young people (CYP) is an area that is rarely researched, particularly from the CYP’s perspective. The motivation for this study stems from my clinical practice as a paediatric neurosurgical nurse specialist, a wish to further understanding of the long-term effects a moderate head injury can have on a CYP and the mother together with a desire to increase the evidence base care for CYP’s. Aims: To explore how the lifeworlds of CYP (aged 6 to 13 years) and the mothers are affected by a moderate head injury. To better understand, in a manner consistent with interpretative phenomenological analysis utilising the concept of lifeworld, how the CYP and their mothers are affected by moderate head injuries. Methods: An interpretative phenomenological analysis (IPA) approach was adopted, using longitudinal semi-structured interviews over nine months. Following the granting of research ethics and governance approvals, three young people who had experienced a moderate head injury and two mothers were recruited from a tertiary NHS Health Board in Wales. CYP’s involvement was used in the initial stages (a Children’s Advisory Group was used from a primary school) to aid in the research design. The data were analysed using the IPA method, explored longitudinally and discussed by using a combination of the adapted Corbin and Strauss Chronic Illness Trajectory (Halcomb and Davidson 2005) and the lifeworld (Galvin and Todres 2013). Main Findings: Three main superordinate themes were developed from the findings for each of the participant groups; for the CYP these were ‘Impact of Restrictions’, ‘Relational Impact of Restrictions’ and ‘Resilience and Post-Traumatic Changes’; for the mothers these were ‘Parental Psychological Trauma’, ‘Family and Friends’ and ‘Recovery Journey’. The main ii findings for the CYP showed that even though the restrictions were important in protecting them from further harm, but they had a large impact on all aspects of their lifeworlds including altered friendships. There was also evidence for defiant behaviour as a coping mechanism and when the restrictions were removed, the CYP did not immediately return to their ‘normality’. For the mothers, the findings pointed to their recovery being embedded in psychological trauma, emotion and anxiety and they had to contend with a duality of roles; one a restriction enforcer and as a mother. At the end of the study period, they had not completed their recovery journey. Discussion: The review of literature shows that a longitudinal analysis of CYP’s lived experiences using a lifeworld concept during the recovery from a moderate head injury has not previously been undertaken. The benefits of adopting a longitudinal approach are clearly demonstrated in the study’s findings. Utilising an IPA approach generated rich data and provided valuable insights into how CYP and the mothers viewed their experiences. For example, the way in which CYP experience their lifeworld and the process of recovery fluctuates over time. It is not linear and the restrictions that were placed on the CYP to keep them safe had lasting implications, even when the restrictions were removed. This has implications for service delivery and longer-term care of CYP following moderate head injuries. The findings suggest that the CYP’s and mothers’ non-linear recovery trajectories and experiences are at odds with the linear care pathways and service planning that dominate current service delivery.

Item Type:	Thesis (Other)
Date Type:	Completion
Status:	Unpublished
Schools:	Healthcare Sciences
Date of First Compliant Deposit:	28 October 2020
Last Modified:	28 Oct 2020 12:06
URI:	https://orca.cardiff.ac.uk/id/eprint/135997

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