Date of Award

2004

Degree Type

Dissertation

First Advisor

Donna Schwartz-Barcott

Abstract

There are hints in the literature that recovery from mild traumatic brain injury may be problematic for older persons, yet there is a paucity of information on the experience. The purpose of this study was to develop a descriptive base and highlight the perspective of the client. This is important to nurses in that appropriate intervention must be grounded in an understanding of the problem as perceived and acted upon by the client. This study describes the experience of three women over 50 years of age who had a mild traumatic brain injury. The analytical process followed the case study method described by Bromley (1986). Each case was developed through a series of interviews. Strategies drawn from field work were also used in the process. The study explored (1) the nature of the overall experience, (2) the perception, evaluation, and response to symptoms, and (3) the individual's perception of recovery. What emerged from the case studies was an appreciation that the mild traumatic brain injury occurred in a personal context and in the context of the larger, more generalized experience. Symptoms were embedded in the experience. Recovery, defined by participants as the ability to function, followed the same pattern as recovery for younger persons, but took longer. Neurological symptoms related to impaired attention were not important initially. When they did surface, they were not immediately recognized, nor were they immediately connected to the diagnosis of mild traumatic brain injury. Recovery occurred before all symptoms resolved and did not mark the end of the experience. The primary findings are descriptive in nature. The larger frame of the client perspective from which the description emerges is distinct from perception. Perception signifies processing, where perspective deals with a recounting of events and includes personal context, but not necessarily perception. Because of the mild traumatic brain injury, the client was not always aware of all that was going on. A mapping out of the description facilitated subsequent exploration of variables influencing the experience. This exploration included client perceptions, which are considered to be secondary findings.

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