Caregiving for adults who suffered severe traumatic brain injury (sTBI) : towards a psychological explanatory model

Abstract

Traumatic brain injury (TBI) is presented in literature as one of the major public health and socioeconomic problems that often results in disability and death. Literature further shows that families of individuals who suffered TBI are often faced with the burden of caring for the individual member, with people with severe traumatic brain injury (sTBI) having limited functional independence and requiring care and support from significant others. Having noted the need for care by individuals who suffered sTBI, the aim of the current study was to explore caregiving in a family context for adults who suffered severe traumatic brain injury with a view to develop a psychological explanatory model. A phenomenological research design was used, with Interpretative Phenomenological Analysis (IPA) being the method utilised. Purposive and snowball sampling methods were used to select 14 individuals who were providing care to adult family members who sustained severe traumatic brain injury. Semi-structures interviews were conducted in Sepedi, Tshivenda and Xitsonga, and later translated into English. Meanings were derived from data collected using IPA. The following superordinate themes were identified: caregiver lived experiences; attributions and meaning making; facilitators and barriers; essential attributes for caregiving; coping strategies; and, motivation for caring. The overall findings indicate that family members who care for adults who suffered severe traumatic brain injury experience barriers and endure emotional difficulties such as shock, denial, anger, frustration, and loss of hope. Based on the findings of the study, I developed a psychological explanatory model on caregiving for adults who suffered sTBI. The Model identified three types of variables, namely, the antecedent variable (which is sTBI), two key variables (that is, caregiver and caregiving), and consequent variables (for example, meanings attached, facilitators and barriers). The interaction of the three variables impact on the beneficiary who is the care recipient. The implications of the current study in terms of theory, clinical practice, research and policy are highlighted.

Dambudzo la khuvhalo ya vhuluvhi li bvukululwa kha manwalwa sa linwe la thaidzo khulwane dza zwa mutakalo na matshilisano, hune la anzela na u vhanga vhuholefhali na lufu. Manwalwa a dovha hafhu a sumbedza uri mita ine ya vha na vhathu vho tshenzhelaho khuvhalo ya vhuluvhi yo livhana na muhwalo wa u thogomela vhenevho vhathu vhane kanzhi vha sa tou vha na vhukoni ha u diitela zwithu nga vhothe. Nga murahu ha u limuwa uri hu na thodea ya u londotwa ha vhathu vho huvhalaho vhuluvhi, ndivho ya ino thodisiso yo vha i ya u tandula vhulondoti mitani ine ya vha na vhathu vho tshenzhelaho khuvhalo ya vhuluvhi hu u toda u bveledza ndila ine ya nga talutshedza zwa u thogomela. Ngona ya thodisiso i saukanyaho tshenzhemo ya vhathu yo shumiswa, khathihi na ngona i sengulusaho tshenzhemo ya vhathu hu u itela u ṋea thaluso ya tshenzhemo yeneyo ho katelwa na kuvhonele kwa mutodisisi. Thumbulo yo anganywaho khathihi na thumbulo ine khayo vhadzheneleli vha themendela vhanwe vhadivhi uri vha shele mulenzhe kha thodisiso, zwo shumiswa musi hu tshi nangwa vhadzheneleli vha fumi iṋa (14) vhe vha tshi khou londota vhathu vho tanganaho na khuvhalo ya vhuluvhi mitani yavho. Mbudzisavhathu dzo farwa na vhadzheneleli nga Sepedi, Tshivenda na Xitsonga, nga vhuya dza pindulelwa kha Luisimane. Thalutshedzo dza mawanwa dzo tutuwa kha mafhungo o kuvhanganywaho hu tshi khou shumiswa tsenguluso na thaluso ya tshenzhemo ya vhathu. Mihumbulo mihulwane i tevhelaho yo tutuwa: tshenzhemo ya vhalondoti ya duvha nga duvha; mveledzo ya thalutshedzo; zwileludzi na zwithivheli; zwitaluli zwa ndeme zwa vhulondoti; ndila dza u tambala; na, thuthuwedzo ya u londota. Mawanwa nga u angaredza a sumbedza uri mirado ya muta ine ya thogomela vhathu vho tanganaho na dambudzo la khuvhalo ya vhuluvhi vha tangana na vhukondi vhu katelaho zwipfi zwa dzhenuwo, khanedza, tsinyuwo, mbiti na u shaya fulufhelo. Ho livhanywa na mawanwa, ho bveledzwa ndila ya thaluso ya zwa muhumbulo. Ndila yeneyo yo talusa tshakha tharu dza zwitenwa, dzine dza vha, tshitenwa tsha murango wa tshenzhemo (tshine tsha vha khuvhalo ya vhuluvhi), zwitenwa zwa ndeme vhukuma (zwine zwa vha, mulondoti na u londota), na zwinwe zwitenwa zwo tutuwaho khazwo (sa tsumbo, thalutshedzo dzo bveledzwaho, zwileludzi na zwithivheli). Ho wanala uri hu na vhuledzani vhukati ha izwi zwitenwa zwiraru zwine zwa vha na mutsindo kha mutanganedzi wa thogomelo ane a vha mulondotiwa. Mbuelo dza ino thodisiso dzi dodombedzwa dzo livhanywa na thyiori, ndowendowe dza vhulondoti ha mutakalo, thodisiso na milayotibe.