FEATURE

Resilience in Families With Adolescents Suffering From Traumatic Brain Injuries  ro ^ me Gauvin-Lepage1,2, PhD, RN, He le ne Lefebvre1, PhD, RN & Denise Malo1, PhD, RN Je 1 Faculty of Nursing, University of Montreal, Montreal, QC, Canada 2 Research Centre of the Sainte-Justine University Hospital, Montreal, QC, Canada

Keywords

Abstract

Family resilience; traumatic brain injury; rehabilitation professionals. Correspondence ro ^me Gauvin-Lepage, Assistant Professor, Je Faculty of Nursing, University of Montreal, Pavillon Marguerite d’Youville, office 5088, PO Box 6128, Station Downtown, Montreal, Quebec, Canada, H3C 3J7. E-mail: [email protected] Accepted January 19, 2015. doi: 10.1002/rnj.204

Purpose: This study aims to coconstruct the building blocks for an intervention program to support family resilience in conjunction with families with an adolescent suffering from traumatic brain injury and rehabilitation professionals. Design: This is a qualitative and inductive study, supported by a collaborative research approach. Methods: Based on the complex intervention design and validation model, the investigator follows a three-stage data collection process: (1) identifying the building blocks of the intervention program in the eyes of families and rehabilitation professionals, (2) prioritizing, and (3) validating the building blocks with the same participants. Findings: After analyzing the data, the investigator identifies five encompassing themes as the building blocks of the intervention program. Conclusions/Clinical Relevance: This study offers promising avenues for practitioners and researchers in nursing and other fields with respect to the implementation of concrete strategies to support the resilience process of families facing particularly difficult times in their lives.

Introduction In Quebec, Canada, traumatic brain injury (TBI) is an important public health problem. Annually, it is estimated that 13,000 people sustain a TBI, 5,000 of whom are hospitalized. More than 10% of these hospitalizations involved boys aged 15–24 (INSPQ, 2012). A moderate to severe TBI leads teenagers to exhibit physical, psychological, cognitive and behavioral symptoms (Anderson, Brown, Newitt, & Hoile, 2011; Chrisman & Richardson, 2012; Muscara, Catroppa, Eren, & Anderson, 2009; Ross, McMillan, Kelly, Sumpter, & Dorris, 2011; Tsai, Lin, & Tsai, 2012). These consequences of moderate to severe TBI impact family members, who in turn experience suffering, distress and dysfunction (Verhaeghe,

368

Defloor, & Grypdonck, 2005), which can decidedly affect the family’s resilience process. While certain studies have addressed the consequences of forms of trauma other than TBI on families (Chen & Boore, 2008; House, Russell, Kelly, Gerson, & Vogel, 2009), few have studied specifically families with a teenager suffering from moderate to severe TBI. This study therefore aims to coconstruct the building blocks for an intervention program to support family resilience in conjunction with families with an adolescent suffering from moderate or severe TBI. The study’s originality lies in the fact that it introduces a coconstruction research approach involving both families and rehabilitation professionals. The results are a first step toward the development of concrete actions that can support families through the resilience process.

© 2015 Association of Rehabilitation Nurses Rehabilitation Nursing 2015, 40, 368–377

J. Gauvin-Lepage et al.

Context and Issues Family life with a teenager has its share of challenges. The teenager’s emotional rollercoasters can make relationships tense and difficult within the family unit, and even outside of it (Campbell, 2003; Wright & Leahey, 2013). By virtue of its unexpected character, the occurrence of TBI in a teenager can weaken the family dynamics even further (DePalma, 2001; Taylor et al., 2002). Additionally, the myriad of impacts caused by a TBI forces the family to alter its plans for the future by committing themselves together to rebuild them (Cimon, Tetrault, & Beaupre, 2000; Francßois, 2005; Gauvin-Lepage & Lefebvre, 2010; Laloua, 2006; Lefebvre, Pelchat, Kalubi, & Michallet, 2002; Lefebvre, Pelchat, Swaine, Gelinas, & Levert, 2004; Pelchat & Lefebvre, 2004). Resilience to trauma does not manifest itself in the same way for all families (Earvolino-Ramirez, 2007; Luthar, Cicchetti, & Becker, 2000; Tusaie & Dyer, 2004). Some manage to effect positive changes, while others are unable to do so, or experience more difficulties (Gauvin-Lepage & Lefebvre, 2010; Lefebvre & Levert, 2005; Lefebvre, Levert, & Gauvin-Lepage, 2010). In light of this, it appears relevant to develop family-centered care approaches fostering the recognition of elements that can support the family’s resilience process through hardships and, ultimately, help reconstruct its plans for the future (Lefebvre, Levert, & Khelia, 2011; Lefebvre, Pelchat, & Levert, 2007). Goals and Objectives of the Study The goal of the study was to coconstruct the building blocks of an intervention program to support family resilience in conjunction with families with a teenager suffering from moderate or severe TBI and rehabilitation professionals. Its objectives are three-fold: (1) identifying the building blocks of an intervention program to support resilience in families with a teenager suffering from moderate or severe TBI; (2) prioritizing the building blocks of this intervention program with families and rehabilitation professionals; and (3) validating the building blocks of this intervention program with families and rehabilitation professionals. Design and Methods The investigator used a qualitative and inductive research approach (LoBiondo-Wood, Haber, Cameron, & Singh, 2009) to coconstruct the building blocks of the interven© 2015 Association of Rehabilitation Nurses Rehabilitation Nursing 2015, 40, 368–377

Family Resilience Following TBI in Adolescents

tion program. This study is inductive insofar as it considers the experience of each family in its own environment as well as that of the rehabilitation professionals working with them, but also because it relies on field research data instead of scientific theories (LoBiondo-Wood et al., 2009). This approach based on the participants’ experience led to the discovery of the various building blocks of an intervention program supporting the resilience process of families faced with their teenager’s moderate or severe TBI. This study was also supported by a collaborative search approach (Desgagne, 1997), consisting of doing research “with” rather than “on” people (Desgagne, 2007; Desgagne, Bednarz, Lebuis, Poirier, & Couture, 2001). In other words, this approach involves a close “collaboration” between the researchers, the individuals affected by the TBI, and the professionals working toward a common goal (Lefrancßois, 1997). The collaborative research approach draws on the constructivist paradigm (Crotty, 1998; Guba & Lincoln, 1985, 1989; Neuman, 2006; Schwandt, 2007) and, in this respect, fosters the coconstruction by the family and the rehabilitation professionals of the building blocks of an intervention program, as demonstrated in this study. Finally, Van Meijel, Gamel, Van Swieten-Duijfjes, and Grypdonck’s (2004) complex intervention design and validation model, widely used in research, education and clinical health practice, was also used (Van Meijel et al., 2004). This model builds on the perceptions and experience of the “experts” involved in the intervention all through the development and validation stages. In other words, it includes the participation of persons and families experiencing the situation, as well as that of healthcare professionals. Research Environment and Sample This study was performed in a children’s rehabilitation center. Convenience sampling (Denzin & Lincoln, 2011) was used to select the participants, which consist of families (n = 6) (Tables 1 and 2) and rehabilitation professionals (n = 5) (Table 3). Data Collection Data collection was performed in three chronological stages, corresponding to each of the study’s three objectives (Table 4). The first stage consisted in identifying the building blocks of an intervention program to support family resilience in conjunction with families with a teenager suffering from moderate or severe TBI and rehabili-

369

Family Resilience Following TBI in Adolescents

J. Gauvin-Lepage et al.

Table 1 Sociodemographic data for the teenagers with traumatic brain injury

Table 3 Sociodemographic data for rehabilitation professionals involved with teenagers with traumatic brain injury

Characteristic

Sample Size (n = 6)

Characteristic

Gender

Male: 4 Female: 2

Gender

Female: 5

Age

Age

14 years old: 2 16 years old: 2 17 years old: 2

30–39 years old: 2 40–49 years old: 2 50–59 years old: 1

Education level

Time since trauma* *At the time of data collection

12–18 months: 3 6–11 months: 1 1–5 months: 2

College: 1 University: 4

Work area

Severity of TBI

Moderate: 2 Severe: 4

Family type

Nuclear: 3 Single-parent: 3

Special education teacher: 1 Nurse: 1 Occupational therapist: 1 Psychologist: 1 Neuropsychologist: 1

Years of practice

Siblings, either brothers and/or sisters

None: 1 1–3: 4 More than 4: 1

10–14 years: 2 15–19 years: 0 More than 20 years: 3

Years of experience with patients with TBI

1–9 years: 2 10–19 years: 2 More than 20 years: 1

Work status

Full-time work: 1 Part-time work: 4

Stages(s) of the care continuum involved: intensive functional rehabilitation, social integration, or both

Both: 5

Education level

Current occupation

Secondary Secondary Secondary Secondary

2: 3: 4: 5:

1 2 2 1

Full-time study: 6

Table 2 Sociodemographic data for the parents of teenagers with traumatic brain injury Characteristic

Sample Size (n = 7)

Gender

Male: 1 Female: 6

Age

30–39 years: old 2 40–49 years old: 2 50–54 years old: 3

Marital status

Divorced/separated: 3 Married: 3

Education level

High school: 3 College: 1 University: 3

Relationship with person with TBI

Parent: 7

Work status

Full-time work: 5 Part-time work: 2

tation professionals. The second stage allowed the prioritization of the building blocks of the intervention program with the families and rehabilitation professionals. Finally, the third stage consisted in validating the building blocks of the intervention program with the families and rehabilitation professionals.

370

Sample Size (n = 5)

Through semistructured family interviews (Loiselle, Profetto-McGrath, Polit, & Beck, 2007) and focus groups (Davila & Dominguez, 2010), and using field notes and sociodemographic questionnaires as tools, empirical data were collected to coconstruct the building blocks of the intervention program to support families with a teenager suffering from moderate or severe TBI. After obtaining consent from the participants, the semistructured family interviews and focus groups were recorded on audiotapes and transcribed verbatim. Data Analysis Data analysis was performed concurrently with data collection. The investigator was looking to portray as accurately as possible what the participants had voiced during the semistructured family interviews and focus groups. Miles and Huberman (2003) break down qualitative data analysis into three processes: (1) reducing data, (2) displaying data, and (3) drawing and verifying © 2015 Association of Rehabilitation Nurses Rehabilitation Nursing 2015, 40, 368–377

J. Gauvin-Lepage et al.

Family Resilience Following TBI in Adolescents

Table 4 Tasks performed in each of the stages of the coconstruction of the building blocks for the intervention program Data Collection 1. Identifying the building blocks of an intervention program 2. Prioritizing the building blocks 3. Validating the building blocks

Tasks

Complex Intervention Design and Validation Model

• SSFIs with FAs (n = 6) • FocusGr with RPs (n=5) • SSFIs with FAs (n = 6) • FocusGr with RPs (n = 5) • Mixed FocusGr with RPs and

Step Step the Step

1: Defining the problem 2: Studying the building blocks of intervention 3: Designing the intervention

Step 3: Designing the intervention (continued)

FAs (n = 4 FAs and n = 5 RPs)

SSFIs, semistructured family interviews; FocusGr, focus group; FAs, families; RPs, rehabilitation professionals.

conclusions. Miles and Huberman pose these processes not as linear but rather as iterative. Their conception of qualitative data analysis was chosen for this study.

Table 5 Elements of the intervention program by themes identified and encompassing themes

Results

Elements linked to family Family characteristics “Fighter” personality Cultural and spiritual beliefs Family’s socioeconomic status Presence of hope Keeping a sense of humor

Following a rigorous data collection and analysis process, the investigator was able to identify the following five encompassing themes, which were considered the matrix of the intervention program: (1) family characteristics and its influences; (2) positive family strategies; (3) family and social support; (4) management of occupational aspects; and (5) contribution of the community and health professionals (Table 5). Family Characteristics and its Influences Among the family characteristics mentioned by participants as having contributed to their resilience process are those associated with a “fighter” personality, cultural and spiritual beliefs, and the family’s socioeconomic status. First, it seems that certain traits present in family members, such as determination and positivity, significantly contributed to the resilience process. Speaking of her daughter, one mother said: “She has a good disposition; she’s a fighter, actually.” The family’s cultural and spiritual beliefs can also play a role in dealing with the new situation. A mother admitted: “I pray to the God I believe in every night.” Finally, the family’s socioeconomic status can also affect the resilience process. Families with sufficient financial resources can better withstand the loss of income if one parent needs to take a leave from work. Regarding this factor, a rehabilitation professional noted that “financial resources certainly make it easier. We know that it helps a family adapt and gain some stability.” © 2015 Association of Rehabilitation Nurses Rehabilitation Nursing 2015, 40, 368–377

Elements and Themes Identified

Selected Encompassing Themes

Family characteristics and its influence

Positive family strategies

Elements linked to the family’s immediate environment Family members’ support Family and social support Friends’ support Practice of sports and Management of leisure activities occupational aspects Back-to-school support Elements linked to the family’s larger environment Help received from Contribution from professionals community and health Feeling of being helpful professionals to teenager Role of health professionals

Positive Family Strategies Some family strategies seem to bolster the resilience process, including the presence of hope and keeping a sense of humor despite the situation. Many of the participating families and rehabilitation professionals mentioned that these two elements could influence the resilience process for the family confronted with a teenager’s moderate or severe TBI. About hope, one mother said: “I haven’t lost hope. Neither has my family.” As for sense of humor, one teenager declared: “I used to laugh about my accident because it made it easier to get over it. . . . People stopped

371

Family Resilience Following TBI in Adolescents

treating me like a victim, like a disabled person who needed help.” Family and Social Support Support from family members and friends came out as a significant influence on the resilience process for families confronted with a teenager’s moderate or severe TBI. Among other things, this study showed that strong, diverse and continued family and social support contributed to the resilience process. For instance, one father indicated: “Knowing that there are people that we can count on is really important.” Along the same lines, a teenager asserted: “I mean, one of the things that helps me the most is my best friend. We talk a little, and then a lot, when I talk to him on the phone, and then boom! I feel better.” Management of Occupational Aspects Occupational aspects, and in particular the practice of sports and leisure activities by the family as well as back-to-school support for the teenager, were determined to impact the family’s resilience process. It seems that participating in sports or leisure activities helps promote the resilience process, in that the family uses these special moments to relax and refocus. For example, one teenager said: “I prefer drawing it [the anxiety]. It helps calm me, because when I draw, as soon as I’m done, everything’s gone.” Back-to-school support is also a factor in improved family resilience. One rehabilitation professional mentioned: “Sometimes, we achieve good collaboration with the school and the principals. But sometimes, it’s the opposite . . . and that’s very hard on the families.” Contribution From the Community and Health Professionals The results of this study also served to highlight the influence of the community, as well as health professionals, on the resilience process for families with a teenager with moderate or severe TBI. Specifically, the help received from professionals, the feeling of being helpful to one’s teenager, and the role played by health professionals with the family are all elements that impact the resilience process. The contribution of a health professional, whether from within the interdisciplinary team working with the teenager or outside of it, seems to have helped some

372

J. Gauvin-Lepage et al.

families. One mother claimed: “I asked for help from a psychologist, and it helped.” Furthermore, a number of participants reported that the professionals who gave them a role in caring for their teenager suffering from TBI enabled them to feel active and useful, which proved beneficial. One mother declared: “It allows us to be active with our child. It’s very important.” Finally, rehabilitation professionals recognized playing a role for families confronted with a teenager with TBI. As guides, by helping them make sense of the event, the rehabilitation professionals noticed that this attitude could foster the resilience process. One professional said: “We worked in collaboration with the parents . . . we accompany them in the process. We noticed that it’s more effective than trying to convince them otherwise.” Discussion The results of this study confirm those of previous research, in addition to bringing clarifications to certain elements and new contributions to the building of knowledge. First, it supports the conclusions of previous research in identifying certain aspects of a “fighter” personality, such as determination and positivity (Mullin & Arce, 2008; Simpson & Jones, 2013; West, Usher, & Foster, 2011), as well as support from family members and friends (Cohen, Ferguson, Harms, Pooley, & Tomlinson, 2011; Genest, 2012; Greeff & du Toit, 2009; Greeff & Thiel, 2012; Greeff & Van der Merwe, 2004) as having an impact on the resilience process. Furthermore, this study adds clarification to certain claims in previous study as to the impact of cultural and spiritual beliefs (Jonker & Greeff, 2009; Wu, 2011) and of the family’s socioeconomic status (Bayat, 2007; Walsh, 2006), of the help received from professionals and the feeling of being helpful to one’s teenager, and of the role of health professionals in the resilience process (Greeff, Vansteenwegen, & Herbiest, 2011; Klerk & Greeff, 2011). Finally, it casts a new light on the positive influence of the presence of hope (Simpson & Jones, 2013; West, Buettner, Stewart, Foster, & Usher, 2012), of keeping a sense of humor (Jourdan-Ionescu, 2010), of practicing sports and leisure activities and of back-to-school support (Ahlert & Greeff, 2012) on the resilience process. Proposal for an Intervention Program The results of this study lead to a preliminary proposal for an intervention program to support the resilience pro© 2015 Association of Rehabilitation Nurses Rehabilitation Nursing 2015, 40, 368–377

J. Gauvin-Lepage et al.

Family Resilience Following TBI in Adolescents

cess of families with a teenager suffering from moderate or severe TBI. The five encompassing themes established in this study are the key components of the intervention program. These components, identified by the families and rehabilitation professionals, share a common characteristic, and are flexible and pragmatic, which denotes relevant and realistic applicability in a clinical setting. In short, these five themes form the matrix of an intervention program to support the resilience process of families with a teenager suffering from moderate or severe TBI. More precisely, this program would be intended for rehabilitation professionals and family members willing to enroll and currently in the intensive functional rehabilitation stage. The program could be offered as six interactive group sessions, the first of which would be preparatory. This introductory session would introduce the theoretical principles of the program and its structure to the rehabilitation professionals and family members. Each session, averaging 60 minutes, would be offered at regular intervals—every 2 weeks—over a period of approximately 3 months (Table 6). Given that the content of the sessions would be largely based on the results of this study and on empirical and theoretical research on the topics addressed, as well as in accordance with the points raised by the partici-

pants in this study, the sessions should be led by a professional with psychosocial clinical experience. In the interest of demonstrating the added value of the training and role of advanced practice nurses, this program could be provided by a nurse with a master’s level education, such as a clinical nurse specialist. A pairing with a family member could also be considered to reinforce the “experiential” aspect of the program, which is fundamental to better understand the family resilience process. Finally, specifically designed learning tools, such as a logbook, would support the evolution of the participants in the program. This preliminary proposal would lead to further validation with the participants. Implications of the Study This study opens up new clinical and scientific horizons for healthcare areas linked to rehabilitation. First, it reasserts the benefits of a humanist approach centered on the life plans of patients and their family. This approach acknowledges the importance of the role of rehabilitation professionals, particularly nurses, in interdisciplinary rehabilitation teams. It also highlights the specific contributions of knowledge building through scientific research performed in an interdisciplinary and compassionate con-

Table 6 Proposal for the structure of an intervention program based on the established themes Elements and Themes Identified

Elements linked to family Family characteristics “Fighter” personality Cultural and spiritual beliefs Family’s socioeconomic status Presence of hope Keeping a sense of humor Elements linked to immediate family environment Support of family members Support of friends Practice of sports and leisure activities Support during return to school Elements linked to the family’s larger environment Help from professionals Feeling of being helpful to the teenager Role of healthcare professionals

© 2015 Association of Rehabilitation Nurses Rehabilitation Nursing 2015, 40, 368–377

Interactive Group Session

Length

Preparatory: The intervention program to support family resilience; its principles and structure

60 minutes

Family characteristics and influences

60 minutes

Sharing of positive family strategies

60 minutes

Impacts of family and social support

60 minutes

Benefits of managing occupational aspects

60 minutes

Contribution of community and healthcare professionals

60 minutes

373

Family Resilience Following TBI in Adolescents

Key Practice Points  Inspired by empirical and theoretical research about resilience, nurses and other rehabilitation professionals working with families are increasingly questioning the nature of interventions that can promote or support these families’ resilience.  By virtue of its unexpected character, the occurrence of TBI in a teenager can weaken the family dynamics even further and the myriad of impacts caused by a TBI forces the family to alter its plans for the future by committing themselves together to rebuild them.  The data analysis process identified the following five encompassing themes, which were considered the matrix of the intervention program: (1) family characteristics and its influences; (2) positive family strategies; (3) family and social support; (4) management of occupational aspects; and (5) contribution of the community and health professionals.  This study opens up new clinical and scientific horizons for healthcare areas linked to rehabilitation.

text that builds on the various viewpoints of the participants involved. Strengths and Limitations From a methodological standpoint, the study’s first strength lies in its inductive and qualitative framework supported by a collaborative research approach (Desgagne, 1997). This framework allowed the coconstruction of an intervention program based on the real-life experience of families and rehabilitation professionals. Given the intensive nature of the research conducted with the participants, the sample size was bound to be small. The investigator was nevertheless able to identify recurring themes that emerged from the interviews with families and professionals, which demonstrates that data saturation was reached. In a similar vein, it must be mentioned that the sample was relatively homogeneous. The investigator wished to enroll families that differed on various characteristics to record a variety of experiences. However, it proved difficult to attain this variety due to several factors, one being that many teenagers who sustain a severe TBI pass away in acute care and never reach the functional rehabilitation stage. Consequently, the few eligible families were from the same geographical area, had a similar family situation and a comparable socioeconomic level.

374

J. Gauvin-Lepage et al.

Furthermore, the postaccident period had to be extended to enroll as many participants as possible. This study therefore involved participants from 1 to 18 months postaccident. Given that the coconstruction of the building blocks of the intervention program was based on the unique experience of each family, it goes without saying that a family whose teenager sustained a moderate or severe TBI 1 or 2 months prior does not have the benefit of the same hindsight than a family whose teenager suffered a TBI 17 months ago. It must also be noted that a memory bias was observed. As time passes, it becomes more difficult for the family to access certain details about their experience that are critical to reach the goal and objectives of the study. Finally, the rehabilitation professionals’ diversity of fields and experience with children or teenagers is one of this study’s strengths. Their rich and often complementary accounts proved to be relevant evidence for the study. However, the absence of the social worker in the group is a limitation. By virtue of their role, social workers are highly involved with individuals, families and communities. Unfortunately, an extraordinary circumstance within the group of social workers in the study’s setting prevented her from participating in the study.

Conclusion Based on a disciplinary perspective promoting a humanist view of experience within the family, this study enabled the coconstruction of the building blocks of an intervention program supporting the resilience of families with a teenager suffering from moderate or severe TBI. Its significance rested on the elaborate inductive framework on which it was based and on the use of a complex intervention design and validation model (Van Meijel et al., 2004) that sought to give a preeminent place to the perspective of a diverse group of participants all throughout the coconstruction process. A collaborative research approach (Desgagne, 1997) supported the building of knowledge which, combined with the investigator’s sound clinical experience, led to extremely rich and relevant results. This study’s many assets will impact the future development of validated family intervention programs.

Conflict of Interest The authors report no declarations of interest.

© 2015 Association of Rehabilitation Nurses Rehabilitation Nursing 2015, 40, 368–377

J. Gauvin-Lepage et al.

References Ahlert, I.A., & Greeff, A.P. (2012). Resilience factors associated with adaptation in families with deaf and hard of hearing children. American Annals of the Deaf, 157(4), 391–404. Anderson, V., Brown, S., Newitt, H., & Hoile, H. (2011). Long-term outcome from childhood traumatic brain injury: Intellectual ability, personality, and quality of life. Neuropsychology, 25(2), 176–184. Bayat, M. (2007). Evidence of resilience in families of children with autism. Journal of Intellectual Disability Research, 51(9), 702–714. Campbell, T.L. (2003). The effectiveness of family interventions for physical disorders. Journal of Marital and Family Therapy, 29(2), 263–281. Chen, H.Y., & Boore, J.R.P. (2008). Living with a relative who has a spinal cord injury: A grounded theory approach. Journal of Clinical Nursing, 18(2), 174–182. Chrisman, S.P., & Richardson, L.P. (2012). Relationship between depression and traumatic brain injury in adolescents. Journal of Adolescent Health, 50(2), S49–S50. Cimon, L., Tetrault, S., & Beaupre, P. (2000). Preparer les familles a la transition du jeune vers la vie adulte. In P. Beaupre, J.-C. Kalubi, J. Trahan and M. Gratton (Eds.), Partenariat en recherche: Un atout pour les intervenants et les familles des personnes vivant avec des incapacites (pp. 47–58).  Montreal, Quebec, Canada: Editions Nouvelles. Cohen, L., Ferguson, C.A., Harms, C.A., Pooley, J., & Tomlinson, S. (2011). Family systems and mental health issues: A resilience approach. Journal of Social Work Practice, 25(1), 109–125. Crotty, M. (1998). The foundations of social research: Meaning and perspective in the research process. Thousand Oaks, CA: Sage. Davila, A., & Dominguez, M. (2010). Formats des groupes et types de discussion dans la recherche sociale qualitative. Recherches qualitatives, 29(1), 50–68. Denzin, N.K., & Lincoln, Y.S. (2011). The SAGE Handbook of Qualitative Research (4th ed). Thousand Oaks, CA: Sage. DePalma, J.A. (2001). Measuring quality of life of patients of traumatic brain injury. Critical Care Nursing Quarterly, 23 (4), 42–51. Desgagne, S. (1997). Le concept de recherche collaborative: L’idee d’un rapprochement entre chercheurs universitaires et praticiens enseignants. Revue des sciences de l’education, 23 (2), 1–23. Desgagne, S. (2007). Le defi de coproduction de savoir en recherche collaborative. Autour d’une demarche de

© 2015 Association of Rehabilitation Nurses Rehabilitation Nursing 2015, 40, 368–377

Family Resilience Following TBI in Adolescents

reconstruction et d’analyse de recits de pratique enseignante. In M. Anadon (Ed.), La recherche participative (pp. 89–121). Quebec City, Canada: Presses de l’Universite du Quebec. Desgagne, S., Bednarz, N., Lebuis, P., Poirier, L., & Couture, C. (2001). L’approche collaborative de recherche en education: Un nouveau rapport a etablir entre recherche et formation. Revue des sciences de l’education, 27(1), 33–64. Earvolino-Ramirez, M. (2007). Resilience: A concept analysis. Nursing Forum, 42(2), 73–82. Francßois, N. (2005). Traumatises cr^aniens. . . et apres: Reeducation et appropriation a l’adolescence. In P. Alvin (Ed.), L’annonce du handicap a l’adolescence (pp. 58–68). Paris, France: Viubert. Gauvin-Lepage, J., & Lefebvre, H. (2010). Social inclusion of persons with moderate head injuries: The points of view of adolescents with brain injuries, their parents and professionals. Brain Injury, 24(9), 1087–1097. Genest, C. (2012). La resilience des familles endeuillees par le  suicide d’un adolescent: Emerger malgre la blessure indelebile (Unpublished doctoral dissertation). Montreal, Canada: Faculty of Nursing of the University of Montreal. Greeff, A.P., & du Toit, C. (2009). Resilience in remarried families. American Journal of Family Therapy, 37(2), 114– 126. Greeff, A.P., & Thiel, C. (2012). Resilience in families of husband with prostate cancer. Rehabilitation Nursing, 37(3), 97–104. Greeff, A.P., & Van der Merwe, S. (2004). Variables associated with resilience in divorced families. Social Indicators Research, 68(1), 59–75. Greeff, A.P., Vansteenwegen, A., & Herbiest, T. (2011). Indicators of family resilience after the death of a child. Omega-Journal of Death and Dying, 63(4), 343– 358. Guba, E.G., & Lincoln, Y.S. (1985). Naturalistic inquiry. Beverly Hills, CA: Sage. Guba, E.G., & Lincoln, Y.S. (1989). Fourth generation evaluation. Newbury Park, CA: Sage. House, L.A., Russell, H.F., Kelly, E.H., Gerson, A., & Vogel, L.C. (2009). Rehabilitation and future participation of youth following spinal cord injury: Caregiver perspectives. Spinal Cord, 47(12), 882–886.  INSPQ (2012). Evolution des hospitalisations attribuables aux traumatismes craniocerebraux d’origine non intentionnelle au Quebec. Quebec, Canada: Gouvernement du Quebec. Jonker, L., & Greeff, A.P. (2009). Resilience factors in families living with people with mental illnesses. Journal of Community Psychology, 37(7), 859–873.

375

Family Resilience Following TBI in Adolescents

Jourdan-Ionescu, C. (2010). L’humour comme facteur de resilience pour les enfants a risque et leur famille. Bulletin de Psychologie, 63(6), 449–456. Klerk, H., & Greeff, A.P. (2011). Resilience in parents of young adults with visual impairments. Journal of Visual Impairment and Blindness, 105(7), 414–424. Laloua, F. (2006). Quelle evaluation chez l’adolescent ou l’adulte jeune traumatise cr^anien grave quand se pose le probleme de la scolarite? In P. Pradat-Diehl and A.  Peskine (Eds.), Evaluation des troubles neuropsychologiques en vie quotidienne (pp. 109–116). Paris, France: SpringerVerlag. Lefebvre, H., & Levert, M.J. (2005). Traumatisme craniocerebral, de la souffrance a la resilience. Frontieres, 17 (2), 77–85. Lefebvre, H., Levert, M.J., & Gauvin-Lepage, J. (2010). Intervention Personnalisee d’Integration Communautaire (IPIC) et resilience. Frontieres, 22(1–2), 78–84. Lefebvre, H., Levert, M.J., & Khelia, I. (2011). Un accompagnement personnalise d’integration communautaire en soutien au developpement de la resilience: Vers un modele. Developpement humain, handicap & changement social, 19(1), 103–110. Lefebvre, H., Pelchat, D., Kalubi, J.C., & Michallet, B. (2002). Experience distinctive de parents, de professionnels et de medecins lors de l’annonce de la deficience motrice cerebrale. In S. Tetreault, P. Beaupre, J.C. Kalubi, & B. Michallet (Eds.), Famille et situation de handicap. Comprendre pour mieux intervenir (pp. 27–48). Sherbrooke,  Canada: Editions du CRP. Lefebvre, H., Pelchat, D., & Levert, M.J. (2007). Interdisciplinary family intervention program: A partnership among health professionals, traumatic brain injury patients, and caregiving relatives. Journal of Trauma Nursing, 14(2), 100–113. Lefebvre, H., Pelchat, D., Swaine, B., Gelinas, I., & Levert, M.J. (2004). Le traumatisme craniocerebral suite a un accident de la route: Les mots des personnes, des familles, des medecins et des professionnels. Recherche en Soins Infirmiers, 78(1), 14–34. Lefrancßois, R. (1997). La recherche collaborative: Essai de definition. Nouvelles Pratiques Sociales, 10(1), 81–95. LoBiondo-Wood, G., Haber, J., Cameron, C., & Singh, M.D. (2009). Nursing research in Canada: Methods, critical appraisal and utilization (2nd ed). Toronto, Canada: Elsevier. Loiselle, C.G., Profetto-McGrath, J., Polit, D.F., & Beck, C.T. (2007). Methodes de recherche en sciences infirmieres. Approches quantitatives et qualitatives. Montreal, Quebec: ERPI.

376

J. Gauvin-Lepage et al.

Luthar, S.S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71(3), 543–562. Miles, M.B., & Huberman, M.A. (2003). Analyse des donnees qualitatives (2nd ed). French translation by M. Hlady Rispal. Paris, France: De Boeck. Mullin, W.J., & Arce, M. (2008). Resilience of families living in poverty. Journal of Family Social Work, 11(4), 424–440. Muscara, F., Catroppa, C., Eren, S., & Anderson, V. (2009). The impact of injury severity on long-term social outcome following pediatric traumatic brain injury. Neuropsychological Rehabilitation, 19(4), 541–561. Neuman, W.L. (2006). Social research methods: Qualitative and quantitative approaches (6th ed). Boston, MA: Allyn & Bacon. Pelchat, D., & Lefebvre, H. (2004). Apprendre ensemble. Le PRIFAM, programme d’intervention interdisciplinaire et familiale. Montreal, Quebec, Canada: Cheneliere McGrawHill. Ross, K.A., McMillan, T., Kelly, T., Sumpter, R., & Dorris, L. (2011). Friendship, loneliness and psychosocial functioning in children with traumatic brain injury. Brain Injury, 25(12), 1206–1211. Schwandt, T.A. (2007). The sage dictionary of qualitative inquiry (3rd ed). Thousand Oaks, CA: Sage. Simpson, G., & Jones, K. (2013). How important is resilience among family members supporting relatives with traumatic brain injury or spinal cord injury? Clinical Rehabilitation, 27 (4), 367–377. Taylor, H.G., Wade, S.L., Stancin, T., Yeates, K.O., Drotar, D., & Minich, N. (2002). A prospective study of shortand long-term outcomes after traumatic brain injury in children: Behavior and achievement. Neuropsychology, 16 (1), 15–27. Tsai, M.-C., Lin, S.-H., & Tsai, K.-J. (2012). Mood disorder after traumatic brain injury in adolescents and young adults: A population-based study of a 5-year follow-up. Journal of Adolescent Health, 50(2), S51–S52. Tusaie, K., & Dyer, J. (2004). Resilience: A historical review of the construct. Holistic Nursing Practice, 18(1), 3–8. Van Meijel, B., Gamel, C., Van Swieten-Duijfjes, B., & Grypdonck, M.H.F. (2004). The development of evidencebased nursing interventions: Methodological considerations. Journal of Advanced Nursing, 48(1), 84–92. Verhaeghe, S., Defloor, T., & Grypdonck, M. (2005). Stress and coping among families of patients with traumatic brain injury: A review of the literature. Journal of Clinical Nursing, 14(8), 1004–1012. Walsh, F. (2006). Strengthening family resilience (2nd ed). New York, NY: Guilford Press. © 2015 Association of Rehabilitation Nurses Rehabilitation Nursing 2015, 40, 368–377

J. Gauvin-Lepage et al.

West, C., Buettner, P., Stewart, L., Foster, K., & Usher, K. (2012). Resilience in families with a member with chronic pain: A mixed methods study. Journal of Clinical Nursing, 21(23–24), 3532–3545. West, C., Usher, K., & Foster, K. (2011). Family resilience: Towards a new model of chronic pain management. Collegian, 18(1), 3–10. Wright, L.M., & Leahey, M. (2013). Nurses and families: A guide to family assessment and intervention (6th ed). Philadelphia, PA: F.A. Davis. Wu, H.C. (2011). The protective effects of resilience and hope on quality of life of the families coping with the criminal traumatisation of one of its members. Journal of Clinical Nursing, 20(13–14), 1906–1915.

© 2015 Association of Rehabilitation Nurses Rehabilitation Nursing 2015, 40, 368–377

Family Resilience Following TBI in Adolescents

Earn nursing contact hours Rehabilitation Nursing is pleased to offer readers the opportunity to earn nursing contact hours for its continuing education articles by taking a posttest through the ARN website. The posttest consists of questions based on this article, plus several assessment questions (e.g., how long did it take you to read the articles and complete the posttest?). A passing score on the posttest and completing of the assessment questions yield one nursing contact hour for each article. To earn contact hours, go to www.rehabnurse.org and select the “Education” page. There you can read the article again, or go directly to the posttest assessment by selecting “RNJ online CE.” The cost for credit is $10 per article. You will be asked for a credit card or online payment service number. The contact hours for this activity will not be available after December 31, 2017. The Association of Rehabilitation Nurses is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC-COA).

377

Resilience in Families With Adolescents Suffering From Traumatic Brain Injuries.

This study aims to coconstruct the building blocks for an intervention program to support family resilience in conjunction with families with an adole...
185KB Sizes 2 Downloads 9 Views