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Self-identity practices in community-based rehabilitation after acquired brain injury

November 22, 2017

Dr Maxine Bevin, a Speech Language Therapist, works as a rehabilitation professional at the Stewart Centre @ EIT, a community-based rehabilitation centre for adults with brain injuries acquired through stroke or trauma. The centre at EIT is part of a national organisation, The Stewart Centre Trust, which provides post-acute rehabilitation services for individuals in a group environment.

Maxine, Alexa Hantler (Registered Nurse and EIT  Senior Nursing Lecturer), Bobbie Cameron (Registered Nurse) and Shona Thompson (EIT Researcher) explored how the experiences of attending the rehabilitation centre may influence the processes that clients go through following a traumatic brain injury which contribute to their senses of self. Historically, rehabilitation after acquired brain injury has focused on cognitive, physical and behavioral changes but people can also experience significant changes in their self-identity following a brain injury. They may talk about the ‘old me’ and the ‘new me’ when describing themselves before and after the injury. The research focused on social interactions occurring routinely amongst clients and staff at the centre, including the formal, facilitated group rehabilitation sessions and informal interactions such as shared lunches. 

With the fully informed consent of 54 clients, staff, helpers and students attending the centre, a number of the routine group rehabilitation sessions and lunchtimes were filmed, collecting 6.5 hours of video data. These recordings were then systematically analysed using an interactional socio-linguistic approach to discourse analysis to highlight social interactions that contributed to the enhancement of clients’ self-identity development. This form of analysis allowed the researchers to look more closely at what was happening at the centre to better understand identity rehabilitation processes at work.  It enabled them to identify six key dimensions which were evident in the process, such as belonging, trusting the group, respecting, sharing humour, balancing the needs, and acknowledging strengths. 

Results of the research resonated with the concept that it is not only ‘what’ is done in rehabilitation that is important but also ‘how’ it is done. The research team recognised that rehabilitation for identity reconstruction following acquired brain injury involves more than just the delivery of a service to clients. It is also embedded in the formal and informal social interactions that take place within the rehabilitation setting.

As well as an extensive written report, Maxine, Alexa and Shona have presented the results of their research to the participants involved, and to the Stewart Centre New Zealand senior management team,  The Hawke’s Bay Brain Injury Interest Group, the EIT School of Nursing and at the EIT  ‘Brown Bag Lunch’ seminar series.

Maxine Bevin, Alexa Hantler, Bobbie Cameron and Shona Thompson