Qualitative Examination of Voting Empowerment and Participation Among People Living With Traumatic Brain Injury.

OBJECTIVE: To examine political participation after traumatic brain injury (TBI). DESIGN: Qualitative, participatory research via interviews and observations. Each participant was interviewed to discuss their experience of voting in 2007 or 2008. Data were coded using Grounded Theory to develop themes, metacodes, and theories. SETTING: Community. PARTICIPANTS: A total of 57 individuals with history of TBI and 28 family members (N=85). MAIN OUTCOME MEASURES: Not applicable. RESULTS: Four themes emerged from the data: (1) people with TBI have barriers to voting; (2) the voting process can be improved for people with TBI; (3) voting is the responsibility of members of society; and (4) voting is one way we have a voice in society. CONCLUSIONS: The data support the importance of voting as an American right regardless of the presence of disability. While persons with TBI report voting represents their freedom and voice, there may be barriers that can threaten or limit their voice.

A Time to Live and a Time to Die: Heterotopian Spatialities and Temporalities in a Pediatric Palliative Care Team.

The death of a child creates especially poignant feelings and extreme stress, distress, and devastation for family members and healthcare providers. In addition, serious or long-term illness forces a reconstruction of our experiences with time and space. In this paper, we report on a long-term ethnographic study of a Pediatric Palliative Care Team (PPCT). Using the concepts of spatiality and temporality; Deleuze's concepts of smooth and striated spaces; Innis's concepts of space and time biases; Foucault's concept of heterotopian space-places with multiple layers of meaning; and a related concept of heterokairoi-moments in time with multiple possibilities-we consider how the PPCT constructs and reconstructs meaning in the midst of chaos, ethical dilemmas, and heartbreaking choices.

Constructing the dead: Retrospective sensemaking in eulogies.

Eulogies serve a sensemaking function of identity construction--both for the deceased and for the survivors. This work examines the communicative construction of identity in eulogies and shows how eulogia discourse affirms and reconstructs our relational identity through communication. The article extends scholarship on eulogies by using relational communication theories to investigate how eulogic discourse functions as identity construction, considering eulogies of ordinary people, and exploring the gendered nature of eulogies. We discuss how eulogies are specific ritualized forms of communication in which the bereaved focus on self-identity as they articulate their experience of grief.

Relational dimension of irritability following traumatic brain injury: a qualitative analysis.

BACKGROUND: Irritability is a common long-term sequelae of traumatic brain injury (TBI). In a prior study on TBI irritability, relational interactions were one of four dimensions of irritability occurrence and precipitation. This present analysis examines these same data in greater detail. METHODS: Fifty focus group transcripts from a study on irritability were re-analysed to examine: (1) irritability in spousal relationships following TBI, (2) retrospective accounts of spousal interactions contributing to irritability and (3) impact of irritability on marital relationships. Grounded Theory was used to develop themes, metacodes and theories. RESULTS: Several theories emerged regarding irritability with respect to spousal relations, all based on the overarching theory that irritability in people with TBI has a strong relational component involved in triggering, experiencing and preventing irritability. Sub-theories supporting this include: (1) irritability breeds further irritability, (2) spousal responses can trigger irritability among persons with TBI and vice versa, (3) difficulties making emotional connections may incite negative interactions, (4) expectations of others may contribute to irritable behaviour, and (5) communication breakdowns may provoke irritability. CONCLUSIONS: Irritability associated with TBI resides in the family system as well as the individual. In treating irritability one should include comprehensive assessment and assistance to improve interpersonal interactions.

Marital adjustment and stability following traumatic brain injury: a pilot qualitative analysis of spouse perspectives.

BACKGROUND: Traumatic brain injury (TBI), causing various impairments and functional changes, may adversely impact marital relationships. However, dynamics of the interactions that contribute to these marital difficulties are complex and poorly understood. There has been little research on marital quality and stability in families of a person with TBI. OBJECTIVE: By identifying themes of marital adjustment and stability, this qualitative exploratory study examines how a spouse who has experienced TBI affects the marital relationship. METHODS: Two gender-specific focus groups, each with 5 spouses of individuals living with the effects of TBI, were conducted to collect data on marital interactions that were analyzed for themes related to marital adjustment and stability. The data were analyzed using grounded theory, and then relational theories were applied as a framework for organizing the metacodes and concepts. RESULTS: This study suggests that, after TBI, changes in family dynamics and the way spouses perceive those dynamics affect movement toward pulling together or pulling apart. CONCLUSION: Changes in spousal perceptions, interactions, responsibilities, and reactions to brain injury may impact marital stability and satisfaction. Further study is warranted to better understand and determine whether and how awareness of these changes may be incorporated into treatment.