A meta-synthesis of individual, interpersonal, and systemic factors impacting resilience after traumatic brain injury.

Abstract

Purpose/Objective: Traumatic brain injuries (TBIs) are increasingly common and a major cause of death and long-term disability. Many individuals experience chronic stressors and adverse health outcomes, emphasizing the importance of cultivating resilience, (defined herein as individual, social, and systemic components engaged in response to the stressors that allow individuals to “bounce back,” or move forward adaptively after TBI). Patients’ perceptions of factors influencing resilience are critical to guide interventions that meet their needs. Here we offer the first metasynthesis of factors influencing resilience after TBI using a Social Ecological model framework. Research Methods/Design: We preregistered our metasynthesis on PROSPERO (CRD42021233975) and followed PRISMA guidelines. We searched 4 electronic databases for qualitative studies from inception up until June 2021. We included qualitative studies detailing perspectives of individuals with a history of moderate-severe TBI. We excluded case studies and systematic reviews. After removal of duplicates, we identified 124 articles for screening. We reviewed 49 articles for full text eligibility and included 38 studies. We extracted study characteristics and data (e.g., author interpretations and relevant quotes) relating to factors influencing resilience. Results: We synthesized findings using a Social Ecological model framework to guide thematic analysis. Persons with TBI identified barriers and facilitators to resilience at individual (e.g., physical and cognitive challenges, coping behaviors), interpersonal, (e.g., stigma and isolation) and systemic (e.g., access to resources, rehabilitation support) levels. Conclusions/Implications: Considering multifaceted factors at individual, interpersonal and systemic levels in clinical, research, and policy-setting contexts is important for cultivating resilience and optimizing recovery after TBI.

The Impact of a Recent Concussion on College-Aged Individuals with Co-Occurring Anxiety: A Qualitative Investigation

“…This finding supports prior evidence of post-traumatic growth following brain injury [51]. A recent meta-synthesis highlighted the framing of traumatic brain injury as a "new beginning" promoting a renewed desire to pursue goals as a strategy promoting resilience after moderate-severe traumatic brain injury [52]. Our results extend these findings, indicating that such renewed desire is evident after mild (rather than only moderate or severe) traumatic brain injury, and in earlier stages after injury than previously found.…”

“We are in this together”: The power of social connection

“…14 Studies of patients suffering traumatic brain injury or severe burn injury also demonstrate the value of social support during recovery, which has led to the development of traumatic brain injury support programs and innovative strategies such as burn camps. [15][16][17] Thus, as we focus on the long-term recovery of our patients, it is important that we incorporate strategies to enhance their social connection and social support.…”