The Influence of Cultural Background on Experiences and Beliefs about Traumatic Brain Injury and their Association with Outcome

Abstract

T he aim of the study was to compare beliefs and experiences of traumatic brain injury (TBI) in patients with TBI from the dominant English-speaking culture in Australia versus those from minority culturally and linguistically diverse (CALD) backgrounds and examine the relative influence of beliefs, acculturation, along with demographic and injury-related variables on outcome. The primary measures included the Illness Perception Questionnaire-Revised (IPQ-R), and the Craig Handicap Assessment and Reporting Technique (CHART). Participants were 70 individuals with mild to severe TBI, including 38 of English-speaking background (ESB) and 32 from CALD backgrounds. Although similar to the ESB participants in education, preinjury employment status, injury severity and experience of TBI, the CALD participants differed significantly from ESB participants on acculturation variables. CALD participants also experienced greater negative emotions and were less likely to have internal locus of control causal beliefs than ESB participants. Regression analyses indicated that describing one's value system as other than Australian, poorer understanding of TBI and greater negative emotional reactions, along with fewer years of education were associated with poorer outcomes on the CHART. Thus, in treating patients from different cultural backgrounds it is important for health professionals to understand beliefs about and responses to TBI, as they could potentially impact on coping, emotional adjustment and long-term outcome.

Brain injury beliefs, self-awareness, and coping: A preliminary cluster analytic study based within the self-regulatory model

“…Whittaker, Kemp, and House (2007) explored illness perceptions and outcome in mild head injury, reporting that poorer functional outcome and enduring post-concussional symptoms were predicted by individuals' beliefs about negative and chronic consequences, rather than by objective clinical measures of injury severity. Saltapidas and Ponsford (2008) examined the influence of cultural background on beliefs about TBI and their association with outcome in an Australian sample comprising individuals of both English-speaking and culturally and linguistically diverse backgrounds. Overall, the authors found that a less comprehensive understanding of TBI (coherence) and greater negative emotions (emotional representations) were associated with reduced psychosocial and functional outcomes; trends that were further pronounced amongst those who described their cultural value system as other than "Australian".…”

“…Leventhal et al (2003) have emphasised the dynamic nature of illness or injury representations over time, necessitating longitudinal research or perhaps single case designs to explore the degree to which individuals' beliefs fluctuate or evolve after TBI (Jessop & Rutter, 2003). The influence of cultural backgrounds on injury beliefs and interactions with rehabilitation professionals also merits further exploration, building upon the recent work by Saltapidas and Ponsford (2008).…”

Life satisfaction and self-efficacy in patients affected by a first stroke living in Kuwait: A two-phase study

“…Culture influences perceptions of symptoms, meanings of health, the experience of personal control, attitudes towards disability, and coping strategies (Gallaher and Hough, 2001;Snead and Davis, 2002;Skaff and Gardiner, 2003). In illustration, Saltapidas and Ponsford (2008) found that patients with traumatic brain injury (TBI) from minority group 3 backgrounds in Australia scored lower in internal locus of control (LOC) than patients from the dominant English-speaking culture. This may reflect Western values that emphasise autonomy and self-responsibility, whilst in some non-Western cultures, LOC is more externalized, and the ill person is more likely to be viewed as dependent on the family and not responsible for self-managing the condition (Stanhope, 2002;Dalvandi et al, 2010).…”

Families Coping With Disability Due to Brain Injury in Oman

“…In LDCs, as the burden of care is limited to the family circle, the consequences of the injury not only affect the victim but also that person's entire social network. Similar trends appear to exist even in developed Western countries (Simpson, Mohr, & Redman, 2000) where it has been demonstrated that the role of the family has a significant impact on the rehabilitative process and its functional prognosis (Kreutzer et al, 2009;Saltapidas & Ponsford, 2008, Schönberger, Ponsford, Olver, & Ponsford, 2010. There is evidence to suggest that social support is critically important in determining the level of adjustment of the patient/family to the situation (Ergh, Hanks, Rapport, & Coleman, 2003;Gan, Gargaro, Brandys, Gerber, & Boschen, 2010;Janda et al, 2008;.…”