"Why aren't you better yet?": Deriving a grounded theory about healthcare experiences of individuals with traumatic brain injuries.

PURPOSE: To develop a grounded theory related to the experiences of individuals with mild, moderate, and severe traumatic brain injuries within healthcare contexts.

METHOD: This investigation examined the open-ended responses of the mCARE-TBI survey, which was distributed throughout the US and Canada. There were 64 responses that met criteria for analyses. Participants self-reported as ≥18 years old, ≥1 year post onset, and indicated they had no unrelated neurological diagnoses prior to their traumatic brain injury, nor prior diagnosed psychiatric conditions. Grounded theory was employed to generate a theoretical model regarding the lived experiences of individuals with traumatic brain injury in healthcare contexts.

RESULT: Qualitative analyses identified three overarching themes: Positive characteristics (collaboration, empathy and attitudes, strong communication skills, and being knowledgeable), neutral (having knowledge and providing adequate care), and negative characteristics of providers (poor communication and limited knowledge, being unprofessional and lacking empathy, and being dismissive and neglectful). This informed a model for effective or 'present' providers versus ineffective or 'absent' providers.

CONCLUSION

There has been limited productive movement regarding development of adaptive strategies in the recovery phases of traumatic brain injury. Our model identifies specific suggestions for providers, primarily derived from subthemes, which could be used to develop provider training.