Experiences that challenge self-identity following traumatic brain injury: a meta-synthesis of qualitative research

Purpose: To systematically review and synthesise the qualitative literature on experiences that challenge self-identity following traumatic brain injury (TBI). Method: Four electronic databases were searched systematically for qualitative research published between 1965 and August 2017, investigating subjective experiences of identity change following TBI. Papers which met the inclusion criteria were evaluated using the Critical Skills Appraisal Programme (CASP) tool and synthesised using guidelines by Thomas and Harden (2008). Results: Of the 1965 papers retrieved, 36 met inclusion and quality criteria. Synthesis resulted in six themes: (1) awareness of change in physical, cognitive, emotional and social functioning; (2) autobiographical memory loss; (3) responses of other people that highlight change; (4) loss of autonomy; (5) comparing old me and new me-loss of valued roles and activities; (6) social rejection and stigma. Conclusions: An in-depth understanding of the experiences that challenge self-identity after TBI can inform rehabilitation to support individuals to negotiate these processes with less distress and more successfully.

Automated summary

This study systematically reviewed and synthesized qualitative literature on experiences that challenge self-identity following traumatic brain injury (TBI). Six themes were identified, including changes in physical, cognitive, emotional, and social functioning, autobiographical memory loss, loss of autonomy, comparing old self with the new self, and social rejection and stigma. These findings can inform rehabilitation efforts to support individuals in negotiating these challenges more successfully and with less distress.