• Challenges and solutions during analysis in a longitudinal narrative case study

      Whiffin, Charlotte Jane; Bailey, Christopher; Ellis-Hill, Caroline; Jarrett, Nicola; University of Derby; University of Nottingham; Bournemouth University; University of Southampton (Royal College of Nursing, 2014-03-27)
      Aim To describe the challenges faced by those performing complex qualitative analysis during a narrative study and to offer solutions. Background Qualitative research requires rigorous analysis. However, novice researchers often struggle to identify appropriately robust analytical procedures that will move them from their transcripts to their final findings. The lack of clear and detailed accounts in the literature that consider narrative analysis and how to address some of the common challenges researchers face add to this problem. Data sources A longitudinal narrative case study exploring the personal and familial changes reported by uninjured family members during the first year of another family member’s traumatic brain injury. Review methods This is a methodological paper. Discussion The challenges of analysis included: conceptualising analysis; demonstrating the relationship between the different analytical layers and the final research findings; interpreting the data in a way that reflected the priorities of a narrative approach; and managing large quantities of data. The solutions explored were: the mapping of analytic intentions; aligning analysis and interpretation with the conceptual framework; and the use of matrices to store and manage quotes, codes and reflections. Conclusion Working with qualitative data can be daunting for novice researchers. Ensuring rigorous, transparent, and auditable data analysis procedures can further constrain the interpretive aspect of analysis. Implications for research/practice The solutions offered in this paper should help novice researchers to manage and work with their data, assisting them to develop the confidence to be more intuitive and creative in their research.
    • An exploration of family in the context of head injury: a narrative understanding of change

      Secretary, SRR; whiffin, charlotte; Bailey, Christopher; Ellis-Hill, Caroline; Nikki, Jarrett; Peter, Hutchinson J.; University of Derby; University of Nottingham; Bournemouth University; University of Portsmouth; et al. (SAGE Publications, 2020-02-13)
      Traumatic brain injury is potentially devastating. Families commonly respond by supporting the injured individual and their recovery. However, family members are at risk of negative psychological outcomes and family functioning has emerged as a key variable post injury. What is less understood are the subjective changes experienced by families and the impact these have post injury. A longitudinal narrative case study using in-depth narrative qualitative interviews. Data were collected a one, three and 12 months post injury. Nine non-injured family members from three families were recruited from an acute neurosurgical ward. Five interwoven narrative threads were identified: trauma, recovery, autobiographical, suffering and family. The narrative approach emphasized that the first-year post-head injury was a turbulent time for families, who were active agents in the process of change. Families’ stories of illness from a nonpatient perspective need recognition and validation in their own right. understanding this experience in terms of biographical narratives helps to recognize the vacillation between change and continuity. Adopting a narrative approach to rehabilitation may be more positive than adopting a model of loss. Change is not limited to the injured person and family members need help to understand that they too are changing as a result of their experiences. In addition, it is proposed that there be a shift in the discourse in research and practice literature away from loss and towards transition, with greater recognition of the role that uninjured family members play in making sense of change post injury.
    • Narratives of family transition during the first year post-head injury: perspectives of the non-injured members

      Whiffin, Charlotte Jane; Bailey, Christopher; Ellis-Hill, Caroline; Jarrett, Nicola; Hutchinson, Peter J.; University of Derby; University of Derby Derbyshire Chambers and Business Link; Canal Wharf Chesterfield UK; Faculty of Health Sciences; University of Southampton; Highfield, Southampton UK; University of Bournemouth; Poole Dorset UK; Faculty of Health Sciences; University of Southampton; Highfield, Southampton UK; et al. (2014-10-23)
      Aim To explore the narratives created by non-injured family members in relation to themselves and their family in the first year after head injury. Background A head injury is a potentially devastating injury. The family responds to this injury by supporting the individual and their recovery. While the perspective of individual family members has been well documented, there is growing interest in how the family as a whole makes sense of their experiences and how these experiences change over time. Design Longitudinal narrative case study using unstructured in-depth interviews. Methods Data were collected during an 18-month period (August 2009-December 2010). Nine non-injured family members from three families were recruited from an acute neurosurgical ward and individual narrative interviews were held at one, three and 12 months postinjury where participants were asked to talk about their experience of head injury. Analysis was completed on three levels: the individual; the family and between family cases with the aim of identifying a range of interwoven narrative threads. Findings Five interwoven narratives were identified: trauma, recovery, autobiographical, suffering and family. The narrative approach emphasized that the year posthead injury was a turbulent time for families, who were active agents in the process of change. Conclusion This study has shown the importance of listening to people's stories and understanding their journeys irrespective of the injured person's outcome. Change postinjury is not limited to the injured person: family members need help to understand that they too are changing as a result of their experiences.
    • Supporting families in the context of adult traumatic brain injury

      Clark, Charlotte; Brown, Janice; Bailey, Christopher; Hutchinson, Peter J.; University of Suffolk; University of Southampton; Cambridge University Hospitals (Mark Allen Group, 2013-09-27)
      Families are fundamental to the wellbeing, quality of life and functional and social outcomes of individuals who sustain traumatic brain injury (TBI). However, the family is often vulnerable and at risk from the challenge of supporting an individual who has been left with long-term neurological disability. Considering the young population often affected, the resulting conditions can have significant emotional and financial burden for families and service providing for their long-term needs. The National Service Framework for Long-term Conditions acknowledges that the whole family is affected by neurological disability and it suggests that a 'whole-family' approach to managing TBI may be useful. This paper will argue that both family systems theory and family-centred care are frameworks that may be helpful in achieving the 'whole-family' approach in practice. However, future research is needed that will assess the efficacy of these and other approaches so that health-care services know the true value of any such intervention.
    • We are not the same people we used to be: an exploration of family biographical narratives and identity change following traumatic brain injury

      Whiffin, Charlotte Jane; Ellis-Hill, Caroline; Bailey, Christopher; Jarrett, Nicola; Hutchinson, Peter J.; University of Derby; Bournemouth University; University of Nottingham; University of Southampton; University of Cambridge (Taylor and Francis, 2017-10-26)
      Subjective changes are increasingly recognised as important in recovery and rehabilitation following traumatic brain injury. Accumulation of subjective changes over time has led many to examine the question of ‘continuity of self’ post-injury. Vacillation between feeling the same and different is common and often at odds with the medical narrative preparing families for permanent change. This position of ambiguity was examined in a qualitative narrative study. The aim of this paper is to describe the narrative structures used by uninjured members of a family to understand change. These changes relate primarily, to their perspective of whether and how the injured person had changed, but also secondarily to whether and why they themselves felt they had changed in the first year post-injury. Nine uninjured family members from three families took part in three unstructured interviews during the first twelve months post-injury. In-depth narrative analysis showed family members used biographical attendance; biographical disruption; biographical continuity and biographical reconstruction to understand change. Drawing on these findings it is argued that concentrating on a narrative of change is too limiting and that engaging in biographical narratives may help humanise care provided to injured individuals and their families. Implications for research and practice are discussed