The process of identity change following ABI from the perspectives of adolescents and their mothers: A relational grounded theory approach

Figures & data

Table 1. Participant characteristics.

Dyad	Pseudonym	Gender	Age	Ethnic Group	Cause of ABI	Age at time of injury	Clinical details (including GCS if known)
1	Noah (adolescent)	Male	17	White British	Severe TBI caused by fall from height	15	Severe Traumatic Brain Injury GCS 4
	Kirsty (mother)		50
2	Aiden (adolescent)	Male	17	White British	ABI – Stroke	14	Intracerebral haemorrhage from ruptured arterio-venous malformation GCS 3
	Kath (mother)		47
3	Leah (adolescent)	Female	16	White British	ABI – Stroke	13	Left Middle Cerebral Artery infarct
	Jenny (mother)		47
4	Matt (adolescent)	Male	18	White British	Moderate TBI caused by RTA – pedestrian hit by vehicle	11	Moderate TBI Contusion between the skin and skull around the eye socket. Mild bilateral contusion of both apices.
	Natalie (mother)		37
5	Jack (adolescent)	Male	15	White British	TBI caused by object falling on head	12	Two traumatic brain injuries (severity unknown) about 1 year apart
	Faye (mother)		41
6	Jordan (adolescent)	Male	16	White British	ABI caused by infection	14	Empyema, cerebral venous thrombosis, and epilepsy requiring neurosurgery
	Amanda (mother)		49

Figure 1. Grounded theory of dyadic identity change processes post adolescent BI.

Read the detailed description of this figure

From left to right, a vertical ellipse with text continuity at the top and change at the bottom, then a vertical 2-head arrow with text “acknowledging” versus “rejecting”. To the right are two circles one above the other with text “my child is here / gone” in the upper circle and “I am / am not normal” in the lower. A diagonal ellipse labelled “the mother's world” extends from here to the right containing text “trying to fix everything” and “my child is changed / the same”. Below, mirroring this is an ellipse labelled “the adolescent's world” containing text “relating and rejection” and “I fit in / don't fit in with my friends”. Between the two ellipses is text “Tentative equilibrium: we are all trying to … figure out what has to be let go of and what can be re-found”.

Table 2. Summary of overarching conceptual themes and subthemes from the grounded theory analysis

Main conceptual theme	Sub-theme or process
Experience of self and tension between continuity and change	Self in relation to self
	Self in relation to others
	Self in relation to the unlived life
Response to experienced continuity/change	I am/am not normal (adolescent)
	My child is here/gone (mothers)
Resolving discrepancies	Fitting in – relatedness and rejection (adolescent)
	My job is to fix everything (mothers)	Preparing		Instilling a resiliency outlook Fighting and advocating Supporting children towards independence and autonomy Supporting adjustment towards personally meaningful goals
		Protecting	Padding	Compensation Mediating relationships
			Presence
			Holding the psychological load	Subjugating and sacrificing Being the emotional punchbag Worrying over vulnerability
Adaptation towards a tentative equilibrium	Adapting, integrating and living with one's self post-injury (adolescent)
	Changed visions or perspectives (mothers)
HIGHER LEVEL THEMES LOWER LEVEL CODING