“Manoeuvring in uncharted waters – a balancing act”: A qualitative exploration of treatment and improvement after mild traumatic brain injury

ABSTRACT

Background: Individuals who have sustained mild traumatic brain injury (mTBI) with a protracted course of recovery may experience long-lasting somatic, cognitive, and emotional symptoms affecting activities of daily living. There is limited knowledge regarding individuals’ lived experiences with treatments and advice provided.

Purpose: To explore how individuals with mTBI describe and make sense of their injury, recovery process, and their experiences with various treatment approaches.

Methods: Eight participants with mTBI were recruited from the intervention group in an ongoing randomized controlled trial regarding return-to-work. They were interviewed once after treatment delivery using a qualitative hermeneutical approach. Thematic analysis was applied, and findings are discussed in light of a salutogenic theory.

Results: Participants expressed uncertainty regarding conflicting advice they received in the early phase of recovery. Three main themes were developed: (1) “Ambiguity and hope”; (2) “Uncertainty concerning activity and rest”; and (3) “To become the person I used to be vs. to become a new version of myself.”

Conclusion: The findings showed that the participants experienced both uncertainty and hope for further recovery. The recovery process is challenged by the variability of TBI symptoms that affects participation in everyday life, as well as the conflicting advice received by the participants.

KEYWORDS:

• Post-concussive symptoms
• mTBI
• Recovery
• Qualitative
• Sense of coherence

Acknowledgements

The authors thank all participants in this study, as well as all members of the RCT research group that contributed.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Declaration of interest statement

This study was derived from an ongoing randomized controlled trial conducted by Oslo University Hospital, Sunnaas Rehabilitation Hospital, the Norwegian Labour and Welfare Administration (NAV), and the Work Research Institute (AFI), and funded by the Research Council of Norway (RCN). The authors report no conflicts of interest.

Authorship

In line with the International Committee on Medical Journal Ethics (ICMJE), all authors made substantial contributions to the conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article and revising it critically for important intellectual content; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Additional information

Funding

The study was partly funded by the Research Council of Norway.