An exploration into the pathways of care and support followed by persons with post-acute traumatic brain injuries living in Soweto, Johannesburg

Abstract
Background: Persons with Traumatic Brain Injuries (TBI) require care and support from various sources during the post-acute phase. Seeking care and support is crucial for persons with TBI to cope with their new realities and deal with the consequences of their injuries. However, little attention has been paid to the care-seeking behaviours of persons with TBI in the African context, and how these behaviours are impacted by cultural and belief structures. Methodology: To guide the narrative interviews of eleven adults with post-acute traumatic brain injuries living in Soweto, Johannesburg, an exploratory qualitative research design was utilized, underpinned by the biopsychosocial model (Engel, 1977). The sample included both male (N=9) and female (N=2) participants who were fluent in isiZulu, English, or Sepedi, and were selected through purposive and convenience sampling. Participants had sustained TBIs from motor vehicle accidents, pedestrian vehicle accidents, assaults, or falls. The data were analysed using Braun and Clarke’s (2017) six-phase framework in an inductive manner. Findings: The pathways of care and sources of support for persons with TBI are influenced by various biological, psychological, and social factors, including impairments resulting from the TBI, personal values, beliefs and preferences, financial issues, interpersonal relationships, family culture and religion, and education. The study revealed that post-hospitalisation, persons with TBI primarily seek care from family members, as well as from other sources such as friends, the community/neighbours, support groups, therapists, the church, and traditional healers, based on the roles these sources play in their healing process. However, the COVID19 pandemic and subsequent restrictions prevented participants from accessing the support they needed. Conclusion: This study sheds light on the importance of decolonizing research methods when studying TBI. It advocates for a holistic approach to the management of persons with TBI, by considering their spiritual, emotional, physical, and cognitive needs when providing support. Through exploring the impact of various factors on care-seeking behaviours, the study provides insight that can help foster ideal health outcomes and improve the health status of persons with TBI.
Description
A dissertation submitted in partial fulfilment of the requirements for the degree of Master of Arts in Speech Pathology to the Faculty of Humanities, University of the Witwatersrand, 2023
Keywords
Traumatic Brain Injury (TBI), Biopsychosocial model, Post-acute phase
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