A description of self-concept following traumatic brain injury
Kathryn R. Lynch, DNSc, RN, CCRN
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The purpose of the present study was to describe self-concept following a mild traumatic brain injury (TBI) at the expected endpoint of maximum recovery of function. According to the literature, this endpoint occurs between six and twelve weeks after injury. Additionally, the study was designed to identify any relationships among self-concept, injury severity, and neuropsychological outcome. It was believed that the description and identification of factors associated with self-concept would enhance nursing's knowledge regarding the experience of mild TBI and the nursing diagnosis 'disturbance in self-concept'. Rosenberg's framework was used to investigate self-concept. Rosenberg describes self-concept as a tripartite structure that is developed, maintained, and enhanced by self-concept motives and principles. Self-concept is operationalized by measuring self-esteem and self-consistency. Additionally, self-consciousness is measured to determine the salience of the self. According to the theory, a healthy self-concept is revealed by high self-esteem, high self-consistency, and low self-consciousness. The sample for this descriptive study was comprised of 40 subjects aged 18 to 40 years who were assigned Glasgow Coma Scale scores between 13 and 15 within one hour of admission to the emergency department, met all inclusion criteria, agreed to participate, and completed all instruments. Subjects completed the demographic data sheet, Rosenberg Self-Esteem Scale, Stability of Self Scale, Self-Consciousness Scale, Digit Span Test, Trail Making Test, California Verbal Learning Test, and Paced Auditory Serial Addition Test. They also responded to a question regarding changes following TBI that nurses should know about. Data were analyzed using descriptive and correlational statistics and content analysis. The study's findings indicated that self-concept was positive and stable at the expected endpoint of maximum recovery of function following mild TBI. Self-concept was weakly to moderately associated with neuropsychological outcome. Subjects who had normal neuropsychological function were more likely to have higher self-concepts than subjects with impaired neuropsychological function. Several themes emerged regarding changes following TBI that nurses should know about including residual symptoms, educational needs, and provider related problems.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9022981; ProQuest document ID: 303665927. The author still retains copyright.
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