Brain injury and the experience of caring : intrapersonal aspects from a personal construct perspective

Abstract

Significant proportions of carers for those with a brain injury have been found to be clinically anxious and depressed. Subjective carer burden (SCB) has been defined as the distress experienced as a result of the observed changes in the person with the brain injury. No research has looked at the individual psychological characteristics, or intrapersonal aspects, of the carer in brain injury in relation to SCB and psychological distress. Very few studies have addressed apparent methodological problems regarding the measurement of SCB; no study in brain injury has explored the meanings carers have found in their role; and very few studies have included positive elements of caring in their research. This study used a non-experimental, non-randomised, cross-sectional design. A theoretically based measure of SCB was used, in combination with a Personal Construct Psychology methodology, to investigate the relationship between the intrapersonal aspects of carers and their relationship to SCB and psychological distress. Positive appraisals of caring and meanings the carers derived from their role were also investigated. Few predicted study hypotheses were supported. Results showed that a significant proportion of carers were anxious and or depressed and that the majority of carers were shown to have very tight construct systems reflective of having limited flexibility in thinking. Novel findings included the previously unreported relationship between perceived burden, a measure of SCB, and anxiety. The manner in which carers construed the brain injured person was found to be related to the appraisals they form, thus adding to the evidence of the importance of the role of construing of the brain injured person by family members. Meanings derived from caring emerged in a number of themes. 60% of carers' meanings could be categorised in the following three themes: life circumstances, emotional states and health and illness. Carers generated positive as well as negative meanings. Findings were considered in relation to previous SCB and Personal Construct Psychology research. Clinical implications of the structure of construct systems in this population were considered. Suggestions for future research with an emphasis on the development of clinical practice were included.