Description et but. Cette étude qualitative porte sur le processus d'adaptation d'adultes présentant des séquelles de traumatisme cranio-cérébral. Ce processus et ses particularités ont été peu étudiés jusqu'à maintenant et l'amélioration des connaissances pourrait contribuer à améliorer la qualité des interventions. Méthodologie. Cinquante-trois adultes vivant dans la communauté et ayant subi un traumatisme cranio-cérébral ont participé à une entrevue individuelle et ont répondu à des questions ouvertes. Résultats. L'analyse qualitative, inspirée de la phénoménologie, rapporte des résultats qui révèlent un processus d'adaptation en six étapes. De plus, les éléments qui ont influencé ce processus ainsi que les stratégies d'adaptation efficaces selon la perception des participants sont décrits. Les particularités de ce processus réfèrent, entre autre, à la nature des séquelles cognitives ainsi qu'aux circonstances de L'événement traumatique. Conséquences cliniques. La réalisation d'occupations significatives est un des éléments clés de ce processus, parfois associée à une transformation intérieure importante sur le plan des normes personnelles et des valeurs.
AbreuB. C.SealeG.ScheibelR. S.HuddlestonN.ZhangL.OttenbacherK. J. (2001). Levels of self-awareness after acute brain injury: How patients' and rehabilitation specialists' perceptions compare. Archives of Physical Medicine and Rehabilitation, 82, 49–56.
2.
AntonakR. F.LivnehH.AntonakC. (1993). A review of research on psychosocial adjustment to impairment in persons with traumatic brain injury. Journal of Head Trauma Rehabilitation, 8 (4): 87–100.
3.
BanduraA. (1986). Social foundations of thought and action : A social cognitive theory. Englewood Cliffs, NJ.: Prentice-Hall.
4.
BerglundB.MattiassonA.NordstromG. (2003). Acceptance of disability and sense of coherence in individuals with Ehlers-Danlos syndrome. Journal of clinical Nursing, 12, 770–777.
5.
BrzuzyS.SpezialeB. A. (1997). Persons with traumatic brain injuries and their families : Living arrangements and well-being post injury. Social Work in Health Care, 26 (1): 77–88.
6.
BurleighS. A.FarberR. S.GillardM. (1998). Community integration and life satisfaction after traumatic brain injury : Long-term findings. American Journal of Occupational Therapy, 52, 45–52.
7.
CagnettaE.CicognaniE. (1999). Surviving a serious traffic accident: Adaptation processes and quality of life. Journal of Health Psychology, 4, 551–564.
8.
CarpenterC. (1994). The experience of spinal cord injury: the individual's perspective: Implications for rehabilitation practice. Physical Therapy, 74, 614–628.
9.
CharmazK. (1994). Discoveries of self in illness. Dans : DietzM. L.PrusR.ShafferW.Doing everyday life. Ethnography as human lived experience (p. 226 à 242). Missisauga, ON: Copp Clark Longman Ltd.
10.
CharmazK. (1995). The body, identity and self: Adapting to impairment. Sociological Quarterly, 36, 657–680.
11.
ChristiansenC. H. (1999). Defining lives : Occupation as identity : An essay on competence, coherence and the creation of meaning. American Journal of Occupational Therapy, 53, 547–558.
12.
CorriganJ. D. (2001). Conducting statewide needs assessments for persons with traumatic brain injury. Journal of Head Trauma Rehabilitation, 16, 1–19.
13.
CreswellJ. W. (1998). Qualitative Inquiry and Research Design. Choosing Among Five Traditions. Thousand Oaks, CA: Sage Publications.
14.
CrispR. (1992). Return to work after traumatic brain injury. Journal of Rehabilitation, 4, 27–33
15.
CurranC. A.PonsfordJ.L.CroweS. (2000). Coping strategies and emotional outcome following traumatic brain injury: A comparison with orthopaedic patients. Journal of Head Trauma Rehabilitation, 15, 1256–1274.
16.
DavisC. H. (2002). Self-perception in mild traumatic brain injury. American Journal of Physical Medicine and Rehabilitation, 81, 609–618.
17.
DeHopeE.FineganJ. (1999). The self determination model : An approach to develop awareness for survivors of traumatic brain injury. NeuroRehabilitation, 13, 3–12.
18.
DenzinN. K.LincolnY. S. Eds. (2000). Handbook of qualitative research. Second Edition. Thousand Oaks, CA: Sage Publications.
19.
DenzinN. K. (1989). Interpretive Interactionism. Applied Social Research Methods Series. Volume 16. Newbury Park, CA: Sage Publications.
20.
DrakeA. I.GrayN.YoderS.PramukaM.LlewellynM. (2000). Factors predicting return to work following mild traumatic brain injury: A discriminant analysis. Journal of Head Trauma Rehabilitation, 15, 1103–1112.
21.
DuboulozC.-J.ChevrierJ.Savoie-ZajcL. (2001). Processus de transformation chez un groupe de personnes cardiaques suivies en ergothérapie pour une modification de leur équilibre du fonctionnement occupationnel. Revue canadienne d'ergothérapie, 68, 171–185.
22.
DuboulozC.-J.LaporteD.HallM.AsheB.SmithD. (2004). Transformation of meaning perspectives in clients with rheumatoid arthritis. American Journal of Occupational Therapy, 58, 398–407.
23.
DumontC.GervaisM.FougeyrollasP.BertrandR. (2004). Toward an explanatory model of social participation for adults with traumatic brain injury. Journal of Head Trauma and Rehabilitation, 19, 431–444.
24.
DumontC.GervaisM.FougeyrollasP.BertrandR. (2005). La perception d'efficacité personnelle comme facteur associé à la participation sociale des adultes ayant subi un traumatisme cranio-cerebral. Revue canadienne d'ergothérapie, 72, 222–233.
25.
FinsetA.AnderssonS. (2000). Coping strategies in patients with acquired brain injury: Relationships between coping, apathy, depression and lesion location. Brain Injury, 14, 887–905.
GadouryM. (1999). Cadre de référence clinique pour l'élaboration de programmes de réadaptation pour la clientèle qui a subi un traumatisme cranio-cérébral. Volet adulte. Direction des politiques et programmes pour les accidentés. Service de la programmation en réadaptation, Société de l'assurance automobile du Québec.
28.
GiacinoJ. T.CiceroneK. D. (1998). Varieties of deficit unawareness after brain injury. Journal of Head Trauma Rehabilitation, 13 (5): 1–15.
29.
GibbonsF. X. (1999). Social comparison as a mediator of response shift. Social Science & Medicine, 48, 1517–1530.
30.
GodfreyH.P.D.KnigntR. G.PartridgeF. M. (1996). Emotional adjustment following traumatic brain injury: A stress-appraisal-coping formulation. Journal of Head Trauma Rehabilitation, 11 (6): 29–40.
31.
HallettJ. D.ZaslerN. D.MaurerP.CashS. (1994). Role change after traumatic brain injury in adults. American Journal of Occupational Therapy, 48, 241–246.
32.
HanksR. A.TemkinN.MachamerJ.DikmenS. S. (1999). Emotional and behavioral adjustment after traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 80, 991–999.
33.
HerrmannM.CurioN.PetzT.SynowitzH.WagnerS.BartelsC.WalleschC. W. (2000). Coping with illness after brain diseases- a comparison between patients with malignant brain tumours, stroke, Parkinson's disease and traumatic brain injury. Disability and Rehabilitation, 22, 539–546.
34.
HillierS. L.MetzerJ. (1997). Awareness and perceptions of outcomes after traumatic brain injury. Brain Injury, 11, 525–536.
35.
HindP. S.ChavesD. E.CypressS. M. (1992). Context as a source of meaning and understanding. Qualitative Health Research, 2, 61–74.
36.
HubermanA. M.MilesM. B. (1991). Analyse des données qualitatives. Recueil de nouvelles méthodes. Pédagogies en développement. Méthodologie de la recherche. Bruxelles, Belgique: Université De Boeck.
37.
KarlovitsT.McCollM. A. (1999). Coping with community reintegration after severe brain injury: A description of stresses and coping strategies. Brain Injury, 13, 845–861.
38.
KhanS.KhanA.FeysM. (2002). Decrease length of stay, cost savings and descriptive findings of enhanced patient care resulting from an integrated traumatic brain injury programme. Brain Injury, 16, 537–554.
39.
KortteK. B.WegenerS. T.ChwaliszK. (2003). Anosognosia and denial: their relationship to coping and depression in acquired brain injury. Rehabilitation Psychology, 48, 131–136.
40.
KreftingI. (1991). Rigor in qualitative research : the assessment of trustworthiness in naturalistic inquiries. American Journal of Occupational Therapy, 45, 214–222.
41.
LazarusR. S.FolkmanS. (1984). Stress, appraisal, and coping. New York: Springer Publishing Company.
42.
LivnehH.AntonakR. F. (1997). Psychosocial Adaptation to Chronic Illness and Disability. Gaithersurg, Maryland, MD: Aspen Publishers Inc.
43.
MagnusE. (2001). Everyday occupations and the process of redefinition: A study of how meaning in occupation influences redefinition of identity in women with a disability. Scandinavian Journal of Occupational Therapy, 8, 115–124.
McCollM. A. (2003). Spirituality and Occupational Therapy. Ottawa, ON: CAOT Publications ACE.
49.
Ministère de la Santé et des Services Sociaux (1999). Continuum de services pour les personnes ayant subi un traumatisme cranio-cérébral. Paramètres d'organisation. Gouvernement du Québec, QC: auteur.
50.
National Institute of Health (1999). Consensus development panel on rehabilitation of persons with traumatic brain injury. Rehabilitation of persons with traumatic brain injury. Journal of the American Medical Association, 282, 974–983.
51.
NochiM. (1998). Struggling with the labelled self: people with traumatic brain injuries in social settings. Qualitative Health Research, 8, 665–681.
52.
OwnsworthT. L.McFarlandK.YoungR. M. (2002). The investigation of factors underlying deficits in self-awareness and self-regulation. Brain Injury, 16, 291–309.
53.
OwnsworthT.FlemingJ. (2005). The relative importance of metacognitive skills, emotional status, and executive function in psychosocial adjustment following acquired brain injury. Journal of Head Trauma Rehabilitation, 20, 315–332.
PalmerS.BaderM. K.QureshiA.PalmerJ.ShaverT.BorzattaM.StalcupC. (2001). The impact on outcomes in a community hospital setting of using the AANS traumatic brain injury guidelines. The Journal of Trauma, Injury, Infection, and Critical Care, 50, 657–664.
56.
PatersonB.ThorneS.CrawfordJ.TarkoM. (1999). Living with diabetes as a transformational experience. Qualitative Health Research, 9, 786–802.
57.
PortA.WillmottC.CharltonJ. (2002). Self-awareness following traumatic brain injury and implications for rehabilitation. Brain Injury, 16, 277–289.
58.
PorterB.KeenanE. (2003). Multiple sclerosis. Nursing at a specialist diagnostic clinic for multiple sclerosis. British Journal of Nursing, 12, 650–656.
59.
RichardsL. (1999). Using NVivo in Qualitative Research, Qualitative Solutions and Research. Bundoora, Victoria, Australia: Pty, Ltd.
60.
SawchynJ. M.MateerC. A.BraxtonSuffield J. (2005). Awareness, emotional adjustment and injury severity in postacute brain injury. Journal of Head Trauma Rehabilitation, 20, 301–314.
61.
SchwartzC. E.SendorR. M. (1999). Helping others helps oneself: Response shift effects in peer support. Social Science & Medicine, 48, 1563–1575.
62.
ShererM.BergloffP.LevinE.HighW. M.Jr.OdenK. E.NickT. G. (1998a). Impaired awareness and employment outcome after traumatic brain injury. Journal of Head Trauma Rehabilitation, 13 (5): 52–61.
63.
ShererM.BoakeC.LevinE.SilverB. V.RingholzG.HighW. M.Jr. (1998b). Characteristics of impaired awareness after traumatic brain injury. Journal of the International Neuropsychological Society, 4, 380–387.
64.
SprangersM. A. G.SchwartzC. E. (1999). Integrating response shift into health-related quality of life research: a theoretical model. Social Science & Medicine, 48, 1507–1515.
65.
Van BalenH. G. G.MulderT.KeyserA. (1996). Towards a disability-oriented epidemiology of traumatic brain injury. Disability and Rehabilitation, 18 (4): 181–190.
66.
WeissD. M.PuchtaJ.B. (1999). Independent living center services for post-hospital traumatic brain injury patients. The Journal of Cognitive Rehabilitation, 17 (6): 6–12.
67.
WilsonI. B. (1999). Clinical understanding and clinical implications of response shift. Social Science & Medicine, 48, 1577–1588.
68.
ZhanL. (2000). Cognitive adaptation and self-consistency in hearing-impaired older persons: testing Roy's adaptation model. Nursing Science Quarterly, 13 (2):158–165.
