Browsing by Author "Jordan, Ann"

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    The long-term impact of severe head injury on the family
    (1989) Richman, Alexandra Elizabeth; Dawes, Andrew; Jordan, Ann
    The purpose of this study was to examine the impact of brain injury upon the family of the brain-injured patient. Although some research into the psychosocial sequelae following head injury and the direct and indirect effects of severe head-injury upon the family have been conducted, these studies have largely been of a quantitative nature. For this reason, and with a view to expanding upon the existing findings, the present study was qualitative in nature in order to gain an in-depth understanding of relatives' experience of living with and caring for a severely head-injured family member. In addition, ways in which family members coped with the impact of the brain injury were elicited. Participants were caregivers to 11 severely head-injured patients who were representative of a range of socio-economic groupings and racial classifications. Severity of head injury was controlled for and participants were interviewed two or more years after the head injury had occurred. Demographic and injury related data were elicited by means of a questionnaire. Thereafter, data was collected by means of in-depth semi-structured interviews. A number of indices were developed based on a qualitative and descriptive analysis of the data. The study found that the mam source of distress experienced by caregivers related to emotional rather than physical symptomatology. All types of family relationships were profoundly affected by the patient's brain injury, although the caregiver's relationship with the patient appeared most vulnerable. Formal sources of support were considered inadequate and most caregivers relied heavily on emotional support, particularly from an intimate source. Coping responses were dependent upon coping resources available. Families of brain-injured patients who were racially and socio-economically disadvantaged were subjected to additional stress related to the unavailability of services and the randomness with which services that were available were dispensed. Rehabilitation services appeared to be failing to meet the needs of "brain-injured families" (Brooks, 1984) as they concentrated on the patient's physical handicap rather than emotional sequelae of the head injury.
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    Neuropsychological sequelae of aneurysmal sub-arachnoid haemorrhage in patients without neurological deficits 6 to 8 months post operatively : an exploratory study
    (1987) Burbach, Frank Robert; Jordan, Ann; Dawes, Andy
    Relatively little is known about the neuropsychological sequelae of sub-arachnoid haemorrhage (SAH) and to date, there has only been one study (Ljunggren et al, 1985) focussing on patients without neurological deficits after aneurysm surgery for major SAH. A detailed exploratory study was designed to investigate the physical, cognitive, emotional, personality and behavioural sequelae of SAH in this group of patients. Neuropsychological sequelae were investigated in terms of a wide range of variables which could affect prognosis, viz location of aneurysm, timing of surgery, severity of the initial bleed, age, gender, educational level and estimated premorbid intelligence. An opportunity sample (N = 18) was drawn from patients treated at the Neurosurgery Department, Groote Schuur Hospital, Cape Town from May to November 1986. Patients were assessed 6.1 to 8.0 months post-operatively (mean 7.0 months) by means of an extensive neuropsychological test battery. A detailed structured interview was also conducted with the patient and somebody who was familiar with the patient's everyday functioning. Subjects ranged in age from 17 to 67 years (mean 38.8 years) and had a mean educational level of Standard 6 (range 2-10). Results were analysed in terms of the total sample and then according to successive subdivisions of subjects, on the basis of prognostic variables. The incidence and severity of symptoms ascribed to SAH are reported. Test data was interpreted in terms of two complementary psychometric theories (cognitive fall-off, and specific cognitive ability models). Results of the various aspects of the assessment were integrated in terms of ratings of general functional outcome. A diffuse SAH-induced encephalopathy was detected, which confirmed the findings of Ljunggren et al (1985). Impairment in functional ability was present in 61% of the sample. Similarities were noted with the Ljunggren et al (1985) study in terms of the cognitive abilities that were impaired, as well as the physical, personality and Differences in emotional, behavioural symptoms that were reported. studies are critically interpretation discussed and between the implications two for rehabilitation based examined. prognostic study with Further, variables regard on integrated functional assessment are tentative findings on the effects of are reported. The implications of this to neuropsychological assessment and further research are discussed.