Misconceptions about Traumatic Brain Injuries among South African University Students

Article excerpt

Worldwide, the most frequent cause of death and disability appears to be acquired brain injury. [1] Traumatic brain injury (TBI) is a devastating condition that affects more than 10 million people a year worldwide. [2] In the United States (US), Faul et al. [3] estimate that TBIs affect 1.7 million people annually. According to the National Health Laboratory Service, [4] the reported number of new cases of TBIs in South Africa (SA) is estimated to be 89 000 per annum. These high incidence rates suggest that TBIs are a serious public health concern worldwide, and SA is one of the countries with the highest rates of new cases.

The long-term consequences of a TBI are alarming. The Brain Injury Association of America [5] estimates that 5.3 million people in the US need lifelong care and assistance with performing their daily activities after sustaining a TBI. A TBI can result in both implicit and explicit deficits: implicit, less observable problems include psychosocial, behavioural and cognitive problems (e.g. difficulties with memory, attention and concentration), changes in mood and even personality changes; whereas more observable deficits may include motor, sensory and speech problems. [6] Obtaining new information and remembering it is typically the most severe deficit for individuals with a TBI. [7]

TBIs therefore merit adequate understanding by the general public, as well as healthcare professionals. However, despite the prevalence of TBIs and the consequences associated with them, a lack of knowledge and misconceptions about brain injuries appear to be common among family members and healthcare professionals involved in the care of individuals with TBIs, [8] and even among people with personal experience with TBIs. [9] The general public are not always informed about or do not always understand the physical, behavioural, cognitive and psychosocial consequences of TBIs. [1]

Thompson and Logue [10] define misconceptions as ideas which cause us to incorrectly understand ideas, objects or events, and can be generally described as a mistaken belief or a myth about a specific concept. As described by Gouvier et al., [11] the most common misconceptions about TBIs relate to the use of seatbelts, the effects of unconsciousness, what individuals with TBIs are capable of doing, memory deficits, brain damage and recovery (how much recovery is possible and how long it takes). Most people also seem to have misconceptions about the long-term consequences of TBIs. [11,12] According to a qualitative study by Swift and Wilson, [8] some of the main misconceptions about the consequences of TBIs relate to how to identify a TBI, the visibility of the impairment, the diversity of TBI symptoms and expectations about the recovery process. Swift and Wilson [8] also reported that people with mistaken beliefs about TBIs may unknowingly and indirectly discriminate against affected individuals, e.g. by having unrealistically high expectations of the individual.

Several studies have investigated misconceptions about TBIs among the general public and family members of people who sustained a TBI. [1,8,9,13-17] Hux et al. [18] focused on the knowledge and misconceptions about brain injury held by the general public, and establishing whether progress had been made in attempts to decrease misconceptions found in prior research. They found that almost half of the participants believed that: (i) after being knocked unconscious, most people wake up shortly and have no lasting effects; (ii) people with amnesia do not have trouble learning new things; and (iii) new learning following a TBI is no harder than remembering information that was mastered before the injury (misconceptions ranging from 23.58% to 48.48%). With regard to the different categories, the most misconceptions were identified in the unconsciousness (43.8%), memory (54.7%) and recovery categories (44.3%) while the least misconceptions were identified in the brain damage category (8. …