Academic journal article Canadian Psychology

"I Can Do Things Now That People Thought Were Impossible, Actually, Things That I Thought Were Impossible": A Meta-Synthesis of the Qualitative Findings on Posttraumatic Growth and Severe Physical Injury

Academic journal article Canadian Psychology

"I Can Do Things Now That People Thought Were Impossible, Actually, Things That I Thought Were Impossible": A Meta-Synthesis of the Qualitative Findings on Posttraumatic Growth and Severe Physical Injury

Article excerpt

Severe injury affects individuals and communities worldwide. Around the world, between 250,000 and 500,000 people will experience a spinal cord injury (SCI) every year (World Health Organization, 2010) and the Center for Head Injury Services (2015) states that the number for traumatic brain injuries (TBI) is 2 million per year. In Ontario, Canada, more than half a million Ontarians live with an acquired brain or SCI (Ontario Neurotrauma Foundation, 2010). In the United States alone, burn centers deal with 200 annual admissions each year (American Burn Association, 2013) and hospitals operate on more than 30,000 traumatic amputations. Moreover, severe injuries are estimated to be the primary cause of long-term disability in people and especially in young people, thus having a profound lasting effect on individuals' lives, abilities, and identities (American Psychiatric Association, 2013; Marini & Stebnicki, 2012; Wright, 1983). This illustrates how extensively injury affects people everywhere, thus emphasizing the urgency to understand the experience further. This metaethnography is answering to that need and embarks to synthesize the qualitative research on severe injuries and the experience of posttraumatic growth (PTG).

Severe Injury, Trauma, and Posttraumatic Growth

An injury is a bodily lesion that can result from either "acute exposure to energy" (e.g., mechanical or thermal) or from "an insufficiency of a vital element" (e.g., drowning or freezing; European Commission, 2015). An injury is often defined by intention, meaning that the cause of injury can be either unintentional (accidental; i.e., motor vehicle accidents) or intentional (e.g., violence against self or others; European Commission, 2015). Furthermore, the severity of the injury can be measured based on physiological severity as well as psychosocial features. For the purposes of this synthesis, severe injury is defined through both factors: physiological severity and potential for trauma.

A physical or mental impairment is considered a disability if it has a "substantial" and "long-term" negative effect on the individual's ability to perform normal daily activities (Equality Act, 2010). Furthermore, according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013), a serious injury or other threat to one's physical integrity is considered as an extreme traumatic stressor and can lead to the development of posttraumatic stress disorder. Following these definitions, severe injury in this study is defined as an unintentional injury that leads to disability. This includes severe multiple fracture, acquired brain injury, paraplegia, quadriplegia, or burns to more than 50% of the body and traumatic amputation of a limb (traumatic meaning sudden trauma that causes the amputation). Therefore severe injury and acquired disability might be used interchangeably in this study.

Severe injury (as defined in this study) has a profound long-term effect on an individual's life. It challenges an individual's social position, which constitutes a personal crisis as one deals with the tremendous change (Livneh & Antonak, 2005; Marini & Stebnicki, 2012; Wright, 1983). With the severe injury, individuals have to deal with losing a body part or parts or changes in the functionality of it. This causes changes in one's body and selfimage (Livneh & Antonak, 2005). Various other changes in the body might occur as well, such as losing physical comfort, changes in mobility, and lacking vitality. Furthermore, the capability to carry out various activities might be challenged or impossible (Marini & Stebnicki, 2012; Vanlandewijck & Thompson, 2011; Wright, 1983). This is why severe injury can be devastating for the individual; it is a substantial disruption to both physiological and psychological well-being (American Psychiatric Association, 2013; Marini & Stebnicki, 2012; Vanlandewijck & Thompson, 2011; Wright, 1983). …

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