‘Do it afraid’: An arts-based reflexive collective case study exploring youth responses to post-concussion communication changes in daily life

IF 1.5 3区医学 Q2 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

International Journal of Language & Communication Disorders Pub Date : 2024-06-26 DOI:10.1111/1460-6984.13082

Jessica A. Harasym, Douglas P. Gross, Andrea A. N. MacLeod, Shanon K. Phelan

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引用次数: 0

Abstract

Background

Concussion and communication researchers have yet to study how post-concussion communication changes affect youths’ daily lives. The lack of attention paid to how young people respond to communication changes during concussion recovery constitutes a significant gap in current concussion management research and practices.

Aims

To explore how youth respond to the effects of post-concussion communication changes in their daily life, including (1) daily routines, (2) relationships with family members, (3) relationships with peers and (4) participation in school/work and community activities.

Methods & Procedures

Five youths (16–25 years) and three family members participated in this arts-based reflexive collective case study. Ecocultural theory provided the theoretical framework for study design, data collection and analysis. Cases consist of (1) pre-interview demographic information, (2) three 60–90-min virtual interviews, (3) optional family member interviews, (4) multi-media arts-based participant-generated materials representing participants’ experiences of communication change and concussion, and (5) researcher observations, discussions and reflexive journal entries. Reflexive thematic analysis was used to analyse the data.

Outcomes & Results

Analysis yielded four themes that illustrate the ways youth navigated and adapted to post-concussion communication changes: (1) navigating changes in communication tasks, daily roles, and identity; (2) re-negotiating relationships and emotional reactions; (3) seeking control and learning to let go during recovery; and (4) helping youth adapt to post-concussion communication changes.

Conclusions & Implications

The study findings deepen our understanding of the impact of post-concussion communication changes on youths' daily lives and underscore considerations critical to the development of communication-focused concussion education programs and interventions tailored specifically for youth.

What this paper adds

What is already known on the subject

Youth is a critical period of social and emotional development. Communication is integral to identity, relationships, participation in daily activities and well-being. Concussions can affect speech clarity, fluency, understanding and use of language, and social interactions. Re-engaging in routine activities and pre-injury roles can be challenging for youth experiencing communication changes as part of complex concussion recoveries.

What this paper adds to the existing knowledge

Findings from this research illuminate how youth navigate and adapt to communication changes post-concussion and support the development of youth-focused communication education programs, assessments and interventions. Youth participants actively managed their recoveries by developing innovative strategies to support their communication during daily activities, learning about communication, practicing communication tasks sequentially, and facing fears. Youth also reframed and challenged narrow views of ‘normal communication’.

What are the potential or actual clinical implications of this work?

Findings highlight the need for more youth- and communication-focused education materials and programs within youth concussion management protocols. Information about the specific ecological and sociocultural factors youth encounter during concussion recovery is needed to develop targeted communication-focused education and intervention programs for youth and their families to mitigate risks of isolation, loneliness, and mental health concerns and increase youths’ participation in family, community and cultural life. By learning from youth about how communication changes affected their participation in daily activities, identity and relationships, clinicians can provide information and interventions to reduce adverse listener reactions and help young people feel supported and understood.

Abstract Image

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害怕"：以艺术为基础的反思性集体案例研究，探索青少年对日常生活中脑震荡后交流变化的反应。

背景：脑震荡和交流研究人员尚未研究脑震荡后交流变化如何影响青少年的日常生活。目的：探讨青少年在日常生活中如何应对脑震荡后交流变化的影响，包括（1）日常生活常规；（2）与家人的关系；（3）与同伴的关系；（4）参与学校/工作和社区活动：五名青少年（16-25 岁）和三名家庭成员参与了这项以艺术为基础的反思性集体个案研究。生态文化理论为研究设计、数据收集和分析提供了理论框架。案例包括：(1) 访谈前的人口统计信息；(2) 三次 60-90 分钟的虚拟访谈；(3) 可选的家庭成员访谈；(4) 以艺术为基础、由参与者生成的多媒体材料，这些材料代表了参与者在交流改变和脑震荡方面的经历；(5) 研究人员的观察、讨论和反思性日志记录。采用反思性主题分析法对数据进行分析：分析得出了四个主题，说明了青少年驾驭和适应脑震荡后交流变化的方式：（1）驾驭交流任务、日常角色和身份的变化；（2）重新协商人际关系和情绪反应；（3）在康复过程中寻求控制和学会放手；以及（4）帮助青少年适应脑震荡后交流变化：研究结果加深了我们对脑震荡后交流变化对青少年日常生活的影响的理解，并强调了在制定以交流为重点的脑震荡教育计划和专门针对青少年的干预措施时应考虑的关键因素：关于该主题的已有知识青年时期是社会和情感发展的关键时期。沟通是身份认同、人际关系、参与日常活动和幸福感的组成部分。脑震荡会影响语言的清晰度、流畅性、对语言的理解和使用以及社会交往。对于在复杂的脑震荡康复过程中经历交流改变的青少年来说，重新参与日常活动和扮演受伤前的角色可能具有挑战性。本文对现有知识的补充本研究的结论阐明了青少年如何引导和适应脑震荡后的交流变化，并支持开发以青少年为重点的交流教育计划、评估和干预措施。青少年参与者在日常活动中通过制定创新的沟通策略、学习沟通知识、按顺序练习沟通任务以及面对恐惧，积极管理自己的康复。青少年还重新审视并挑战了 "正常交流 "的狭隘观点。这项工作有哪些潜在或实际的临床意义？研究结果凸显了在青少年脑震荡治疗方案中增加以青少年和交流为重点的教育材料和项目的必要性。我们需要了解青少年在脑震荡恢复过程中遇到的特定生态和社会文化因素，以便为青少年及其家人制定有针对性的以交流为重点的教育和干预计划，从而降低孤独、寂寞和心理健康问题的风险，并提高青少年对家庭、社区和文化生活的参与度。通过向青少年了解交流方式的改变对他们参与日常活动、身份认同和人际关系的影响，临床医生可以提供信息和干预措施，减少听者的不良反应，帮助青少年感受到支持和理解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Language & Communication Disorders AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION

CiteScore

3.30

自引率

12.50%

发文量

116

审稿时长

6-12 weeks

期刊介绍： The International Journal of Language & Communication Disorders (IJLCD) is the official journal of the Royal College of Speech & Language Therapists. The Journal welcomes submissions on all aspects of speech, language, communication disorders and speech and language therapy. It provides a forum for the exchange of information and discussion of issues of clinical or theoretical relevance in the above areas.