Category: Military and Veterans Affairs; Brain Injury; Cross-Cutting
Objective : Explore Veterans' and informal caregivers' perceptions regarding therapeutic effects of participation in a participatory action research (PAR)1 study focused on community reintegration after brain injury.
Design : Veterans and caregivers collaborated on a photovoice study2 over a period of 2+ years. Individual participants took photographs and completed a 1-on-1 qualitative interview, resulting in a photo-narrative depicting personal experiences and perceptions of community reintegration after brain injury. Veteran-caregiver dyads shared their photo-narratives with each other and completed a dyadic interview. Small discussion groups were also held with participating dyads. Transcripts from dyadic interviews and group discussions were analyzed using thematic analysis.3
Setting : Veterans and caregivers in community and outpatient clinical settings at two Veterans Affairs Medical Centers.
Participants (or Animals, Specimens, Cadavers) : Twenty-six dyads consisting of a post-9/11 US Veteran who had sustained a service-related traumatic brain injury and the person ("caregiver") they identified as most involved in aiding them in community reintegration.
Interventions : Not Applicable.
Main Outcome Measure(s) : Self-reported therapeutic effects of study participation.
Results : Veterans and caregivers described how creating individual photo-narratives helped them reflect on painful and often disordered events since the Veteran's injury and led to increased self-awareness regarding unmet needs and sources of strength for both Veteran and caregiver. Veteran-caregiver dyads observed how sharing their stories with each other provided a safe space for discussing sensitive topics and resulted in improved family relationships. Group discussions provided an opportunity for Veterans and caregivers to connect with others like themselves, which they said made them feel less alone.
Conclusions : Engaging in PAR using visual and narrative methods has potential therapeutic effects for individuals and couples living with brain injury.
Gala True– Investigator, South Central MIRECC, Department of Veterans Affairs, New Orleans, Louisiana
Jessica Wyse– Investigator, Oregon Health Science University- Portland State University School of Public Health, Portland, Oregon
Laura Lorenz– Affiliate Faculty, University of Hawaii, Manoa (Center on Disability Studies), Marlborough, Massachusetts
Raymond Facundo– Project Manager, South Central MIRECC, United States Department of Veteran Affairs, New Orleans, Louisiana
John Marmion– Program Coordinator, Tulane University School of Public Health & Tropical Medicine, New Orleans, Louisiana
Sarah Ono– Investigator, VA Portland Health Care System, Department of Veterans Affairs, Portland, Oregon