Life Threads – TBI

• Research type

  Research Study

• Full title

  Working with the 'Life Threads' approach to support families after traumatic brain injury.

• IRAS ID

  329362

• Contact name

  Charlotte Whiffin

• Contact email

  c.whiffin@derby.ac.uk

• Sponsor organisation

  Nottingham University Hospitals NHS Trust

• Duration of Study in the UK

  1 years, 0 months, 31 days

• Research summary

  Background: For those under 40 years of age TBI is a leading cause of disability. Traumatic brain injury damages the stability of the family system and negatively affects family functioning. There is very little support to help families to understand and come to terms with the substantial impact of TBI on themselves.

  Storytelling approaches are emerging as helping the injured person after TBI. However, there is no empirical evidence for storytelling approaches with family members. This study will seek to understand if a specific approach to storytelling (the ‘Life Threads' approach) can support processes of family well-being and adjustment post-TBI.

  Research question: Does narrative storytelling, through the 'Life Threads' approach, support processes of family well-being and adjustment post-Traumatic Brain Injury (TBI)?

  Aim: To understand the clinical potential of storytelling through the 'Life Threads' approach and gather the information required to plan a feasibility randomised control trial.

  Methods: This study will adopt a qualitative methodology. Up to twenty family members of relatives who have sustained TBI at least 2 years prior will be recruited from the East and West Midlands. Participants will first complete a focus group to introduce the storytelling approach and related study materials. We will then ask participants to work with the study materials to construct their story of TBI and share this during an individual follow-up interview. We will evaluate the acceptability and perceived usefulness of this approach to storytelling in a second, and final focus group. We will use thematic analysis, to make sense of participant experiences and determine if and how engaging with storytelling has led to any perceived benefits.

  Anticipated Impact: This study will be amongst the first to provide empirical evidence of the possible acceptability and usefulness of the 'Life Threads' approach to support family members post-TBI.

  Summary of results
  Despite family members living with stress, anxiety, depression, and poor quality of life, following a loved one’s traumatic brain injury (TBI), support for them remains limited. While storytelling is increasingly used for survivors, its role in helping families is less understood. This study explored whether storytelling through the ‘Life Threads’ approach (LTA) could support family members' well-being and adjustment. Twenty participants initially took part in an online focus group and then engaged with the LTA for four weeks. The LTA included strands of neutral coloured wool, parcel tags of varying sizes, a guide, and pictures representing life stories sent to the participant's homes in a large letter postal box. Seventeen completed follow-up interviews and a second focus group. We analysed the data

  to understand the potential benefits of the LTA and identified themes to reflect participant’s experiences. Findings revealed that 11 of 17 participants found the LTA clearly beneficial, with two others reporting some benefit but not directly from the LTA. Thirteen participants felt the LTA enhanced the storytelling process beyond simply recounting experiences. Four key themes were identified: Theme one captured significant and enduring consequences of being a family member after TBI; Theme two highlighted their deep commitment to caregiving, often at the cost of personal identity, and increasing recognition that their own needs were important too; Theme three described the healing process of telling a more enriched and purposeful story creating opportunities for growth and hope; Theme four

  underscored the challenges of engaging with the LTA, the importance of being heard, and the symbolism of life threads when words were insufficient. The study suggests that the LTA is a promising, accessible tool to help family members after TBI reflect, make sense of their experiences, and begin healing.
  

• REC name

  East Midlands - Nottingham 1 Research Ethics Committee

• REC reference

  23/EM/0185

• Date of REC Opinion

  4 Sep 2023

• REC opinion

  Further Information Favourable Opinion