'I think mild almost trivializes it': a meta synthesis of experiences of care among individuals with mild traumatic brain injury.

Abstract

Mild traumatic brain injury (mTBI) and concussion can lead to persistent symptoms which have a pervasive impact on quality of life. The myriad of symptoms and variable experiences of mTBI, precludes creation of singular treatment recommendations. We aimed to understand the experiences of care for individuals with mTBI. We used a qualitative meta-synthesis approach consistent with the PRISMA guidelines. Four databases were searched to identify primary qualitative or mixed methods studies, published in English, included a majority (>50%) of participants with mTBI, and mean age of participants >16 years. Two researchers independently completed and compared data extraction, synthesis, and quality assessment. Twenty-four studies were included, inclusive of 319 people, 219 males and 89 females, with mean age of 40.80 (5.29 SD) years. The experiences of care for individuals with mTBI were defined by; Pervasive feelings of ambiguity and uncertainty; caring for the person, not the injury; and varied experience of outcomes. In better understanding the experience of people with mTBI, we recommend that care for this population should be timely, person centered, multidisciplinary, and emphasize positive therapeutic relationships. Future research could consider co-design to develop interventions or service models for people with mTBI.