128
JCPSLP
Volume 16, Number 3 2014
Journal of Clinical Practice in Speech-Language Pathology
Data collection procedure
Semi-structured interviews were used to collect data for
this study, providing the opportunity for participants to tell
their story (Smith et al., 2009). The interviews were
audio-recorded and transcribed to aid data analysis. The
interviews were conducted at Mandy’s home on two
separate occasions. The first interview involved Mandy and
Vivienne. This interview took approximately one hour and
focused on Mandy’s perceptions of her brain injury, her
communication, relationships, and personality before and
after the accident. Prior to the second interview, the first
interview was transcribed and read several times to
establish areas that required further discussion.
The second interview took approximately 90 minutes and
involved a joint conversation between Mandy, Vivienne, and
Mandy’s friend Bridget. Many of the questions for Vivienne
and Mandy were based on their responses in the first
interview, seeking elaboration or clarification as a method
of member-checking (Curtin & Fossey, 2007). Bridget’s
questions were related to her friendship with Mandy and
her perception of Mandy’s communication, personality, and
any changes that may have occurred in these domains.
Data analysis
Prior to analysing the data the transcripts were shared
between the three authors and read several times to ensure
familiarisation with the participants’ perspectives.
Descriptive, linguistic, and conceptual comments and key
words were then written on the transcripts and quotes
highlighted according to IPA guidelines (Smith et al., 2009).
Key words and ideas were discussed among the authors
and collaboratively matched with the quotes to form
categories. These were later synthesised according to their
similarity to create themes, which were thought to
encapsulate the message of the participants. Consultation
between the three authors throughout the analysis process
enhanced the trustworthiness of the findings.
To assist with comprehending the data and interpreting
the transcripts a journal was maintained throughout the
study. The first author wrote reflective entries throughout
the research process and shared these with the other
authors to aid understanding of the participants’ story.
The reflections directed the more in-depth, collaborative
IPA analysis. Finlay and Gough (2003) and Johnson and
Waterfield (2004) state that writing in a reflective journal
acknowledges the researcher’s participation in interpreting
and constructing findings, with the understanding that the
researcher inevitably brings his or her own background into
the research process.
Mandy’s story
At the time of the study Mandy was a 14-year-old girl who
lived in a rural town with her parents and two younger
siblings. She was in year nine and prior to her TBI identified
herself as a good runner, with aspirations to be a personal
trainer when she left school. She sustained a mild TBI
approximately 12 months prior to the interview after an
accidental knock to the head at school. Medical file notes
report a loss of consciousness of up to one minute with no
neurological changes noted on CT imaging. Mandy did not
remember the events surrounding the accident.
Mandy’s schoolmates and teachers did not understand
the lasting effects of the TBI because she did not look any
different than before the injury. Her friends believed she
was feigning her complaints of fatigue, headaches and not
being able to keep up with schoolwork. Her brain injury
than ascertaining the adolescent’s perception (Anderson
et al., 2013). The aim of our study was to examine the
impact of social communication impairment on the
life of an adolescent with TBI, from the perspectives
of the adolescent, one of her parents, and a friend. It
was anticipated that the findings could contribute to a
greater understanding of the potential impact of social
communication impairment for adolescents post-TBI.
Methodology and method
Research approach
An interpretative phenomenological analysis (IPA) approach
(Smith, Flowers, & Larkin, 2009) was employed to facilitate
an in-depth investigation of the experience of having a
social communication impairment following TBI, from the
perspectives of an adolescent, her mother, and a friend. IPA
is a research method that investigates how a person
understands and interprets experiences, providing an
insider’s perspective of the experience (Smith et al., 2009).
This research project was granted ethical approval from
the Human Research Ethics Committees of Charles Sturt
University and the relevant health authority.
Recruitment of participants
One adolescent who had a TBI, her mother, and a friend of
the adolescent were purposefully recruited for this study to
facilitate multiple perspectives. This permitted triangulation,
enhancing trustworthiness of the data by acknowledging
more than one view of a phenomenon (Curtin & Fossey,
2007). IPA research is typically conducted with a small
number of participants, allowing for more in-depth
exploration of data (Smith et al., 2009). IPA research is not
about generalisability of findings, but focuses on an involved
understanding of the phenomenon being researched for the
participants in the study. To be eligible for participation in
this study the adolescent had to:
•
be aged between 13 to 19 years old with diagnosed
social communication impairment (based on speech
pathology and neuropsychology assessment findings
post-TBI), with awareness of this impairment;
•
have sustained the TBI during adolescence;
•
have returned to their mainstream school after the injury;
•
have age-appropriate IQ and/or receptive language
skills, in order to have the capacity to consent; and
•
have no obvious physical impairment as a result of their
TBI, because this project focused on the way the person
behaves in social interactions due to the cognitive
deficits following TBI, rather than motor communication
impairment.
A staff member from a local brain injury rehabilitation
facility developed a de-identified list of adolescents who
met the inclusion criteria. An appropriate adolescent was
chosen from the de-identified list. The staff member then
sent a research information sheet and expression of interest
form to the adolescent and her mother. This adolescent
and her mother each returned a completed expression
of interest form, after which the first author phoned the
adolescent and mother to answer any questions and
arranged a time to meet. At this meeting consent forms
were signed and the interviews commenced. At the end of
this meeting, the adolescent was provided with a research
information sheet and expression of interest form to give to
a friend, to incorporate a third perspective into the study.
For the purposes of this study, the adolescent with TBI was
given the pseudonym Mandy, her mother the pseudonym
Vivienne, and her friend the pseudonym Bridget.
