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Marital Adjustment and Stability Following Traumatic Brain Injury: A Pilot Qualitative Analysis of Spouse Perspectives

Hammond, Flora M. MD; Davis, Christine S. PhD; Whiteside, Omar Y. MSPH; Philbrick, Peggy; Hirsch, Mark A. PhD

The Journal of Head Trauma Rehabilitation: January/February 2011 - Volume 26 - Issue 1 - p 69–78
doi: 10.1097/HTR.0b013e318205174d

Background: Traumatic brain injury (TBI), causing various impairments and functional changes, may adversely impactmarital relationships. However, dynamics of the interactions that contribute to these marital difficulties are complex and poorlyunderstood. There has been little research on marital quality and stability in families of a person with TBI.

Objective: Byidentifying themes of marital adjustment and stability, this qualitative exploratory study examines how a spouse who has experienced TBIaffects the marital relationship.

Methods: Two gender-specific focus groups, each with 5 spouses of individuals living withthe effects of TBI, were conducted to collect data on marital interactions that were analyzed for themes related to marital adjustmentand stability. The data were analyzed using grounded theory, and then relational theories were applied as a framework for organizing themetacodes and concepts.

Results: This study suggests that, after TBI, changes in family dynamics and the way spousesperceive those dynamics affect movement toward pulling together or pulling apart.

Conclusion: Changes in spousalperceptions, interactions, responsibilities, and reactions to brain injury may impact marital stability and satisfaction. Further studyis warranted to better understand and determine whether and how awareness of these changes may be incorporated into treatment.

Carolinas Rehabilitation, Carolinas Healthcare System, Charlotte, North Carolina, and Indiana University, Indianapolis (Dr Hammond); Department of Communication Studies, University of North Carolina at Charlotte (Dr Davis); Department of Epidemiology and Biostatisics, University of South Carolina (Mr Whitside); Carolinas Rehabilitation, Carolinas Healthcare System, Charlotte, North Carolina (Mrs Philbrick); and Carolinas Rehabilitation, Carolinas Healthcare System, University of North Carolina at Charlotte (Dr Hirsch).

Corresponding Author: Flora M. Hammond, MD, Indiana University 541 N Clinical Drive, Sute 626 Indianapolis, IN 46202 (

This study was partially supported by US Department of Education, Office of Special Education and Rehabilitative Services, National Institute on Disability Rehabilitation and Research grant H133A20016, and by a grant from Carolinas Medical Center, Carolinas HealthCare System, Charlotte, North Carolina.

The authors thank graduate student Dawn Creason, BA, Research Assistant Chelsea Kinnett, BA, both of the Department of Communication Studies, University of North Carolina at Charlotte, for the assistance, and Dr Heather Gallardo for her helpful comments and suggestions. We also thank the persons with TBI, and the spouses of persons with TBI, for so generously giving us their time and participation.

© 2011 Lippincott Williams & Wilkins, Inc.