Family impact and influence following severe traumatic brain injury.

Negotiating is the core variable or central concern of families who have a close relative in a state of post-comatose unawareness or minimal responsiveness following a severe traumatic brain injury. Family members negotiate with each other, with members of the health care team, and with others such as insurance agents, case managers, and representatives of the justice system on behalf of the injured individual. Family members also negotiate the intricacies of the health care system. These are the findings of a 16-month grounded theory study conducted on two acute neurosurgical units in Toronto, with 25 family members from 11 families who had a close family member who suffered a severe traumatic brain injury and who was in a state of post-comatose unawareness or minimal responsiveness. An extensive review of the scholarly literature related to family research methodology and family research related to families following the brain injury of a family member is also provided in this paper.