Hong Kong family caregivers' stress and coping for people with brain injury

Chinese families,in caring for their members with a brain injury have faced longterm burdens for which they were usually ill prepared. The complicated. Intertwined disability- and family-related factors appeared to be affecting their effective family coping especially in the context of Chinese families. The present study examined the impact of brain injury, which was based on analysing individual families' differences, and conceptualized through an empowerment framework for possible guidance in designing appropriate, indigenous family intervention. A total of 50 families with a brain injured members were successfully recruited by convenient sampling to attend an individual interview. Discussion was guided by open-ended questions. All the families' responses to questions, and the verbatim transcripts of long interviews of four randomly selected families, were used to construct themes of coping strategies. They were found to show the typical coping strategies of people facing stress, including shock and uncertainty, which were suggested to be related closely to the nature of brain injury, especially if the injury was traumatic in nature, and their difficulties in managing problems that were novel, unpredictable and global in nature (affecting physical and cognitive functions, personality change and social integration). The physical and psychological burdens involved in day-to-day caring for members with brain injury were unanimously reflected in the interviews. Further content analysis of the long interviews of four selected families showed that some families coped well and some did not. For those successful coping situations, families reported that they became empowered after the onset of their members' brain injury. They expressed possible factors leading to better adjustment, which included setting clear personal expectations, the flexibility to adjust life goals, a desire to master the situation, strong motivation, awareness of their own powerless state and willingness to ask for help from different sources. The results indicated that families cope with a brain-injured member differently, depending on the family's structure, and this should be explored further for the development of intervention guidelines.