Access to care for acquired brain injury survivors: A critical qualitative inquiry

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Hrabi, Gladys
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The purpose of this study was to examine the influence of language, power relations, and constructions of knowledge in shaping the experiences of acquired brain injury (ABI) survivors when accessing care. Using a critical qualitative inquiry, specifically the Foucauldian perspective, an in-depth semi-structured interview was conducted among 15 ABI survivors in Manitoba. The framework provided by Andersen’s behavioural model of care (2008) was used to determine how ABI survivors experience access to care. Data were interpreted and discussed using deductive thematic analysis. The findings from this analysis illustrate the role of power, knowledge, and language concerning disability related to the participants’ access to care. In particular, the five interconnected themes (1) contextual characteristics domain, (2) individual characteristics domain, (3) perceived need, (4) power and knowledge nexus, and (5) language and power nexus in combination with the quantitative results of the pre-interview survey described the impact of the medicalization of brain injury on access to care. ABI survivors often face difficulties in meeting eligibility criteria owing to the invisible nature of the disability. This study’s participants’ unmet needs include access to community-based specialized services, quicker access to specialists/resources, service navigation support, and mental health services. Furthermore, this study showed that healthcare and social service systems’ multifaceted nature affected how ABI survivors perceived their disability, how the dominant discourses of ABI influenced the knowledge that is privileged, and how power was exercised within service navigation and service user-service provider interactions. This thesis concluded that access to care should be informed by shared knowledge construction between the service provider and service user.
access to care, social work, brain injury