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PHE3SPH 2016: Theoretical Perspectives & Practical Applications - Nursing Assessment Answers

November 15, 2017
Author : Charles Hill

Solution Code: 1FGE

Question: Nursing Assignment Writing

This assignment is related to “Nursing Assignment Writing” and experts at My Assignment Services AU successfully delivered HD quality work within the given deadline.

Nursing Assignment


For this assignment you are to select a type of acquired brain injury that is to be your focus for the task. The brain injury can have been acquired through brain trauma, a cerebrovascular accident (a stroke), anoxia (as a consequence of a cardiac or a respiratory arrest), or through the development of a neurodegenerative disease that affects the central nervous system (e.g. multiple sclerosis; motor neurone disease; Parkinson's disease). You are to discuss the type of acquired brain injury that you have selected, in the context of a theory/model of psychosocial adaptation and/or adjustment to a chronic health condition; OR discuss the type of acquired brain injury that you have selected, in the context of a theory/model of the impacts of social support on health. You are then to consider how the insights provided by your discussion can be applied to rehabilitation and service delivery in community settings.

• Provide an introduction to the topic by way of: identifying, and briefly describing the characteristics, of the type of acquired brain injury that you have selected to be the focus; and identifying and briefly outlining the theory/model that you have chosen for the contextualisation/discussion of this type of acquired brain injury.

• Drawing on references that report empirical studies of the lived experience of the type of acquired brain injury that you have selected to be focussed upon, and also on references that provide accounts of your chosen theory/model, discuss the ways in which, and the extent to which, the theory/model describes, explains, and predicts, psychosocial adaptation and/or adjustment, to acquired brain injury; OR discuss the ways in which, and the extent to which, the theory/model describes, explains, and predicts, the health impacts of social support for those with an acquired brain injury.

• Drawing on relevant literature (where applicable), describe and explain how the key aspects of your discussion for point 2 (above) could be applied to rehabilitation and to the delivery of community-based services, for those with an acquired brain injury.

• Provide a conclusion that draws upon and draws together the key insights with relation to points 2 and 3 (above).

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Brain injury constitutes one of the serious public health and poses challenge for medical fraternity. It has resulted into several chronic health issues (Corrigan & Hammond, 2013). Brain injury causes severe consequences for the sufferer and the caregivers. It has disabling effect on individual’s lives those who are having traumatic brain injury. The reason behind brain injury could be trauma, anoxia, cerebrovascular accident etc. Traumatic brain injury has created negative health outcome despite an advancement in medical field. It could produce both mental and financial stress. Traumatic brain injury has devastating impact on patient and the family (Vangel, Rapport & Hanks, 2011). Cognitive and behavioral problems are the general issues associated with traumatic brain injury. These become as a complex challenges and requires additional preventive measures. Neurobehavioral challenges are also found associated with such type of injury. Generally it is caused by an external brain damage which might occur due to head piercing on an object. Brain damage can cause mild to severe symptoms. Mild symptoms could be dizziness, blurred vision, headache, behavioral changes, lethargy etc. While severe symptoms include nausea, loss of confusion, agitation, convulsions etc. One of the important symptom is altered consciousness due to brain damage. Possibly it leads to loss of physical & psychosocial function, cognitive power. More than 50% of the patient experiencing brain injury undergoes surgery which is the only treatment available. Brain injury has a negative impact on our lives such as it changes the personality. As discussed above, it affects physical activity followed by occurrence of depressive episodes hence social support is needed to get rid of the situation. Medical treatment is easier rather than providing emotional support though family members. Hence post injury time period is very critical time for the patient and caregiver as well.

Health impacts of social support

Recovery after brain injury depends upon various factors such as severity of an injury, patient’s response to health condition etc. The post traumatic recovery is a costly affair. The financial burden falls on the patient and the family (Finkelstein, Corso & Miller, 2006). It disrupts the whole functioning of the family. This can cause anxiety, stress and depression among family members. Neuro behavioral issues seems more complicated than others. Caregivers are often placed at high risk because of lack of adequate support and services. Care givers well-being is essential to maintain as their capacity is required to take proper care of the injured person (Temkin et al, 2009).

Two terms have been coined to explain the health condition of an affected person – pre traumatic health status and post traumatic health status. Bigger the gap between these two could lead for severe health consequences. This is known as quality of life as the patient wants to enjoy his/her freedom without any dependence. Overall, traumatic brain injury hampers the quality of life and has an impact on one’s self esteem and motivational level. Therefore concept or theory of social support has gained popularity worldwide.

Theory of social support

Social environment and social support both the terms are used interchangeably. Caregivers, friends and medical professionals constitutes a patient’s social environment. All three are an important source of social support. They provide different kind of support as needed during post traumatic time period. The theory of social support is based upon following three concepts –emotional support, tangible support, and informational support. Emotional support is provided in the form of patient care that probably motivates to think in a positive manner and avoids negative thinking. Financial support is known as tangible support as the cost of treatment is very high and cannot be afforded easily. Sources of social support give advice that is the main part of informational support (Driver, 2005).

Extensive research studies are available to indicate the role of unsupportive social support that results into lower self-esteem and motivation level. These have detrimental effect on a patient’s health if happens in an uncontrolled manner. Sources like family or friends are always not related with positive health outcomes. Various research studies have indicated that social support variables are not significantly related with behavioral outcomes. It can be explained on the basis of differences in individual’s needs. It is evident from several research studies that different types of sources are needed as per the demand of the situation. For example, tangible support may be more effective in comparison with other support system. It is difficult to generalize which variable is more important but emotional support has worked better to become physically active. It is suggested from researches specifically conducted for traumatic brain injury, greater level of emotional support has resulted into greater quality of life.

Impact of different social support has been analyzed through various research studies. Around 87 studies have been conducted to examine the role of social support for exercise behavior. Significant associations were found between family support and increased motivational level to do physical exercise. Other studies were also examined to find out a link between social support of family and friends versus patient’s attitude and behavior. Similar findings were obtained in another study conducted for older patients which reinforce the importance of social support of spouses and physical activity. Family was found the primary source of social support (Driver, 2005). Overall, type of social support can influence an individual’s behavior. The same principle can be applied for the traumatic brain injury.

The theory of social support plays a central role to ensure that individuals are able to cope up with the stress level cause by impairment of physical activity, psychosocial and cognitive capability. Post traumatic period creates mental pressure on an individual so it is required to have greater number of sources of social support. Sources of social support can increase motivational level to change behavioral pattern of an individual (Driver, 2005). Hence, social support provides enough emotional support to attend rehabilitation activities.

Despite knowing the fact of importance of social support for traumatic brain injury, individuals do not receive proper care and support which is needed for recovery. It is evident from research studies that social support has decreased after an injury. Lower social support has been found associated with lower self-esteem and motivational level that finally alters quality of life. Negative health outcomes have been witnessed such as societal isolation, inability to work etc. This has a negative impact in terms of increased isolation and less interaction with others.

In contrast to the above fact, studies have also suggested that behaviors of family members changed immediately after a brain injury. Family support is the first response to mitigate the stress associated with traumatic brain injury. Family members have been found active after 6 months of traumatic brain injury. They are involved in making financial arrangements, spending more time with the patient etc. After 6 month time period, family members behave differently either they provide emotional support or few of them withdraw from social support.

A gradual decline in family and friends support has been observed post traumatic brain injury. It is perceived by the family that recovery will take time and requires more supportive efforts. This will lead to a situation where they all face financial crisis so they start showing withdrawing behavior. It also increases psychological pressure on patient and family as well.

Changes have been observed after a traumatic brain injury as an individual lose his/her friends and social gathering. Finally, family members provide emotional and motivational support. In response to this, an individual become more depressive and starts living in isolation. It has been observed that people who experience lack of friends support are not at all motivated to become physically active. There is a link between social support and motivation after traumatic brain injury (Resnick et al, 2002).

Theoretical application

As per mediational model of global self-worth, an individual’s motivational level is effected by social support, self-worth, perceived competence and outcomes. Self-worth is an important link between social support, perceived competence and its affect. Global self-worth is defined by one’s ability to perform while motivation is someone’s desire for a particular behavior. Self-worth and motivation both are interlinked characteristics of this model (Driver, 2005). This can be explained through the following example, an individual who left with cognitive and physical disability after traumatic brain injury requires social support to live quality of life. It may be possible that his/her parents show over protective behavior and do not allow him/her to do physical activity due to fear of hurting or falling again. So this has a negative impact for an individual and directly affects the self-worth and he/she starts thinking that he/she cannot do physical activity anymore. This behavior could be avoided by providing social support by influencing an individual to put effort to do physical activity. This in turn will motivate him/her to perform physical work.

The success of rehabilitation program largely depends upon social support. Caregivers also play an important role for these programs. To complete a specific behavior, an individual must be motivated to feel encourage through various social sources. Attending rehabilitation classes could be a particular activity for a person with traumatic brain injury. Evidences are available supporting reluctance to attend rehabilitative activity. Hence self-worth and social support both function to motivate a person to participate in such activities actively. Global self-worth will increase if perceived social support increases. It has been demonstrated through various studies that self-worth is totally dependent on social support. Continuous social support can motivate a person by increasing his self-worth to achieve a behavior. Achievement and maintenance of a particular behavior form an important aspect. Constant social support is needed to maintain the behavior which otherwise could have negative impact (Ylvisaker, Jacobs, Feeney, 2003). It can be stated that different set of support act together to increase self-worth and that in turn, have positive impact on an individual’s motivational level.

The same principle applies for community based services. Social support is important at an individual level while community support is needed at larger scale to initiate community based rehabilitative programs. Social supports starts from an individual level and then extends up to community level. Family is considered as an individual entity while community represents the extension of this. Therefore, success of community programs depends upon support of all irrespective of a single family. If the community supports an individual then he will motivated to attend rehabilitation classes. In reverse, an individual may withdraw if community influences negatively to him. Overall, social support of the family and the community both are an essential component to implement a successful program. Planning should include various aspects such as financial burden of family members & their mental stress, patient’s health condition, education & information to be shared with the patient and the family etc.


It can be concluded that, social variables are important determinants to predict individual’s behavior. Research studies have shown constant linkage between positive health aspect and social support. Mediational model of global self-worth explains relationship between increased social support, increased self-worth and increased motivation level. Physical benefits are associated with physical activity that can be increased through various mode of action. Research has proven the phenomenon that social support is essential to motivate a person for rehabilitation services. Theory of social support has explained its importance to reverse the cognitive, physical and psychosocial impairment. Psychological damage caused due to traumatic brain damage could be altered or changed by application of the above stated theory.

Prolonged physical damage to care givers hampers their daily routine activities. One important point is that care givers need proper information pertaining to rehabilitation, treatment, emotional support etc. They should be first given proper education so that they can comprehend the situation in the right manner. Huge money is invested for acute rehabilitation process that usually lasts for approximately two months. So most of the people take decision to return home rather than availing services of rehabilitation unit so family must be aware of the financial burden.

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