A hermeneutic phenomenological inquiry into the life-world of an altered state of consciousness secondary to brain injury

Buckley, Alison (2022) A hermeneutic phenomenological inquiry into the life-world of an altered state of consciousness secondary to brain injury. Doctoral thesis, University of Cumbria.

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Abstract

Aim: To explore the construction and interpretation of meaning of a transitory period of an altered state of consciousness (ASC) in the immediacy of the acute phase of the acquired brain injury (ABI) trajectory in the inpatient, hospital setting from the perspective of the patient and the layperson witness.

Background: In the immediacy of the acute phase of the ABI trajectory, the patient presents with clinical neurological sequelae which may result in a transitory period of altered consciousness. Whilst they may return to personal and situational awareness, and orientation, there is a paucity of empirical data which has constructed the meaning of the phenomenon of ASC from the perspective of the patient and the layperson witness.

Research Design: The philosophical legacies of Heidegger, Gadamer, Van Manen and Merleau-Ponty, informed the hermeneutic phenomenological study design. Ethical approval was granted by the University of Cumbria.

Method: Following discharge from inpatient services, ten participants who self-reported a transitory period of an ASC secondary to an ABI, and eight who were present as the layperson witness were recruited from a United Kingdom charitable organisation. Data collection was conducted via a combination of individual and shared, in-depth semi-structured interviews, to capture first-person accounts of the hermeneutics of the phenomenon of ASC.

Findings: The meaning of the phenomenon of an ASC was constructed based upon identification of the existential life-world structures: spatiality, corporeality, temporality, relationality, and discourse. These life-world experiences independently and collectively influenced participants’ perceptions and sense-making regarding the recognition and recovery of the patient’s ‘self’, identity, and personhood along a ‘Quest Trajectory’. This trajectory situated participants between one of two, diametrically opposed narrative positions, defined as ‘chaos’ or ‘restitution’. Throughout the ‘Quest Trajectory’, the patient’s pre-injury, ‘legacy self’ was searched for, and privileged. The construction of the patient’s ‘self’, identity and personhood was not solely determined by the pathological changes associated with an ABI but constructed throughout the complex and formative trajectory of ASC.

Conclusion: For the participants of this inquiry, the meaning of the phenomenon of ASC is represented by a conceptual model, entitled ‘The Phenomenological Life-World of an Altered State of Consciousness secondary to Acquired Brain Injury: The Quest Trajectory’. Understanding the narrative threads which construct the autobiographical experience of an ASC, offers a unique and original contribution to the epistemology of the ABI in the inpatient, hospital setting. The findings of this inquiry have implications for practice, education, and research in the field of clinical neurosciences.

Item Type: Thesis/Dissertation (Doctoral)
Departments: Institute of Health > Nursing
Additional Information: Thesis submitted in partial fulfilment of the requirements for the Degree of Doctor of Philosophy (Nursing), Alison Ruth Buckley, January 2022, University of Cumbria, word count: 94,888.
Depositing User: Alison Buckley
Date Deposited: 03 Jan 2023 10:43
Last Modified: 16 Jan 2023 10:15
URI: https://insight.cumbria.ac.uk/id/eprint/6777

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