Brown, Alison; (2001) Psychological adjustment following severe lower limb trauma: A repertory grid study. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

The study explores prospectively how people come to terms with a severe injury to a lower limb following acute trauma. Participants were adults admitted to plastic surgery or orthopaedic surgery wards with open tibial fractures undergoing reconstructive surgery. Participants were seen within six weeks of injury, and asked to complete three short questionnaires (the Hospital Anxiety and Depression Scale, the Impact of Events Scale, and the Short-form McGill Pain Questionnaire). In addition, participants completed a repertory grid using self and social role elements. After a three-month interval participants were sent the questionnaires and were asked to rerate their repertory grid elements according to the constructs generated in the initial interview. The repertory grid data was analysed using Principal Component Analysis and by examining construct correlations and inter-element distances. The constructs generated were also considered thematically. Data from the questionnaires was used primarily to describe the population and changes over time. The results are discussed in relation to psychological theory and previous research findings on adjustment, trauma, self-concept and construct systems. Findings indicate that the personal meaning of lower limb trauma influences the impact on the self-concept, and that changes in the construct system are apparent over time suggesting a process of adjustment to injury. Limitations of the present study are discussed and the implications of the findings for service provision and further research are presented.

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