M.A. / With the advances achieved in medical technology in recent years, society is increasingly faced with the issue of determining how fit individuals are for reintegration in society following the event of traumatic brain injury. Together with Neurology and it's diagnostic capabilities, many other disciplines such as Neuropsychology, Physiotherapy and Occupational Therapy, to name but a few, have placed strong emphasis on the rehabilitation of individuals with brain damage, with a view to reintegrate them into society. Besides the physical rehabilitation which aims at normalizing the individual's physical health, issues such as psychological ,cognitive and social functioning have been the focus of a great body of research in recent years. Whereas in the past the prognosis for many such patients in respect of returning to a normal life style were discouraging, health workers are now more optimistic in most cases regarding the individuals' probability to achieve a higher level of functioning after recovery. In this context, the individuals' ability to function in society, their ability to be integrated into the family and working environment and competence to be active and valued members of society have thus become the new aims which the therapeutic team together with the patient strive to achieve. With this in mind, rehabilitation teams now place greater emphasis and effort on optimizing recovery in the areas of cognitive and emotional competence. Amongst these issues, the individuals' competence to make moral judgements and socially adequate decisions in everyday living is of the utmost importance. This impacts on their ability to abide by social rules and norms which will determine their competence and desirability as active members in the family, social and working environments. This is the main focus of the present study. The issue of moral judgement and behaviour is central to this discussion, and a delineation of what defines morality and moral judgement is mandatory. Contributions to this analysis were found in the writings of the various authors and schools of thought presented here, and each of them has dealt with the theme of morality, moral behaviour and judgement from a different theoretical perspective. Theorists such as Lawrence Kohlberg made a major contribution to the understanding of the development of moral judgement through his stage theory, which forms one of the cornerstones of the present study. The site and the severity of the brain injury is paramount to the prognosis for rehabilitation. The frontal lobes have been described as the structures responsible for the widest range of symptoms and seen as the seat of intellect, responsible for deviations in moral and emotional functioning. An overview of the frontal lobes and associated cognitive functions as well as behaviors observed as a result of injury to these structures is presented. The existential-phenomenological system of inquiry has been described by its proponents as the most adequate to investigate phenomena relating to human behaviour, when an understanding of the subjective experience of the individuals involved is desired. For this reason this methodology is used in the present study to facilitate a qualitative analysis of the experience of brain injury particularly in respect of possible alterations in moral judgement and behaviour following the accident. The present investigation is based on interviews with three subjects and their primary caretakers, who answered questions regarding moral dilemmas. These dilemmas aim at tapping the individual's underlying reasoning processes when faced with the decision of what is right and wrong. The analysis and integration of the data obtained through these interviews reveals a complex cluster of alterations in thought and behaviour, much in line with those expected from patients suffering traumatic injury of the frontal lobes. Although different behaviours were revealed by each participant in this study, they were generally in line with the alterations described in the literature resulting from injury to the described brain areas. The value of this study lies in projecting a clearer picture of the experience of brain injury from the point of view of the victims as well as the close family members. Furthermore, analysis of data obtained in this investigation highlights certain typical behaviors and responses observed in individuals with such brain injuries, as described in the literature presented here.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uj/uj:9870 |
| Date | 10 September 2012 |
| Creators | Santos, Maria Teresa Bordalo |
| Source Sets | South African National ETD Portal |
| Detected Language | English |
| Type | Thesis |
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