| Sumario: | Upon discharge from community re-entry rehabilitation centers, many survivors of acquired brain injury (ABI) fail to demonstrate optimal goal attainment and suffer heightened psychosocial distress. Social work's ecological perspective stresses the importance of a survivor's family functioning and individual role on the ABI survivor's health care outcomes. Talcott Parson's structural role theory frames this problem in terms of the survivor in the role of a 'sick' person recovering in the rehabilitation environment. However, sick role is a static concept that neglects the dynamic nature of the human change process. To recover, survivors must go though a 'sick role process' in which they embrace a right to be 'sick' when they are first injured, but then accept responsibility for their own recovery as time goes on. This study developed the dynamic concept of sick role process and through a multivariate, correlational, ex-post facto research design examined the effects of sick role process and family functioning on goal attainment and psychosocial distress of adult survivors of acquired brain injury. Bivariate analysis found a significant low-to-moderate relationship between family functioning and goal attainment (r=.27, p<.05) and a moderate but significant correlation between responsibilities at time of discharge and psychosocial distress (r=-.37, p<.01). Multiple regression analysis did not fully support the multivariate hypotheses. It did reveal that while the level of sick role rights at intake did not have a significant effect on psychosocial distress at discharge, the level of sick role responsibilities assumed at time of discharge did have a significant effect on psychosocial distress at that time The lack of effect of rights on distress was likely due to the questionnaire's being completed at time of discharge, and questions related to rights at intake were memory dependent. The study has implications for ABI rehabilitation programs in placing greater emphasis on acceptance of sick role responsibility in minimizing psychosocial distress and in further development and examination of sick role process in guiding future research with survivors of ABI.
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