Increasing Community Participation following Severe Traumatic Brain Injury
Social isolation and lack of community involvement are well-established chronic consequences of severe traumatic brain injury (TBI). Survivors of TBI frequently express the need and desire to establish reciprocal friendships and to pursue social and leisure activities in the community. For many, increased community involvement is associated with reduced emotional disturbance. In this paper, we report the outcomes of involvement in a community leisure program for a group of 24 adults (20 men and 4 women) with severe TBI (PTA > 14 days). All of the participants were living in the community with family and/or attendant care support. Outcome was evaluated with respect to subjective quality of life (QOL) and factors that have been found to have a significant impact on subjective QOL (depression, social support needs and community integration). Both quantitative and qualitative data were collected from participants before they commenced involvement in the program (time 1) and 6 months after they had participated regularly in activities (time 2). Significant relationships between QOL, depression and social support were evident at time 1 and time 2. Lack of friends and reduced participation were clearly associated with depression and poor quality of life when participants were first seen. Follow-up evaluation revealed considerable variability across participants at time 2 with some reporting positive change on outcome measures and others reporting little change. Case studies will be used to illustrate the trends in the group data and variability in the responses of participants. Overall, the results provide evidence to support the notion that programs that successfully facilitate involvement in leisure activities and provide opportunities for the development of friendships will promote improved mental health and quality of life outcomes for adults with severe TBI.