Research Reports - The effect of environmental barriers on community integration for individuals with moderate to severe traumatic brain injury

J Head Trauma Rehabil. 2013 Mar 7

Fleming J, Nalder E, Alves-Stein S, Cornwell P

OBJECTIVE:: To describe environmental barriers endorsed by individuals with
traumatic brain injury during the first 6 months after discharge and determine
their effect on community integration. DESIGN:: Prospective longitudinal study
with data collected at predischarge and at 1, 3, and 6 months postdischarge.
PARTICIPANTS:: One hundred thirty-five individuals with a diagnosis of traumatic
brain injury discharged from a large metropolitan hospital to a home/community
environment. MEASURES:: Sydney Psychosocial Reintegration Scale; Craig Hospital
Inventory of Environmental Factors; and Mayo-Portland Adaptability Inventory-4.
RESULTS:: Multiple regression analyses indicated that environmental barriers
arising during the transition from hospital to home had a negative association
with community integration outcomes. Physical barriers were most commonly
endorsed, but attitudinal barriers were significantly correlated with
relationship changes. CONCLUSION:: Environmental barriers should be addressed in
rehabilitation and considered in policy development for people with traumatic
brain injury. Future research on the measurement of environmental barriers is

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