Determinants of Successful Transitions To Community-Based Services After Traumatic Brain Injury

Research Objectives To identify the factors influencing transitions to community-based services as perceived by persons living with traumatic brain injury (TBI) and their caregivers. Design Descriptive qualitative study. Setting The study was conducted in partnership with a TBI association offering services to community living TBI survivors in two sociodemographic regions (including urban, semi-urban and rural communities), in the province of Quebec, Canada. Participants Eleven adults living with TBI (8 men; 3 women) and twelve caregivers (2 men; 10 women) were recruited, using a purposive sampling method, until data saturation was achieved. Interventions Not applicable. Main Outcome Measures Data were collected through semi-structured telephone interviews. The interview guide was validated by interdisciplinary researchers and collaborators from the TBI association. The interview transcripts were analyzed using a thematic content analysis that combined inductive and deductive approaches. Two experienced researchers reviewed the coding matrix. Themes were validated with representatives from the TBI association. Results The results suggest that a complex interplay between personal factors (e.g., coping and group identification by TBI survivors and caregivers) and environmental factors (at individual, community and societal levels) may influence transitions in the use of services that promote participation in the home and community settings. Key determinants included: personalized services, accompaniment by a support person, positive relationships (e.g., therapists, peers), attitudes and understanding of TBI, and access to support programs and services across urban and rural communities (e.g., psychosocial services, transportation) to address the evolving needs of this population. The roles and strategies of brain injury associations for connecting persons with TBI to these community-based services were described. Conclusions These findings will contribute to inform the co-development of a concerted action plan between TBI associations and other key stakeholders involved in supporting transitions post-TBI. Author(s) Disclosures The authors have no conflict of interest to declare.