"Part of the world again": qualitative enquiry into community participation during inpatient rehabilitation and transition years following severe brain injury.

Abstract

Purpose: To understand the experience of community and social participation for people with severe ABI during inpatient rehabilitation and the transition years.

Methods: Constructivist grounded theory methodology informed participant recruitment and data analysis. Adults with ABI were recruited using purposive sampling and data collected via in-depth interviews.

Results: Thirteen adults with severe ABI participated, with average age of 36.7 yrs at the time of injury, 9.1 months length of stay of in inpatient rehabilitation, and 4 years post discharge from hospital at time of interviews.The core category developed from thematic analysis was 'lack of focus on community and social participation.' Additional categories included: restricted participation, a focus on impairment and function, acceptance and connection within the community, influence of family and delayed return to community participation.

Conclusion: Community and social participation are recognized as the goal of rehabilitation following ABI; however, experiences shared by participants revealed that community and social participation were not the focus of their rehabilitation.

Implications for rehabilitation: To support positive holistic outcomes, focus on community and social participation is required within the rehabilitation continuum, using participatory frameworks, contextual goal setting, transparent endorsement for community access and the provision of opportunities for meaningful experiences with family and friends.