Mixed Methods Analysis of Social Support Experiences and Priorities Among Adults with Traumatic Brain Injury 8254

Abstract

Objectives

To examine the social support experiences and priorities of community-dwelling adults with chronic traumatic brain injury (TBI).

Design

Convergent parallel mixed methods design with a cross-sectional examination of quantitative data to describe social network size and perceived social support, and qualitative interviews to examine values and priorities related to social support structure and quality.

Setting

Community-based day rehabilitation program.

Participants

Sixteen community-dwelling adults with moderate-severe TBI, >6 months postinjury.

Interventions

None.

Main Outcome Measures

The size of social networks was measured as the number of close social contacts who can be regularly relied upon, and the number of total social contacts. Overall perceived frequency of social support was measured by a transformed total score on MOS Social Support Survey (range, 0-100; higher scores indicate greater support). We also examined subscales on the following MOS Social Support Survey domains: tangible support, emotional and instrumental support, affectionate support, and positive social interaction. Subscale scores are the mean score of the items on each subscale (range, 1-5; higher scores indicate greater support).

Results

Participants had small social networks, which were comprised primarily of family members (mean of 4.3 close social contacts and 8.5 total social contacts). Participants had low perceived frequency of social support (mean, 28.4; SD, 24.7). Their greatest perceived social support was in the tangible support domain (mean, 2.9; SD, 0.8) and the lowest perceived social support was in the affectionate support domains (mean, 1.8; SD, 1.0). The size of the social network and perceived frequency of social support did not align. We identified 3 themes to describe participant values related to the quality of social support: commitment versus indifference, doing things with and for others adds meaning, and “they just love me.”

Conclusions

Although participants had small social networks and low frequency of social support, they did identify several characteristics of social support that contributed to their social support satisfaction. Participants valued people who seemed committed to being there for them, people with whom they share a reciprocal relationship with shared contributions and shared activities, and people who love value them. These priorities align closely with affectionate support and positive social interaction, which are low among people with TBI. These results suggest that rehabilitation interventions should focus on strengthening relationships with close family members and identifying strategies for sustainable, loving, reciprocal relationships within the context of a new TBI.

Disclosures

none.