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Citation
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Venkatesan UM, Adams LM, Rabinowitz AR, Agtarap S, Bombardier CH, Bushnik T, Chiaravalloti ND, Juengst SB, Katta-Charles S, Perrin PB, Pinto SM, Weintraub A, Whiteneck GG, Hammond FM. Arch. Phys. Med. Rehabil. 2023; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: To examine the impact of the COVID-19 pandemic on societal participation in people with moderate-to-severe traumatic brain injury (TBI).
DESIGN: Cross-sectional retrospective cohort. SETTING: National TBI Model Systems (TBIMS) centers, United States. PARTICIPANTS: TBIMS enrollees (N=7,003), ages 16 and older and 1-30 years post-injury, interviewed either pre-pandemic (PP) or during the pandemic (DP). The sample was primarily male (72.4%) and White (69.5%), with motor vehicle accidents as the most common cause of injury (55.1%). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The 3 subscales of the Participation Assessment with Recombined Tools-Objective (PART-O): Out and About (community involvement), Productivity, and Social Relations.
RESULTS: Out and About, but not Productivity or Social Relations, scores were appreciably lower among DP participants compared to PP participants (medium effect). Demographic and clinical characteristics showed similar patterns of association with participation domains across PP and DP. When their unique contributions were examined in regression models, age, self-identified race, education level, employment status, marital status, income level, disability severity, and life satisfaction were variably predictive of participation domains, though most effects were small or medium in size. Depression and anxiety symptom severities each showed small zero-order correlations with participation domains across PP and DP, but had negligible effects in regression analyses.
CONCLUSIONS: Consistent with the impact of COVID-19 on participation levels in the general population, people with TBI reported less community involvement during the pandemic, potentially compounding existing post-injury challenges to societal integration. The pandemic does not appear to have altered patterns of association between demographic/clinical characteristics and participation. Assessing and addressing barriers to community involvement should be a priority for TBI treatment providers. Longitudinal studies of TBI that consider pandemic-related effects on participation and other societally linked outcomes will help to elucidate the potential longer-term impact the pandemic has on behavioral health in this population.
Language: en |