Is it prime time for sex and gender considerations in traumatic brain injury? Perspectives of rehabilitation care professionals

Abstract

Purpose

The purpose of this study was to explore rehabilitation clinicians’ understanding of how sex and gender facilitate or hinder care provided to patients with traumatic brain injury (TBI).

Materials and methods

Sixteen clinicians from various specialities, attending to patients with TBI from a large rehabilitation hospital in Ontario, Canada, were recruited using purposive sampling. Data was collected through semi-structured interviews and thematic analysis was used to identify reoccurring themes.

Results

Three themes that facilitate or hinder care of TBI patients were identified: (1) knowledge and evidence; (2) gender and other aspects of recovery; and (3) family caregiving. Lack of education about the topic and inconsistent scientific evidence limited clinicians’ attention to sex and gender topics. Social, financial, and cultural characteristics of patients were considered to be more relevant than their sex and gender. The gendered nature of caregiving and its burden on caregivers’ health were acknowledged.

Conclusions

Currently, attention to topics of sex and gender as they may influence patients’ recovery is limited. However, clinicians are willing to be educated on these topics to enhance rehabilitation care. Further research on the gendered nature of interactions between patient, clinician, and family caregiver during recovery is warranted.

IMPLICATIONS FOR REHABILITATION

• Sex and gender matter for patients undergoing recovery for their traumatic brain injury; however, clinical attention to this topic is limited.

• Based on the clinicians’ perceptions, resources that address patients’ psychosocial vulnerabilities should be prioritized (e.g., unequal access to care, financial status, cultural diversity etc.).

• Clinicians highlighted that psychosocial vulnerability and patients’ life roles, before and after injury, are sex and gender specific.

• Guidelines about sex and gender influences in traumatic brain injury rehabilitation have the potential to enhance clinical practice.

Keywords:

• Brain injuries
• traumatic
• rehabilitation
• sex
• gender identity
• social determinants of health

Acknowledgements

This research project was developed with endorsement by Brain Injury Canada, Ontario Neurotrauma Foundation and DisAbled Women’s Network Canada. We wish to express sincere gratitude to research team members Dr. Cullen and Dr. Velikonja for their contributions to the grant development. We also wish to express our sincere gratitude to Ms. Andrea D’Souza and Mr. Navindra Baldeo for proofreading the manuscript and providing valuable comments.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by a research grant from the Canadian Institutes of Health Research, Institute of Gender and Health [#CGW-126580].