Community reintegration of people with traumatic brain injury in South Africa

ABSTRACT

Background

Traumatic brain injury (TBI) affects cognitive, behavioral and physical function, influencing community reintegration.

Objectives

To describe the level of community reintegration and the associated influencing factors post-TBI in South Africa.

Methods

A cross-sectional analysis of patients living with TBI was done, using the Community Integration Questionnaire (CIQ), the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and the Quality of Life after Brain Injury Overall Score (QOLIBRI-OS).

Results

Of the 80 participants 54.0% presented with mild TBI. The median (IQR) score of the CIQ, WHODAS 2.0 and QOLIBRI-OS was 22 (7.5)/29, 31(18)/100 and 73 (45.5)/100. There was a moderate inverse relationship between the WHODAS 2.0 and CIQ scores (r = −0.68; p < 0.001) and a moderate positive correlation between the QOLIBRI-OS and CIQ scores (r = 0.54; p < 0.001). The WHODAS 2.0 scores also showed a strong inverse correlation with the QOLIBRI-OS scores (r = −0.76; p < 0.001).

Conclusion

The participants had high levels of functioning and low levels of disability, both of which were found to be in tandem with high CIQ scores and generally good quality of life. Post-TBI patients are capable of achieving good community integration provided they attain high levels of functioning.

KEYWORDS:

• Brain injury
• community reintegration
• disability
• quality of life

Biographical notes

Mrs Nicolette Comley-White is a physiotherapy lecturer at the University of the Witwatersrand, South Africa. Her area of specialty is adult neurology and HIV, and she lectures undergraduate and postgraduate physiotherapy students. She is currently a PhD candidate, with her research addressing the physical sequelae of perinatal HIV in adolescents.

Professor Witness Mudzi is the Director of the Postgraduate School at the University of the Free State. He has over 20 years of experience in the higher education sector. He holds a PhD from the University of the Witwatersrand. He has published more than 35 articles in peer reviewed journals, has supervised to completion more than 20 MSc students and has also supervised to completion PhD students. His research interest is in adult neurology, public health and education.

Mrs Heidi Gouws is a physiotherapist working in a rural hospital and clinic setting in the Eastern Cape, South Africa, where she grew up. She has a special interest in adult and pediatric neurology, with a passion for community and family reintegration.

Acknowledgments

The authors wish to acknowledge the study site, participants and caregivers for their involvement. Furthermore, Dr Tunde Ajidahun is acknowledged for his role in structuring and formatting the manuscript.

Disclosure statement

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

Data availability statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Additional information

Funding

This study was privately funded by HG.