The Effect of Environmental Barriers on Community Integration for Individuals With Moderate to Severe Traumatic Brain Injury

OBJECTIVE: To describe environmental barriers endorsed by individuals with traumatic brain injury during the first 6 months after discharge and determine their effect on community integration. DESIGN: Prospective longitudinal study with data collected at predischarge and at 1, 3, and 6 months postdischarge. PARTICIPANTS: One hundred thirty-five individuals with a diagnosis of traumatic brain injury discharged from a large metropolitan hospital to a home/community environment. MEASURES: Sydney Psychosocial Reintegration Scale; Craig Hospital Inventory of Environmental Factors; and Mayo-Portland Adaptability Inventory-4. RESULTS: Multiple regression analyses indicated that environmental barriers arising during the transition from hospital to home had a negative association with community integration outcomes. Physical barriers were most commonly endorsed, but attitudinal barriers were significantly correlated with relationship changes. CONCLUSION: Environmental barriers should be addressed in rehabilitation and considered in policy development for people with traumatic brain injury. Future research on the measurement of environmental barriers is recommended.