Uncovering the social determinants of brain injury rehabilitation

Abstract

Objective: The paper explores the personal experiences of loneliness among brain injury survivors during lockdown in the COVID-19 pandemic.Design: This is a mixed methods research design, employing a combination of quantitative statistical analysis and semi-structured interviews with subsequent reflexive thematic analysis.Methods: 24 brain injury survivors from across the UK (8 females, 16 males; 24-68 years old; Mage = 48.65) participated in semi-structured interviews and completed questionnaires relating to loneliness, resilience, and wellbeing. Statistical and reflexive thematic analysis methods were employed in the interpretation of the data.Results: The interview data and subsequent analysis created three overarching themes: the experience of loneliness, loneliness during the pandemic, and loneliness after the pandemic. These themes explore survivors’ experiences of loneliness generally post-brain injury, but also chronicle how these feelings developed in lockdown and survivors’ feelings regarding society returning to ‘normal’. Lockdown provided participants with time and space, an opportunity to reflect in circumstances that did not further exacerbate their symptoms or anxiety associated with societal expectations or responsibility. Participants’ accounts detailed a greater societal awareness of brain injury and feeling more included during the pandemic but concern they would be left behind with society returning to normal. Conclusions: We recommend that future interventions focus on reframing survivors’ beliefs regarding societal expectations and minimise the pressure they often experience to keep up with their peers physically and emotionally. Additionally, we recommend creating accessible peer support options for all brain injury survivors as an important step for alleviating loneliness in this population.