title: The effect of environmental barriers on community integration for individuals with moderate to severe traumatic brain injury.
abstract: 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.
  
  
  METHODS
  Prospective longitudinal study with data collected at predischarge and at 1, 3, and 6 months postdischarge.
  
  
  METHODS
  One hundred thirty-five individuals with a diagnosis of traumatic brain injury discharged from a large metropolitan hospital to a home/community environment.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Health and Rehabilitation Sciences, The University of Queensland (Drs Fleming and Nalder and Ms Alves-Stein); Centre for Functioning and Health Research, Queensland Health (Dr Fleming); Occupational Therapy Department, Princess Alexandra Hospital (Dr Fleming); Metro North Hospital and Health Service (Dr Cornwell); and Behavioural Basis of Health program, Griffith Health Institute, Griffith University (Dr Cornwell), Brisbane, Queensland, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Fleming
authors.forename: Emily
authors.initials: E
authors.lastname: Nalder
authors.forename: Serena
authors.initials: S
authors.lastname: Alves-Stein
authors.forename: Petrea
authors.initials: P
authors.lastname: Cornwell
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000328:Adult; D001930:Brain Injuries / Q000175:diagnosis* / Q000534:rehabilitation*; D062309:Community Integration / Q000523:psychology / Q000706:statistics & numerical data*; D003266:Continuity of Patient Care; D004777:Environment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D020380:Needs Assessment; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012931:Social Environment; D016896:Treatment Outcome; D055815:Young Adult