title: Social participation and quality-of-life of patients with traumatic brain injury living in the community: A mixed methods study.
abstract: OBJECTIVE
  To investigate the quality-of-life (QoL) and social participation of patients with traumatic brain injury (TBI) living in the community in Japan.
  
  
  METHODS
  A mixed-methods study of 29 post-TBI patients and 12 family members was conducted. Objective scales were used to evaluate QoL (Short Form Health Survey SF-36), depression (Zung Self-rating Depression Scale) and psychosocial function (Sydney Psychosocial Reintegration Scale, 2ndedition). Subjective views of changes in social functioning, participation and suitability of family support were obtained by a semi-structured interview. Participants were classified into 'change' and 'no-change' groups for social participation and between-group comparisons of QoL and determinant factors of QoL were evaluated.
  
  
  RESULTS
  The SF-36 social role component was significantly associated with the suitability of family support, followed by their understanding. However, QoL was not significantly associated with changes in social participation. Social participation was particularly influenced by the absence of rehabilitation support for low-skill labourers and housewives, whether they lost their employment or not.
  
  
  CONCLUSIONS
  Advances in rehabilitation services are required, particularly to meet the specific needs of housewives and low-skill labourers. Families should receive sufficient education and short- and long-term strategies for providing suitable support to patients and their families should be implemented.
authors.affiliation: a Department of Rehabilitation Medicine.|b Department of Psychiatry , Yokohama City University , Yokohama City , Kanagawa , Japan.
authors.forename: Kaoruko
authors.initials: K
authors.lastname: Takada
authors.affiliation: a Department of Rehabilitation Medicine.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sashika
authors.affiliation: a Department of Rehabilitation Medicine.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Wakabayashi
authors.affiliation: b Department of Psychiatry , Yokohama City University , Yokohama City , Kanagawa , Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Hirayasu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012111:Residence Characteristics; D012189:Retrospective Studies; D012727:Sex Characteristics; D058992:Social Participation; D018709:Statistics, Nonparametric; D055815:Young Adult
keywords: Post-TBI; family support; housewife; rehabilitation