The COVID-19 pandemic exacerbated social isolation among people with traumatic brain injury (TBI). Yet, little is known about how changes in personal factors, environmental factors, or the characteristics of activities affected social participation. We examined experiences with social isolation and barriers to social participation using the person-environment-occupation-performance model as a framework. Twelve adults with TBI participated in a series of three focus groups. Data were analyzed using thematic analysis. We identified two primary themes with sub-themes: (1) social isolation experiences: (1a) emotional impact and (1b) managing personal risk; and (2) greater barriers but a lack of strategies to address them: (2a) access and opportunities and (2b) social and societal factors. New environmental barriers and task demands affected occupational performance, and participants identified few successful strategies to overcome these barriers. Occupational therapy can develop new strategies to re-balance the person-environment fit and enhance social participation.
Keywords: environment; qualitative research; social participation.
Ongoing Challenges Related to the COVID-19 Pandemic Among People With Brain InjuryPeople with traumatic brain injury (TBI) have experienced increased social isolation because of the COVID-19 pandemic. There has been limited research to describe how social isolation has been experienced beyond the initial pandemic lockdowns, what limits people from participating in more social activities, and how occupational therapy can help people overcome these new challenges. We interviewed 12 people with TBI to understand their experiences of social isolation using the person–environment–occupation–performance model as a framework. We found that people with TBI have continued to experience worse social isolation, which has affected their emotional well-being. They continue to worry about their risk of exposure and illness. We found that limited opportunities for social activities, inaccessibility of activities, and a lack of social support have contributed to social isolation. Occupational therapy practitioners can help people with TBI develop new strategies to overcome barriers to social participation so they may safely return to important social activities.