Date Presented 04/04/2025
This study investigated unmet needs identified by persons with traumatic brain injury (TBI) living in rural communities. Findings provide evidence to support the need for enhanced OT training in the areas of cognitive rehabilitation and social integration.
Primary Author and Speaker: Amanda Acord-Vira
Additional Authors and Speakers: Megan Bruce, SueAnn Woods, Heather M. Livengood, Steven Wheeler
Contributing Authors: Cortland Nesley
PURPOSE: This study investigated unmet needs of individuals with traumatic brain injury (TBI) living in rural communities to better inform clinical practice. In a 5-year follow-up survey, 70% of individuals with a brain injury reported at least one perceived unmet need [1]. Persons residing in rural areas had a higher incidence of TBI and experienced barriers to accessing specialized care [2].
DESIGN: Descriptive, 37-item survey. Survey questions were both quantitative and qualitative.
METHOD: Subject recruitment was conducted over a one-year period; 102 community dwelling individuals self-identifying with a TBI completed the survey. Respondents ranged in age from 18 to 80 years with 51% identified as female, 42% indicated being unable to work, and 42% reported an annual household income of less than $20,000.
RESULTS: The most frequently identified ‘barriers’ to receiving needed services were a lack of awareness of the ways to receive services/benefits (66%), inadequate knowledge about available supports and supports (63%), and difficulty finding a healthcare provider who understands brain injury (58%). Needs reported as being most frequently ‘unmet’ were cognition (46%), establishing relationships (40%), opportunities to socialize (40%), and accessing TBI resources/information (33%). Needs most frequently identified as ‘met’ were substance use support (94%), mobility devices (91%), work and school accommodations (90%), activities of daily living (90%), and medication management (88%).
CONCLUSION: Participants prioritized unmet needs that were consistently within OT’s scope of practice. Findings indicate a lack of services and supports related to cognition and to social aspects of recovery.
IMPACT: Study findings support the need to ensure that OT practitioners have the knowledge and skills to support client cognitive performance and facilitating meaningful social networks. Discharge considerations should consider higher level cognitive and social needs.
References
Andelic, N., Soberg, H. L., Berntsen, S., Sigurdardottir, S., & Roe, C. (2014). Self-perceived health care needs and delivery of health care services 5 years after moderate-to-severe traumatic brain injury. PM&R, 6(11), 1013–1021. https://doi.org/10.1016/j.pmrj.2014.05.005
Daugherty, J., Zhou, H., Sarmiento, K., & Waltzman, D. (2021). Differences in state traumatic brain injury–related deaths, by the principal mechanism of injury, intent, and percentage of the population living in rural areas — United States, 2016–2018. Morbidity and Mortality Weekly Report, 70(41), 1447–1452. https://doi.org/10.15585/mmwr.mm7041a3
