The Effect of Environmental Barriers

Past Studies

Past Studies suggest that the initial severity of a brain injury can be linked to an individual’s eventual level of disability, impairment, and long-term outcome. Individuals with more severe brain injuries appear to have poorer long-term outcomes and to report lower levels of life satisfaction. They can experience a decrease in the abilities needed for work, school, social interaction with others, and living alone in the community. Research has not extensively examined factors beyond the individual, termed “environmental factors,” which can influence outcome. Examples of environmental barriers include a lack of family support, architectural barriers, a negative attitude from society towards individuals with disabilities, and public policy.

This Study

This study sought to identify the types of environmental barriers that were reported by individuals with traumatic brain injury. The researchers’ goal was to find out how the environmental barriers affected the individual’s level of participation in society and overall life satisfaction. The researchers surveyed 73 individuals with traumatic brain injury, one year after their injury date. The participants were assessed with professional scales, including the Craig Hospital Inventory of Environmental Factors (CHIEF), which rates the frequency and impact of 25 possible barriers.

The participants stated that the barriers that most often affected them to the greatest degree were transportation limitations, their surroundings (lighting, noise, crowding, etc.), government policies, other people’s attitudes at home, and the natural environment. Women, older individuals, married people, and members of minority groups tended to report more barriers. Those individuals who were not employed or in school at the time of their injuries reported the greatest impact of environmental barriers on their lives. Further, those individuals who reported the greatest impact from environmental barriers also reported lower levels of participation in society and life satisfaction.

Who May Be Affected By These Findings

Individuals with brain injuries and their loved ones, healthcare professionals, community re-entry and rehabilitation discharge planners, public policy professionals, vocational rehabilitation specialists, and researchers.

Caveats

The individuals with the mildest brain injuries reported more barriers than the individuals with moderate or severe brain injuries. The researchers suspect that this may be because the individuals with the mildest brain injuries were more aware of the environmental barriers around them, perhaps because they were more involved in community life.

Bottom Line

Transportation limitations, their surroundings (lighting, noise, crowding, etc.), government policies, other people’s attitudes at home, and the natural environment were the types of environmental barriers reported most often by individuals with traumatic brain injury in this study. The participants who reported the greatest impact from environmental barriers reported lower levels of participation in society and life satisfaction.

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