INTRODUCTION

1. Physical Medicine and Rehabilitation INTRODUCTION Life satisfaction, conceptualized as the subjective evaluation of life circumstances versus expectations, is one of the principal components of subjective well-being.1-2 Assessment of life satisfaction is an important measure of outcome following rehabilitation interventions, and a growing body of literature has investigated predictors of life satisfaction following traumatic brain injury (TBI).1, 3-12 Some studies have found a relationship between injury severity and life satisfaction, with persons with more severe injuries reporting greater life satisfaction than persons with less severe injuries.1, 13 However, other studies have not supported these findings.4,14 Higher levels of life satisfaction following TBI have been associated with increased integration in the community and gainful employment, whereas lower life satisfaction have been associated with depression and lack of perceived social support . 7,8,12,15 PURPOSE The purpose of the current study was to examine relationships between measures of community participation, employment, and subjective life satisfaction, and to investigate predictors of life satisfaction at one-year post-injury. METHOD Participants: 54 adults with medically documented TBI who participated in a longitudinal study of TBI outcome. All participants received inpatient brain injury rehabilitation. The mean (SD) age was 31.28 (13.18), and mean (SD) education was 12.6 (2.8). Mean (SD) Glasgow Coma Scale score on admission to the emergency room was 6.52 (4.17). Participants were predominantly male (68.5%) and Caucasian (74% Caucasian; 13% Hispanic; 7% African American). Seventy percent were competitively employed at the time of injury, and 40% were employed at one-year post-injury. METHOD, CONT. Measures Satisfaction with Life Scale (SWLS):16 The SWLS is a 5 item measure of subjective satisfaction with life circumstances. Higher scores reflect greater life satisfaction. Community Integration Scale (CIQ):17The CIQ is a 15-item measure of integration into home and family life, social activity, and productive activity. Total scores, computed according to the updated scoring system described by Sander et al.18 were used in the analyses. Higher scores reflect greater community integration. Craig Handicap Assessment and Reporting Technique (CHART):19 The CHART is a 32-item measure of community participation. Five domains are assessed: physical independence; mobility; occupation; social integration; and economic self-sufficiency. Higher scores reflect greater community participation. Social Integration subscale scores were used in the analyses. Procedure As part of a longitudinal study on TBI outcome, measures of community participation, integration, and life satisfaction were administered at one-year post-injury. Data regarding vocational status, categorized as employed or unemployed, was also collected. Associations between demographic, injury severity, and functional outcome measures were examined with Pearson or point-biserial correlations. A series of hierarchical multiple regression analyses was used to predict life satisfaction from measures of community participation, integration, and employment status, controlling for age, education and severity of injury. RESULTS, CONT. Model 1: CIQ Total score as predictor variable, controlling for age, education, and injury severity Community Participation and Life Satisfaction One-Year Following Traumatic Brain InjuryAllison N. Clark, Ph.D., Margaret A. Struchen, Ph.D.,Angelle M. Sander,Ph.D., & Walter M. High, Jr., Ph.D. Model 2: CHART-Social Integration score as predictor variable, controlling for age, education, and injury severity • DISCUSSION/CONCLUSIONS • Higher levels of life satisfaction were associated with greater community integration and social participation at one-year post-injury, which is consistent with previous research. Employment status was not associated with life satisfaction at one-year post-injury in this sample. Furthermore, there was no significant relationship between demographic or injury characteristics and life satisfaction. • These results suggest that the ability to participate in the community and to resume social relationships plays an important role in perceived well-being, and are important goals of brain injury rehabilitation. • A significant portion of the variance in life satisfaction was unexplained with these predictors. Further study investigating the influence of additional factors, such as social and environmental supports, economic resources, mobility, and emotional functioning is warranted. • RESULTS • Correlations of predictor and outcome variables • 1 2 3 4 5 6 7 • Age 1.00 .37** .19 -.12 .16 -.03 .10 • Education 1.00 .04 .32* .16 .29* .20 • ER GCS score 1.00 .10 -.07 .07 .06 • CIQ Total 1.00 .40** .44** .33* • CHART Social Integration 1.00 .08 .50** • Employment at 1-year post 1.00 .05 • SWLS 1.00 • ** significant at the .01 level; *significant at the .05 level • CIQ Total scores and CHART Social Integration scores accounted for a significant proportion of variance in life satisfaction scores. Current employment was not predictive of self-reported life satisfaction at one-year post-injury (p>.05). *References available on handout