Disability and the COVID-19 Pandemic: A Survey of Individuals With Traumatic Brain Injury

Morrow, Emily; Patel, Nirav; Duff, Melissa C.

doi:10.1016/j.apmr.2021.01.064

Cited by 32 publications

(49 citation statements)

References 35 publications

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“…In this study, participants with TBI reported less frequently than NC participants that they use some platforms involving synchronous communication (eg, Zoom and Skype), although they were more comparable in their use of FaceTime. This pattern was consistent with findings from a separate survey on the COVID-19 pandemic [ 35 ], in which individuals with a history of TBI reported that they found video chat to be less successful than face-to-face communication, and some participants stated that impoverished visual and verbal cues via video chat make it more difficult to read social signals. In this context, it is interesting to consider how asynchronous communication via social media may prove even more challenging for some individuals with TBI than synchronous video chat.…”

Section: Discussionsupporting

confidence: 88%

Computer-Mediated Communication in Adults With and Without Moderate-to-Severe Traumatic Brain Injury: Survey of Social Media Use

Morrow

Zhao

Turkstra

et al. 2021

JMIR Rehabil Assist Technol

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Background Individuals with a history of traumatic brain injury (TBI) report fewer social contacts, less social participation, and more social isolation than noninjured peers. Cognitive-communication disabilities may prevent individuals with TBI from accessing the opportunities for social connection afforded by computer-mediated communication, as individuals with TBI report lower overall usage of social media than noninjured peers and substantial challenges with accessibility and usability. Although adaptations for individuals with motor and sensory impairments exist to support social media use, there have been no parallel advances to support individuals with cognitive disabilities, such as those exhibited by some people with TBI. In this study, we take a preliminary step in the development process by learning more about patterns of social media use in individuals with TBI as well as their input and priorities for developing social media adaptations. Objective This study aims to characterize how and why adults with TBI use social media and computer-mediated communication platforms, to evaluate changes in computer-mediated communication after brain injury, and to elicit suggestions from individuals with TBI to improve access to social media after injury. Methods We conducted a web-based survey of 53 individuals with a chronic history of moderate-to-severe TBI and a demographically matched group of 51 noninjured comparison peers. Results More than 90% of participants in both groups had an account on at least one computer-mediated communication platform, with Facebook and Facebook Messenger being the most popular platforms in both groups. Participants with and without a history of TBI reported that they use Facebook more passively than actively and reported that they most frequently maintain web-based relationships with close friends and family members. However, participants with TBI reported less frequently than noninjured comparison participants that they use synchronous videoconferencing platforms, are connected with acquaintances on the web, or use social media as a gateway for offline social connection (eg, to find events). Of the participants with TBI, 23% (12/53) reported a change in their patterns of social media use caused by brain injury and listed concerns about accessibility, safety, and usability as major barriers. Conclusions Although individuals with TBI maintain social media accounts to the same extent as healthy comparisons, some may not use them in a way that promotes social connection. Thus, it is important to design social media adaptations that address the needs and priorities of individuals with TBI, so they can also reap the benefits of social connectedness offered by these platforms. By considering computer-mediated communication as part of individuals’ broader social health, we may be able to increase web-based participation in a way that is meaningful, positive, and beneficial to broader social life.

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Section: Discussionsupporting

confidence: 88%

Computer-Mediated Communication in Adults With and Without Moderate-to-Severe Traumatic Brain Injury: Survey of Social Media Use

Morrow

Zhao

Turkstra

et al. 2021

JMIR Rehabil Assist Technol

View full text Add to dashboard Cite

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“…A recent survey [47] conducted during the ongoing COVID-19 pandemic on 47 individuals in the chronic phase of moderate–severe TBI, concluded that healthcare providers should look for ways to provide tailored education and reduce social isolation for individuals with disability. They discuss a number of direct suggestions from participant responses.…”

Section: Discussionmentioning

confidence: 99%

The impact of COVID-19 on home, social, and productivity integration of people with chronic traumatic brain injury or stroke living in the community

et al. 2022

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Compare community integration of people with stroke or traumatic brain injury (TBI) living in the community before and during the coronavirus severe acute respiratory syndrome coronavirus 2 disease (COVID-19) when stratifying by injury: participants with stroke (G1) and with TBI (G2); by functional independence in activities of daily living: independent (G3) and dependent (G4); by age: participants younger than 54 (G5) and older than 54 (G6); and by gender: female (G7) and male (G8) participants.Prospective observational cohort studyIn-person follow-up visits (before COVID-19 outbreak) to a rehabilitation hospital in Spain and on-line during COVID-19.Community dwelling adults (≥18 years) with chronic stroke or TBI.Community integration questionnaire (CIQ) the total-CIQ as well as the subscale domains (ie, home-CIQ, social-CIQ, productivity CIQ) were compared before and during COVID-19 using the Wilcoxon ranked test or paired t test when appropriate reporting Cohen effect sizes (d). The functional independence measure was used to assess functional independence in activities of daily living.Two hundred four participants, 51.4% with stroke and 48.6% with TBI assessed on-line between June 2020 and April 2021 were compared to their own in-person assessments performed before COVID-19.When analyzing total-CIQ, G1 (d = −0.231), G2 (d = −0.240), G3 (d = −0.285), G5 (d = −0.276), G6 (d = −0.199), G7 (d = −0.245), and G8 (d = −0.210) significantly decreased their scores during COVID-19, meanwhile G4 was the only group with no significant differences before and during COVID-19.In productivity-CIQ, G1 (d = −0.197), G4 (d = −0.215), G6 (d = −0.300), and G8 (d = −0.210) significantly increased their scores, meanwhile no significant differences were observed in G2, G3, G5, and G7.In social-CIQ, all groups significantly decreased their scores: G1 (d = −0.348), G2 (d = −0.372), G3 (d = −0.437), G4 (d = −0.253), G5 (d = −0.394), G6 (d = −0.319), G7 (d = −0.355), and G8 (d = −0.365).In home-CIQ only G6 (d = −0.229) significantly decreased, no significant differences were observed in any of the other groups.The largest effect sizes were observed in total-CIQ for G3, in productivity-CIQ for G6, in social-CIQ for G3 and in home-CIQ for G6 (medium effect sizes).Stratifying participants by injury, functionality, age or gender allowed identifying specific CIQ subtotals where remote support may be provided addressing them.

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“…A recent survey conducted in Nashville, United States, by Morrow et al. (2021) on 47 individuals in the chronic phase of moderate‐severe TBI reported that for 51.06% of the participants, the pandemic has affected their sense of mental and physical well‐being. In our case, we analyzed 20 psychological items and only in one of them a significant increase of the level of stress was reported (Impulsivity; does things without thinking).…”

Section: Discussionmentioning

confidence: 99%

The impact of coronavirus disease 2019 on emotional and behavioral stress of informal family caregivers of individuals with stroke or traumatic brain injury at chronic phase living in a Mediterranean setting

et al. 2021

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Introduction Even in nonpandemic times, persons with disabilities experience emotional and behavioral disturbances which are distressing for them and for their close persons. We aimed at comparing the levels of stress in emotional and behavioral aspects, before and during coronavirus disease 2019 (COVID‐19), as reported by informal family caregivers of individuals with chronic traumatic brain injury (TBI) or stroke living in the community, considering two different stratifications of the recipients of care (cause and injury severity). Methods We conducted a STROBE‐compliant prospective observational study analyzing informal caregivers of individuals with stroke (IC‐STROKE) or traumatic brain injury (IC‐TBI). IC‐STROKE and IC‐TBI were assessed in‐person before and during COVID‐19 online, using the Head Injury Behavior Scale (HIBS). The HIBS comprises behavioral and emotional subtotals (10 items each) and a total‐HIBS. Comparisons were performed using the McNemar's test, Wilcoxon signed‐rank test or t‐test. Recipients of care were stratified according to their injury severity using the National Institutes of Health Stroke Scale (NIHSS) and the Glasgow Coma Scale (GCS). Results One hundred twenty‐two informal caregivers (62.3% IC‐STROKE and 37.7% IC‐TBI) were assessed online between June 2020 and April 2021 and compared to their own assessments performed in‐person 1.74 ± 0.88 years before the COVID‐19 lockdown. IC‐STROKE significantly increased their level of stress during COVID‐19 in five emotional items (impatience, frequent complaining, often disputes topics, mood change and overly sensitive) and in one behavioral item (overly dependent). IC‐TBI stress level only increased in one behavioral item (impulsivity). By injury severity, (i) mild (14.7%) showed no significant differences in emotional and behavioral either total‐HIBS (ii) moderate (28.7%) showed significant emotional differences in two items (frequent complaining and mood change) and (iii) severe (56.6%) showed significant differences in emotional (often disputes topics) and behavioral (impulsivity) items. Conclusions Our results suggest specific items in which informal caregivers could be supported considering cause or severity of the recipients of care.

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Disability and the COVID-19 Pandemic: A Survey of Individuals With Traumatic Brain Injury

Cited by 32 publications

References 35 publications

Computer-Mediated Communication in Adults With and Without Moderate-to-Severe Traumatic Brain Injury: Survey of Social Media Use

Computer-Mediated Communication in Adults With and Without Moderate-to-Severe Traumatic Brain Injury: Survey of Social Media Use

The impact of COVID-19 on home, social, and productivity integration of people with chronic traumatic brain injury or stroke living in the community

The impact of coronavirus disease 2019 on emotional and behavioral stress of informal family caregivers of individuals with stroke or traumatic brain injury at chronic phase living in a Mediterranean setting

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