Participation in leisure activity after traumatic brain injury: a qualitative exploration

Traumatic brain injury (TBI) causes physical, cognitive and behavioural impairments that impact leisure participation. Whilst quantitative studies have documented decreased leisure participation, there has been limited focus on the experience of leisure participation from the perspective of individuals with TBI. Therefore, this study aimed to qualitatively examine leisure participation in individuals with TBI more than one-year post-injury, barriers and facilitators to participation, and its impact on wellbeing.

Twelve participants (58% male, mean age = 32.8 years (SD = 15.7)) completed semi-structured interviews, and the data were interpreted using reflexive thematic analysis.

Return to leisure participation following TBI was variable whereby some failed to successfully return and several ceased participation altogether, while others returned successfully. Various injury-related physical and cognitive factors hindered leisure participation including reduced balance, poor communication and judgement, fatigue, rehabilitation and relationship demands, and changes in priorities and responsibilities. Social support, independent functioning and internal motivation were pivotal for re-engagement in leisure activities, which in turn was associated with greater wellbeing post-injury.

Overall, leisure participation outcomes post-TBI were variable, where low participation negatively impacted wellbeing. These findings may inform intervention development to improve leisure participation and maximise wellbeing after TBI.