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OBJECTIVE: To evaluate the efficacy of a novel intervention facilitating volunteer activity to improve well-being in individuals with traumatic brain injury (TBI). DESIGN: Randomized two-arm controlled trial, with a wait-list control condition (ClinicalTrials.gov NCT#01728350). SETTING: Community-based setting. PARTICIPANTS: Seventy-four community-dwelling individuals at least 1-year post TBI, who had completed inpatient or outpatient TBI rehabilitation. INTERVENTIONS: A novel intervention, HOPE – Helping Others through Purpose and Engagement, involving orientation/training and a 3-month volunteer placement for the participant, along with training for community agencies regarding TBI. MAIN OUTCOME MEASURE(S): Satisfaction With Life Scale (SWLS); Flourishing Scale (FS); Brief Symptom Inventory-18 (BSI-18); Scale of Positive and Negative Experience (SPANE); Purpose in Life subscale (one of six in the Ryff Scale of Psychological Well-Being – 54 item version). RESULTS: There were significantly greater improvements in life satisfaction (SWLS) and self-perceived success (FS) in the intervention group compared to the control group. There were no significant treatment effects on the additional secondary measures of well-being, although they trended in a positive direction. CONCLUSIONS: This study supports our primary hypothesis that individuals who take part in a volunteer intervention will demonstrate greater psychological well-being in comparison to a control group.

BACKGROUND: Well-being and quality of life issues remain a long-term problem for many individuals with traumatic brain injury (TBI). Meaningful activity is key to developing life satisfaction and a sense of contribution to society, yet individuals with TBI are often unable to return to competitive employment. OBJECTIVE: To describe the self-reported psychological well-being of a cohort of unemployed individuals living in the community at least 1 year post TBI with low life satisfaction. METHODS: Seventy-four unemployed individuals with low life satisfaction at least 1 year post TBI were administered measures of psychological well-being and cognitive functioning. RESULTS: This cohort of 74 participants demonstrated cognitive impairment and elevated levels of emotional distress. Significant bivariate relationships were noted among nearly all measures of well-being, and associations were in the directions as expected. Individuals reported low life satisfaction and well-being. Two newer measures of well-being correlated with established measures used with this population. CONCLUSIONS: Individuals with TBI living in the community who are not employed but who seek to be productive reported low life satisfaction and well-being. This study highlights the need for interventions aimed at increasing productivity and meaning in life for individuals with TBI, and a broader understanding of psychological health after TBI.

Objective: Disrupted sleep is common during acute recovery from traumatic brain injury (TBI) and has been linked to daytime agitation. This study investigated the relationship among nighttime sleep efficiency (SE), total sleep time (TST), wakefulness after sleep onset (WASO), and number of wake bouts (NWB) as measured by actigraphy to observer ratings of agitation for patients with TBI who were undergoing inpatient rehabilitation. Methods: This is a retrospective, observational study of a convenience sample of 65 individuals admitted to TBI inpatient rehabilitation who were monitored with actigraphy and the Agitated Behaviour Scale (ABS) for the first 72 h. Each patient's average SE, TST, WASO, and NWB for the 72-h period was calculated using actigraphy for the rest interval from 2100 to 0700. Daily ABS scores were obtained for each day following the nighttime sleep period. Results: Patients were not significantly different on age, gender, etiology of injury, days post-injury, rehabilitation length of stay, or severity of injury as measured by length of posttraumatic amnesia (PTA). SE and TST were significantly lower for patients with agitation than for patients without agitation. Conclusions: This study suggests a relationship between disrupted sleep and agitation for patients with TBI who are undergoing inpatient rehabilitation.

To (1) identify demographic characteristics of individuals with traumatic brain injury (TBI) who attend religious services, (2) understand the relationship between attending religious services and psychosocial outcomes and (3) examine the independent contribution of religious service attendance to psychosocial outcomes while controlling for demographic characteristics, functional status and geographic location at 1, 5 and 10-years post injury.Retrospective, cross-sectional cohort study using secondary data analysis of the TBI Model Systems (TBIMS) National Database (NDB).TBIMS NDB participants who completed 1, 5 or 10-year follow-up interview with data on religious attendance. A total of 5573 interviews were analysed.Satisfaction with Life scale (SWLS), Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9) and Participation Assessment with Recombined Tools-Objective Social sub-scale.Approximately half of the sample was attending religious services at each time point. Attendance was a significant protective factor for each outcome across all three-time periods. After controlling for demographic characteristics, functional status and geographic makeup, religious attendance contributed a small but significant amount of unique variance in all models except for GAD-7 at years 1 and 10.This study highlights the benefits of religious attendance on psychosocial outcomes post-TBI. Implications for rehabilitation are discussed.