Batchos Elisabeth, Easton Amanda, Haak Christopher, Ditchman Nicole
a Department of Psychology , Illinois Institute of Technology , Chicago , IL , USA.
Disabil Rehabil. 2018 Aug;40(17):2062-2069. doi: 10.1080/09638288.2017.1326175. Epub 2017 May 18.
Individuals with acquired brain injury (ABI) may not only struggle with physical and cognitive impairments, but may also face challenges reintegrating into the community socially. Research has demonstrated that following ABI, individuals' social networks tend to dwindle, support may decline, and isolation increases. This study examined factors impacting social integration in a community-based sample of 102 individuals with ABI.
Potential predictors included emotional support, instrumental support, problem solving confidence, and approach-avoidance style (AAS) of problem solving, while controlling for age, gender, education, and time since injury. Hierarchical regression was used to analyze whether these factors were predictive of social integration.
The final model accounted for 33% of the variance in social integration outcomes. Results demonstrated that emotional support was initially a significant predictor; however, when controlling for emotional support the variance in social integration was better accounted for by social problem solving - specifically, AAS. A follow-up mediation analysis indicated that the relationship between social problem solving (specifically, AAS) and social integration was partially mediated by emotional support.
This suggests that for individuals with ABI, a tendency to approach rather than avoid social problem solving issues is a significant predictor for social integration both directly and indirectly through its association with emotional social support. Implications for Rehabilitation Both instrumental and emotional social support should be assessed in patients with acquired brain injury (ABI), ensuring that emotional needs are met in addition to the more obvious instrumental needs. Barriers to problem solving for people with ABI may limit optimal social integration; thus, assessment and intervention aimed at increasing AAS are recommended. To enhance the social integration outcomes of people with brain injury, strength-based psychosocial rehabilitation should optimally balance an individual's abilities with areas requiring compensation, focusing on how to approach rather than avoid problems as well as strategies to cultivate emotional social support.
后天性脑损伤（ABI）患者不仅可能在身体和认知障碍方面挣扎，还可能在重新融入社会时面临挑战。研究表明，脑损伤后，个人的社交网络往往会缩小，支持可能会减少，孤独感会增加。本研究调查了影响102名后天性脑损伤患者社区样本中社会融合的因素。
潜在预测因素包括情感支持、工具性支持、解决问题的信心以及解决问题的趋近-回避风格（AAS），同时控制年龄、性别、教育程度和受伤后的时间。采用分层回归分析这些因素是否能预测社会融合。
最终模型解释了社会融合结果中33%的方差。结果表明，情感支持最初是一个显著的预测因素；然而，在控制情感支持后，社会融合的方差能更好地由社会问题解决能力——特别是AAS来解释。一项后续中介分析表明，社会问题解决能力（特别是AAS）与社会融合之间的关系部分由情感支持介导。
这表明，对于后天性脑损伤患者，倾向于解决而非回避社会问题是社会融合的一个重要预测因素，这一因素不仅直接起作用，还通过与情感社会支持的关联间接起作用。
对于后天性脑损伤（ABI）患者，应评估其工具性和情感性社会支持，确保除了更明显的工具性需求外，情感需求也能得到满足。后天性脑损伤患者解决问题的障碍可能会限制最佳的社会融合；因此，建议进行评估和干预以提高AAS。为了提高脑损伤患者的社会融合结果，基于优势的心理社会康复应在个人能力与需要补偿的领域之间实现最佳平衡，重点关注如何解决而非回避问题以及培养情感社会支持的策略。
