Attitudes about Seeking Social Support in Rural and Urban Areas

Past Studies

Past Studies reveal that individuals with traumatic brain injury can experience social isolation within the first few years after their injury. Former social support networks tend to decrease and dependency on family members for emotional support seems to increase. For some individuals, the experience of being alone and lonely can lead to feelings of depression and a perceived poor quality of life. The reasons why individuals with traumatic brain injury do or do not reach out to others for social support have not been fully examined by researchers. This study provided information about attitudes toward seeking support from others following brain injury. It also examined factors that might influence this type of behavior and quality of life after an injury, including an individual’s personal characteristics (e.g., severity of injury) and environmental factors (e.g., family structure, living in a rural or urban community).

This Study

This Study focused on 56 adults with traumatic brain injury who lived in community settings in a Midwest rural area. The participants had experienced their brain injuries at least 6 months prior to the study. The researchers tested and interviewed the participants with a variety of scales to obtain information about their injuries, attitudes and beliefs about seeking social support ,perceptions about their quality of life, lifestyles, and social support systems. The researchers developed a new assessment measure called the “Hesitation Scale” for this study. The Hesitation Scale consists of twenty items that are to be rated as reasons why an individual might be reluctant to reach out to others for support after experiencing a traumatic brain injury. Over one-third of the participant’s indicated on the Hesitation Scale that they were reluctant to seek social support because they did not want to be a burden, did not want others to know about their problems, and that they wanted to be able to take care of themselves. They also expressed concern about fitting in socially and repaying others who help them. Almost one-third of the participants stated that a lack of money, difficulties making decisions, problems with following through with plans, and not knowing how to ask others for help kept them from seeking social supports. Individuals who were divorced, separated, and lived in a city most frequently indicated reluctance to seek support from others. It appeared that those who had experienced negative personal relationships were less likely to initiate new ones. Participants who lived in rural areas reported more openness to seeking social support and a higher quality of life than those living in a city or town. Severity of injury was not related to attitudes and beliefs about seeking social support, nor was it a predictor of quality of life. 

Who May Be Affected By These Findings

Individuals with traumatic brain injury and their loved ones, discharge planners, healthcare providers, and researchers

Caveats

Living in a rural area was associated with more openness to seeking social support and a better quality of life, compared with living in an urban area. This finding was unexpected, given that metropolitan areas have more rehabilitation and vocational services, better access to jobs, and an assumed potential for a better quality of life.

Bottom Line

Individuals who were divorced, separated, and lived in a city most frequently indicated reluctance to seek support from others. Participants who lived in rural areas reported more openness to seeking social support and a higher quality of life than those who lived in a city or town. Severity of injury was not related to attitudes and beliefs about seeking social support, nor was it a predictor of quality of life.

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