Developing a comprehensive framework of community integration for people with acquired brain injury: a conceptual analysis

Purpose: Despite increasing emphasis on the importance of community integration as an outcome for acquired brain injury, there is still no consensus on the definition of community integration. The aim of this study was to complete a concept analysis of community integration in people with acquired brain injury. Materials and Methods: The method of concept clarification was used to guide concept analysis of community integration based on a literature review. Articles were included if they explored community integration in people with acquired brain injury. Data extraction was performed by the initial coding of (i) the definition of community integration used in the articles, (ii) attributes of community integration recognized in the articles' findings, and (iii) the process of community integration. This information was synthesised to develop a model of community integration. Results: Thirty-three articles were identified that met the inclusion criteria. The construct of community integration was found to be a non-linear process reflecting recovery over time, sequential goals, and transitions. Community integration was found to encompass six components including: independence, sense of belonging, adjustment, having a place to live, involved in a meaningful occupational activity and being socially connected into the community. Antecedents to community integration included individual, injury-related, environmental and societal factors. Conclusion: The findings of this concept analysis suggest that the concept of community integration is more diverse than previously recognised. New measures and rehabilitation plans capturing all attributes of community integration are needed in clinical practice. Keywords: Community integration, concept analysis, acquired brain injury, concept clarification, framework