A recent study led by Dr. Tatyana Mollayeva at UHN’s KITE Research Institute sheds light on the often-overlooked gender differences in community reintegration following traumatic brain injury (TBI). Occupational Therapy students Lulu (Guangjia) Lian and Rachel Coupland from the University of Toronto conducted the study as part of their research course placement, exploring the lived experiences of 42 adults recovering from mild to severe TBI and focusing on how gender influences challenges at home, work, and in social settings.
The study uncovered three major themes that highlight the challenges faced by individuals recovering from TBI. First, the absence of a “graduated home plan” left many struggling with gendered roles and responsibilities at home. Men frequently expressed frustration over their inability to fulfil household and parenting duties, while women often found creative ways to adapt and continue performing such tasks, despite their limitations.
Second, participants described feeling overwhelmed at work, with one person sharing the sentiment, “It’s something that I can’t handle.” Women, in particular, felt they couldn’t meet occupational expectations, while men noted a reduced productive capacity.
Lastly, the emotional toll of TBI came through in the theme “slipping away,” as many felt disconnected from their social circles and their own selves, grappling with the strain on personal relationships and changes in self-identity. Women highlighted struggles with maintaining social activities, while men often avoided them altogether, fearing stigma or shame.
Dr. Mollayeva and her team emphasize the need for health care providers to address these unique obstacles to help patients regain their sense of identity and find a smoother path back into their communities. To do so, rehabilitation must extend beyond addressing physical impairments and consider the disruption of gender roles, relationships, and identities.
"The importance of this work becomes evident in one patient's experience, who said: ‘I felt like I was slowly slipping away, no longer at work, not exercising, and my entire routine reduced to just staying at home, waiting for others to return,’" explains Dr. Mollayeva. This research paves the way for tailored strategies that improve quality of life, empowering health care providers to design more inclusive, person-centred programs that promote equitable recovery.
This work was supported by the Canadian Institutes of Health Research (CIHR)’s Institute of Gender and Health, Canada Research Chairs Programs, the Global Brain Health Institute (GBHI), the Alzheimer’s Association, the Alzheimer’s Society UK Pilot Award for Global Brain Health Leaders and UHN Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Dr. Tatyana Mollayeva is a Scientist at the KITE Research Institute, Toronto Rehabilitation Institute, University Health Network. She is also an Assistant Professor at the faculties of Rehabilitation Sciences and Dalla Lana School of Public Health at the University of Toronto. Dr. Mollayeva is a Tier II Canada Research Chair in Neurological Disorders and Brain Health.
Lian L, Coupland R, Tylinski Sant'Ana T, Colantonio A, Mollayeva T. Community Integration Challenges of Men and Women After Traumatic Brain Injury: A Reflexive Thematic Analysis of Lived Experiences Through a Gender Lens. J Head Trauma Rehabil. 2024 Aug 8. doi: 10.1097/HTR.0000000000000994. Epub ahead of print. PMID: 39115412.