Rural versus urban social support seeking as a moderating variable in traumatic brain injury outcome

Objective: To investigate personal beliefs about seeking social support following traumatic brain injury (TBI) and the relationship of these appraisals to demographic and injury variables, social integration, and quality of life ratings. Setting: The central region of a Midwest state. Participants: Fifty-six adults with TBI who were more than 6 months postinjury and living in the community. Main outcome measures: The Hesitation Scale, a 20-item survey that assesses reasons that people might hesitate to reach out to others in the community, and portions of the Living Life After Traumatic Brain Injury Scale. Results: Negative attitudes and beliefs about seeking social support were significantly related to lower perceptions of social support, lower ratings of quality of life, longer time since injury, being divorced or separated, and living in an urban area. Predictors of higher quality of fife ratings included more positive appraisals about seeking social support, living in a rural area, and the ability to engage in productive activity. Conclusions: Positive outcomes after TBI appear to be moderated by living in a rural area, which is associated with more openness to seeking social supports and contributes to better quality of life.