Rationale: Youth and adults with traumatic brain injury (TBI) often experience difficulties initiating and maintaining intimate relationships, and social isolation is well recognized as one of the prevalent long-term consequences. Given that intimate relationships are a critical component of mental health and an important part of human development, research which explores the experiences of intimacy in those with TBI is necessary to understand the needs as well as barriers and facilitators to the development of appropriate interventions. As males have a higher incidence of TBI, most studies have focused primarily on male survivors, however, there is increased awareness of sex and gender differences in recovery following TBI and increasing evidence that women have unique needs for rehabilitation. Also, the challenges faced by younger woman with TBI in developing and maintaining intimate relationships are often overlooked in both research and traditional rehabilitation programs, leaving them vulnerable to loneliness, lack of meaningful friendships, and potentially, exploitation and abuse. Furthermore, parents of girls and young women have identified significant concerns regarding their daughter’s emotional and physical well-being and safety.

Objectives: This study aimed to explore the lived experiences of young women with moderate to severe TBI in relation to how they engage in intimate relationships and, to explore the experiences of their parents as their daughters navigated intimate relationships.

Methods: A qualitative study using interpretative phenomenological analysis was conducted with four women (18-25 years old) with moderate to severe TBI and two parents. Data were collected through individual semi-structured interviews and analysed by two coauthors. The interview guide was revised through consultation of interdisciplinary experts (clinicians and researchers) and a young woman with TBI.

Results: The young women described a loss of friends and social networks after their TBI and a lack of opportunities to build intimate relationships. Positive support from their close social environment, particularly their family members, was perceived as a facilitator. They also discussed the benefits of engaging in valued and meaningful occupations to promote their sense of self-worth and self-confidence, as a prerequisite to engagement in satisfying intimate relationships. Parents reported being concerned with various issues regarding their daughter's ability to navigate intimate relationships; both sexual and non-sexual. They also cited concerns regarding lack of balance between their caregiving responsibilities and their other life roles since their child's TBI, as well as the limited access to educational and support services for both themselves and their daughter.

Conclusion: This study represents a first step towards a better understanding of the development of intimate relationships in young women with TBI. Findings may contribute to inform the development of future gender-specific multi-disciplinary interventions to promote the development and maintenance of sustainable, healthy, intimate relationships, which may facilitate positive social outcomes.

Experiences of intimate relationships in young women with brain injury