• Ivana Klepo, Claire Sangster Jokić, and Dubravko Tršinski.
• Department of Neurorehabilitation, Special Hospital for Medical Rehabilitation Krapinske Toplice, Krapinske Toplice, Croatia.
• Disabil Rehabil. 2020 Dec 11: 1-14.

PurposeImproving participation and quality of life is a desirable goal following traumatic brain injury (TBI). The purpose of this systematic review was to summarize existing findings concerning the role of occupational participation for persons with TBI.MethodsA systematic literature search using four electronic databases was followed by a review of all titles and abstracts. Articles were included if the studies were conducted with adults with TBI, used a qualitative methodology and explored the role or meaning of occupations and occupational participation from the perspectives of individuals with TBI. Following data extraction, a thematic synthesis was conducted.ResultsA total of 642 articles were identified, of which 14 met all inclusion criteria. Three themes related to the role of occupations for people with TBI emerged: reflecting on change in occupational performance and occupational participation, occupational adaptation, and individual meaning of occupational participation.ConclusionThe findings demonstrate the significance of occupational participation for people following TBI. Occupational participation enabled better understanding of one's abilities and limitations, assisted in occupational adaptation, and held unique meaning for participants. The findings also highlight the importance of providing long-term services focused on enabling participation in occupations in order to ensure successful adaptation following TBI.Implications for rehabilitationFor persons with TBI, occupational participation enables recognition of changes in their performance, contributes to the process of adaptation and identity (re)construction, fulfils various intrinsic needs and provides a sense of personal meaning.Rehabilitation professionals should recognize persons with TBI as occupational beings and work with individuals to identify the meaning of important occupations in the process of understanding and adapting to changes in capability, performance and participation.The rehabilitation process should focus on enabling persons to perform and participate in the occupations they want, need or are expected to do in their daily lives.National and regional health care systems should ensure that persons with TBI are provided with appropriate physical, social and institutional support and services in order to achieve meaningful occupational engagement.

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