"Together is no longer completely together": Exploring the influence of social cognition problems on partner relationships following acquired brain injury.

Objective: To examine the experiences of individuals with acquired brain injury and their partners regarding the effects of social cognition problems on their relationships.

Design: Qualitative interview study.

Setting: Interviews were conducted 1 to 5 years post-injury, either in the participants' home or at a care facility in the Netherlands.

Participants: Nine couples consisting of an individual with acquired brain injury and a partner without acquired brain injury. Scores on neuropsychological tests indicated social cognition difficulties in individuals with acquired brain injury.

Methods: Individual semi-structured interviews were conducted, audio recorded, and transcribed verbatim. Two independent analysts analyzed the data using thematic analysis aimed at finding common themes across the data set. Data analysis was carried out recursively and parallel to data collection to help determine when saturation was reached.

Results: Six themes were generated from the interview data: (1) partners feeling disappointed, lonely, and despondent, (2) individuals with acquired brain injury feeling insecure and ashamed of falling short, (3) relationship roles changing, (4) the aggravating role of fatigue and sensory hypersensitivity, (5) the importance of professional help, and (6) silver linings: increased awareness creating closeness.

Conclusion: Social cognition problems have the potential to strongly affect relationships between those with acquired brain injury and their partners in many ways. Addressing social cognition problems is recommended as it is greatly appreciated by individuals with acquired brain injury and their partners and holds promise for improving their relationship.