Factors influencing human flourishing in the traumatic brain injury population within the first two years after injury: a systematic review of the literature

PURPOSE: To explore the factors influencing human flourishing in the Traumatic Brain Injury (TBI) population within the first two years after injury. The PERMA (Positive Emotion, Engagement, Relationships, Meaning, Achievement) framework developed by Seligman was used to frame the topic of interest. METHOD: A systematic review of the academic literature published between 1/4/1988 and 31/1/2025 was undertaken. Four databases were searched for research papers: CINAHL, Medline, Embase, and PsycINFO. Extracted data were analysed using content analysis to create a descriptive summary of the results. RESULTS: Sixty studies met the inclusion criteria. The individual factors influencing human flourishing included an ability to self-reflect, develop an inner self, or identity. Social and community facilitators comprised a supportive family, and healthy relationships. Structural facilitators included interventions such as art therapy and dignity conserving care. CONCLUSION: There are many factors influencing human flourishing in the TBI population within two years of injury. More research is needed to explore how these factors could be targeted for interventions in inpatient rehabilitation settings to enhance patient outcomes.