Patient correlates of caregivers' distress and family functioning after traumatic brain injury.
ABSTRACT This study examined the relationship of patient variables to caregiver distress and family functioning after TBI in 62 families. An extension of Kreutzer et al. 1994 (in press), the present investigation used four categories of predictor variables: indices of injury severity, neuropsychological tests, neurobehavioural problem checklist scales, and kinship of caregiver (i.e. spouse vs. parent). Caregiver distress and family functioning were measured by the Brief Symptom Inventory (BSI) and Family Assessment Device (FAD), respectively. Regression analyses revealed that indices of injury severity did not predict BSI scores. Time post-injury predicted several FAD subscales. The number of the patient's neurobehavioural problems predicted BSI subscale scores most consistently, particularly the Global Severity Index, Somatic, Obsessive-Compulsive and Depression scales. Scores on the behaviour problem subscale predicted BSI scores better than other kinds of problems, and also had some relation to several FAD subscales. Of the 10 neuropsychological test scores, those which measured verbal abilities were more predictive of caregiver's BSI scores. Kinship (i.e. being a spouse) predicted Depression scores, even when other variables were partialled out. Research findings are integrated with European studies and clinical implications for understanding caregiver distress are discussed.
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ABSTRACT: Abstract Objectives: The present study aimed to assess long-term health-related quality-of-life (HRQoL) and potential predictors as well as burden in caregivers of patients with acquired brain injury (ABI). Furthermore, depressive symptoms, well-being, HRQoL and happiness were evaluated in caregivers and patients who had regained communication skills. Research design: Prospective cross-sectional survey. Methods: Data of 104 caregivers and 30 patients were analysed. A multiple linear regression model was calculated to identify independent predictors for HRQoL in caregivers. Additionally, correlation analysis was conducted to evaluate associations between patient questionnaire results and caregiver HRQoL. Results: After a mean time post-injury of 18 years, HRQoL and perceived health status in caregivers remained below normative scores of age-matched controls. Although HRQoL and perceived health status were lower in patients than in caregivers, there was no difference in happiness, perceived QoL or enjoyment of life. Reduced perception in well-being (WHO-5 score < 13) was found in 52% of the caregivers and 36% of the patients. HRQoL in caregivers was predicted by well-being, caregiver strain, depressive symptoms and caregiver age. Furthermore, HRQoL of caregivers was correlated with depressive symptoms and happiness in patients. Conclusion: This study under-scores the importance of long-term support for caregivers.Brain Injury 06/2014; · 1.86 Impact Factor
- Neurorehabilitation 01/1998; 11(2). · 1.74 Impact Factor
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ABSTRACT: The training and expertise of healthcare professionals in diagnosing and treating pathology can mean that every situation is treated as an instance of illness or abnormality requiring treatment. This medicalised perspective is often evident in clinical approaches to family members of people with prolonged disorders of consciousness. This editorial was stimulated by reviewing an article (final version now published in this issue) concerning the distress of families with severely brain injured relatives,(2) and by reading the larger body of literature to which that article contributes. It was also prompted by the recent publication of national clinical guidelines in the UK about the management of prolonged disorders of consciousness. In this editorial we highlight the depth and range of emotional reactions commonly experienced by families with a severely brain injured relative. We suggest that clinicians should understand such emotions as normal responses to a terrible situation, and consider the ways in which clinical practice can be adapted to avoid contributing to family trauma.Clinical Rehabilitation 06/2014; 28(7):627-631. · 2.18 Impact Factor