Early Indicators and Contributors to Psychological Distress in Relatives During Rehabilitation Following Severe Traumatic Brain Injury
- 1 November 2006
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Head Trauma Rehabilitation
- Vol. 21 (6), 453-466
- https://doi.org/10.1097/00001199-200611000-00001
Abstract
Objectives: To develop a multivariate model of the dynamic interactions among key variables associated with relative distress and disrupted family functioning after traumatic brain injury (TBI). Participants: A relative sample (parents, spouses, close others; n = 134) derived from a statewide cohort of people with TBI recruited to the multicenter Brain Injury Outcomes Study. Setting: A consecutive series of referrals over a 2-year period to the 11 adult units of the Brain Injury Rehabilitation Program in New South Wales, Australia. Main Outcome Measures: Relative measures included General Health Questionnaire-28 (psychological distress), Family Assessment Device (family functioning), and BIOS Family Needs Questionnaire (perceived adequacy of support). The degree of impairment and level of participation of the person with TBI were assessed by the Mayo-Portland Adaptability Inventory and Sydney Psychosocial Reintegration Scale, respectively. Analysis: Path analysis examined the varying contribution of impairment, participation, and support variables to both relative distress and disturbances in family functioning. Results: The overall model accounted for substantial proportions of the variance in psychological distress and family functioning. Importantly, the distress experienced by relatives was not due to the direct impact of the neurobehavioral impairments, but the effect of these impairments was mediated by the degree of community participation achieved by the person with TBI. Conclusions: The model highlights the impact on families when the person with TBI experiences restrictions in participation. Clinically, a greater focus on the provision of respite or case management services may assist in reducing relative distressKeywords
This publication has 27 references indexed in Scilit:
- Impact of traumatic brain injury on the family: A critical review.Rehabilitation Psychology, 1999
- Neurobehavioral Symptoms and Family Functioning in Traumatically Brain-Injured AdultsArchives of Clinical Neuropsychology, 1998
- Primary caregivers of persons with brain injury: life change 1 year after injury.Brain Injury, 1998
- Caregiver burden at 1 year following severe traumatic brain injuryBrain Injury, 1998
- Kinship and Family Membersʼ Psychological Distress after Traumatic Brain Injury: A Large Sample StudyJournal of Head Trauma Rehabilitation, 1997
- Relatives' perceptions of role change, social support and stress after traumatic brain injuryBrain Injury, 1996
- Family stressors in traumatic brain injury: A two-year follow-upArchives Of Physical Medicine and Rehabilitation, 1994
- Primary caregivers' psychological status and family functioning after traumatic brain injuryBrain Injury, 1994
- Patient outcome in the year following severe head injury and relatives' psychiatric and social functioning.Journal of Neurology, Neurosurgery & Psychiatry, 1985
- Stresses upon the Relatives of Head-Injured PatientsThe British Journal of Psychiatry, 1978