Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 6 , Pages 939-946, June 2009

Caregivers' Well-Being After Traumatic Brain Injury: A Multicenter Prospective Investigation

  • Jeffrey S. Kreutzer, PhD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA
    • Corresponding Author InformationReprint requests to Jeffrey S. Kreutzer, PhD, Dept of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Box 980542, Richmond, VA 23298-0542
    • ,
  • Lisa J. Rapport, PhD

      Affiliations

    • Department of Psychology, Wayne State University, Detroit, MI
    • ,
  • Jennifer H. Marwitz, MA

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA
    • ,
  • Cynthia Harrison-Felix, PhD

      Affiliations

    • Craig Hospital, Englewood, CO
    • ,
  • Tessa Hart, PhD

      Affiliations

    • Moss Rehabilitation Research Institute and Department of Rehabilitation Medicine, Jefferson Medical College, Philadelphia, PA
    • ,
  • Mel Glenn, MD

      Affiliations

    • Spaulding Rehabilitation Hospital, Boston, MA
    • ,
  • Flora Hammond, MD

      Affiliations

    • Carolinas Rehabilitation, Charlotte, NC

Abstract 

Kreutzer JS, Rapport LJ, Marwitz JH, Harrison-Felix C, Hart T, Glenn M, Hammond F. Caregivers' well-being after traumatic brain injury: a multicenter prospective investigation.

Objective

To describe frequency and magnitude of caregivers' emotional distress and life satisfaction using standardized assessment procedures; compare distress levels among spouses, parents, and other caregivers; and identify risk factors.

Design

Prospective collaborative cohort study.

Setting

Six Traumatic Brain Injury Model System Centers providing neurotrauma care, rehabilitation, and outpatient follow-up.

Participants

Caregivers (N=273) of patients who were 1, 2, or 5 years postinjury.

Interventions

Acute neurotrauma care, inpatient interdisciplinary brain injury rehabilitation, and postacute services.

Main Outcome Measure

Brief Symptom Inventory-18 Depression, Anxiety, and Somatic dimensions.

Results

Levels of Depression, Anxiety, and Somatic symptoms were equally prevalent, with 1 in 5 caregivers scoring above the cutoff in each area. The proportion of participants with 1, 2, and 3 elevations was 17.9%, 5.5%, and 10.6%, respectively. Conversely, approximately two thirds (65.9%) had no scores exceeding cutoffs. Distress levels among spouses, parents, and other caregivers were comparable. Higher caregiver distress was associated with caring for survivors who had worse functional status, received more supervision, were less satisfied with life, and used alcohol excessively.

Conclusions

Depression, Anxiety, and Somatic symptoms are common among caregivers. Findings substantiate the importance of clinical care systems addressing the needs of caregivers in the long term as well as survivors.

Key Words: Brain injuries, Caregivers, Family, Rehabilitation, Stress, psychological

List of Abbreviations: ANCOVA, analysis of covariance, ANOVA, analysis of variance, BRFSS, Behavioral Risk Factor Surveillance System, BSI-18, Brief Symptom Inventory-18, DRS, Disability Rating Scale, GCS, Glasgow Coma Scale, GOAT, Galveston Orientation and Amnesia Test, GSI, Global Severity Index, PTA, posttraumatic amnesia, SCL-90, Symptom Checklist-90, SRS, Supervision Rating Scale, SWLS, Satisfaction with Life Scale, TBI, traumatic brain injury, TBIMS, Traumatic Brain Injury Model System

 

 Supported by the National Institute on Disability and Rehabilitation Research, US Department of Education (grant nos. H133A020516, H133A020509, H133A020510, H133A020513).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

PII: S0003-9993(09)00202-0

doi:10.1016/j.apmr.2009.01.010

Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 6 , Pages 939-946, June 2009

Article Tools