Abstract
Sander AM, Maestas KL, Sherer M, Malec JF, Nakase-Richardson R. Relationship of caregiver
and family functioning to participation outcomes after postacute rehabilitation for
traumatic brain injury: a multicenter investigation.
Objective
To investigate the contribution of caregiver emotional functioning and family functioning
to participation outcomes after postacute rehabilitation for traumatic brain injury
(TBI).
Design
Prospective cohort study.
Setting
Three postacute comprehensive-integrated postacute rehabilitation programs associated
with National Institute on Disability and Rehabilitation Research–funded TBI Model
Systems Centers.
Participants
Persons with medically documented TBI (N=136; 57% with severe TBI, 12% moderate, 31%
mild), primarily men and 69% white.
Interventions
Not applicable.
Main Outcome Measures
Community Integration Questionnaire and Craig Handicap Assessment and Reporting Technique
(CHART).
Results
After accounting for age, education, sex, and race/ethnicity, there was a significant
interaction between caregiver emotional functioning and time since injury for CHART
Occupation and Social Integration Scale scores. Better emotional functioning in caregivers
was associated with greater occupation and social integration outcomes for persons
who entered the postacute rehabilitation program within 6 months of injury, but not
for those >6 months postinjury. There was no relationship of family functioning to
participation outcomes, and no interaction between family functioning and time since
injury.
Conclusions
Caregiver distress should be accounted for in studies investigating the effectiveness
of postacute rehabilitation after TBI. Screening of caregivers early during postacute
rehabilitation can target those who need assistance to improve their support of the
person with TBI.
Key Words
List of Abbreviations:
BSI (Brief Symptom Inventory), BSI-GSI (Brief Symptom Inventory–Global Severity Index), CHART (Craig Handicap Assessment and Reporting Technique), CHocc (CHART–Occupation Scale), CHsi (CHART–Social Integration Scale), CIQ (Community Integration Questionnaire), CIQhi (CIQ–Home Integration Scale), CIQprod (CIQ–Productivity Scale), CIQsi (CIQ–Social Integration Scale), FAD (Family Assessment Device), FAD-GFS (Family Assessment Device–General Functioning Scale), GFS (General Functioning Scale), TBI (traumatic brain injury)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 14, 2012
Footnotes
Supported in part by grants from the National Institute on Disability and Rehabilitation Research, U.S. Department of Education (grant nos. H133A70015, H133B090023, H133A070043, H133P080007).
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.
Reprints are not available from the author.
In-press corrected proof published online on Mar 14, 2012, at www.archives-pmr.org.
Identification
Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
