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Relationship of Preinjury Caregiver and Family Functioning to Community Integration in Adults With Traumatic Brain Injury

      Abstract

      Sady MD, Sander AM, Clark AN, Sherer M, Nakase-Richardson R, Malec JF. Relationship of preinjury caregiver and family functioning to community integration in adults with traumatic brain injury.

      Objective

      To investigate the relationship of preinjury caregiver and family functioning to community integration outcomes in persons with traumatic brain injury (TBI).

      Design

      Inception cohort.

      Setting

      Three TBI Model Systems inpatient rehabilitation facilities.

      Participants

      Persons with TBI (N=141) and their caregivers admitted to inpatient rehabilitation and followed up at 1 to 2 years after injury.

      Interventions

      Not applicable.

      Main Outcome Measures

      Community Integration Questionnaire and the Social and Occupation scales of the Craig Handicap Assessment and Reporting Technique.

      Results

      There were significant interactions of several preinjury caregiver and family variables with injury severity. For persons with complicated mild/moderate injury, better family functioning was associated with greater home integration, and less caregiver distress was associated with better social integration. For persons with severe injuries, greater caregiver perceived social support was associated with better outcomes in productivity and social integration.

      Conclusions

      Preinjury caregiver and family characteristics interact with injury severity to affect outcomes in persons with injury. Research on outcomes should include measures of caregiver and family functioning. Early interventions targeted toward decreasing caregiver distress, increasing support, and improving family functioning may have a positive impact on later outcomes.

      Key Words

      List of Abbreviations:

      BSI (Brief Symptom Inventory), 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), DRS (Disability Rating Scale), FAD (Family Assessment Device), GCS (Glasgow Coma Scale), GSI (Global Severity Index), MSPSS (Multidimensional Scale of Perceived Social Support), TBI (traumatic brain injury)
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      • Correction
        Archives of Physical Medicine and RehabilitationVol. 91Issue 12
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          In Sady MD, Sander AM, Clark AN, Sherer M, Nakase-Richardson R, Malec JF. Relationship of preinjury caregiver and family functioning to community integration in adults with traumatic brain injury. Arch Phys Med Rehabil 2010:91;1542-50, the authors regret that the following acknowledgment was omitted from the initial publication.
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