Medical and Psychosocial Predictors of Caregiver Functioning After Traumatic Brain Injury Lynne C. D

1
Medical and Psychosocial Predictors of Caregiver
Functioning After Traumatic Brain Injury Lynne
C. Davis, Ph.D., Angelle M. Sander,
Ph.D.,Margaret A. Struchen, Ph.D., Mark Sherer,
Ph.D., Risa Nakase-Richardson, Ph.D. , James
F. Malec, Ph.D.
Physical Medicine and Rehabilitation
Model 1 Predictors of Caregiver Burden

• INTRODUCTION
• Emotional distress and sense of burden are
• experienced by many caregivers of persons
• with traumatic brain injury (TBI).1-8
• Predicting which caregivers will experience
• distress is critical for developing
  empirically-
• based interventions.
• Researchers have examined injury-related
• variables and caregiver demographics to
• predict caregivers adjustment following TBI.
• Injury severity appears to be related to
  caregiver
• distress at 3 to 6 months post-injury, but not
  at
• longer follow-up intervals.4, 9-12
• Changes in emotional and social functioning in
• injured persons are strongly related to
• caregivers perceived stress and emotional
• functioning.4, 8-10, 13-17
• Caregiver demographics relationship to the

• METHOD
• Participants
• Sample consisted of 114 caregivers of persons
• with medically documented complicated
• mild/moderate (35) or severe (65) injury,
• admitted to 1 of 3 participating centers.
• Of 217 caregivers with baseline data, 114 had
• follow-up data at 1 year post-injury.
• Caregivers lost to follow-up did not differ
  from
• those with follow-up data with regard to
• demographics, medical or psychiatric history,
• or severity of the person with injury.
• Measures
• Brief Symptom Inventory (BSI)24 53 items
• yield 3 global distress indices. Global
• Severity Index scores were used as an
• outcome measure of caregiver distress.

• DISCUSSION
• Perceived Burden
• Poorer functional status of persons with injury
  was
• associated with greater sense of burden among
  caregivers.
• Increased perceived social support was related
  to
• decreased sense of burden.
• Increased use of Escape-Avoidance was associated
  with
• elevated caregiver burden.
• Global Distress
• Caregivers with reported histories of
  significant illness(es)
• reported higher levels of distress.
• Similarly, caregivers with histories of
  treatment for
• psychological problems reported higher levels
  of distress.
• Increased use of Escape-Avoidance was
  associated with
• elevated distress.
• CONCLUSIONS
• After accounting for the functioning of the
  person with

RESULTS
Model 1 Predictors of Perceived Burden
Model 2 Predictors of Global Distress
References available on handout