The Effect of Preinjury Psychiatric Difficulties on Caregiving Needs and Postinjury Emotional Distress in Care Partners of Persons With Traumatic Brain Injury
Fedora Biney PhD , Jennifer H. Marwitz MA , Yue Zhang PhD , Richard Kennedy MD, PhD , Flora M. Hammond MD , Katherine Abbasi MA
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引用次数: 0
Abstract
Objective
To examine differences in postinjury needs in traumatic brain injury (TBI) care partners with and without a preinjury psychiatric history (positive preinjury psychiatric history [PH+] vs negative preinjury psychiatric history [PH−]).
Design
A multisite, prospective, observational cohort study.
Setting
Community.
Participants
Two hundred fifty-eight care partners (N=258) for persons with TBI meeting the following criteria: ≥18 years old; nonpaid caregiver; TBI care recipient criteria: ≥16 years old at time of injury, TBI requiring inpatient rehabilitation; acute hospitalization/admission at Traumatic Brain Injury Model System–approved inpatient rehabilitation site.
Interventions
Not applicable.
Main Outcome Measures
Family Needs Questionnaire-Revised assessed percentage of emotional, instrumental, professional, and community support needs met at 6 months after injury. Secondary Outcome Measures: Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 assessed care partner depression and anxiety at 6, 12, and 24 months after injury.
Results
At 6 months after injury, care partners reported more met needs for community support relative to instrumental support needs (estimates, 7.30; 95% confidence interval [CI], 3.91-10.69; P<.001). PH+ care partners did not differ from PH− care partners in the percentage of met needs across any need category. Number of psychiatric diagnoses (0 vs 1 vs 2 vs 3+) was not associated with differences in met needs. PH+ care partners endorsed more depression and anxiety symptoms than PH− care partners from 6 to 24 months after injury (depression: estimates, 3.78; 95% CI, 2.55-5.00; P<.001; anxiety: estimates, 2.91; 95% CI, 1.58-4.24; P<.001).
Conclusions
While PH+ TBI care partners do not appear to have differing needs compared to PH− care partners at 6 months after injury, they do experience persistent emotional distress. Evaluating care partners’ psychiatric history is warranted to identify caregivers vulnerable to developing post-TBI emotional distress.
期刊介绍:
The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities.
Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.