Understanding the relationship between family functioning and health-related quality of life in very young children with moderate-to-severe TBI.

Objective

To investigate the relationship of pre-injury and concurrent family functioning with health-related quality of life (HR QoL) following traumatic brain injury (TBI) or orthopedic injury (OI) in very young children. Method: Prospective enrollment of children ages 0-4 years who presented to the emergency department after sustaining either acute TBI or OI. This is a sub-analysis of children who completed at least one post-injury follow-up visit. At time of study enrollment, parents rated pre-injury family functioning (Family Assessment Device-General Functioning Scale) and the child's HR QoL (Pediatric Quality of Life InventoryTM). Family functioning and HR QoL were assessed at one and six months post-injury. Mixed models were used to examine family functioning as a moderator of a child's HR QoL following injury.

Results

Data were analyzed for 42 children with TBI and 24 children with OI. For both groups, better pre-injury family functioning was significantly associated with better HR QoL over time. A triple interaction of injury type by time since injury by concurrent family functioning indicated that children with TBI and poor family functioning had significantly worse HR QoL at six months post-injury relative to other groups.

Conclusion

Despite a small sample size, current results underscore the importance of family functioning to recovery following early childhood TBI and support the need for continued research and development of interventions to improve outcomes in this population.