Archives of physical medicine and rehabilitation · 2025
The Effect of Preinjury Psychiatric Difficulties on Caregiving Needs and Postinjury Emotional Distress in Care Partners of Persons With Traumatic Brain Injury.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Biney Fedora, Marwitz Jennifer H, Zhang Yue, Kennedy Richard, Hammond Flora M, Abbasi Katherine
Аннотация
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.
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.