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Sorrentino G, Bayen E, Câmara-Costa H, Francillette L, Toure H, Laurent-Vannier A, Meyer P, Dellatolas G, Chevignard M. Long-term burden of informal caregiver 7-years after severe childhood traumatic brain injury in the traumatisme grave de l'Enfant (TGE) study. Brain Inj 2024; 38:467-478. [PMID: 38379310 DOI: 10.1080/02699052.2024.2318588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 02/09/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE To investigate reported burden by the Primary Family Caregiver (PFC) 7-years after severe pediatric traumatic brain injury in the TGE (Traumatisme Grave de l'Enfant) longitudinal study. METHODS Subjective burden was estimated with the Zarit Burden Inventory (ZBI) in 36 PFC (parents), who rated their own health status (Medical Outcome Study Short Form-12), family functioning and their child's level of care and needs (Pediatric/Adult Care And Needs Scale [PCANS/CANS]). Data collection included: child and PFC sociodemographic characteristics, injury-related factors, 'objective' (e.g. overall level of disability: Glasgow Outcome Scale - Extended, GOS-E/GOS-E-Peds) and 'subjective' outcomes (e.g. participation, behavior, executive functions, quality of life and fatigue). RESULTS 25% of PFC reported mild-moderate burden, and 19% moderate-severe burden. Higher burden correlated with worse outcomes in all 'subjective' PFC-rated outcomes, and with self-reported participation. The ZBI correlated strongly with CANS/PCANS and GOS-E/GOS-E-Peds. Overall level of disability and PFC-reported executive functioning explained 62% of the ZBI variance. For equal levels of disability, burden was higher when PFC reported a 'negative' picture of their child. CONCLUSION Significant PFC-reported burden 7-years post-injury was associated with overall disability and 'subjective' PFC-rated outcomes. Factors influencing parental burden in the long term should be identified and psychological support implemented over time.
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Affiliation(s)
- Gregorio Sorrentino
- Sorbonne Université, GRC 24 Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Paris, France
| | - Eléonore Bayen
- Sorbonne Université, GRC 24 Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Paris, France
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France
| | - Hugo Câmara-Costa
- Sorbonne Université, GRC 24 Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Paris, France
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Leila Francillette
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Hanna Toure
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Anne Laurent-Vannier
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Philippe Meyer
- Pediatric Anesthesiology Department, Hôpital Necker Enfants Malades, Paris, France
- Faculty of Medicine, Paris Descartes University, Paris, France
| | - Georges Dellatolas
- Sorbonne Université, GRC 24 Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Paris, France
| | - Mathilde Chevignard
- Sorbonne Université, GRC 24 Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Paris, France
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals, Saint Maurice, France
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Vlasnik J, Cambron-Mellott MJ, Costantino H, Kunjappu M. Burden of Wilson Disease among patients and care partners in the United States: results from a cross-sectional survey. Curr Med Res Opin 2024; 40:863-876. [PMID: 38571385 DOI: 10.1080/03007995.2024.2337684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/28/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE This study assessed the burden of Wilson Disease (WD) among patients and care partners (WD-CPs) in the US and compared it to a US general population of adults (GPs) and care partners (GP-CPs). METHODS This cross-sectional, self-reported survey included patients with WD and WD-CPs aged ≥18 years recruited through the Wilson Disease Association (WDA), while data for GPs and GP-CPs were obtained from the 2022 National Health and Wellness Survey. GPs and GP-CPs were propensity score matched (3:1) with WD patients and WD-CPs for demographics and health characteristics. Bivariate analysis evaluated differences in comorbidity burden and health-related outcomes of the WD cohorts compared to matched GP cohorts. RESULTS Thirty-seven patients with WD and 53 WD-CPs completed the survey. Most patients reported some treatment burden (73.3%), experienced sleep problems (60%), and visited a healthcare provider (HCP) in the past 6 months (91.9%). Compared with matched GPs, patients with WD had a significantly higher mortality risk (p < .001) and reported greater rates of chronic liver disease, cirrhosis (both, p < .001), migraines (p = .032), non-alcoholic steatohepatitis (p = .004), sleep problems (p = .009) and HCP visits (p = .002). Most WD-CPs (75.5%) reported high burden of caring (mean ZBI-12 score, 26.5) and more negative impact on esteem than GP-CPs. CONCLUSION This study highlights the burden of WD experienced by patients and WD-CPs, with patients experiencing high treatment burden, comorbidity burden and healthcare resource utilization, and WD-CPs experiencing high impact of caring, including impact on employment and self-esteem.
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Affiliation(s)
- Jon Vlasnik
- Alexion Pharmaceuticals Inc, AstraZeneca Rare Disease, Boston, MA, USA
| | | | | | - Mary Kunjappu
- Alexion Pharmaceuticals Inc, AstraZeneca Rare Disease, Boston, MA, USA
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Hendryckx C, Couture M, Gosselin N, Nalder E, Gagnon-Roy M, Thibault G, Bottari C. The dual reality of challenging behaviours: Overlapping and distinct perspectives of individuals with TBI and their caregivers. Neuropsychol Rehabil 2024; 34:485-509. [PMID: 37219424 DOI: 10.1080/09602011.2023.2212172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/03/2023] [Indexed: 05/24/2023]
Abstract
Challenging behaviours significantly impact the lives of people with traumatic brain injury (TBI) and their family caregivers. However, these behaviours are rarely defined from the perspectives of both individuals, a necessary step to developing interventions targeting meaningful goals for individuals and caregivers. This study aimed to (1) explore and confirm the perspective of individuals with TBI living in the community and their family caregivers on behaviours they consider challenging and, (2) identify overlapping or distinct views on challenging behaviours. A qualitative descriptive design was used. Twelve caregivers (8 females; 59.67 ± 11.64 years old) and 14 participants with mild-severe TBI (6 females; 43.21 ± 10.98 years old; time post-injury: 21.71 ± 10.84 years) were interviewed (10 dyads and two triads). Data were analysed using inductive qualitative analysis. Challenging behaviours most frequently reported by all participants were aggressive/impulsive behaviours, inappropriate social behaviours, and behavioural manifestations of cognitive impairments. Overlapping perspectives were identified regarding aggressive behaviours. Distinctions exist as inappropriate social behaviours and cognitive difficulties were mainly reported by caregivers. Our results confirm that perspectives may vary between dyad members. Interventions should include dyad inputs to formulate goals that are significant to the person with TBI and their caregiver.
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Affiliation(s)
- Charlotte Hendryckx
- Department of Psychology, Université de Montréal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux (CIUSSS) Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
- Center for Advanced Research in Sleep Medicine (CEAMS), Hôpital du Sacré-Coeur de Montréal, Centre de recherche du CIUSSS NIM, Montreal, Canada
| | - Mélanie Couture
- Centre for research and expertise in social gerontology (CREGÉS), CIUSSS West-Central Montreal, Côte Saint-Luc, Canada
- École de travail social, Faculté des lettres et sciences humaines, Université de Sherbrooke, Sherbrooke, Canada
| | - Nadia Gosselin
- Department of Psychology, Université de Montréal, Montreal, Canada
- Center for Advanced Research in Sleep Medicine (CEAMS), Hôpital du Sacré-Coeur de Montréal, Centre de recherche du CIUSSS NIM, Montreal, Canada
| | - Emily Nalder
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Mireille Gagnon-Roy
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux (CIUSSS) Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
- School of RehabilitationUniversité de Montréal, Montreal, Canada
| | - Geneviève Thibault
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Canada
- Service québécois d'expertise en troubles graves du comportement (SQETGC), CIUSSS MCQ, Montreal, Canada
| | - Carolina Bottari
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux (CIUSSS) Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
- School of RehabilitationUniversité de Montréal, Montreal, Canada
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Câmara-Costa H, Bayen E, Francillette L, Toure H, Meyer P, Laurence W, Dellatolas G, Chevignard M. Parental report of levels of care and needs 7-years after severe childhood traumatic brain injury: Results of the traumatisme grave de l'Enfant (TGE) cohort study. APPLIED NEUROPSYCHOLOGY. CHILD 2024; 13:152-164. [PMID: 36353798 DOI: 10.1080/21622965.2022.2142792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study investigated parental reports of the level of care and needs 7-years following severe childhood traumatic brain injury (TBI), and the factors associated with this outcome. From the 65 children (0-15 years) consecutively admitted to the Parisian regional TBI reference intensive care unit following severe TBI, included in this prospective longitudinal study, 39 patients [M(SD) age at injury = 7.5 years (4.6) and assessment 15.3(4.4)] were followed 7-years post-injury and matched with a control group composed of typically developing participants (n = 34) matched by age, sex and parental education level. We used the Care and Need Scale (CANS) and its Pediatric version (PCANS) to assess the primary outcome 7-years post-injury. Concurrent measures included overall level of disability, and parent- and/or self-reported questionnaires assessing executive functioning, behavior, quality of life, fatigue, participation and caregivers' burden. The level of care and needs was significantly higher in the TBI group than in the control group, the difference being significant with the CANS only. PCANS scores were extremely variable in the control group. High level of dependency was associated with initial TBI severity (higher coma duration and initial Injury Severity Score), higher levels of behavioral problems, executive function deficits, fatigue, and lower participation levels. Caregivers' burden was strongly associated with the CANS. The CANS provides a simple and reliable measure of the support needed long-term after childhood TBI, in accordance with previous studies. The PCANS scores were not significantly different between the TBI and the control groups, which seems to illustrate the difficulty to assess accurately mild-to-moderate deficits of functional independence/adaptive behavior in children based exclusively on parental reports.
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Affiliation(s)
- Hugo Câmara-Costa
- Sorbonne Université, Laboratoire d'Imagerie Biomédicale, LIB, CNRS, INSERM, Paris, France
- Sorbonne Université, GRC 24, Handicap Moteur et Cognitif et Réadaptation - HaMCre, Paris, France
| | - Eléonore Bayen
- Sorbonne Université, Laboratoire d'Imagerie Biomédicale, LIB, CNRS, INSERM, Paris, France
- Sorbonne Université, GRC 24, Handicap Moteur et Cognitif et Réadaptation - HaMCre, Paris, France
- Department of Physical Rehabilitation Medicine, Pitié-Salpêtrière Hospital (AP-HP), Paris, France
| | - Leila Francillette
- Sorbonne Université, Laboratoire d'Imagerie Biomédicale, LIB, CNRS, INSERM, Paris, France
| | - Hanna Toure
- Rehabilitation Department for Children with Acquired Brain Injury, Outreach Team for Children and Adolescents with Acquired Brain Injury; Saint Maurice Hospitals, Saint Maurice, France
| | - Philippe Meyer
- Assistance Publique des Hôpitaux de Paris (APHP), Centre - Université de Paris, Paris, France
| | - Watier Laurence
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM. UVSQ, Institut Pasteur, Université Paris-Saclay, Paris, France
| | - Georges Dellatolas
- Sorbonne Université, GRC 24, Handicap Moteur et Cognitif et Réadaptation - HaMCre, Paris, France
| | - Mathilde Chevignard
- Sorbonne Université, Laboratoire d'Imagerie Biomédicale, LIB, CNRS, INSERM, Paris, France
- Sorbonne Université, GRC 24, Handicap Moteur et Cognitif et Réadaptation - HaMCre, Paris, France
- Rehabilitation Department for Children with Acquired Brain Injury, Outreach Team for Children and Adolescents with Acquired Brain Injury; Saint Maurice Hospitals, Saint Maurice, France
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Halalmeh DR, Salama HZ, LeUnes E, Feitosa D, Ansari Y, Sachwani-Daswani GR, Moisi MD. The Role of Neuropsychology in Traumatic Brain Injury: Comprehensive Literature Review. World Neurosurg 2024; 183:128-143. [PMID: 38104936 DOI: 10.1016/j.wneu.2023.12.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Abstract
Traumatic brain injury (TBI) is a major public health concern, often leading to significant behavioral and cognitive changes with subsequent impairment in daily functioning and personal interactions. The management of TBI involves a multidisciplinary approach. Neuropsychology has emerged as a critical discipline in assessing, diagnosing, treating, and rehabilitating individuals with TBI. Successful management also requires careful consideration of the patient's cognitive status. Therefore, clinicians must have a comprehensive understanding of the overall clinical picture of the patient at the cognitive and physical level. The primary aim of this research is to explore the role of neuropsychology in TBI management and rehabilitation thoroughly while providing an updated review of the literature. Various neuropsychological assessment tools used to evaluate cognitive functioning in individuals with TBI will be discussed in addition to their validity, reliability, and usefulness in identifying cognitive deficits and developing individualized treatment plans. The findings in this article will have significant implications on the clinical practice of neuropsychology in TBI patients, highlighting the importance of neuropsychological assessment in optimizing the management of this population. The need for increased awareness of neuropsychology among health care professionals, especially in the acute hospital setting, is growing along with the increase in diagnosis of TBI and its complications. Adequate understanding of the complex interplay between cognitive, emotional, and behavioral factors in TBI can inform the development of new interventions and treatment strategies, making it equally as important for patients and their families.
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Affiliation(s)
- Dia R Halalmeh
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA; Department of Surgery, Michigan State University-College of Human Medicine, Traverse City, Michigan, USA; Department of Trauma and Acute Care Surgery, Hurley Medical Center, Flint, Michigan, USA.
| | | | - Emma LeUnes
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA
| | - David Feitosa
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA
| | - Yusuf Ansari
- Temple University, Philadelphia, Pennsylvania, USA
| | - Gul R Sachwani-Daswani
- Department of Trauma and Acute Care Surgery, Hurley Medical Center, Flint, Michigan, USA
| | - Marc D Moisi
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA; Department of Surgery, Michigan State University-College of Human Medicine, Traverse City, Michigan, USA; Department of Trauma and Acute Care Surgery, Hurley Medical Center, Flint, Michigan, USA
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Selzler AM, Brooks D, Marques A, Souto-Miranda S, Goldstein R, Cruz J. Assessing caregiving experience in COPD: content validity of the Zarit Burden Interview in Canadian and Portuguese caregivers. Disabil Rehabil 2023; 45:2826-2836. [PMID: 35976167 DOI: 10.1080/09638288.2022.2107089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/20/2022] [Accepted: 07/23/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Informal caregivers play an important role in chronic disease management but their experience is often neglected. The objective of this study was to explore the content validity of the Zarit Burden Interview (ZBI) in caregivers of individuals with COPD in Canada and Portugal. MATERIALS AND METHODS Cognitive debriefing interviews were conducted with informal caregivers of individuals with moderate to very severe COPD. Participants completed the ZBI and verbalised their thinking process to assess the adequacy of the questionnaire's content and instructions. Content validity was assessed using deductive content analysis of interviews and descriptive statistics of questionnaire responses. RESULTS Nine caregivers from Canada (age = 67 ± 8 years) and 13 from Portugal (age = 69 ± 7 years) participated. For Canadian caregivers, 3/22 items were not understood, and 8/22 items were not relevant to at least 1/3 of them. For Portuguese caregivers, 1/22 items were not understood, and 20/22 items were not relevant to at least 1/3 of them. The distribution of response choices was approximately symmetrical for 17/22 items in the Canadian sample. The response option "no/never" was selected by at least 75% of Portuguese participants for 18/22 items. CONCLUSIONS The instrument was well understood by caregivers of people with COPD, but its relevance is uncertain.IMPLICATIONS FOR REHABILITATIONInformal caregivers provide essential care for people living with disability and chronic disease, but their experience is often neglected.The Zarit Burden Interview assesses caregiver burden but has not been validated in caregivers of people with chronic obstructive pulmonary disease.In its current form, the Zarit Burden Interview does not adequately represent the experience of COPD caregivers.We recommend selecting tools that assess caregiver burden that have been validated in the caregiver population of interest.
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Affiliation(s)
| | - Dina Brooks
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada
- Rehabilitation Science Institute, Department of Physical Therapy, University of Toronto, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Alda Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Sara Souto-Miranda
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Roger Goldstein
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Joana Cruz
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
- School of Health Sciences (ESSLei), Polytechnic of Leiria, Leiria, Portugal
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Ramezani-Doroh V, Karimi F, Rangchian M, Hamidi Y. Monetary valuation of COVID-19 informal care: caregivers' willingness to pay and willingness to accept. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2023; 21:22. [PMID: 37013619 PMCID: PMC10069359 DOI: 10.1186/s12962-023-00437-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Informal care can reduce hospitalization frequency and time, elevate bed turnover, and increase the health systems' capacity. This type of care has shown meaningful value in managing many cases through the COVID-19 pandemic. The present study aimed to identify determinants of monetary valuation of informal care and the burden of this care on the COVID-19 patients' caregivers. METHODS Through a cross-sectional phone survey from June to September 2021 in Sanandaj city, the west of Iran, COVID-19 patients and their caregivers (Each Group No. 425) were separately interviewed. A simple probabilistic sampling method was applied. Two questionnaires were developed and used after validation. Monetary valuation of informal caregivers was done using Willingness to pay (WTP) and willingness to accept (WTA). Double hurdle regressions were used to determine related variables to WTP/WTA. R software was used for the data analysis. RESULTS The total mean (Standard Deviation) of WTP and WTA were $12.02(28.73), $10.30(15.43) USD. Most respondents put a zero value on informal care by WTA (243(57.18%) and WTP [263 (61.88%)]. Caregivers' Employment, and being spouse/child of the care recipient increased the probability of reporting a positive value for WTP (p-value < 0.0001, p-value = 0.011 respectively) and WTA (p-value = 0.004, p-value < 0.0001 respectively). An increase in the number of caring days decreased the probability of reporting positive WTA (p-value = 0.001) and increased the mean of lnWTP (p-value = 0.044). Perceived difficulty in doing indoor activities and perceived difficulty in doing outdoor activities decreased lnWTA mean (p-value = 0.002) and lnWTP mean (p-value = 0.043) respectively. CONCLUSIONS Increasing caregivers' self-efficacy and facilitating their involvement in the caring process could be facilitated through flexible work status, educational programs, and interventions on decreasing their burnout.
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Affiliation(s)
- Vajiheh Ramezani-Doroh
- Department of Health Management and Economics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Faride Karimi
- Department of Health Management and Economics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Rangchian
- Department of Clinical Pharmacy, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Yadolah Hamidi
- Department of Health Management and Economics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Kjeldgaard A, Soendergaard PL, Wolffbrandt MM, Norup A. Predictors of caregiver burden in caregivers of individuals with traumatic or non-traumatic brain injury: A scoping review. NeuroRehabilitation 2023; 52:9-28. [PMID: 36617762 DOI: 10.3233/nre-220134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Caregivers of individuals with traumatic (TBI) or non-traumatic (nTBI) brain injuries are at risk of significant caregiver burden. Consequently, it is crucial to examine predictors of caregiver burden to enable early identification and intervention. OBJECTIVE To examine predictors of caregiver burden in caregivers of individuals with TBI/nTBI. METHODS A scoping review was conducted in the bibliographic databases PubMed, EMBASE (Ovid) and APA PsycInfo (EBSCO). Search terms included: 'acquired brain injur*', 'traumatic brain injur*', 'brain injur*', 'non-traumatic brain injur*', or 'stroke*' combined with 'burden', 'caregiver burden', 'perceived burden', or 'caregiver strain'. The search was limited to articles written in English and published in academic journals between 2000 and March 2022. EndNote was used to manage the references and identify duplicates. RESULTS Twenty-four studies were included. Care recipient-related predictors of caregiver burden included more severe injuries, functional disabilities (including decreased physical and neuropsychological functioning), and worse mental health. Caregiver-related predictors included more time spent caregiving, worse mental health, and unmet needs. For several predictor variables, evidence was mixed or vague. CONCLUSION The results highlight which caregivers are at risk of caregiver burden and point to several areas of potential intervention to prevent caregiver burden. Future research should explore the relationship between characteristics of the caregiver and caregiver burden, including coping style, problem-solving techniques, and personality, as these have been sparsely investigated and are potentially modifiable through intervention. Further research is needed to elucidate if burden can be prevented by interventions targeting caregivers at risk. Addressing these gaps may clarify the link between caregiver burden and predictor variables and assist in development of interventions that may prevent burden.
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Affiliation(s)
- Amanda Kjeldgaard
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Langer Soendergaard
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Mia Moth Wolffbrandt
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Copenhagen, Denmark
| | - Anne Norup
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Southern Denmark, Odense, Denmark
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Juengst SB, Wright B, Driver S, Calhoun S, Muir A, Dart G, Goldin Y, Lengenfelder J, Bell K. Multisite randomized feasibility study of Problem-Solving Training for care partners of adults with traumatic brain injury during inpatient rehabilitation. NeuroRehabilitation 2023; 52:109-122. [PMID: 36617760 DOI: 10.3233/nre-220129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Problem-Solving Training (PST) during inpatient rehabilitation could provide care partners the skills needed to manage their life roles after discharge. OBJECTIVE Determine the feasibility of PST+ Education versus Education for care partners of adults with traumatic brain injury (TBI) during inpatient rehabilitation. METHODS We conducted a multisite randomized feasibility trial across three sites. We present recruitment rates, reasons for refusal to participate, and reasons for non-completion of interventions. We measured client satisfaction, participant engagement, and fidelity for both interventions. We compared change in depressive symptoms and caregiver burden between PST and Education groups. RESULTS Though the interventions were generally feasible, recruitment and retention rates were lower than anticipated largely due to the COVID-19 pandemic. Participants who completed >3 sessions were less likely to be employed full-time and more often spouses and co-residing. Length of inpatient rehabilitation stay was correlated with number of sessions completed. We observed potential benefits of PST over Education, specifically for reducing depression symptoms and caregiver burden. CONCLUSION High satisfaction, engagement, and fidelity, overall recruitment and retention, and positive change in outcomes suggest that PST is generally feasible and beneficial for care partners of persons with TBI. Adaptations, such as developing a 3-session version of PST, could improve feasibility.
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Affiliation(s)
| | - Brittany Wright
- Department of Physical Medicine and Rehabilitation, North Texas TBI Model System, UT Southwestern Medical Center, Dallas, TX, USA
| | - Simon Driver
- North Texas TBI Model System, Baylor Scott and White Research Institute, Dallas, TX, USA
| | - Stephanie Calhoun
- North Texas TBI Model System, Baylor Scott and White Research Institute, Dallas, TX, USA
| | - Aimee Muir
- North Texas TBI Model System, Baylor Scott and White Research Institute, Dallas, TX, USA
| | - Georgianna Dart
- Hackensack Meridian JFK Johnson Rehabilitation Institute, Edison, NJ, USA
| | - Yelena Goldin
- Hackensack Meridian JFK Johnson Rehabilitation Institute, Edison, NJ, USA
| | - Jean Lengenfelder
- Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark, NJ, USA
| | - Kathleen Bell
- Department of Physical Medicine and Rehabilitation, North Texas TBI Model System, UT Southwestern Medical Center, Dallas, TX, USA
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10
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Kim KH, Kim H, Song KJ, Shin SD, Kim HC, Lim HJ, Kim Y, Kang HJ, Hong KJ. Prediction of Increased Intracranial Pressure in Traumatic Brain Injury Using Quantitative Electroencephalogram in a Porcine Experimental Model. Diagnostics (Basel) 2023; 13:diagnostics13030386. [PMID: 36766491 PMCID: PMC9914917 DOI: 10.3390/diagnostics13030386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/21/2022] [Accepted: 01/11/2023] [Indexed: 01/22/2023] Open
Abstract
Continuous and non-invasive measurement of intracranial pressure (ICP) in traumatic brain injury (TBI) is important to recognize increased ICP (IICP), which can reduce treatment delays. The purpose of this study was to develop an electroencephalogram (EEG)-based prediction model for IICP in a porcine TBI model. Thirty swine were anaesthetized and underwent IICP by inflating a Foley catheter in the intracranial space. Single-channel EEG data were collected every 6 min in 10 mmHg increments in the ICP from baseline to 50 mmHg. We developed EEG-based models to predict the IICP (equal or over 25 mmHg) using four algorithms: logistic regression (LR), naive Bayes (NB), support vector machine (SVM), and random forest (RF). We assessed the performance of each model based on the accuracy, sensitivity, specificity, and AUC values. The accuracy of each prediction model for IICP was 0.773 for SVM, 0.749 for NB, 0.746 for RF, and 0.706 for LR. The AUC of each model was 0.860 for SVM, 0.824 for NB, 0.802 for RF, and 0.748 for LR. We developed a machine learning prediction model for IICP using single-channel EEG signals in a swine TBI experimental model. The SVM model showed good predictive power with the highest AUC value.
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Affiliation(s)
- Ki-Hong Kim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul 03080, Republic of Korea
| | - Heejin Kim
- Clinical Trials Center, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Kyoung-Jun Song
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul 03080, Republic of Korea
- Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul 07061, Republic of Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Sang-Do Shin
- Department of Emergency Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul 03080, Republic of Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Hee-Chan Kim
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Hyouk-Jae Lim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul 03080, Republic of Korea
| | - Yoonjic Kim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul 03080, Republic of Korea
| | - Hyun-Jeong Kang
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul 03080, Republic of Korea
| | - Ki-Jeong Hong
- Department of Emergency Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul 03080, Republic of Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
- Correspondence: ; Tel.: +82-2-2072-0294
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11
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Hendryckx C, Nalder E, Drake E, Leclaire É, Pituch E, Gouin-Vallerand C, Wang RH, Poulin V, Paquet V, Bottari C. Managing challenging behaviours in adults with traumatic brain injury: A scoping review of technology-based interventions. J Rehabil Assist Technol Eng 2023; 10:20556683231191975. [PMID: 37614442 PMCID: PMC10443634 DOI: 10.1177/20556683231191975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Abstract
Challenging behaviours are one of the most serious sequelae after a traumatic brain injury (TBI). These chronic behaviours must be managed to reduce the associated burden for caregivers, and people with TBI. Though technology-based interventions have shown potential for managing challenging behaviours, no review has synthesised evidence of technology aided behaviour management in the TBI population. The objective of this scoping review was to explore what technology-based interventions are being used to manage challenging behaviours in people with TBI. Two independent reviewers analysed 3505 studies conducted between 2000 and 2023. Studies were selected from five databases using search strategies developed in collaboration with a university librarian. Sixteen studies were selected. Most studies used biofeedback and mobile applications, primarily targeting emotional dysregulation. These technologies were tested in a variety of settings. Two interventions involved both people with TBI and their family caregivers. This review found that technology-based interventions have the potential to support behavioural management, though research and technology development is at an early stage. Future research is needed to further develop technology-based interventions that target diverse challenging behaviours, and to document their effectiveness and acceptability for use by people with TBI and their families.
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Affiliation(s)
- Charlotte Hendryckx
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut Universitaire sur la Réadaptation en déficience Physique de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, QC, Canada
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Research Center from CIUSSS du Nord-de-l’Île-de-Montréal, Montreal, QC, Canada
- Department Of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Emily Nalder
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Emma Drake
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Éliane Leclaire
- Department Of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Evelina Pituch
- Department of Health and Society, University of Toronto Scarborough, Toronto, ON, Canada
| | - Charles Gouin-Vallerand
- Centre de Recherche Createch sur les Organisations Intelligentes, Université de Sherbrooke, Sherbrooke, QC, Canada
- DOMUS Laboratory, Université de Sherbrooke, Sherbrooke, QC, Canada
- University of Sherbrooke, Sherbrooke, QC, Canada
| | - Rosalie H Wang
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Valérie Poulin
- Department Of Occupational therapy, Université du Québec à Trois-Rivières, Trois-Rivieres, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), CIUSSS de la Capitale-Nationale, QC, Canada
| | - Virginie Paquet
- Bibliothèque Marguerite-D’Youville, Université de Montréal, Montréal, QC, Canada
| | - Carolina Bottari
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut Universitaire sur la Réadaptation en déficience Physique de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, QC, Canada
- Occupational Therapy Program, School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
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12
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Rasmussen MS, Howe EI, Andelic N, Soberg HL. Associations between protective resources and family functioning after traumatic brain injury: A cross-sectional study using a structural equation modeling approach. NeuroRehabilitation 2023; 52:47-58. [PMID: 36617761 PMCID: PMC9912729 DOI: 10.3233/nre-220131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/13/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND A strength-based approach in the rehabilitation after traumatic brain injury (TBI) is recommended for patients and their families. However, further exploration of the complexity of individual and family factors is needed. OBJECTIVE To explore the associations between individual protective resources in patients and family members and the overall family functioning using a strength-based approach. METHODS Secondary analysis of data collected at baseline in a randomized controlled trial. Structural equation modeling with two latent constructs and six observed variables was performed. Outcome measures included the Resilience Scale for Adults, the Mental Component Summary (SF-36), the General Self-Efficacy Scale, and the Family Adaptability and Cohesion Evaluation Scale-IV. RESULTS Hundred and twenty-two participants (60 patients, 62 family members) with a mean age of 43 years were included at a median of 11 months post-injury. The final model demonstrated a strong covariance (coefficient = 0.61) between the latent Protective construct and Family functioning. Model-fit statistics indicated an acceptable fit to the data. CONCLUSION Higher levels of protective resources (resilience, self-efficacy, and mental HRQL) were positively associated with family functioning. These resources should be further assessed in patients and their families, to identify factors that can be strengthened through TBI rehabilitation intervention.
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Affiliation(s)
- Mari S. Rasmussen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Emilie I. Howe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Helene L. Soberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Met - Oslo Metropolitan University, Oslo, Norway
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13
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Frank C, Coulthard J, Lee JEC, Skomorovsky A. A moderated-mediation analysis of pathways in the association between Veterans’ health and their spouse’s relationship satisfaction: The importance of social support. Front Psychol 2022; 13:988814. [PMID: 36405134 PMCID: PMC9666880 DOI: 10.3389/fpsyg.2022.988814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction Military personnel and Veterans are at increased risk of mental and physical health conditions, which can impact their families. Spouses often perform a vital role in caring for service members and Veterans facing illness or injury, which can lead to caregiver burden. In turn, this may contribute to relationship issues. Research suggests that ensuring that spouses are well supported can alleviate some of these negative effects. The current study examined whether social support received by spouses of newly released Veterans buffers the impact of Veterans’ health on caregiver burden, subsequently impacting spouses’ relationship satisfaction. Methods Data were collected as part of the Canadian Armed Forces Transition and Well-being Survey. The sample included N = 595 spouses of Regular Force Veterans who released in 2016 with at least 2 years of service. We examined Veterans’ mental and physical health and spouses’ caregiver burden, social support, and relationship satisfaction. A moderated mediation model was tested using structural equation modeling. Results There was a significant indirect association between Veterans’ health (both physical and mental) and spouses’ relationship satisfaction through caregiver burden. Furthermore, social support moderated the association, as evidenced by a weaker association between Veterans’ health and caregiver burden at low levels (−1SD) of social support compared to high levels (+1SD). Implications Findings suggest additional efforts should be made to ensure sufficient support is provided to spouses, especially when they are caring for a service member or Veteran facing illness or injury, to strengthen their families’ well-being.
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14
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Zauszniewski JA, Sweetko JS, She HY, Schreiner N. Documenting the need for teaching resourcefulness skills to family caregivers. Appl Nurs Res 2022; 67:151627. [DOI: 10.1016/j.apnr.2022.151627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 10/15/2022]
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15
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Baldeo N, D'Souza A, Haag HL, Hanafy S, Quilico E, Archambault P, Colquhoun H, Lewko J, Riopelle R, Colantonio A, Mollayeva T. A thematic analysis of patients' and their informal caregivers' gendered experiences in traumatic brain injury. Disabil Rehabil 2022; 45:1636-1645. [PMID: 35575401 DOI: 10.1080/09638288.2022.2071483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Research shows that patients' perceptions of themselves and others, in addition to their understanding of the concept of gender, changes after traumatic brain injury (TBI). Little is known about gendered experiences in TBI and care delivery. This study aims to explore perceptions of gender through life experiences and interactions between adult patients with TBI and their informal caregivers. MATERIALS AND METHODS Seven patients with mild and moderate-severe TBI and eight informal caregivers were interviewed. Transcripts were coded and analysed according to Braun and Clarke's thematic analysis. The Consolidated Criteria for Reporting Qualitative Research guidelines were followed in reporting results. RESULTS The participants described a transformation of their understanding and experiences of gender following the TBI event. Three themes were identified: (1) Gender designations of "man" and "woman";( 2) Post-injury performativity of gender; and (3) Gender in giving and receiving care. CONCLUSIONS The findings emphasize the importance of raising awareness among researchers and practitioners on gender as a transformative process for patients with TBI and informal caregivers after the injury. The diversity of patient-caregiver experiences and critical needs based on gender call for intervention approaches that mitigate gender disparities in giving and receiving care. Implications for RehabilitationHistorically, rehabilitation of persons with traumatic brain injury has targeted physical and cognitive impairments, with little attention to their gendered demands in the lived environment.Gender prevails in the lived experiences of persons with traumatic brain injury, and their informal caregivers, and in giving and receiving quality care.A major challenge for clinicians is identifying harmful gendered roles, norms, and relations and the affective/behavioral problems they produce to alleviate enduring distress and reduce disability.Rehabilitation interventions focusing on flexible and adaptive responses to gendered demands in the lived environment of persons with traumatic brain injury are timely.
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Affiliation(s)
- Navindra Baldeo
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, Canada
| | - Andrea D'Souza
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada
| | - Halina Lin Haag
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada.,Faculty of Social Work, Wilfrid Laurier University, Waterloo, Canada
| | - Sara Hanafy
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Enrico Quilico
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Patrick Archambault
- Department of Family and Emergency Medicine, Unviersite Laval, Quebec, Canada
| | - Heather Colquhoun
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - John Lewko
- School of Rural and Northern Health, Laurentian University, Sudbury, Canada
| | - Richard Riopelle
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Angela Colantonio
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Tatyana Mollayeva
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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16
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Carneiro de Oliveira PE, Carmona IM, Casarotto M, Silveira LM, Oliveira ACB, Canto-de-Souza A. Mice Cohabiting With Familiar Conspecific in Chronic Stress Condition Exhibit Methamphetamine-Induced Locomotor Sensitization and Augmented Consolation Behavior. Front Behav Neurosci 2022; 16:835717. [PMID: 35517576 PMCID: PMC9062221 DOI: 10.3389/fnbeh.2022.835717] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Recognizing and sharing emotions are essential for species survival, but in some cases, living with a conspecific in distress condition may induce negative emotional states through empathy-like processes. Studies have reported that stressors promote psychiatric disorders in both, those who suffer directly and who witness these aversive episodes, principally whether social proximity is involved. However, the mechanisms underlying the harmful outcomes of emotional contagion need more studies, mainly in the drug addiction-related behaviors. Here, we investigated the relevance of familiarity and the effects of cohabitation with a partner submitted to chronic stress in the anxiety-like, locomotor sensitization, and consolation behaviors. Male Swiss mice were housed in pairs during different periods to test the establishment of familiarity and the stress-induced anxiety behavior in the elevated plus maze. Another cohort was housed with a conspecific subjected to repeated restraint stress (1 h/day) for 14 days. During chronic restraint the allogrooming was measured and after the stress period mice were tested in the open field for evaluation of anxiety and locomotor cross-sensitization induced by methamphetamine. We found that familiarity was established after 14 days of cohabitation and the anxiogenic behavior appeared after 14 days of stress. Repeated restraint stress also increased anxiety in the open field test and induced locomotor cross-sensitization in the stressed mice and their cagemates. Cagemates also exhibited an increase in the consolation behavior after stress sessions when compared to control mice. These results indicate that changes in drug abuse-related, consolation, and affective behaviors may be precipitated through emotional contagion in familiar conspecifics.
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Affiliation(s)
| | - Isabela Miranda Carmona
- Psychobiology Group/Department of Psychology/CECH - Federal University of São Carlos, São Carlos, Brazil.,Joint Graduate Program in Physiological Sciences UFSCar/UNESP, Federal University of São Carlos, São Carlos, Brazil
| | - Mariana Casarotto
- Psychobiology Group/Department of Psychology/CECH - Federal University of São Carlos, São Carlos, Brazil
| | - Lara Maria Silveira
- Psychobiology Group/Department of Psychology/CECH - Federal University of São Carlos, São Carlos, Brazil.,Graduate Program in Psychology, Federal University of São Carlos, São Carlos, Brazil
| | - Anna Cecília Bezerra Oliveira
- Psychobiology Group/Department of Psychology/CECH - Federal University of São Carlos, São Carlos, Brazil.,Joint Graduate Program in Physiological Sciences UFSCar/UNESP, Federal University of São Carlos, São Carlos, Brazil
| | - Azair Canto-de-Souza
- Psychobiology Group/Department of Psychology/CECH - Federal University of São Carlos, São Carlos, Brazil.,Joint Graduate Program in Physiological Sciences UFSCar/UNESP, Federal University of São Carlos, São Carlos, Brazil.,Graduate Program in Psychology, Federal University of São Carlos, São Carlos, Brazil.,Neuroscience and Behavioral Institute, Ribeirão Preto, Brazil
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17
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Mureșanu IA, Grad DA, Mureșanu DF, Dobran SA, Hapca E, Strilciuc Ș, Benedek I, Capriș D, Popescu BO, Perju-Dumbravă L, Cherecheș RM. Evaluation of post-traumatic stress disorder (PTSD) and related comorbidities in clinical studies. J Med Life 2022; 15:436-442. [PMID: 35646173 PMCID: PMC9126456 DOI: 10.25122/jml-2022-0120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/25/2022] [Indexed: 12/14/2022] Open
Abstract
Patients with traumatic brain injury (TBI) of varying severities are experiencing adverse outcomes during and after rehabilitation. Besides depression and anxiety, post-traumatic stress disorder (PTSD) is highly encountered in civilian and military populations. As more prospective and retrospective studies - focused on evaluating new or old psychological therapies in inpatient, outpatient, or controlled environments, targeting patients with PTSD with or without a history of TBI - are carried out, researchers are employing various scales to measure PTSD as well as other psychiatric diagnoses or cognitive impairments that might appear following TBI. We aimed to explore the literature published between January 2010 and October 2021 by querying three databases. Our preliminary results showed that several scales - such as the Clinician-Administered PTSD Scale (CAPS), the Posttraumatic Stress Disorder Checklist Military Version (PCL-M) as well as Specific Version (PCL-S), and Civilian Version (PCL-C) - have been frequently used for PTSD diagnosis and symptom severity. However, heterogeneity in the scales used when assessing and evaluating additional psychiatric comorbidities and cognitive impairments are due to the study aim and therapeutic approaches. Therefore, conducting an intervention focusing on post-TBI PTSD patients requires increased attention to patients' medical history in capturing multiple cognitive impairments and affected neuropsychological processes when designing the study and including validated instruments for measuring primary and secondary neuropsychological outcomes.
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Affiliation(s)
- Ioana Anamaria Mureșanu
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania,Department of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,Corresponding Author: Ioana Anamaria Mureșanu, RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Cluj, Romania. Department of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. E-mail:
| | - Diana Alecsandra Grad
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania,Department of Public Health, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Dafin Fior Mureșanu
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania,Department of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Elian Hapca
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania,Department of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ștefan Strilciuc
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania,Department of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Irina Benedek
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania,Department of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - David Capriș
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Bogdan Ovidiu Popescu
- Department of Neuroscience, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Răzvan Mircea Cherecheș
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania,Department of Public Health, Babes-Bolyai University, Cluj-Napoca, Romania
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18
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Filipčíková M, Wearne T, Li R, McDonald S. The prevalence, predictors, associated symptoms, and outcomes of social disinhibition following moderate-to-severe TBI: A scoping review of quantitative evidence. J Clin Exp Neuropsychol 2021; 43:716-736. [PMID: 34930093 DOI: 10.1080/13803395.2021.2000589] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The present study aimed to map existing quantitative evidence of research related to the nature of social disinhibition following moderate-to-severe traumatic brain injury (TBI), with a specific focus on its prevalence, predictors, associated symptoms and outcomes in studies that met minimal methodological criteria. We conducted a scoping review of the literature following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for Scoping Reviews (PRISMA-ScR). Seventeen peer-reviewed articles including 1440 participants met the inclusion criteria and were included in the qualitative synthesis. Results of the study indicate that social disinhibition is a common and significant consequence of moderate-to-severe TBI with its prevalence estimates ranging from 21% to 32%. Inappropriate sexual behavior appears to be more prevalent in men and younger survivors. Rule-breaking/perseverative errors in fluency tests are significantly associated with social disinhibition. The perceived burden of caregivers of people with TBI is a very common outcome. An interesting finding was an association between higher social disinhibition and higher emotional empathy levels. However, similarly to many potential predictors, this was only found in a single study and therefore requires further investigation. Some common methodological flaws are discussed, such as the use of non-probability sampling, lack of sample size justification or not including a control group. Due to the heterogeneity of measures used to assess social disinhibition in the reviewed articles, conducting a meta-analysis was not possible. In conclusion, social disinhibition is a significant consequence of moderate-to-severe TBI, as it impacts both the TBI survivor and their family/caregivers. The present study extends the scope of the prior overview by offering a clearer picture of social disinhibition after surviving moderate-to-severe TBI, as it focuses on studies with strong methodology and validated measures. It also assesses potential predictors other than executive dysfunction, such as demographics and injury characteristics.
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Affiliation(s)
| | - Travis Wearne
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Ranran Li
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Skye McDonald
- School of Psychology, University of New South Wales, Sydney, Australia
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19
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Souesme G, Voyer M, Gagnon É, Terreau P, Fournier-St-Amand G, Lacroix N, Gravel K, Vaillant MC, Gagné MÈ, Ouellet MC. Barriers and facilitators linked to discharge destination following inpatient rehabilitation after traumatic brain injury in older adults: a qualitative study. Disabil Rehabil 2021; 44:4738-4749. [PMID: 34126821 DOI: 10.1080/09638288.2021.1919212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To identify facilitators and barriers associated with returning home for older adults having received inpatient rehabilitation after traumatic brain injury (TBI). METHODS A qualitative design was used. Five older patients with TBI and four family caregivers were interviewed and six healthcare professionals participated in a focus group. RESULTS Main facilitators to returning home highlighted by all participants were: (1) Patient's adequate health condition and functional status, (2) Access to health and other services at home, (3) Availability of help from a family caregiver. Conversely, if one of these factors was not met, it represented a barrier. Other facilitators identified were (4) Attachment to one's home, (5) Feeling of commitment toward a loved one, (6) Having the possibility of going through a transitional phase, (7) United front between the patient and the family caregiver towards a return home. Additional barriers to returning home included: (8) Incongruent perspectives, and (9) Unclear knowledge about available health and other services at home. CONCLUSION The results of this study could be translated into a practical tool to guide patients, families and professionals in the decision about returning home or exploring an alternative option after inpatient rehabilitation for TBI in older adults.IMPLICATIONS FOR REHABILITATIONWhen orienting an older patient home or to an alternative living environment after a traumatic brain injury (TBI), the perspective of rehabilitation professionals can differ from that of patients and caregivers.Professionals tend to emphasize security, whereas patients and caregivers' focus on the well-being associated with home and on the importance of being with their loved one.Integrating the views, values and wishes of older patients with TBI and their caregivers will support a shared decision-making approach for orientation after rehabilitation.
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Affiliation(s)
- Guillaume Souesme
- Interdisciplinary Centre for Research in Rehabilitation and Social Integration, Québec, Canada.,School of Psychology, Laval University, Québec, Canada
| | - Manon Voyer
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale- Site, Institut de réadaptation en déficience physique de Québec, Canada
| | - Éric Gagnon
- Centre de Recherche sur les Soins et les Services de Première Ligne, Québec, Canada.,Sociology Department, Laval University, Québec, Canada
| | - Paule Terreau
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale- Site, Institut de réadaptation en déficience physique de Québec, Canada
| | - Geneviève Fournier-St-Amand
- Interdisciplinary Centre for Research in Rehabilitation and Social Integration, Québec, Canada.,School of Psychology, Laval University, Québec, Canada
| | - Nadine Lacroix
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale- Site, Institut de réadaptation en déficience physique de Québec, Canada
| | - Kristina Gravel
- Interdisciplinary Centre for Research in Rehabilitation and Social Integration, Québec, Canada.,School of Psychology, Laval University, Québec, Canada
| | - Marie-Claude Vaillant
- Interdisciplinary Centre for Research in Rehabilitation and Social Integration, Québec, Canada.,School of Psychology, Laval University, Québec, Canada
| | - Marie-Ève Gagné
- Interdisciplinary Centre for Research in Rehabilitation and Social Integration, Québec, Canada.,School of Psychology, Laval University, Québec, Canada
| | - Marie-Christine Ouellet
- Interdisciplinary Centre for Research in Rehabilitation and Social Integration, Québec, Canada.,School of Psychology, Laval University, Québec, Canada
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Albrecht JS, Wickwire EM. Healthcare Utilization Following Traumatic Brain Injury in a Large National Sample. J Head Trauma Rehabil 2021; 36:E147-E154. [PMID: 33201034 DOI: 10.1097/htr.0000000000000625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the impact of traumatic brain injury (TBI) on healthcare utilization (HCU) over a 1-year period in a large national sample of individuals diagnosed with TBI across multiple care settings. SETTING Commercial insurance enrollees. PARTICIPANTS Individuals with and without TBI, 2008-2014. DESIGN Retrospective cohort. MAIN MEASURES We compared the change in the 12-month sum of inpatient, outpatient, emergency department (ED), and prescription HCU from pre-TBI to post-TBI to the same change among a non-TBI control group. Most rehabilitation visits were not included. We stratified models by age ≥65 and included the month of TBI in subanalysis. RESULTS There were 207 354 individuals in the TBI cohort and 414 708 individuals in the non-TBI cohort. Excluding the month of TBI diagnosis, TBI resulted in a slight increase in outpatient visits (rate ratio [RtR] = 1.05; 95% confidence interval [CI], 1.04-1.06) but decrease in inpatient HCU (RtR = 0.86; 95% CI, 0.84-0.88). Including the month of TBI in the models resulted in increased inpatient (RtR = 1.55; 95% CI, 1.52-1.58) and ED HCU (RtR = 1.37; 95% CI, 1.34-1.40). CONCLUSION In this population of individuals who maintained insurance coverage following TBI, results suggest that TBI may have a limited impact on nonrehabilitation HCU at the population level.
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Affiliation(s)
- Jennifer S Albrecht
- Departments of Epidemiology and Public Health (Dr Albrecht), Psychiatry (Dr Wickwire), and Medicine (Dr Wickwire), University of Maryland School of Medicine, Baltimore; and OptumLabs, Cambridge, Massachusetts (Dr Albrecht)
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Carlozzi NE, Kallen MA, Brickell TA, Lange RT, Boileau NR, Tulsky D, Hanks RA, Massengale JP, Nakase-Richardson R, Ianni PA, Miner JA, French LM, Sander AM. Measuring emotional suppression in caregivers of adults with traumatic brain injury. Rehabil Psychol 2020; 65:455-470. [PMID: 31580109 PMCID: PMC7117989 DOI: 10.1037/rep0000291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Caregivers of individuals with traumatic brain injury (TBI) often feel pressure to maintain the appearance that they are emotionally well adjusted, despite feelings to the contrary. Because there are currently no measures examining this construct, this article focuses on the development of a new measure that is specific to caregivers of people with TBI. DESIGN A total of 533 caregivers of civilians with TBI (n = 218) or service members/veterans (SMVs) with TBI (n = 315) completed 43 emotional suppression items, as well as other patient-reported outcomes and an estimate of the functional ability of the person with TBI. RESULTS Exploratory and confirmatory factor analyses supported the retention of 25 items. Graded response model (GRM) analyses and differential item functioning (DIF) studies supported the retention of 21 items in the final measure. Expert review and GRM calibration data were used to develop a 6-item static short form (SF) and program a computer adaptive test (CAT). Internal consistency was excellent for both the CAT and SF (reliabilities ≥ 0.91); 3-week test-retest stability was good (all intraclass correlations ≥ 0.89). Convergent validity was supported by moderate associations between TBI-CareQOL Emotional Suppression and related measures (rs from 0.47 to 0.59); discriminant validity was supported by small correlations between Emotional Suppression and positive aspects of caregiving and physical health (rs from 0.14 to 0.28). Known-groups validity was also supported. CONCLUSIONS The new TBI-CareQOL Emotional Suppression CAT and 6-item short form is the first self-report measure of this construct in this population. Our findings suggest this new measure has strong psychometric properties. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Noelle E. Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Michael A. Kallen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Tracey A. Brickell
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
- Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Rael T. Lange
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicholas R. Boileau
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - David Tulsky
- Center for Health Assessment Research and Translation, and Departments of Physical Therapy and Psychological Brain Sciences, University of Delaware, Newark, DE
| | - Robin A. Hanks
- Department of Psychology and Neuropsychology, Rehabilitation Institute of Michigan, Detroit, MI
- Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI
| | | | - Risa Nakase-Richardson
- MHBS, James A. Haley Veterans’ Hospital, Tampa, FL
- Defense and Veterans Brain Injury Center, James A. Haley Veterans’ Hospital, Tampa, FL
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Phillip A. Ianni
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, MI
| | - Jennifer A. Miner
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Louis M. French
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
- Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Angelle M. Sander
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine/Harris Health System, Houston, TX
- Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX
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Mental Health and Family Functioning in Patients and Their Family Members after Traumatic Brain Injury: A Cross-Sectional Study. Brain Sci 2020; 10:brainsci10100670. [PMID: 32992808 PMCID: PMC7600942 DOI: 10.3390/brainsci10100670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 11/17/2022] Open
Abstract
Traumatic brain injury (TBI) affects the family as a whole. This study aimed to describe and compare mental health and family functioning in TBI patients and their family members, and to identify individual and family-related factors that were associated with mental health. It was conducted at an urban, specialized, TBI outpatient clinic and included 61 patients with mild to severe TBI and 63 family members. Baseline demographics and injury-related data were collected, and the participants answered standardized, self-reported questionnaires 6-18 months post-injury that assessed mental health; general health; family functioning, communication, and satisfaction; depression and anxiety; self-efficacy; resilience; and condition-specific quality of life. The patients reported significantly worse mental health, depression, resilience, self-efficacy, and general health compared with the family members. Patients and family members had similar perceptions, showing balanced family functioning, high family communication levels, and moderate family satisfaction. Factors significantly associated with mental health in patients and family members were depression, anxiety, and resilience, explaining 56% of the variance (p < 0.001). Family-related factors were not associated with mental health. The disease burden was mainly on the patients; however, the family members also reported emotional distress. Family-targeted interventions across the TBI continuum should be considered.
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Tay M, Kong KH. Caregiver burden in familial caregivers and foreign domestic workers of patients with traumatic brain injury in a multi-ethnic Asian population. Brain Inj 2020; 34:1513-1517. [PMID: 32835512 DOI: 10.1080/02699052.2020.1809709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the prevalence and risk factors associated with caregiver burden in familial caregivers and foreign domestic workers of patients with severe traumatic brain injury. METHODS A total of 77 caregivers were consecutively recruited, who were either familial caregivers or foreign domestic workers. All caregivers were evaluated with the Zarit Burden Index (ZBI), Patient Health Questionnaire-9 (PHQ-9), and General Anxiety Disorder 7-item (GAD-7) scale. Logistic regression analysis was conducted to determine factors associated with caregiver burden. RESULTS The majority of participants were familial caregivers (N = 60), of which 70% experienced significant caregiver burden. In this group, 10.0% caregivers had clinically significant depression and 16.7% caregivers who had clinically significant anxiety. On multivariate analysis, factors found to be associated with caregiver burden were Glasgow Outcome Scale Extended (GOSE) of <7, presence of neuropsychiatric complications, and presence of anxiety. There was also a high prevalence of caregiver burden in foreign domestic workers (29.4%). CONCLUSION There is a high rate of caregiver burden in both familial caregivers and foreign domestic workers who care for patients with severe traumatic brain injury. Caregivers experiencing stress should also be monitored for the presence of anxiety or depression.
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Affiliation(s)
- Matthew Tay
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital Rehabilitation Center , Singapore
| | - Keng He Kong
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital Rehabilitation Center , Singapore
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Burden and Preparedness amongst Informal Caregivers of Adults with Moderate to Severe Traumatic Brain Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176386. [PMID: 32887272 PMCID: PMC7503757 DOI: 10.3390/ijerph17176386] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 01/23/2023]
Abstract
This study examined the patterns of informal (unpaid) caregiving provided to people after moderate to severe traumatic brain injury (TBI), explore the self-reported burden and preparedness for the caregiving role, and identify factors predictive of caregiver burden and preparedness. A cross-sectional cohort design was used. Informal caregivers completed the Demand and Difficulty subscales of the Caregiving Burden Scale; and the Mutuality, Preparedness, and Global Strain subscales of the Family Care Inventory. Chi-square tests and logistic regression were used to examine the relationships between caregiver and care recipient variables and preparedness for caregiving. Twenty-nine informal caregivers who reported data on themselves and people with a moderate to severe TBI were recruited (referred to as a dyad). Most caregivers were female (n = 21, 72%), lived with the care recipient (n = 20, 69%), and reported high levels of burden on both scales. While most caregivers (n = 21, 72%) felt “pretty well” or “very well” prepared for caregiving, they were least prepared to get help or information from the health system, and to deal with the stress of caregiving. No significant relationships or predictors for caregiver burden or preparedness were identified. While caregivers reported the provision of care as both highly difficult and demanding, further research is required to better understand the reasons for the variability in caregiver experience, and ultimately how to best prepare caregivers for this long-term role.
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Factors Influencing Burden in Spouse-Caregivers of Patients with Chronic-Acquired Brain Injury. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6240298. [PMID: 32685509 PMCID: PMC7350075 DOI: 10.1155/2020/6240298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/27/2020] [Accepted: 06/08/2020] [Indexed: 11/17/2022]
Abstract
In this cross-sectional study, we assess associated factors of burden in spouse-caregivers of patients with acquired brain injury (ABI) in the chronic phase. 35 spouse-caregivers (71% female, mean age ± SD: 55.7 ± 11.1y) of patients with mild/moderate ABI (29% female, mean age ± SD: 57.5 ± 10.7y), admitted to the intensive rehabilitation unit of the Institute S. Anna (Crotone, Italy) between January 2013 and December 2017, were contacted 2 years postinjury and asked to complete a series of questionnaires. The outcome measure was the Caregiver Burden Inventory (CBI) test, while several demographical and clinical data were considered as predictive factors. Two years after injury, a high level of burden was reported in 34.2% of spouse-caregivers. Stepwise multiple linear regression analyses revealed that caring for a patient with more severe disability (as measured by the Barthel Index scale) and the family life cycle (from the initial phase of engagement to marriage with adult children) explain the vast majority of variance for higher caregiver burden. The functional clinical status and the stages through which a family may pass over time were identified as areas in which the spouse-caregiver of ABI patients experienced high levels of burden in the chronic phase.
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Rotteveel AH, Lambooij MS, Zuithoff NPA, van Exel J, Moons KGM, de Wit GA. Valuing Healthcare Goods and Services: A Systematic Review and Meta-Analysis on the WTA-WTP Disparity. PHARMACOECONOMICS 2020; 38:443-458. [PMID: 32096146 DOI: 10.1007/s40273-020-00890-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVE The objective of this systematic review was to review the available evidence on the disparity between willingness to accept (WTA) and willingness to pay (WTP) for healthcare goods and services. METHODS A tiered approach consisting of (1) a systematic review, (2) an aggregate data meta-analysis, and (3) an individual participant data meta-analysis was used. MEDLINE, EMBASE, Scopus, Scisearch, and Econlit were searched for articles reporting both WTA and WTP for healthcare goods and services. Individual participant data were requested from the authors of the included studies. RESULTS Thirteen papers, reporting WTA and WTP from 19 experiments/subgroups, were included in the review. The WTA/WTP ratios reported in these papers, varied from 0.60 to 4.01, with means of 1.73 (median 1.31) for 15 estimates of the mean and 1.58 (median 1.00) for nine estimates of the median. Individual data obtained from six papers, covering 71.2% of the subjects included in the review, yielded an unadjusted WTA/WTP ratio of 1.86 (95% confidence interval 1.52-2.28) and a WTA/WTP ratio adjusted for age, sex, and income of 1.70 (95% confidence interval 1.42-2.02). Income category and age had a statistically significant effect on the WTA/WTP ratio. The approach to handling zero WTA and WTP values has a considerable impact on the WTA/WTP ratio found. CONCLUSIONS AND IMPLICATIONS The results of this study imply that losses in healthcare goods and services are valued differently from gains (ratio > 1), but that the degree of disparity found depends on the method used to obtain the WTA/WTP ratio, including the approach to zero responses. Irrespective of the method used, the ratios found in our meta-analysis are smaller than the ratios found in previous meta-analyses.
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Affiliation(s)
- Adriënne H Rotteveel
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA, Bilthoven, The Netherlands.
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Mattijs S Lambooij
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Nicolaas P A Zuithoff
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Job van Exel
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Karel G M Moons
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Cochrane Netherlands, University Medical Center Utrecht, Utrecht, The Netherlands
| | - G Ardine de Wit
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA, Bilthoven, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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Webber K, Davies AN, Leach C, Bradley A. Alcohol and drug use disorders in patients with cancer and caregivers: effects on caregiver burden. BMJ Support Palliat Care 2020; 10:242-247. [DOI: 10.1136/bmjspcare-2019-002127] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/27/2019] [Accepted: 01/06/2020] [Indexed: 01/13/2023]
Abstract
BackgroundThe estimated prevalence of alcohol use disorders in patients with advanced cancer is reported as 4%–38%. There are limited data regarding alcohol and drug use disorders in caregivers of patients with cancer and the effects on other issues.AimTo establish the prevalence of alcohol and drug use disorders in a large cohort of patients with advanced cancer and their caregivers.To evaluate the relationship between alcohol and drug use disorders and patient symptoms and caregiver burden.DesignThe patient with cancer and caregiver completed the Alcohol Use Disorders Identification Tool, CAGE questionnaire and Drug Abuse Screening Test. The patient completed the Memorial Symptom Assessment Scale–Short Form, and the caregiver completed the Zarit Burden Questionnaire.Statistical analysis compared cases and non-cases of alcohol and drug use disorders with symptom and burden score.Setting/participantsPatients with cancer, and their caregivers, were recruited from 11 UK sites, 6 hospices and 5 hospitals.ResultsFive hundred and seven patients and their caregivers were recruited. Twenty-seven patients (5%) and 44 caregivers (9%) screened positively for alcohol use disorders on the Alcohol Use Disorders Identification Tool. Thirty patients (6%), and 16 caregivers (3%), screened positively for drug abuse problems on the Drug Abuse Screening Test.There was a significantly higher carer burden score in caregivers screening positively for alcohol and drug abuse problems.ConclusionsThe prevalence of alcohol use disorders in patients with cancer and caregivers was lower than reported in previous studies. Caregiver burden scores were significantly higher in carers screening positively for alcohol and drug use disorders.Trial registration numberTrial registered National Institute for Health Research Clinical Research Network Portfolio (CPMS ID 30723) IRAS ID 198753.
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de Goumoëns V, Rio LM, Jaques C, Ramelet AS. Family-oriented interventions for adults with acquired brain injury and their families: a scoping review. ACTA ACUST UNITED AC 2019; 16:2330-2367. [PMID: 30531483 DOI: 10.11124/jbisrir-2017-003846] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE This scoping review sought to describe the literature on the different types of interventions to support families of patients with acquired brain injuries (ABIs) and their outcomes. INTRODUCTION Acquired brain injuries are among the leading causes of disability in adults worldwide and have physical, cognitive or/and behavioral consequences not only for the patient, but also for the family. Several support interventions have been proposed in different contexts at different phases of recovery with various levels of evidence, yet no synthesis is available to date. INCLUSION CRITERIA We included studies that focused on family members of patients suffering from ABI. The concept under review included any type of intervention or action oriented to support families of patients with ABI, in any care setting. We included all published qualitative and quantitative designs, including those in the gray literature. METHODS A three-step search strategy was performed. Searches were conducted in eight major databases, MEDLINE, PubMed, Embase, CINAHL, PsycINFO, Cochrane, JBI Database of Systematic Reviews and Implementation Reports, Web of Science in April 2017, and seven databases for unpublished studies in November 2017. This review was limited to studies published in English and French since January 2007. Additional studies were searched amongst reference lists of all included articles. RESULTS We included 89 studies, 19 secondary studies (systematic reviews n = 13, other type of reviews n = 6) and 70 primary studies (experimental studies n = 20, quasi-experimental studies n = 33, other designs n = 17). Even if heterogeneity was found in the characteristics of the 64 selected interventions, emotional support and education were highlighted as the main core components for family-oriented interventions. Mental health and burden were the two most prevalent outcomes found in this scoping review. Interventions targeted families and patients together in 56% of the cases or families alone. CONCLUSION This scoping review provides an actual state of the current evidence available for families of patients with ABI. Extended and heterogeneous literature was found, showing the growing interest for considering ABI as a family issue in recent years. However, the overall level of evidence found indicates that more research is still needed to determine key components to intervene within this specific population.
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Affiliation(s)
- Véronique de Goumoëns
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.,Department of Nursing, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.,Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): a Joanna Briggs Institute Centre of Excellence
| | - Laura Marques Rio
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.,Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): a Joanna Briggs Institute Centre of Excellence
| | - Cécile Jaques
- Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): a Joanna Briggs Institute Centre of Excellence.,Medical Library, Research and Education Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Anne-Sylvie Ramelet
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.,Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): a Joanna Briggs Institute Centre of Excellence
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Anke A, Røe C, Sigurdardottir S, Norup A, Soberg HL, Arango-Lasprilla JC, Manskow US. Family needs at one and two years after severe traumatic brain injury: a prospective study of changes and predictors. Brain Inj 2019; 34:89-97. [DOI: 10.1080/02699052.2019.1682191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromso, Norway
- Faculty of Health Sciences, Department of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Cecilie Røe
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | | | - Anne Norup
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Helene L. Soberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Juan Carlos Arango-Lasprilla
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- IKERBASQUE, Basque Foundation For Science, Bilbao, Spain
- Department of Cell Biology and Histology, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Unn Sollid Manskow
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
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Driver S, Juengst S, Reynolds M, McShan E, Kew CL, Vega M, Bell K, Dubiel R. Healthy lifestyle after traumatic brain injury: a brief narrative. Brain Inj 2019; 33:1299-1307. [DOI: 10.1080/02699052.2019.1641623] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Simon Driver
- North Texas TBI Model System, Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA
| | - Shannon Juengst
- North Texas TBI Model System, University of Texas at Southwestern, Dallas, TX, USA
| | - Megan Reynolds
- North Texas TBI Model System, Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA
| | - Evan McShan
- North Texas TBI Model System, Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA
| | - Chung Lin Kew
- North Texas TBI Model System, University of Texas at Southwestern, Dallas, TX, USA
| | - Marlene Vega
- North Texas TBI Model System, University of Texas at Southwestern, Dallas, TX, USA
| | - Kathleen Bell
- North Texas TBI Model System, University of Texas at Southwestern, Dallas, TX, USA
| | - Randi Dubiel
- North Texas TBI Model System, Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA
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Care partner problem solving training (CP-PST) for care partners of adults with traumatic brain injury during inpatient rehabilitation: Study protocol for a multisite, randomized, single-blind clinical feasibility trial. Contemp Clin Trials 2019; 80:9-15. [DOI: 10.1016/j.cct.2019.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 03/02/2019] [Accepted: 03/14/2019] [Indexed: 11/19/2022]
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Rasmussen MS, Andelic N, Nordenmark TH, Arango-Lasprilla JC, Soberg HL. The family as a resource for improving patient and family functioning after traumatic brain injury: A descriptive nonrandomized feasibility study of a family-centered intervention. COGENT MEDICINE 2019. [DOI: 10.1080/2331205x.2019.1607433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Mari S. Rasmussen
- Oslo University Hospital, Ulleval, Oslo, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nada Andelic
- Oslo University Hospital, Ulleval, Oslo, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Juan C. Arango-Lasprilla
- BioCruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain
- IKERBASQUE. Basque Foundation for Science, Bilbao, Spain
| | - Helene L. Soberg
- Oslo University Hospital, Ulleval, Oslo, Norway
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
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Bayen E, Ruet A, Jourdan C, Ghout I, Meaude L, Pradat-Diehl P, Nelson G, Vallat-Azouvi C, Charanton J, Aegerter P, Azouvi P. Lawsuit and Traumatic Brain Injury: The Relationship Between Long-Lasting Sequelae and Financial Compensation in Litigants. Results From the PariS-TBI Study. Front Neurol 2019; 10:320. [PMID: 31031685 PMCID: PMC6473085 DOI: 10.3389/fneur.2019.00320] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 03/14/2019] [Indexed: 11/26/2022] Open
Abstract
Purpose: People with traumatic brain injury are frequently involved in a litigation because another person was at fault for causing the accident. A compensation amount will often be settled to compensate the victim for the past, present, future damages and losses suffered. We report descriptive data about the full and final personal compensation amount and investigated its association with patient's outcomes. Methods: We used a longitudinal prospective study of severe TBI patients injured in 2005–2007 (PariS-TBI). Questions regarding involvement in a litigation were asked concurrently with 4 and 8-year outcomes. Results: Among 160 participants assessed 4 and/or 8 years post-injury, a total of 67 persons declared being involved in a litigation, among which 38 people reported a compensation amount of a mean €292,653 (standard deviation = 436,334; interquartile 25–50–75 = 37,000–100,000–500,000; minimum = 1,500-maximum = 2,000,000). A higher compensation amount was associated with more severe disability and cognitive impairment in patients, and with more informal care time provided by caregivers. However, no significant association related to patient's gender, age, years of education, motor/balance impairment, return to work status, mood and related to caregiver's subjective burden was found. Conclusion: Financial compensation was related to victims' long-term severity of impairment, although some extreme cases with severe disability were granted very poor compensation.
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Affiliation(s)
- Eléonore Bayen
- Physical Medicine and Rehabilitation Department, Assistance Publique des Hôpitaux de Paris, Pitie-Salpetriere Hospital, Paris, France.,Physical and Rehabilitation Department, Sorbonne Université GRC18, Paris, France.,Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
| | - Alexis Ruet
- Physical Medicine and Rehabilitation Department, Caen Faculty Hospital, INSERM U1077, France
| | - Claire Jourdan
- Physical Medicine and Rehabilitation Department, Lapeyronie Faculty Hospital, Montpellier, France
| | - Idir Ghout
- Department of Biostatistics, Assistance Publique des Hôpitaux de Paris, Ambroise Paré Hospital, Boulogne, France
| | - Layide Meaude
- Unité de Recherche Clinique Paris Ile-de-France Ouest, Ambroise Paré Hospital (APHP), Paris, France
| | - Pascale Pradat-Diehl
- Physical Medicine and Rehabilitation Department, Assistance Publique des Hôpitaux de Paris, Pitie-Salpetriere Hospital, Paris, France.,Physical and Rehabilitation Department, Sorbonne Université GRC18, Paris, France.,Laboratoire d'Imagerie Biomedicale INSERM U1146, Paris, France
| | - Gaëlle Nelson
- Regional Reference Center for Brain Injury in the Parisian Area, Paris, France
| | - Claire Vallat-Azouvi
- Laboratoire de Recherches Cliniques et en Santé publique sur les Handicaps Psychiques, Cognitifs et Moteurs (HANDIReSP, EA4047), Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France.,Physical Medicine and Rehabilitation Department, Assistance Publique des Hôpitaux de Paris, Raymond-Poincaré Faculty Hospital, Garches, France
| | - James Charanton
- Regional Reference Center for Brain Injury in the Parisian Area, Paris, France
| | - Philippe Aegerter
- Department of Biostatistics, Assistance Publique des Hôpitaux de Paris, Ambroise Paré Hospital, Boulogne, France
| | - Philippe Azouvi
- Laboratoire de Recherches Cliniques et en Santé publique sur les Handicaps Psychiques, Cognitifs et Moteurs (HANDIReSP, EA4047), Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France.,Physical Medicine and Rehabilitation Department, Assistance Publique des Hôpitaux de Paris, Raymond-Poincaré Faculty Hospital, Garches, France
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Carlozzi NE, Kallen MA, Hanks R, Kratz AL, Hahn EA, Brickell TA, Lange RT, French LM, Ianni PA, Miner JA, Sander AM. The Development of a New Computer Adaptive Test to Evaluate Feelings of Being Trapped in Caregivers of Individuals With Traumatic Brain Injury: TBI-CareQOL Feeling Trapped Item Bank. Arch Phys Med Rehabil 2019; 100:S43-S51. [PMID: 30075146 PMCID: PMC6422745 DOI: 10.1016/j.apmr.2018.06.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/25/2018] [Accepted: 06/23/2018] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To develop a new patient-reported outcome measure that captures feelings of being trapped that are commonly experienced by caregivers of individuals with traumatic brain injury (TBI). DESIGN Cross-sectional. SETTING Three TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility. PARTICIPANTS Caregivers (N=560) of civilians with TBI (n=344) and caregivers of service members/veterans with TBI (n=216). INTERVENTIONS Not applicable. OUTCOME MEASURES Traumatic Brain Injury Caregiver Quality of Life (TBI-CareQOL) Feeling Trapped item bank. RESULTS From an initial item pool of 28 items, exploratory and confirmatory factor analyses supported the retention of 16 items. After graded response model (GRM) and differential item functioning analyses were conducted, 15 items were retained in the final measure. GRM calibration data, along with clinical expert input, were used to choose a 6-item, static short form (SF), and the calibration data were used for programming of the TBI-CareQOL Feeling Trapped computer adaptive test (CAT). CAT simulation analyses produced an r=0.99 correlation between CAT scores and the full item bank. Three-week short-form test-retest reliability was very good (r=0.84). CONCLUSIONS The new TBI-CareQOL Feeling Trapped item bank was developed to provide a sensitive and efficient examination of the effect that feelings of being trapped, due to the caregiver role, have on health-related quality of life for caregivers of individuals with TBI. Both the CAT and corresponding 6-item SF demonstrate excellent psychometric properties. Future work is needed to establish the responsiveness of this measure to clinical interventions for these caregivers.
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Affiliation(s)
- Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
| | - Michael A Kallen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Robin Hanks
- Rehabilitation Institute of Michigan, Department of Psychology and Neuropsychology, Detroit, MI; Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI
| | - Anna L Kratz
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Elizabeth A Hahn
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Tracey A Brickell
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Rael T Lange
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; University of British Columbia, Vancouver, British Columbia, Canada
| | - Louis M French
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Phillip A Ianni
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Jennifer A Miner
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Angelle M Sander
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine and Harris Health System, Houston, TX; Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX
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Carlozzi NE, Hanks R, Lange RT, Brickell TA, Ianni PA, Miner JA, French LM, Kallen MA, Sander AM. Understanding Health-related Quality of Life in Caregivers of Civilians and Service Members/Veterans With Traumatic Brain Injury: Establishing the Reliability and Validity of PROMIS Mental Health Measures. Arch Phys Med Rehabil 2019; 100:S94-S101. [PMID: 29932885 PMCID: PMC6301134 DOI: 10.1016/j.apmr.2018.05.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/07/2018] [Accepted: 05/24/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To provide important reliability and validity data to support the use of the Patient-Reported Outcomes Measurement Information System (PROMIS) mental health measures in caregivers of civilians or service members/veterans (SMVs) with traumatic brain injury (TBI). DESIGN Patient-reported outcome surveys administered through an electronic data collection platform. SETTING Three TBI model systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility. PARTICIPANTS Caregivers (N=560) of individuals with a documented TBI (344 civilians and 216 military). INTERVENTION Not applicable. MAIN OUTCOME MEASURES PROMIS anxiety, depression, and anger item banks. RESULTS Internal consistency for all the PROMIS Mental Health item banks was very good (all α>.86) and 3-week test-retest reliability was good to adequate (ranged from .65 to .85). Convergent validity and discriminant validity of the PROMIS measures were also supported. Caregivers of individuals who were low functioning had worse emotional health-related quality of life (HRQOL) (as measured by the 3 PROMIS measures) than caregivers of high-functioning individuals, supporting known groups validity. Finally, levels of distress, as measured by the PROMIS measures, were elevated for those caring for low-functioning individuals in both samples (rates ranged from 26.2% to 43.6% for caregivers of low-functioning individuals). CONCLUSIONS Results support the reliability and validity of the PROMIS anxiety, depression, and anger item banks in caregivers of civilians and SMVs with TBI. Ultimately, these measures can be used to provide a standardized assessment of HRQOL because it relates to mental health in these caregivers.
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Affiliation(s)
- Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
| | - Robin Hanks
- Department of Psychology and Neuropsychology, Rehabilitation Institute of Michigan, Detroit, MI; Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI
| | - Rael T Lange
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; University of British Columbia, Vancouver, British Columbia, Canada
| | - Tracey A Brickell
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Phillip A Ianni
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Jennifer A Miner
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Louis M French
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Michael A Kallen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Angelle M Sander
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine & Harris Health System, Houston, TX; Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX
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Ruet A, Bayen E, Jourdan C, Ghout I, Meaude L, Lalanne A, Pradat-Diehl P, Nelson G, Charanton J, Aegerter P, Vallat-Azouvi C, Azouvi P. A Detailed Overview of Long-Term Outcomes in Severe Traumatic Brain Injury Eight Years Post-injury. Front Neurol 2019; 10:120. [PMID: 30846966 PMCID: PMC6393327 DOI: 10.3389/fneur.2019.00120] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 01/29/2019] [Indexed: 11/29/2022] Open
Abstract
Background and aims: Severe traumatic brain injury is a leading cause of acquired persistent disabilities, and represents an important health and economic burden. However, the determinants of long-term outcome have rarely been systematically studied in a prospective longitudinal study of a homogeneous group of patients suffering exclusively from severe TBI Methods: Prospective observational study of an inception cohort of adult patients with severe traumatic brain injury in the Parisian area (PariS-TBI). Outcome was assessed with face-to-face interview 8 years after Traumatic Brain Injury, focusing on impairments, activity limitations, and participation restriction. Results: Five hundred and four patients were included between 2005 and 2007. At 8-year follow-up, 261 patients were deceased, 128 were lost to follow-up, 22 refused to participate, and 86 were finally evaluated. Age, gender, initial injury severity did not significantly differ between evaluated patients and lost to follow-up, but the latter were more frequently students or unemployed. Mean age was 41.9 (SD 13.6), 79% were male, median initial Glasgow Coma Scale Score was 6. The most frequent somatic complaints concerned balance (47.5%), motricity (31%), and headaches (36%), but these were less frequent than cognitive complaints (Memory 71%, Slowness 68%, Concentration 67%). According to the Hospital Anxiety and Depression Scale (HADS), 25 % had a score >8 for anxiety and 23.7% for depression. According to the Extended Glasgow Outcome Scale, 19.8% remained severely disabled, 46.5% moderately disabled, 33.7% had a good recovery. Older age, longer education duration, lower functional status upon intensive care discharge, and more severe 8-year dysexecutive problems were significantly associated with a lower Extended Glasgow Outcome Scale score in multivariable analysis. At 8 years, 48.7% of patients were employed in a productive job. Of those, 38% declared a salary loss since traumatic brain injury. Unemployment was significantly associated with lower 1-year GOSE score and more severe 8-year dysexecutive problems. Conclusions: These results from an inception cohort study highlight the fact that long-term outcome after severe TBI is determined by a complex combination of injury-related, demographic and neuropsychological factors. Long after the injury, persisting impairments still interfere with social integration, and participation.
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Affiliation(s)
- Alexis Ruet
- Physical Medicine and Rehabilitation Department, CHRU, Caen, France.,Laboratoire de Recherches Cliniques et en Santé publique sur les Handicaps Psychiques, Cognitifs et Moteurs (HANDIReSP, EA4047), Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France.,EPHE, INSERM, U1077, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - Eléonore Bayen
- Physical Medicine and Rehabilitation Department, Pitie-Salpetriere Hospital, APHP, Paris, France.,Sorbonne Université GRC18, Paris, France
| | - Claire Jourdan
- Physical Medicine and Rehabilitation Department, Lapeyronie Hospital, CHRU, Montpellier, France
| | - Idir Ghout
- Unité de Recherche Clinique Paris Ile-de-France Ouest, Ambroise Paré Hospital, APHP, Boulogne, France
| | - Layidé Meaude
- Unité de Recherche Clinique Paris Ile-de-France Ouest, Ambroise Paré Hospital, APHP, Boulogne, France
| | - Astrid Lalanne
- Physical Medicine and Rehabilitation Department, APHP, Raymond-Poincaré Hospital, Garches, France
| | - Pascale Pradat-Diehl
- Physical Medicine and Rehabilitation Department, Pitie-Salpetriere Hospital, APHP, Paris, France.,Laboratoire d'Imagerie Biomedicale Inserm U1146, Sorbonne Université GRC18, Paris, France
| | - Gaëlle Nelson
- Regional Reference Center for Bain Injury in the Parisan Area, CRFTC, Paris, France
| | - James Charanton
- Regional Reference Center for Bain Injury in the Parisan Area, CRFTC, Paris, France
| | - Philippe Aegerter
- Unité de Recherche Clinique Paris Ile-de-France Ouest, Ambroise Paré Hospital, APHP, Boulogne, France
| | - Claire Vallat-Azouvi
- Laboratoire de Recherches Cliniques et en Santé publique sur les Handicaps Psychiques, Cognitifs et Moteurs (HANDIReSP, EA4047), Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France.,Antenne UEROS-SAMSAH92-UGECAM IDF, Hôpital Raymond Poincaré, Garches, France.,Laboratoire de Psychopathologie et Neuropsychologie, EA 2027, Université Paris 8, Saint-Denis, France
| | - Philippe Azouvi
- Laboratoire de Recherches Cliniques et en Santé publique sur les Handicaps Psychiques, Cognitifs et Moteurs (HANDIReSP, EA4047), Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France.,Physical Medicine and Rehabilitation Department, APHP, Raymond-Poincaré Hospital, Garches, France
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Labbé D, Rushton PW, Mortenson WB, Demers L, Miller WC. Longitudinal Outcomes Among Family Caregivers of Power Mobility Users. Arch Phys Med Rehabil 2018; 100:656-662. [PMID: 30914119 DOI: 10.1016/j.apmr.2018.08.194] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/30/2018] [Accepted: 08/08/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To examine the change over 1 year in the burden, wheelchair skills, social support, social participation, and mental health of family caregivers providing assistance to older adult powered wheelchair users. DESIGN Longitudinal study. SETTING Community. PARTICIPANTS Participants (N=35) included family caregivers (mean age ± SD=63.7±10.2y) who provided at least 2 hours of general care per week for a powered wheelchair user. INTERVENTION Not applicable. MAIN OUTCOME MEASURES The Power Mobility Caregiver Assistive Technology Outcome Measure (frequency of care and subjective burden), the Wheelchair Skills Test Questionnaire for caregivers (wheelchair skills), the Interpersonal Support Evaluation List-6 (social support), the Late-Life Function and Disability Instrument (social participation), the Hospital Anxiety and Depression Scale (mental health). Measures were taken at baseline, 1, 3, 6, and 12 months. Descriptive statistics were calculated, and a linear mixed model was used to assess changes over time in the outcomes. RESULTS The results showed that the caregivers helped on average with 3 powered wheelchair-related activities and 10 other caregiving activities. They also experienced moderate subjective burden and social participation and were within the normal range for depression and anxiety. Moreover, those outcomes remained stable over the 1-year study period. However, the wheelchair skills scores showed significant changes over time, as the scores improved during the first 6 months of the study. CONCLUSION Given that previous research indicated that subjective burden tends to decline over time among caregivers, the findings of stability in this study may reflect increasing needs among this population of caregivers, who may benefit from additional support and interventions. This would need further consideration.
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Affiliation(s)
- Delphine Labbé
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Rehabilitation Research Program, GF Strong Rehabilitation Center, Vancouver, British Columbia, Canada.
| | - Paula W Rushton
- School of Rehabilitation, University of Montréal, Montréal, Québec, Canada; CHU St-Justine Research Center, Montréal, Québec, Canada
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Rehabilitation Research Program, GF Strong Rehabilitation Center, Vancouver, British Columbia, Canada
| | - Louise Demers
- School of Rehabilitation, University of Montréal, Montréal, Québec, Canada; Centre de recherche de l'institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada
| | - William C Miller
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Rehabilitation Research Program, GF Strong Rehabilitation Center, Vancouver, British Columbia, Canada
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Sander AM, Hanks RA, Ianni PA, Boileau NR, Kratz AL, Hahn EA, Tulsky DS, Carlozzi NE. Sociocultural Factors Influencing Caregiver Appraisals Following Traumatic Brain Injury. Arch Phys Med Rehabil 2018; 100:S58-S64. [PMID: 30365926 DOI: 10.1016/j.apmr.2018.08.193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 08/03/2018] [Accepted: 08/30/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To investigate the association of the sociocultural variables race/ethnicity, education, and poverty level to caregivers' positive and negative appraisals following traumatic brain injury. DESIGN Survey. SETTING Community. PARTICIPANTS Caregivers (N=344; 216 white; 69 black; 39 Hispanic) of persons with complicated mild to severe TBI at least 1-year postinjury. INTERVENTION Not applicable. MAIN OUTCOME MEASURES Modified Caregiver Appraisal Scale (M-CAS); Zarit Burden Interview (ZBI). RESULTS Black caregivers reported lower levels of perceived burden on both the M-CAS and the ZBI. Black and Hispanic caregivers reported more traditional caregiver ideology (caregiving as a responsibility) than did whites. Greater poverty was associated with higher burden on the M-CAS, lower caregiver satisfaction, and less mastery. Higher education was associated with higher burden on the ZBI and with lower caregiver mastery. CONCLUSIONS Treatment professionals should be culturally sensitive to the different perspectives that caregivers may have based on sociocultural factors. Sociocultural factors should be considered in research investigating caregiver outcomes, including appraisals.
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Affiliation(s)
- Angelle M Sander
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine & Harris Health System, Houston, TX; Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX.
| | - Robin A Hanks
- Rehabilitation Institute of Michigan, Department of Psychology and Neuropsychology, Detroit, MI; Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI
| | - Phillip A Ianni
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Nicholas R Boileau
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Anna L Kratz
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Elizabeth A Hahn
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - David S Tulsky
- Center for Health Assessment Research and Translation, and the Departments of Physical Therapy and Psychological and Brain Sciences, University of Delaware, Newark, DE
| | - Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
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Vallat-Azouvi C, Azouvi P, Le-Bornec G, Brunet-Gouet E. Treatment of social cognition impairments in patients with traumatic brain injury: a critical review. Brain Inj 2018; 33:87-93. [PMID: 30346856 DOI: 10.1080/02699052.2018.1531309] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective: The aim of this study is to review published research on treatment of social cognition impairments in patients with traumatic brain injury (TBI).Methods: Following the PRISMA guidelines, a PubMed literature search was conducted, followed by a manual search in recently published papers. Main criteria for selection were that patients had sustained a TBI, and that social cognition was the main target of treatment. A total of 16 papers and three reviews were selected and included in the present review.Results: Five studies (including three randomized controlled trials (RCT)) addressed facial affect recognition, one study specifically addressed emotional prosody, two RCTs used a combination of treatment strategies addressing social perception deficits. Six studies, including two RCTs, addressed social communication skills or theory of mind. Finally, two RCTs reported the effectiveness of a more global approach, addressing multiple domains of social cognition, such as emotion perception, social skills training, and theory of mind.Discussion/conclusion: Although there has been much less research on treatment of social cognition in patients with TBI as compared with psychiatric conditions, the findings reported in the present review are encouraging. Further multicenter large-scale RCTs are needed, with special emphasis on the generalization of treatment effects to social skills in everyday life.
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Affiliation(s)
- Claire Vallat-Azouvi
- Laboratoire de Psychopathologie et Neuropsychologie, EA 2027, Université Paris 8, Saint-Denis.,Antenne UEROS- UGECAMIDF, Hôpital Raymond Poincaré, Garches, France
| | - Philippe Azouvi
- Service de Médecine Physique et de Réadaptation, APHP, Hôpital Raymond Poincaré, Garches, France.,HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
| | - Gaelle Le-Bornec
- Service de Médecine Physique et de Réadaptation, APHP, Hôpital Raymond Poincaré, Garches, France.,HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
| | - Eric Brunet-Gouet
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France.,Service de Psychiatrie, Centre Hospitalier de Versailles, Le Chesnay, France
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McIntyre M, Ehrlich C, Kendall E. Informal care management after traumatic brain injury: perspectives on informal carer workload and capacity. Disabil Rehabil 2018; 42:754-762. [DOI: 10.1080/09638288.2018.1508511] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Michelle McIntyre
- Synapse Australia Ltd. Brisbane, Australia
- The Hopkins Centre, Menzies Health Institiute Queensland, Griffith University, Brisbane, Australia
| | - Carolyn Ehrlich
- The Hopkins Centre, Menzies Health Institiute Queensland, Griffith University, Brisbane, Australia
| | - Elizabeth Kendall
- The Hopkins Centre, Menzies Health Institiute Queensland, Griffith University, Brisbane, Australia
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Carlozzi NE, Kallen MA, Sander AM, Brickell TA, Lange RT, French LM, Ianni PA, Miner JA, Hanks R. The Development of a New Computer Adaptive Test to Evaluate Anxiety in Caregivers of Individuals With Traumatic Brain Injury: TBI-CareQOL Caregiver-Specific Anxiety. Arch Phys Med Rehabil 2018; 100:S22-S30. [PMID: 29958902 DOI: 10.1016/j.apmr.2018.05.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/07/2018] [Accepted: 05/29/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To design a new measure of caregiver-specific anxiety for use in caregivers of individuals with traumatic brain injury (TBI), the Traumatic Brain Injury Caregiver Quality of Life (TBI-CareQOL) Caregiver-Specific Anxiety item bank. DESIGN Cross-sectional survey study. SETTING Three TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility. PARTICIPANTS Three hundred forty-four caregivers of civilians with TBI and 216 caregivers of service members/veterans with TBI (N=560). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES TBI-CareQOL Caregiver-Specific Anxiety item bank. RESULTS The retention of 40 Caregiver-Specific Anxiety items was supported by exploratory and confirmatory factor analyses. Graded response model (GRM) and differential item functioning analyses supported the retention of 33 items in the final measure. Expert review and GRM calibration data was used to select a 6-item static short form, and GRM calibration data was used to program the TBI-CareQOL Caregiver-Specific Anxiety computer adaptive test (CAT). CONCLUSIONS Established, rigorous measurement development standards were used to develop the new TBI-CareQOL Caregiver-Specific Anxiety CAT and corresponding 6-item short form. This measure is the first patient-reported outcome measure designed to assess caregiver-specific anxiety in caregivers of individuals with TBI. The measure exhibits strong psychometric properties.
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Affiliation(s)
- Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
| | - Michael A Kallen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Angelle M Sander
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine and Harris Health System, Houston, TX; Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX
| | - Tracey A Brickell
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Rael T Lange
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; University of British Columbia, Vancouver, British Columbia, Canada
| | - Louis M French
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Phillip A Ianni
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Jennifer A Miner
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Robin Hanks
- Rehabilitation Institute of Michigan, Department of Psychology and Neuropsychology, Detroit, MI; Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI
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Carlozzi NE, Ianni PA, Tulsky DS, Brickell TA, Lange RT, French LM, Cella D, Kallen MA, Miner JA, Kratz AL. Understanding Health-Related Quality of Life in Caregivers of Civilians and Service Members/Veterans With Traumatic Brain Injury: Establishing the Reliability and Validity of PROMIS Fatigue and Sleep Disturbance Item Banks. Arch Phys Med Rehabil 2018; 100:S102-S109. [PMID: 29932884 DOI: 10.1016/j.apmr.2018.05.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 04/20/2018] [Accepted: 05/25/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To examine the reliability and validity of Patient-Reported Outcomes Measurement Information System (PROMIS) measures of sleep disturbance and fatigue in traumatic brain injury (TBI) caregivers and to determine the severity of fatigue and sleep disturbance in these caregivers. DESIGN Cross-sectional survey data collected through an online data capture platform. SETTING A total of 4 rehabilitation hospitals and Walter Reed National Military Medical Center. PARTICIPANTS Caregivers (N=560) of civilians (n=344) and service member/veterans (SMVs) (n=216) with TBI. INTERVENTION Not applicable. MAIN OUTCOME MEASURES PROMIS sleep and fatigue measures administered as both computerized adaptive tests (CATs) and 4-item short forms (SFs). RESULTS For both samples, floor and ceiling effects for the PROMIS measures were low (<11%), internal consistency was very good (all α≥0.80), and test-retest reliability was acceptable (all r≥0.70 except for the fatigue CAT in the SMV sample r=0.63). Convergent validity was supported by moderate correlations between the PROMIS and related measures. Discriminant validity was supported by low correlations between PROMIS measures and measures of dissimilar constructs. PROMIS scores indicated significantly worse sleep and fatigue for those caring for someone with high levels versus low levels of impairment. CONCLUSIONS Findings support the reliability and validity of the PROMIS CAT and SF measures of sleep disturbance and fatigue in caregivers of civilians and SMVs with TBI.
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Affiliation(s)
- Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
| | - Phillip A Ianni
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - David S Tulsky
- Center for Assessment Research and Translation, Department of Psychological and Brain Sciences, University of Delaware, Newark, DE
| | - Tracey A Brickell
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Rael T Lange
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; University of British Columbia, Vancouver, British Columbia, Canada
| | - Louis M French
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD; National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Michael A Kallen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jennifer A Miner
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Anna L Kratz
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
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Late Functional Changes Post-Severe Traumatic Brain Injury Are Related to Community Reentry Support: Results From the PariS-TBI Cohort. J Head Trauma Rehabil 2018; 32:E26-E34. [PMID: 28060204 DOI: 10.1097/htr.0000000000000276] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To explore late functional changes after a traumatic brain injury and their relation to patients' characteristics and reentry support. DESIGN Prospective follow-up of an inception cohort of adults with severe traumatic brain injury recruited in 2005-2007 in the Parisian area, France. One and 4-year assessments were performed by trained neuropsychologists. One-to-4-year change in the Glasgow Outcome Scale-Extended defined 3 groups: "improvement," "stability," and "worsening." Relationships between these groups and patients' characteristics were analyzed. RESULTS Among 504 recruited patients and 245 four-year survivors, 93 participated in both evaluations. Overall Glasgow Outcome Scale-Extended improved by 0.4. Forty percent of the sample improved, 44% were stable, and 16% worsened. Being in a more unfavorable group was related to preinjury alcohol abuse and to higher anxiety and depression at 4 years. Attendance to a specialized community reentry unit was related to higher chances of being in the "improvement" group in univariate analyses and after adjustment for age, time to follow command, preinjury alcohol and occupation, and mood disorders (adjusted odds ratio [OR] = 4.6 [1.1-20]). CONCLUSION Late functional changes were related to psychosocial variables and to reentry support. The effect of reentry support on late recovery needs to be confirmed by further investigations.
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Characteristics and Health Outcomes of Post-9/11 Caregivers of US Service Members and Veterans Following Traumatic Brain Injury. J Head Trauma Rehabil 2018. [PMID: 29517593 DOI: 10.1097/htr.0000000000000384] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To (a) characterize a sample of post-9/11 caregivers providing help to service members and veterans (SMV) following traumatic brain injury (TBI), (b) examine the level of support provided, and (c) determine caregiver health and well-being outcomes. SETTING Military treatment facility. PARTICIPANTS Caregivers (N = 278) of SMVs who sustained a mild, moderate, severe, or penetrating TBI (96.0% female; 86.0% spouse/partner; age: M = 38.7 years, SD = 10.4). Participants were divided into 3 groups on the basis of the level of support provided (low, medium, high). DESIGN Prospective observational. MAIN MEASURES Caregiver Appraisal Scale, SF-36v2 Health Survey, Mayo-Portland Adaptability Inventory-4, Caregiver Questionnaire. RESULTS The majority of caregivers were helping an SMV with mild TBI and comorbid posttraumatic stress disorder/depression, who was injured in a blast-related incident during combat. Caregivers helped predominantly with activities of daily living and/or instrumental activities of daily living and spent more than 40 hours per week providing care. High-support caregivers were more likely to be caring for an SMV with comorbid posttraumatic stress disorder, report poor physical and mental health outcomes, and have a negative impact on employment and finances. CONCLUSIONS A better understanding of protective factors is required to ensure that burden of care does not exceed the caregiver's health and financial capacity, or undermine the care, well-being, and recovery of the SMV.
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de Goumoëns V, Marques Rio L, Ramelet AS. Family-oriented interventions for adults with acquired brain injury and their families: a scoping review protocol. ACTA ACUST UNITED AC 2018. [DOI: 10.11124/jbisrir-2017-003410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Chesnel C, Jourdan C, Bayen E, Ghout I, Darnoux E, Azerad S, Charanton J, Aegerter P, Pradat-Diehl P, Ruet A, Azouvi P, Vallat-Azouvi C. Self-awareness four years after severe traumatic brain injury: discordance between the patient’s and relative’s complaints. Results from the PariS-TBI study. Clin Rehabil 2017; 32:692-704. [DOI: 10.1177/0269215517734294] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective: To evaluate the patient’s awareness of his or her difficulties in the chronic phase of severe traumatic brain injury (TBI) and to determine the factors related to poor awareness. Design/Setting/Subjects: This study was part of a larger prospective inception cohort study of patients with severe TBI in the Parisian region (PariS-TBI study). Intervention/Main measures: Evaluation was carried out at four years and included the Brain Injury Complaint Questionnaire (BICoQ) completed by the patient and his or her relative as well as the evaluation of impairments, disability and quality of life. Results: A total of 90 patient-relative pairs were included. Lack of awareness was measured using the unawareness index that corresponded to the number of discordant results between the patient and relative in the direction of under evaluation of difficulties by the patient. The only significant relationship found with lack of awareness was the subjective burden perceived by the relative (Zarit Burden Inventory) ( r = 0.5; P < 0.00001). There was no significant relationship between lack of awareness and injury severity, pre-injury socio-demographic data, cognitive impairments, mood disorders, functional independence (Barthel index), global disability (Glasgow Outcome Scale), return to work at four years or quality of life (Quality Of Life after Brain Injury scale (QOLIBRI)). Conclusion: Lack of awareness four years post severe TBI was not related to the severity of the initial trauma, sociodemographic data, the severity of impairments, limitations of activity and participation, or the patient’s quality of life. However, poor awareness did significantly influence the weight of the burden perceived by the relative.
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Affiliation(s)
- Camille Chesnel
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
| | - Claire Jourdan
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
| | - Eleonore Bayen
- Laboratoire d’Économie et de Gestion des Organisations de Santé (LEDa-LEGOS), Université Paris-Dauphine, Paris, France
- Université Pierre et Marie Curie, Paris, France
- Service de Médecine Physique et de Réadaptation, APHP – Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Idir Ghout
- Unité de Recherche Clinique (URC), APHP – Hôpital Ambroise Paré, Boulogne, France
| | - Emmanuelle Darnoux
- Centre Ressources Francilien du Traumatisme Crânien (CRFTC), Paris, France
| | - Sylvie Azerad
- Unité de Recherche Clinique (URC), APHP – Hôpital Ambroise Paré, Boulogne, France
| | - James Charanton
- Centre Ressources Francilien du Traumatisme Crânien (CRFTC), Paris, France
| | - Philippe Aegerter
- Unité de Recherche Clinique (URC), APHP – Hôpital Ambroise Paré, Boulogne, France
- UMR-S 1168, Université de Versailles Saint-Quentin, Versailles, France
| | - Pascale Pradat-Diehl
- Université Pierre et Marie Curie, Paris, France
- Service de Médecine Physique et de Réadaptation, APHP – Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Alexis Ruet
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
| | - Philippe Azouvi
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
| | - Claire Vallat-Azouvi
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
- Antenne UEROS-SAMSAH92-UGECAM IDF, Hôpital Raymond Poincaré, Garches, France
- EA 2027: Laboratoire de Psychopathologie et Neuropsychologie, Université Paris 8, Saint-Denis, France
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Ruet A, Jourdan C, Bayen E, Darnoux E, Sahridj D, Ghout I, Azerad S, Pradat Diehl P, Aegerter P, Charanton J, Vallat Azouvi C, Azouvi P. Employment outcome four years after a severe traumatic brain injury: results of the Paris severe traumatic brain injury study. Disabil Rehabil 2017; 40:2200-2207. [PMID: 28521527 DOI: 10.1080/09638288.2017.1327992] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To describe employment outcome four years after a severe traumatic brain injury by the assessment of individual patients' preinjury sociodemographic data, injury-related and postinjury factors. DESIGN A prospective, multicenter inception cohort of 133 adult patients in the Paris area (France) who had received a severe traumatic brain injury were followed up postinjury at one and four years. Sociodemographic data, factors related to injury severity and one-year functional and cognitive outcomes were prospectively collected. METHODS The main outcome measure was employment status. Potential predictors of employment status were assessed by univariate and multivariate analysis. RESULTS At the four-year follow-up, 38% of patients were in paid employment. The following factors were independent predictors of unemployment: being unemployed or studying before traumatic brain injury, traumatic brain injury severity (i.e., a lower Glasgow Coma Scale score upon admission and a longer stay in intensive care) and a lower one-year Glasgow Outcome Scale-Extended score. CONCLUSION This study confirmed the low rate of long-term employment amongst patients after a severe traumatic brain injury. The results illustrated the multiple determinants of employment outcome and suggested that students who had received a traumatic brain injury were particularly likely to be unemployed, thus we propose that they may require specific support to help them find work. Implications for rehabilitation Traumatic brain injury is a leading cause of persistent disablity and can associate cognitive, emotional, physical and sensory impairments, which often result in quality-of-life reduction and job loss. Predictors of post-traumatic brain injury unemployment and job loss remains unclear in the particular population of severe traumatic brain injury patients. The present study highlights the post-traumatic brain injury student population require a close follow-up and vocational rehabilitation. The study suggests that return to work post-severe traumatic brain injury is frequently unstable and workers often experience difficulties that caregivers have to consider.
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Affiliation(s)
- Alexis Ruet
- a Service de Médecine Physique et de Réadaptation , CHU de Caen , France.,b U1077, INSERM , Caen , France
| | - Claire Jourdan
- c Service de Médecine Physique et de Réadaptation , APHP, Hôpital Raymond Poincaré , Garches , France.,d EA 4047 HANDIReSP , Université de Versailles Saint-Quentin , France
| | - Eléonore Bayen
- e Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière , Service de Médecine Physique et Réadaptation, Paris, France, Université Pierre et Marie Curie , Paris , France
| | - Emmanuelle Darnoux
- f Assistance Publique-Hôpitaux de Paris , Hôpital Ambroise Paré, Unité de Recherche Clinique (URC) , Boulogne , France.,g Centre Ressources Francilien du Traumatisme Crânien (CRFTC) , Paris , France
| | - Dalila Sahridj
- c Service de Médecine Physique et de Réadaptation , APHP, Hôpital Raymond Poincaré , Garches , France
| | - Idir Ghout
- f Assistance Publique-Hôpitaux de Paris , Hôpital Ambroise Paré, Unité de Recherche Clinique (URC) , Boulogne , France
| | - Sylvie Azerad
- f Assistance Publique-Hôpitaux de Paris , Hôpital Ambroise Paré, Unité de Recherche Clinique (URC) , Boulogne , France
| | - Pascale Pradat Diehl
- e Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière , Service de Médecine Physique et Réadaptation, Paris, France, Université Pierre et Marie Curie , Paris , France
| | - Philippe Aegerter
- f Assistance Publique-Hôpitaux de Paris , Hôpital Ambroise Paré, Unité de Recherche Clinique (URC) , Boulogne , France
| | - James Charanton
- g Centre Ressources Francilien du Traumatisme Crânien (CRFTC) , Paris , France
| | - Claire Vallat Azouvi
- d EA 4047 HANDIReSP , Université de Versailles Saint-Quentin , France.,h Antenne UEROS-SAMSAH 92-UGECAM IDF , Hôpital Raymond Poincaré , Garches , France
| | - Philippe Azouvi
- c Service de Médecine Physique et de Réadaptation , APHP, Hôpital Raymond Poincaré , Garches , France.,d EA 4047 HANDIReSP , Université de Versailles Saint-Quentin , France
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Bayen E, Jourdan C, Ghout I, Pradat-Diehl P, Darnoux E, Nelson G, Vallat-Azouvi C, Charenton J, Aegerter P, Ruet A, Azouvi P. Negative impact of litigation procedures on patient outcomes four years after severe traumatic brain injury: results from the PariS-traumatic brain injury study. Disabil Rehabil 2017; 40:2040-2047. [PMID: 28508698 DOI: 10.1080/09638288.2017.1325522] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To analyze the effect of litigation procedures on long-term outcomes in severe traumatic brain injury. MATERIALS AND METHODS Prospective observational follow-up of an inception cohort including 504 adults with severe traumatic brain injury recruited in 2005-2007 in the Parisian area, France, with initial, one- and four-year outcomes measures. RESULTS Four years after the traumatic brain injury, 147 patients, out of 257 who survived the acute phase, were assessed. Among these patients, 53 patients declared being litigants and 78 nonlitigants (litigation status was unknown in 16 cases). Sociodemographic characteristics, type of injury and initial severity did not differ significantly between litigants and nonlitigants, except for Injury Severity Score (worse in litigants) and the proportion of road traffic accidents (higher in litigants). One- and four-year outcomes were significantly worse in litigants for autonomy, participation, psychiatric and cognitive function but not quality of life (measured with the Glasgow Outcome Scale-Extended, the working activity status, the Brain Injury Community Rehabilitation Outcome, the Hospital Anxiety and Depression scale, the Neurobehavioral Rating Scale-revised and the Quality of Life after Brain Injury, respectively). Multivariate analyses highlighted litigation procedure as an independent significant predictor of lower autonomy, participation and psychiatric function and tended to predict lower cognitive function, but not lower quality of life, after adjustment for pretrauma characteristics, Injury Severity Score, road traffic accidents and work-related accident status. CONCLUSIONS Patients with severe traumatic brain injury have a worse prognosis when involved in a litigation procedure and require special attention in clinical practice. Implications for rehabilitation The influence of litigation procedure on health and social outcomes in severe traumatic brain injury is a major issue that entail numerous levels of complexities. A wide range of interactions and factors related to the prolonged process of litigation against a third party may influence recovery. Results from the PariS-Traumatic Brain Injury study suggest that patients with a severe Traumatic Brain Injury who are involved in a litigation procedure within French jurisdiction compensation scheme have a worse prognosis than patients who do not. Health professionals should be aware of the potential adverse effects of litigation procedures on recovery, and provide appropriate interventions and information to patients and families in such cases.
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Affiliation(s)
- Eléonore Bayen
- a Physical Medicine and Rehabilitation Department , Pitie-Salpetriere Hospital, APHP , Paris , France ; Health Economics Department LEDa-LEGOS , University Paris-Dauphine , Paris , France
| | - Claire Jourdan
- b Physical Medicine and Rehabilitation Department , Lapeyronie Hospital, CHRU , Montpellier , France
| | - Idir Ghout
- c Department of Biostatistics , Ambroise Paré Hospital, APHP UVSQ , Boulogne , France ; EA4047 , University of Versailles Saint Quentin , France
| | - Pascale Pradat-Diehl
- d Physical Medicine and Rehabilitation Department , Pitie-Salpetriere Hospital, APHP , Paris , France ; Laboratoire d'Imagerie Biomédicale Inserm U1146 Sorbonne Universités University Pierre et Marie Curie UMCR2 - CNRS UMR7371
| | - Emmanuelle Darnoux
- c Department of Biostatistics , Ambroise Paré Hospital, APHP UVSQ , Boulogne , France ; EA4047 , University of Versailles Saint Quentin , France
| | - Gaëlle Nelson
- c Department of Biostatistics , Ambroise Paré Hospital, APHP UVSQ , Boulogne , France ; EA4047 , University of Versailles Saint Quentin , France
| | - Claire Vallat-Azouvi
- e Physical Medicine and Rehabilitation Department , AP-HP, Raymond-Poincaré Hospital , Garches , France ; EA4047 , University of Versailles Saint Quentin , France
| | - James Charenton
- f Regional Reference Center for Bain Injury in the Parisan area, CRFTC , Paris , France
| | - Philippe Aegerter
- c Department of Biostatistics , Ambroise Paré Hospital, APHP UVSQ , Boulogne , France ; EA4047 , University of Versailles Saint Quentin , France
| | - Alexis Ruet
- g Physical Medicine and Rehabilitation Department , CHU Caen , France and INSERM U1077 , France
| | - Philippe Azouvi
- e Physical Medicine and Rehabilitation Department , AP-HP, Raymond-Poincaré Hospital , Garches , France ; EA4047 , University of Versailles Saint Quentin , France
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Manskow US, Friborg O, Røe C, Braine M, Damsgard E, Anke A. Patterns of change and stability in caregiver burden and life satisfaction from 1 to 2 years after severe traumatic brain injury: A Norwegian longitudinal study. NeuroRehabilitation 2017; 40:211-222. [DOI: 10.3233/nre-161406] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Unn Sollid Manskow
- Department of Rehabilitation, University Hospital of North Norway, Tromso, Norway
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Oddgeir Friborg
- Faculty of Health Sciences, Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mary Braine
- School of Nursing and Midwifery, Faculty of Health and Social Care, University of Salford, Salford, UK
| | - Elin Damsgard
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromso, Norway
- Faculty of Health Sciences, Department of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway
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Azouvi P, Ghout I, Bayen E, Darnoux E, Azerad S, Ruet A, Vallat-Azouvi C, Pradat-Diehl P, Aegerter P, Charanton J, Jourdan C. Disability and health-related quality-of-life 4 years after a severe traumatic brain injury: A structural equation modelling analysis. Brain Inj 2016; 30:1665-1671. [DOI: 10.1080/02699052.2016.1201593] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Philippe Azouvi
- Assistance Publique-Hôpitaux de Paris, Hôpital Raymond Poincaré, Service de Médecine Physique et de Réadaptation, Garches, France
- EA 4047 HANDIReSP, Université de Versailles, Saint-Quentin, France
| | - Idir Ghout
- Assistance Publique-Hôpitaux de Paris, Hôpital Ambroise Paré, Unité de Recherche Clinique (URC), Boulogne, France
| | - Eleonore Bayen
- Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Service de Médecine Physique et Réadaptation, Paris, France Université Pierre et Marie Curie, Paris, France
| | - Emmanuelle Darnoux
- Assistance Publique-Hôpitaux de Paris, Hôpital Ambroise Paré, Unité de Recherche Clinique (URC), Boulogne, France
- Centre Ressources Francilien du Traumatisme Crânien (CRFTC), Paris, France
| | - Sylvie Azerad
- Assistance Publique-Hôpitaux de Paris, Hôpital Ambroise Paré, Unité de Recherche Clinique (URC), Boulogne, France
| | - Alexis Ruet
- Assistance Publique-Hôpitaux de Paris, Hôpital Raymond Poincaré, Service de Médecine Physique et de Réadaptation, Garches, France
- EA 4047 HANDIReSP, Université de Versailles, Saint-Quentin, France
| | - Claire Vallat-Azouvi
- EA 4047 HANDIReSP, Université de Versailles, Saint-Quentin, France
- Antenne UEROS-SAMSAH 92-UGECAM IDF, Hôpital Raymond Poincaré, Garches, France
| | - Pascale Pradat-Diehl
- Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Service de Médecine Physique et Réadaptation, Paris, France Université Pierre et Marie Curie, Paris, France
| | - Philippe Aegerter
- Assistance Publique-Hôpitaux de Paris, Hôpital Ambroise Paré, Unité de Recherche Clinique (URC), Boulogne, France
| | - James Charanton
- Centre Ressources Francilien du Traumatisme Crânien (CRFTC), Paris, France
| | - Claire Jourdan
- Assistance Publique-Hôpitaux de Paris, Hôpital Raymond Poincaré, Service de Médecine Physique et de Réadaptation, Garches, France
- EA 4047 HANDIReSP, Université de Versailles, Saint-Quentin, France
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