Objectives
The objective is to 1) evaluate the feasibility of a family centered intervention provided in collaboration with municipal health professionals, 2) explore aspects of mental health and family functioning in people with TBI, and 3) determine the effectiveness of a family-oriented intervention to improve self-reported health-related quality of life (HRQL), burden of care, and family functioning compared to a group receiving interdisciplinary follow-up at a TBI outpatient clinic.
Background
Traumatic brain injury is challenging for those sustaining the injury as well as for their families. There has been an increased focus on family functioning and the family's participation in the rehabilitation process after TBI. Nevertheless, there is insufficient knowledge on evidence-based measures and effective family-centered interventions.
Method
In accordance with the recommendations for complex interventions, a feasibility study was carried out to as a pilot for a family oriented intervention. In the subsequent effect study, the families were randomized to a receive a manualized family oriented intervention with 8 sessions; while the families in the control group received an information session only without any additional intervention.
Results
Sixty one families participated in the study. At the beginning of the intervention, 48 % of the patients had reduced HRQL, and they had worse depressive symptoms and lower levels of resilience and self reliance compared to the family members. Over 50 % of the family members reported mild to moderate depressive symptoms. Being woman, the presence of psychological problems and lower levels of resilience were factors associated with lower mental HRQL in the patients and the family members. Family intervention combined with specialized follow ups yielded no additional advantage compared to only specialized follow ups, even though it could have contributed to faster recovery during the treatment period.
Conclusion
This study has provided new insights into how families response to TBI, it also describes an innovative intervention for family oriented care after TBI that can be applicable to other patient groups.
Funding
The Extra Foundation for Health and Rehabilitation and the National Association for the Traumatically Injured (LTN).
Cooperation
- Trauma Rehabilitation Research Unit at the Oslo University Hospitals
- Baerum Municipality, Dept. of Health and Rehabilitation
- Juan Carlos Arango-Lasprilla, BioCruces Health Research Institute, Cruces University Hospital, Spain
Phd students
- Mari S. Rasmussen has completed her PhD in the project.