Predictors of family caregivers' life satisfaction after traumatic brain injury at one and two years post-injury: a longitudinal multi-center investigation.

OBJECTIVE: To determine predictors of family caregiver life satisfaction at one and two years after traumatic brain injury (TBI). METHODS: Prospective collaborative longitudinal study of 336 family members caring for individuals with TBI participating in the National Institute on Disability and Rehabilitation Research (NIDRR) designated TBI Model Systems of Care (TBIMS). Survivors' medical and demographic information was obtained from the TBIMS database. Follow-up interviews were completed with both survivors and family caregivers at 1 year and 2 years post injury. The primary outcome variable, caregiver life satisfaction, was measured with the Satisfaction with Life Scale (SWLS). RESULTS: Repeated measures ordinal logistic regression showed that survivors' functional status at discharge, drug use, and neurobehavioral problems were significant predictors of family caregivers' life satisfaction at 1 and 2 years post injury. CONCLUSIONS: Family members of individuals with TBI often experience reduced life satisfaction in the first 2 years following their relatives' TBI. Psychiatric and neurobehavioral problems, such as drug use and depression, as well as motor dysfunction in survivors may be important contributors to decreased life satisfaction among their caregivers.

Caregivers' concerns about judgment and safety of patients with brain injury: a preliminary investigation.

OBJECTIVE: To identify caregivers' most common concerns about the judgment and safety of patients with brain injury in home and community environments. To quantify caregivers' stress levels and their level of comfort leaving patients at home unsupervised and examine the interrelationships between caregivers' safety and judgment ratings, stress levels, and levels of comfort leaving patients unattended. DESIGN: Retrospective, cross-sectional design. SETTING: Outpatient brain injury neuropsychology clinic at a university medical center. PARTICIPANTS: A convenience sample of 121 caregivers of traumatic brain injury survivors at least 1 month postinjury and 18 years of age or older. MAIN OUTCOME MEASUREMENTS: Scores in 9 domains from the Judgment and Safety Screening Inventory; ratings of stress levels and levels of comfort leaving patients at home unattended derived from the General Health and History Questionnaire. RESULTS: Caregivers' most common judgment and safety-related concerns were in the Travel and Financial domains, with many reflecting patients' memory deficits. Heightened caregiver stress levels were prevalent. Higher levels of concern about judgment and safety were associated with higher stress levels and concerns about leaving patients unattended. CONCLUSIONS: Consistent with research on patients with other types of neurological disorders, concerns about driving and financial management among caregivers are prevalent. Additional research is needed to identify the most cost-effective methods of evaluating patients and enabling them to function at their highest level in the community.