Psychological distress and family satisfaction following traumatic brain injury: Injured individuals and their primary, secondary, and tertiary carers

Objective: To assess family psychosocial outcome following traumatic brain injury (TBI) in all family members, including relatives more peripheral to the person with the injury Design: A cross-sectional design was used to gat her outcome data from individuals with TBI and primary secondary and tertia ry carers, 19.3 months posttrauma. Multivariate analyses of variance (ANOVA s) ascertained differences in levels of psychological distress and family s atisfaction within families. Setting and participants: Sevenh-nine families (65 individuals with TBI, 72 primary carers, 43 secondary carers, and 22 t ertiary carers) were drawn from a sample of outpatients of three metropolit an, acute rehabilitation hospitals over a 12-month period. Outcome measures : in addition to using the Family Satisfaction Scale (FSS), measures of psy chological distress included the Beck Depression Inventory (BDI), State Anx iety inventory (SAI), and Profile of Mood States (POMS). Results: Although it was noted that a significant proportion of family members were not psych ologically distressed and reported good family satisfaction, people with TB I remain at greater risk of poor psychosocial outcome than do their relativ es. Of other family members, primary carers-particularly wives-are at great est risk of poor psychosocial outcome, and a number of secondary and tertia ry carers also displayed high levels of psychological distress. Conclusions : Male relatives (the majority of whom were secondary or tertiary carers) m ay report their distress in terms of anger and fatigue, rather than as depr ession and anxiety. Future research could develop TBI-specific measures of anger and fatigue as screening instruments to identify peripheral family me mbers requiring assistance in adapting to TBI. Many families-despite their initial traumatic experience-eventually cope well, encouraging researchers and clinicians to focus future research efforts on those families who have made good adjustments to TBI.