Research Reports - Determinants of effective caregiver communication after adolescent traumatic brain injury

PM R. 2015 Aug;7(8):836-44. doi: 10.1016/j.pmrj.2015.02.004. Epub 2015 Feb 14.

Hobart-Porter L(1), Wade S(2), Minich N(3), Kirkwood M(4), Stancin T(5), Taylor

OBJECTIVE: To characterize the effects of caregiver mental health and coping
strategies on interactions with an injured adolescent acutely after traumatic
brain injury (TBI).
DESIGN: Multi-site, cross-sectional study.
SETTING: Outpatient setting of 3 tertiary pediatric hospitals and 2 tertiary
general medical centers.
PARTICIPANTS: Adolescents (N = 125) aged 12-17 years, 1-6 months after being
hospitalized with complicated mild to severe TBI.
METHODS: Data were collected as part of a multi-site clinical trial of family
problem-solving therapy after TBI. Multiple regression analyses were used to
examine the relationship of caregiver and environmental characteristics to the
dimensions of effective communication, warmth, and negativity during
caregiver-adolescent problem-solving discussions.
MAIN OUTCOMES MEASURES: Adolescent and caregiver interactions, as measured by the
Iowa Family Interaction Rating Scales.
RESULTS: Caregivers who utilized problem-focused coping strategies were rated as
having higher levels of effective communication (P < .01), as were those with
higher socioeconomic status (P < .01). Problem-focused coping style and higher
socioeconomic status were also associated lower levels of negative interactions
(P < .01 and P < .05, respectively). Female gender of the adolescent and fewer
children in the home were associated with increased parental warmth during the
interaction (P < .01 and P < .05, respectively). Neither adolescent TBI severity
nor caregiver depression significantly influenced caregiver-teen interactions.
CONCLUSIONS: Problem-focused coping strategies are associated with higher levels
of effective communication and lower levels of caregiver negativity during the
initial months after adolescent TBI, suggesting that effective caregiver coping
may facilitate better caregiver-adolescent interactions after TBI. 

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