Research Reports - Predictors of informal care burden 1 year after a severe traumatic brain injury

J Head Trauma Rehabil. 2012 Jun 9

Bayen E, Pradat-Diehl P, Jourdan C, Ghout I, Bosserelle V, Azerad S, Weiss JJ, Joël ME, Aegerter P, Azouvi P

OBJECTIVE:: To investigate predictors of informal care burden 1 year after a
severe traumatic brain injury (TBI). PARTICIPANTS:: Patients (N = 66) aged 15
years or older with severe TBI (Glasgow Coma Scale score of 8 or less) and their
primary informal caregivers. SETTING:: Multicenter inception cohort study over 22
months in Paris and the surrounding area (PariS-TBI study). MAIN MEASURES::
Patients' preinjury characteristics; injury severity data; outcome measures at
discharge from intensive care and 1 year after the injury; Dysexecutive
Questionnaire; Medical Outcome Study Short Form-36; Zarit Burden Inventory.
RESULTS:: Among the 257 survivors at discharge from acute care, 66
patient-caregiver couples were included. Primary informal caregivers were
predominantly women (73%), of middle age (age, 50 years), supporting male
patients (79%), of mean age of 38 years. The majority (56%) of caregivers
experienced significant burden, and 44% were at risk of depression. Caregivers'
impaired health status and perceived burden significantly correlated with
patients' global disability (as assessed with the Glasgow Outcome Scale-Extended)
and impairments of executive functions (as assessed with the Dysexecutive
Questionnaire). A focused principal component analysis suggested that disability
and executive dysfunctions were independent predictors of perceived burden,
whereas demographics, injury severity, and Glasgow Outcome Scale at discharge
from acute care did not significantly correlate with caregiver's burden.
CONCLUSION:: Global handicap and impairments of executive functions are
independent significant predictors of caregiver burden 1 year after TBI.

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