title: Parental stress and burden following traumatic brain injury amongst children and adolescents.
abstract: OBJECTIVE
  To assess parental stress following paediatric traumatic brain injury (TBI), and examine the relationship between self-reported problems, parental stress and general health.
  
  
  METHODS
  Parents of 97 children admitted with a TBI (49 mild, 19 moderate, 29 severe) to North Staffordshire National Health Service Trust, and parents of 31 uninjured children were interviewed and assessed.
  
  
  METHODS
  Structured interviews were carried out with families, and parents assessed on the Parenting Stress Index (PSI/SF) and General Health Questionnaire (GHQ-12) at recruitment, and repeated 12 months later.
  
  
  RESULTS
  Forty parents (41.2%) of children with TBI exhibited clinically significant stress. Regardless of injury severity, parents of injured children suffered greater stress than control parents as measured by the PSI/SF (p = 0.001). There was a highly significant relationship between number of problems reported and level of parental stress (p = 0.001). Financial burden was related to severity of TBI. At follow-up, one third of parents of children with severe TBI scored > or =18 on the GHQ-12, signifying poor psychological health.
  
  
  CONCLUSIONS
  The parents of a child with serious TBI should be screened for abnormal levels of stress. Parental stress and family burden may be alleviated by improved information, follow-up and support.
authors.affiliation: Centre for Health Services Studies, University of Warwick, Coventry, UK. c.a.hawley@warwick.ac.uk
authors.forename: Carol A
authors.initials: CA
authors.lastname: Hawley
authors.forename: Anthony B
authors.initials: AB
authors.lastname: Ward
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Magnay
authors.forename: Julie
authors.initials: J
authors.lastname: Long
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001930:Brain Injuries / Q000191:economics / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D004739:England; D005191:Family Characteristics; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D010290:Parents / Q000523:psychology*; D011203:Poverty; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires