title: Long-term parental and family adaptation following pediatric brain injury.
abstract: OBJECTIVE
  To determine whether parents of children with traumatic brain injuries (TBI) report increased injury-related burden, distress, and family dysfunction and to examine the effects of attrition on the results.
  
  
  METHODS
  Children with severe TBI, moderate TBI, and orthopedic injuries were followed at six time points from baseline to 6 years after injury. Parents completed measures of injury-related burden, psychological distress, and family functioning at each assessment. Mixed model analysis was used to examine long-term changes.
  
  
  RESULTS
  Attrition was higher among families in the severe TBI group with lower burden thereby amplifying group differences. The severe TBI group reported higher injury-related burden over time after injury than the other groups. Family functioning was moderated by social resources. Families of children with severe TBI and low resources reporting deteriorating functioning over the follow-up interval.
  
  
  CONCLUSIONS
  Although environmental advantages moderate long-term effects on family functioning, families of children with severe TBI experience long-standing injury-related burden.
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229-3039, USA. shari.wade@cchmc.org
authors.forename: Shari L
authors.initials: SL
authors.lastname: Wade
authors.forename: H
authors.initials: H
authors.lastname: Gerry Taylor
authors.forename: Keith Owen
authors.initials: KO
authors.lastname: Yeates
authors.forename: Dennis
authors.initials: D
authors.lastname: Drotar
authors.forename: Terry
authors.initials: T
authors.lastname: Stancin
authors.forename: Nori M
authors.initials: NM
authors.lastname: Minich
authors.forename: Mark
authors.initials: M
authors.lastname: Schluchter
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D015982:Bias; D001930:Brain Injuries / Q000523:psychology*; D002648:Child; D017281:Cost of Illness; D005190:Family / Q000523:psychology*; D005260:Female; D050723:Fractures, Bone / Q000523:psychology; D015600:Glasgow Coma Scale; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010290:Parents / Q000523:psychology*; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data; D012931:Social Environment; D012959:Socioeconomic Factors