title: Caregivers' well-being after traumatic brain injury: a multicenter prospective investigation.
abstract: OBJECTIVE
  To describe frequency and magnitude of caregivers' emotional distress and life satisfaction using standardized assessment procedures; compare distress levels among spouses, parents, and other caregivers; and identify risk factors.
  
  
  METHODS
  Prospective collaborative cohort study.
  
  
  METHODS
  Six Traumatic Brain Injury Model System Centers providing neurotrauma care, rehabilitation, and outpatient follow-up.
  
  
  METHODS
  Caregivers (N=273) of patients who were 1, 2, or 5 years postinjury.
  
  
  METHODS
  Acute neurotrauma care, inpatient interdisciplinary brain injury rehabilitation, and postacute services.
  
  
  METHODS
  Brief Symptom Inventory-18 Depression, Anxiety, and Somatic dimensions.
  
  
  RESULTS
  Levels of Depression, Anxiety, and Somatic symptoms were equally prevalent, with 1 in 5 caregivers scoring above the cutoff in each area. The proportion of participants with 1, 2, and 3 elevations was 17.9%, 5.5%, and 10.6%, respectively. Conversely, approximately two thirds (65.9%) had no scores exceeding cutoffs. Distress levels among spouses, parents, and other caregivers were comparable. Higher caregiver distress was associated with caring for survivors who had worse functional status, received more supervision, were less satisfied with life, and used alcohol excessively.
  
  
  CONCLUSIONS
  Depression, Anxiety, and Somatic symptoms are common among caregivers. Findings substantiate the importance of clinical care systems addressing the needs of caregivers in the long term as well as survivors.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23298-0542, USA. jskreutz@vcu.edu
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Kreutzer
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Rapport
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Marwitz
authors.forename: Cynthia
authors.initials: C
authors.lastname: Harrison-Felix
authors.forename: Tessa
authors.initials: T
authors.lastname: Hart
authors.forename: Mel
authors.initials: M
authors.lastname: Glenn
authors.forename: Flora
authors.initials: F
authors.lastname: Hammond
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D001930:Brain Injuries / Q000534:rehabilitation*; D017028:Caregivers / Q000523:psychology*; D015331:Cohort Studies; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D013315:Stress, Psychological / Q000523:psychology*; D015599:Trauma Severity Indices; D055815:Young Adult