title: Relationship of caregiver and family functioning to participation outcomes after postacute rehabilitation for traumatic brain injury: a multicenter investigation.
abstract: OBJECTIVE
  To investigate the contribution of caregiver emotional functioning and family functioning to participation outcomes after postacute rehabilitation for traumatic brain injury (TBI).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Three postacute comprehensive-integrated postacute rehabilitation programs associated with National Institute on Disability and Rehabilitation Research-funded TBI Model Systems Centers.
  
  
  METHODS
  Persons with medically documented TBI (N=136; 57% with severe TBI, 12% moderate, 31% mild), primarily men and 69% white.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Community Integration Questionnaire and Craig Handicap Assessment and Reporting Technique (CHART).
  
  
  RESULTS
  After accounting for age, education, sex, and race/ethnicity, there was a significant interaction between caregiver emotional functioning and time since injury for CHART Occupation and Social Integration Scale scores. Better emotional functioning in caregivers was associated with greater occupation and social integration outcomes for persons who entered the postacute rehabilitation program within 6 months of injury, but not for those >6 months postinjury. There was no relationship of family functioning to participation outcomes, and no interaction between family functioning and time since injury.
  
  
  CONCLUSIONS
  Caregiver distress should be accounted for in studies investigating the effectiveness of postacute rehabilitation after TBI. Screening of caregivers early during postacute rehabilitation can target those who need assistance to improve their support of the person with TBI.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Baylor College of Medicine and Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX 77019, USA. asander@bcm.edu
authors.forename: Angelle M
authors.initials: AM
authors.lastname: Sander
authors.forename: Kacey Little
authors.initials: KL
authors.lastname: Maestas
authors.forename: Mark
authors.initials: M
authors.lastname: Sherer
authors.forename: James F
authors.initials: JF
authors.lastname: Malec
authors.forename: Risa
authors.initials: R
authors.lastname: Nakase-Richardson
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation*; D017028:Caregivers / Q000523:psychology*; D004644:Emotions; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D058992:Social Participation / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult