title: Determinants of Effective Caregiver Communication After Adolescent Traumatic Brain Injury.
abstract: OBJECTIVE
  To characterize the effects of caregiver mental health and coping strategies on interactions with an injured adolescent acutely after traumatic brain injury (TBI).
  
  
  METHODS
  Multi-site, cross-sectional study.
  
  
  METHODS
  Outpatient setting of 3 tertiary pediatric hospitals and 2 tertiary general medical centers.
  
  
  METHODS
  Adolescents (N = 125) aged 12-17 years, 1-6 months after being hospitalized with complicated mild to severe TBI.
  
  
  METHODS
  Data were collected as part of a multi-site clinical trial of family problem-solving therapy after TBI. Multiple regression analyses were used to examine the relationship of caregiver and environmental characteristics to the dimensions of effective communication, warmth, and negativity during caregiver-adolescent problem-solving discussions.
  
  
  METHODS
  Adolescent and caregiver interactions, as measured by the Iowa Family Interaction Rating Scales.
  
  
  RESULTS
  Caregivers who utilized problem-focused coping strategies were rated as having higher levels of effective communication (P < .01), as were those with higher socioeconomic status (P < .01). Problem-focused coping style and higher socioeconomic status were also associated lower levels of negative interactions (P < .01 and P < .05, respectively). Female gender of the adolescent and fewer children in the home were associated with increased parental warmth during the interaction (P < .01 and P < .05, respectively). Neither adolescent TBI severity nor caregiver depression significantly influenced caregiver-teen interactions.
  
  
  CONCLUSIONS
  Problem-focused coping strategies are associated with higher levels of effective communication and lower levels of caregiver negativity during the initial months after adolescent TBI, suggesting that effective caregiver coping may facilitate better caregiver-adolescent interactions after TBI.
authors: Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: Laura
authors: L
authors: Hobart-Porter
authors: Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: Shari
authors: S
authors: Wade
authors: Case Western Reserve University, Cleveland, OH.
authors: Nori
authors: N
authors: Minich
authors: Children's Hospital Colorado, Aurora, CO.
authors: Michael
authors: M
authors: Kirkwood
authors: Case Western Reserve University, Cleveland, OH.
authors: Terry
authors: T
authors: Stancin
authors: Case Western Reserve University, Cleveland, OH.
authors: Hudson Gerry
authors: HG
authors: Taylor
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001930:Brain Injuries / Q000523:psychology / Q000534:rehabilitation*; D017028:Caregivers / Q000523:psychology*; D002648:Child; D003142:Communication; D003430:Cross-Sectional Studies; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008603:Mental Health; D011340:Problem Solving / Q000502:physiology*; D011369:Professional-Patient Relations; D055815:Young Adult