Citation

Kreitzer N, Kurowski BG, Bakas T. Arch. Phys. Med. Rehabil. 2018; 99(11): 2342-2354.

Affiliation

University of Cincinnati College of Nursing.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.apmr.2018.04.016

PMID

29752909

Abstract

OBJECTIVE: To describe and synthesize the existing literature of published adult TBI family caregiver and dyad intervention studies. Traumatic brain injuries (TBIs) are common and have a significant long-term impact, with some characterizing TBI as a chronic condition. Informal family caregivers of adults with TBI suffer from high rates of burnout, depression, fatigue, anxiety, lower subjective well-being, and poorer levels of physical health compared to non-caregivers. There is a critical gap in the understanding of interventions designed to address the impact of TBI on adult patients and their family caregivers. DATA SOURCES: PubMed and Medline STUDY SELECTION: Studies were selected using the following criteria: 1) English language 2) quasi-experimental or experimental design 3) subjects were TBI caregivers, survivors with heavy involvement of caregivers, or caregiver dyads 4) moderate and severe TBIs and 5) described an intervention that was implemented during some portion of the TBI care continuum. DATA EXTRACTION: The search identified 2171 total articles. After duplicates were removed, additional screening, and application of inclusion and exclusion criteria, we identified 14 studies that met criteria for inclusion. 10 were randomized clinical trials and 4 were non randomized quasi-experimental studies. A secondary search to describe studies that included individuals with other forms of acquired brain injury in addition to TBI resulted in 852 additional titles, of which 5 met inclusion for review. DATA SYNTHESIS: Interventions that targeted the caregiver primarily were more likely to provide benefit than those that targeted caregiver/survivor dyad or the survivor only. Many of the studies were limited by poor fidelity, low sample sizes, and high risk for bias based on randomization techniques.

CONCLUSIONS: Future studies should enroll a more generalizable number of participants, and ensure adequate fidelity to properly compare interventions.

Copyright © 2018. Published by Elsevier Inc.

Language: en

Keywords

caregiver interventions; caregivers; traumatic brain injury