Predictors of Emotional Distress in Family Caregivers of Persons with Traumatic Brain Injury: A Systematic Review

The purpose of the current paper was to conduct a systematic review of the literature on predictors of emotional distress in caregivers of persons with traumatic brain injury (TBI), and to provide evidence-based classification for prognostic variables to guide future research and clinical practice. A search was conducted using PubMed, CINAHL and PsycINFO databases. The citations of resulting articles were also reviewed. Twenty-eight articles met inclusion criteria and were retained for review. Reviews were conducted in accordance with the 2011 edition of the American Academy of Neurology (AAN) Guidelines for classifying evidence for prognostic studies. Data abstraction revealed one Class I study, four Class II studies, eight Class III studies, and 15 Class IV studies. Results of the review indicated that caregivers’ report of neurobehavioural problems in the person with injury is a probable predictor of emotional distress for caregivers of persons with complicated mild, moderate or severe TBI (Class B evidence). The level of participation in the person with injury, level of support needed by the person with injury, and family systems functioning are probably predictors of emotional distress for caregivers of persons with severe TBI (Class B evidence). Executive functioning impairment in the person with injury, pre-injury emotional distress in caregivers, caregiver age, caregivers’ use of emotion-focused coping, and social support may possibly be risk factors for caregivers’ emotional distress (Class C evidence). Recommendations for future research and implications for assessment and treatment of family caregivers are discussed.

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The Relationship Between Coping and Psychological Adjustment in Family Caregivers of Individuals With Traumatic Brain Injury: A Systematic Review

Annual Review of Nursing Research ◽

10.1891/0739-6686.33.219 ◽

2015 ◽

Vol 33 (1) ◽

pp. 219-247 ◽

Cited By ~ 4

Author(s):

Malcolm I. Anderson ◽

Grahame K. Simpson ◽

Maysaa Daher ◽

Lucinda Matheson

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Family Caregivers ◽

Psychological Adjustment ◽

Class Iii ◽

Ways Of Coping Questionnaire ◽

Class 1 ◽

American Academy Of Neurology ◽

Class Iv

A systematic review was conducted to evaluate the association between coping (as measured by the Ways of Coping Questionnaire [WOCQ]) and psychological adjustment in caregivers of individuals with traumatic brain injury (TBI). A search conducted using the CINAHL, Medline, and PsycINFO databases yielded 201 citations between 1974 and 2014. A total of seven articles met the inclusion criteria; namely, the respondents who completed the WOCQ were family caregivers of individuals with TBI (including 66-item, 42-item, or 21-item versions). Reviews were conducted in accordance with the American Academy of Neurology guidelines (2011) for classifying evidence. The results found no Class 1 or Class II studies but only four Class III and three Class IV studies. The major finding across the better-rated Class III studies was that the use of emotion-focused coping and problem-focused coping was possibly associated with psychological adjustment in caregivers. The Class IV studies were determined to be inadequate or conflicting in determining the association between coping and psychological adjustment. Future studies need to employ carefully crafted designs, adhere to statistical procedure, apply advanced analytic techniques, and employ explicit models of coping, which will increase the accuracy and generalizability of the findings.

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Challenges and Opportunities for Neuroimaging in Young Patients with Traumatic Brain Injury: a Coordinated Effort towards Advancing Discovery from the ENIGMA Pediatric Moderate/Severe TBI Group

10.31234/osf.io/y2txh ◽

2019 ◽

Cited By ~ 4

Author(s):

Emily L. Dennis ◽

Karen Caeyenberghs ◽

Robert F. Asarnow ◽

Talin Babikian ◽

Brenda Bartnik-Olson ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Meta Analysis ◽

Young Patients ◽

Future Research ◽

Childhood And Adolescence ◽

Developmental Issues ◽

Challenges And Opportunities ◽

Severe Tbi ◽

Advance Research

Traumatic brain injury (TBI) is a major cause of death and disability in children in both developed and developing nations. Children and adolescents suffer from TBI at a higher rate than the general population; however, research in this population lags behind research in adults. This may be due, in part, to the smaller number of investigators engaged in research with this population and may also be related to changes in safety laws and clinical practice that have altered length of hospital stays, treatment, and access to this population. Specific developmental issues also warrant attention in studies of children, and the ever-changing context of childhood and adolescence may require larger sample sizes than are commonly available to adequately address remaining questions related to TBI. The ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) Pediatric Moderate-Severe TBI (msTBI) group aims to advance research in this area through global collaborative meta-analysis. In this paper we discuss important challenges in pediatric TBI research and opportunities that we believe the ENIGMA Pediatric msTBI group can provide to address them. We conclude with recommendations for future research in this field of study.

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Predictors of discharge destination from acute care in patients with traumatic brain injury

BMJ Open ◽

10.1136/bmjopen-2017-016694 ◽

2017 ◽

Vol 7 (8) ◽

pp. e016694 ◽

Cited By ~ 3

Author(s):

Sareh Zarshenas ◽

Laetitia Tam ◽

Angela Colantonio ◽

Seyed Mohammad Alavinia ◽

Nora Cullen

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Acute Care ◽

English Language ◽

Healthcare Providers ◽

Trial Registration ◽

Future Research ◽

Reference List ◽

Registration Number

IntroductionMany studies have assessed the predictors of morbidity/mortality of patients with traumatic brain injury (TBI) in acute care. However, with the increasing rate of survival after TBI, more attention has been given to discharge destinations from acute care as an important measure of clinical priorities. This study describes the design of a systematic review compiling and synthesising studies on the prognostic factors of discharge settings from acute care in patients with TBI.Methods and analysisThis systematic review will be conducted on peer-reviewed studies using seven databases including Medline/Medline in-Process, Embase, Cochrane Database of Systematic Reviews, Cochrane CENTRAL, PsycINFO, CINAHL and Supplemental PubMed. The reference list of selected articles and Google Scholar will also be reviewed to determine other relevant articles. This study will include all English language observational studies that focus on adult patients with TBI in acute care settings. The quality of articles will be assessed by the Quality in Prognostic Studies tool.Ethics and disseminationThe results of this review will provide evidence that may guide healthcare providers in making more informed and timely discharge decisions to the next level of care for patient with TBI. Also, this study will provide valuable information to address the gaps in knowledge for future research.Trial registration numberTrial registration number (PROSPERO) is CRD42016033046.

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Methodological Issues in Longitudinal Research on Cognitive Recovery after Traumatic Brain Injury: Evidence from a Systematic Review

Brain Impairment ◽

10.1017/brimp.2013.24 ◽

2013 ◽

Vol 14 (3) ◽

pp. 450-474 ◽

Cited By ~ 10

Author(s):

Regina Schultz ◽

Robyn L. Tate

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Longitudinal Research ◽

Effect Sizes ◽

Methodological Issues ◽

Post Injury ◽

Cognitive Recovery ◽

Cognitive Domains ◽

Severe Tbi

Background: Previous research addressing cognitive recovery after traumatic brain injury (TBI) in adults has predominately used cross-sectional methods. This systematic review examines longitudinal research into cognitive recovery in the first 2 years following moderate-to-severe TBI in adults and aims to identify apparent methodological issues with the existing literature.Design: Systematic review of the first 2 years post-trauma.Setting: Data were extracted from three electronic databases and manual searches of published articles until October 2012.Participants: Two hundred and forty-two participants with severe TBI and 281 comparison participants were used to calculate effect sizes.Results: Twenty papers met the selection criteria, with effect sizes computed from four studies. Moderate-to-large effect sizes were initially observed between the TBI and comparison groups on most measures (range: d = 0.2–2.8). Recovery continued in all five cognitive domains over the 2 years post-injury.Conclusions: Results demonstrated that cognitive recovery was continuous throughout the first 2 years following moderate-to-severe TBI. Findings also indicated different rates of recovery for the specific cognitive domains, highlighting the heterogeneous nature of cognitive recovery after TBI. The review highlighted several methodological issues within the limited existing literature; recommendations were developed to improve the evidence base.

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Intracranial Pressure Monitors in Traumatic Brain Injury: A Systematic Review

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100015286 ◽

2012 ◽

Vol 39 (5) ◽

pp. 571-576 ◽

Cited By ~ 29

Author(s):

Asher A. Mendelson ◽

Chris Gillis ◽

William R. Henderson ◽

Juan J. Ronco ◽

Vinay Dhingra ◽

...

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Intracranial Pressure ◽

Observational Studies ◽

Pooled Analysis ◽

Point Estimate ◽

Icp Monitoring ◽

Study Heterogeneity ◽

Severe Tbi

We conducted a systematic review to examine the relationship between intracranial pressure monitors (ICP) monitors and mortality in traumatic brain injury (TBI). We systematically searched for articles that met the following criteria: (1) adults patients, (2) TBI, (3) use of an ICP monitor, (4) point estimate for mortality with ICP monitoring (5) adjustment for potential confounders. Six observational studies were identified with 11,371 patients. There was marked between-study heterogeneity that precluded a pooled analysis. Patients with ICP monitors had different clinical characteristics and received more ICP targeted therapy in the ICU. Four studies found no significant relationship between ICP monitoring and survival, while the other two studies demonstrated conflicting results. Significant confounding by indication in observational studies limits the examination of isolated TBI interventions. More research should focus on interventions that affect TBI careplan systems. Further research is needed to identify which subset of severe TBI patients may benefit from ICP monitoring.

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The Impact of Traumatic Brain Injury on Neurocognitive Outcomes in Children: a Systematic Review and Meta-Analysis

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2020-325066 ◽

2021 ◽

pp. jnnp-2020-325066

Author(s):

Mark Sen Liang Goh ◽

Dawn Shu Hui Looi ◽

Jia Ling Goh ◽

Rehena Sultana ◽

Sharon Si Min Goh ◽

...

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Executive Function ◽

Brain Injury ◽

Learning And Memory ◽

Meta Analysis ◽

Cochrane Central Register ◽

Neurocognitive Outcomes ◽

Severe Tbi ◽

The Impact

ObjectiveTo assess the burden of paediatric traumatic brain injury (TBI) on neurocognition via a systematic review and meta-analysis.MethodsStudies that compared neurocognitive outcomes of paediatric patients with TBI and controls were searched using Medline, Embase, PsycINFO and Cochrane Central Register of Controlled Trials, between January 1988 and August 2019. We presented a random-effects model, stratified by TBI severity, time of assessment post injury and age.ResultsOf 5919 studies, 41 (patients=3717) and 33 (patients=3118) studies were included for the systematic review and meta-analysis, respectively. Studies mostly measured mild TBI (n=26, patients=2888) at 0–3 months postinjury (n=17, patients=2502). At 0–3 months postinjury, standardised mean differences between TBI and controls for executive function were −0.04 (95% CI −0.14 to 0.07; I2=0.00%), −0.18 (95% CI −0.29 to –0.06; I2=26.1%) and −0.95 (95% CI −1.12 to –0.77; I2=10.1%) for mild, moderate and severe TBI, respectively; a similar effect was demonstrated for learning and memory. Severe TBI had the worst outcomes across all domains and persisted >24 months postinjury. Commonly used domains differed largely from workgroup recommendations. Risk of bias was acceptable for all included studies.ConclusionA dose-dependent relationship between TBI severity and neurocognitive outcomes was evident in executive function and in learning and memory. Cognitive deficits were present for TBIs of all severity but persisted among children with severe TBI. The heterogeneity of neurocognitive scales makes direct comparison between studies difficult. Future research into lesser explored domains and a more detailed assessment of neurocognitive deficits in young children are required to better understand the true burden of paediatric TBI.

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Community-Based Physical Activity Interventions for Individuals with Moderate to Severe Traumatic Brain Injury: Scoping Review Protocol (Preprint)

10.2196/preprints.24689 ◽

2020 ◽

Author(s):

Enrico Quilico ◽

Bonnie Swaine ◽

Christophe Alarie ◽

Angela Colantonio

Keyword(s):

Physical Activity ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

Scoping Review ◽

Current Evidence ◽

Future Research ◽

Sex And Gender ◽

Community Based ◽

Severe Tbi

BACKGROUND Long-term physical, cognitive, and psychosocial problems resulting from moderate to severe traumatic brain injury (TBI) can prevent individuals from returning to preinjury lifestyles because of significant challenges with employment, leisure, and relationships. While physical activity (PA) is proposed as a cost-effective method to alleviate problems after moderate to severe TBI, there is no review to date that synthesizes the evidence for PA in the community-based context. Further, although sex- and gender-based considerations in research are considered requisite to good science, there is no review on PA and TBI that has included this explicit focus. OBJECTIVE The purpose of this review is to map and synthesize the current evidence identified through a systematic search of community-based PA interventions for individuals of all ages with moderate to severe TBI and provide an overview of that evidence by asking the following research questions: (1) what are the characteristics of community-based PA programs for individuals with moderate to severe TBI, (2) what are the reported health-related outcomes and measurement tools used to evaluate them, and (3) what considerations have been given to sex and/or gender? METHODS Searches will be conducted of six academic databases for peer-reviewed articles. Two reviewers will independently screen the articles for inclusion and extract data for the analysis. The extracted data will be coded according to the Consensus on Exercise Reporting Template checklist and the Template for Intervention Description and Replication checklist to provide sufficient detail for replication. RESULTS The abstract screening was completed by two reviewers and the extracted data were analyzed. A qualitative synthesis and description of community-based PA interventions for individuals with moderate to severe TBI will be provided. CONCLUSIONS This scoping review will generate new knowledge from published and publicly available literature. Dissemination of the results will include activities related to knowledge transfer for community-based PA after moderate to severe TBI for future research and practice. Evidence-based recommendations, future directions, potential limitations, use of online/digital components, and the possible need for a systematic review will be discussed as well. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/24689

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Prognostic Models of Mortality from Accidental Severe Traumatic Brain Injury in Children and Adolescents: A Systematic Review

Archives of Pediatric Neurosurgery ◽

10.46900/apn.v3i3(september-december).106 ◽

2021 ◽

Vol 3 (3(September-December)) ◽

Author(s):

Jose Roberto Tude Melo ◽

Marcelo Liberato Coelho Mendes de Carvalho

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Children And Adolescents ◽

Severe Traumatic Brain Injury ◽

Scientific Evidence ◽

Prognostic Models ◽

Evidence Based ◽

Level Of Evidence ◽

Severe Tbi

Introduction: Prognostic models are statistical models that combine two or more items of patient data to predict clinical outcomes. Objective: Identify prognostic models of mortality developed and published in the medical literature for possible applicability in children and adolescents victims of severe traumatic brain injury (TBI). Methods: Systematic review in the Medline electronic database (PubMed platform) of scientific articles published from 2006 (year of publication of the last systematic review on prognostic models for TBI before 2017) until July 29, 2017. Results: Ten studies on prognostic models of mortality in children and adolescents victims of severe TBI were identified for final inclusion in the review. There were eight development and two validation studies conducted in different countries. Conclusion: The analysis of this systematic review makes it possible to conclude that the ten prognostic models included in the final sample provide health professionals with a scientific evidence-based understanding of the severity of pediatric victims of severe TBI. This systematic review is classified as presenting 2A and 1 level of evidence (systematic review of homogeneous cohorts), according to the 2009 and 2011 classifications, respectively, of the Oxford Center for Evidence-Based Medicine

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Recommendations for the Design and Implementation of Virtual Reality for Acquired Brain Injury Rehabilitation: Systematic Review

Journal of Medical Internet Research ◽

10.2196/26344 ◽

2021 ◽

Vol 23 (7) ◽

pp. e26344

Author(s):

Sophie Brassel ◽

Emma Power ◽

Andrew Campbell ◽

Melissa Brunner ◽

Leanne Togher

Keyword(s):

Systematic Review ◽

Virtual Reality ◽

Brain Injury ◽

Systematic Reviews ◽

Methodological Quality ◽

Current Evidence ◽

Future Research ◽

Inclusion Criteria ◽

Design And Implementation ◽

Assessment And Treatment

Background Virtual reality (VR) is increasingly being used for the assessment and treatment of impairments arising from acquired brain injuries (ABIs) due to perceived benefits over traditional methods. However, no tailored options exist for the design and implementation of VR for ABI rehabilitation and, more specifically, traumatic brain injury (TBI) rehabilitation. In addition, the evidence base lacks systematic reviews of immersive VR use for TBI rehabilitation. Recommendations for this population are important because of the many complex and diverse impairments that individuals can experience. Objective This study aims to conduct a two-part systematic review to identify and synthesize existing recommendations for designing and implementing therapeutic VR for ABI rehabilitation, including TBI, and to identify current evidence for using immersive VR for TBI assessment and treatment and to map the degree to which this literature includes recommendations for VR design and implementation. Methods This review was guided by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). A comprehensive search of 11 databases and gray literature was conducted in August 2019 and repeated in June 2020. Studies were included if they met relevant search terms, were peer-reviewed, were written in English, and were published between 2009 and 2020. Studies were reviewed to determine the level of evidence and methodological quality. For the first part, qualitative data were synthesized and categorized via meta-synthesis. For the second part, findings were analyzed and synthesized descriptively owing to the heterogeneity of data extracted from the included studies. Results In the first part, a total of 14 papers met the inclusion criteria. Recommendations for VR design and implementation were not specific to TBI but rather to stroke or ABI rehabilitation more broadly. The synthesis and analysis of data resulted in three key phases and nine categories of recommendations for designing and implementing VR for ABI rehabilitation. In the second part, 5 studies met the inclusion criteria. A total of 2 studies reported on VR for assessment and three for treatment. Studies were varied in terms of therapeutic targets, VR tasks, and outcome measures. VR was used to assess or treat impairments in cognition, balance, and anxiety, with positive outcomes. However, the levels of evidence, methodological quality, and inclusion of recommendations for VR design and implementation were poor. Conclusions There is limited research on the use of immersive VR for TBI rehabilitation. Few studies have been conducted, and there is limited inclusion of recommendations for therapeutic VR design and implementation. Future research in ABI rehabilitation should consider a stepwise approach to VR development, from early co-design studies with end users to larger controlled trials. A list of recommendations is offered to provide guidance and a more consistent model to advance clinical research in this area.

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Speech-Language Pathologists' Practices for Addressing Cognitive Deficits in College Students With Traumatic Brain Injury

American Journal of Speech-Language Pathology ◽

10.1044/2020_ajslp-20-00079 ◽

2020 ◽

Vol 29 (4) ◽

pp. 2226-2241

Author(s):

Kristen Ackley ◽

Jessica Brown

Keyword(s):

College Students ◽

Traumatic Brain Injury ◽

Brain Injury ◽

The United States ◽

Future Research ◽

Speech Language Pathologists ◽

Treatment Practices ◽

Assessment And Treatment ◽

Specific Assessment ◽

Narrative Literature Review

Purpose Traumatic brain injury (TBI) accounts for a large percentage of death and disability in the United States. Survivors of TBI and their families often face impaired cognition (e.g., memory or attention). Currently, evidence supports the use of individualized cognitive therapy for individuals who experience TBI. Therefore, we conducted a modified narrative literature review of speech-language pathologists' practices relative to college students with TBI. Method We conducted a search across three platforms. Nine hundred sixty-three articles were reviewed by title. From this, 178 articles were selected to be reviewed by abstract and 36 articles were read in full. Of these, 13 articles were included in the review. Articles were selected for inclusion or exclusion based on specific criteria related to population and diagnosis. Results Overall, little evidence exists to guide clinicians regarding specific assessment and treatment practices for college students postinjury. The findings of this review article span four major areas: (a) general service delivery efforts, (b) education, (c) assessment, and (d) treatment. Conclusion Results of the literature search indicate that evidence is lacking to support specific practices for use by speech-language pathologists with this population and highlight future research needs to inform clinical practice.

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