Long Term Changes in Family Needs After Brain Injury: A Preliminary Review

1997 ◽  
Vol 3 (1) ◽  
pp. 30-39 ◽  
Author(s):  
Peter Stebbins

When a family member acquires a brain injury the family as a whole is likely to experience severe emotional stress and strain in coping with and adjusting to the injured family member. Longitudinal studies of family adjustment have shown that families find it increasingly difficult to cope with the brain injured family member as the time (years) since injury increases. The increasing difficulty family members experience in coping with their brain injured relative led several researchers to investigate the needs of family members. Research investigating family needs after brain injury is limited to the first couple of years post trauma despite the finding that stress and burden continue to increase as the years progress. This paper reviews family needs research over the last three decades and provides a discussion of family needs and surrounding issues relevant to rehabilitation professionals.

2002 ◽  
Vol 90 (2) ◽  
pp. 415-425 ◽  
Author(s):  
Gregory J. Boyle ◽  
Sandra Haines

This study assesses the effects of severe traumatic brain injuries on family members and functioning—a topic of interest for those working with survivors and their families. This issue is receiving increased attention as recent findings suggest that family adjustment influences outcome for brain-injured persons. The Family Environment Scale and the Profile of Mood States were completed by 25 individuals who had a family member with a severe traumatic brain injury. These scales were also completed by a comparison group of 32 individuals who had no brain-injured family member. In terms of family functioning, the findings suggest that, when a family member suffers a severe traumatic brain injury, depression may be elevated, along with a decreased ability to express feelings, decreased time and energy for social and recreational activities, and increased control in comparison to families without a brain-injured member. While this might contribute to family isolation which could last for many years, the overall finding of the present study was that caregiver families were coping adequately.


2005 ◽  
Vol 90 (11) ◽  
pp. 6085-6092 ◽  
Author(s):  
Gianluca Aimaretti ◽  
Maria Rosaria Ambrosio ◽  
Carolina Di Somma ◽  
Maurizio Gasperi ◽  
Salvatore Cannavò ◽  
...  

Abstract Context: Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are conditions at high risk for the development of hypopituitarism. Objective: The objective of the study was to clarify whether pituitary deficiencies and normal pituitary function recorded at 3 months would improve or worsen at 12 months after the brain injury. Design and Patients: Pituitary function was tested at 3 and 12 months in patients who had TBI (n = 70) or SAH (n = 32). Results: In TBI, the 3-month evaluation had shown hypopituitarism (H) in 32.8%. Panhypopituitarism (PH), multiple (MH), and isolated (IH) hypopituitarism had been demonstrated in 5.7, 5.7, and 21.4%, respectively. The retesting demonstrated some degree of H in 22.7%. PH, MH, and IH were present in 5.7, 4.2, and 12.8%, respectively. PH was always confirmed at 12 months, whereas MH and IH were confirmed in 25% only. In 5.5% of TBI with no deficit at 3 months, IH was recorded at retesting. In 13.3% of TBI with IH at 3 months, MH was demonstrated at 12-month retesting. In SAH, the 3-month evaluation had shown H in 46.8%. MH and IH had been demonstrated in 6.2 and 40.6%, respectively. The retesting demonstrated H in 37.5%. MH and IH were present in 6.2 and 31.3%, respectively. Although no MH was confirmed at 12 months, two patients with IH at 3 months showed MH at retesting; 30.7% of SAH with IH at 3 months displayed normal pituitary function at retesting. In SAH, normal pituitary function was always confirmed. In TBI and SAH, the most common deficit was always severe GH deficiency. Conclusion: There is high risk for H in TBI and SAH patients. Early diagnosis of PH is always confirmed in the long term. Pituitary function in brain-injured patients may improve over time but, although rarely, may also worsen. Thus, brain-injured patients must undergo neuroendocrine follow-up over time.


2020 ◽  
Vol 34 (6) ◽  
pp. 495-504
Author(s):  
Azlinda Azman ◽  
Nor Amalina Jali ◽  
Paramjit Singh Jamir Singh ◽  
Jafri Malin Abdullah ◽  
Haidi Ibrahim

PurposeAdvanced medical technology has reduced the mortality rate among traumatic brain injury (TBI) patients. This, however, has led to an increasing number of surviving patients with a major disability. As a consequence, these patients need attentive care which becomes an important issue for the society, particularly family members. Thus, this paper aims to review some of the salient roles, challenges and needs of the family caregivers in caring or nursing for their family members diagnosed with TBI.Design/methodology/approachAn inclusive search of the literature was undertaken to identify the family roles, challenges and needs in supporting and nursing TBI patients.FindingsPrevious studies have shown that the family needs to address two important aspects of taking care of TBI patients, which involve emotional and physical affairs. Hence, it is essential for the family members to have adequate information on healing treatment, nursing and care methods, financial support, support groups, managing self-care and, more importantly, emotional and social support.Originality/valueThis paper is not currently under consideration, in press or published elsewhere. In Malaysian culture, nursing disabled patients have always been a family responsibility. The role of nursing the patients has been done domestically and is considered a private affair. In order to execute the role, some put the patient needs as their priority and leave aside their needs and matters.


1998 ◽  
Vol 7 (1) ◽  
pp. 30-36 ◽  
Author(s):  
DA Jacob

BACKGROUND: Understanding the challenges faced by family members involved in decisions about the use of life-sustaining treatment for incompetent patients in the ICU is necessary for developing empirically based supportive interventions. OBJECTIVES: To describe and explain the experiences of family members who were involved in decisions on behalf of their loved ones in order to promote understanding of such experiences and to suggest areas for effective, supportive intervention. METHODS: The grounded-theory method of qualitative research was used. Data collection involved semistructured interviews of 17 persons who had been involved in decisions about the use of life-sustaining treatment for a family member in the ICU. RESULTS: Family members discussed the need to arrive at a judgment of the patient's condition and to work with caregivers to have the family member's decision about life-sustaining treatment enacted. Data analysis suggests that clinicians can best support family members by helping the members arrive at a judgment about the patient's condition and treatment desires and by connecting with the family members to ensure that treatment goals are mutual. Supporting family members in this way helps them accept and go on in a positive way after the experience. CONCLUSIONS: Family members of patients in the ICU are willing and able to take responsibility for decisions about the use of life-sustaining treatment for their loved ones. The long-term acceptance of the experience and the decisions made depends greatly on the interactions between the family member who makes the decision and nurses and physicians in the clinical setting.


2018 ◽  
pp. 110-119

Primary Objectives: By extending the scope of knowledge of the primary care optometrist, the brain injury population will have expanded access to entry level neurooptometric care by optometric providers who have a basic understanding of their neurovisual problems, be able to provide some treatment and know when to refer to their colleagues who have advanced training in neuro-optometric rehabilitation.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 444-445
Author(s):  
Naomi Meinertz ◽  
Pi-Ju Liu ◽  
Ron Acierno

Abstract Abuse in later life could potentially lead to lower levels of social support, especially when perpetrated by family members who are charged with protecting the older adult in their care. Using both waves of the National Elder Mistreatment longitudinal data (wave one collected in 2008 and wave two in 2015; N=774), long-term effects of abuse (i.e., physical, emotional, sexual, and financial) on levels of social support, physical health, and clinical depressive symptoms for respondents at or above the age of 60 years were analyzed. A multivariate analysis of variance showed that respondents abused at wave one (n=261) by a family member (B=-0.55, p≤0.001), a spouse or ex-partner (B=-0.349, p=0.02), or a non-relative or stranger (B=-0.301, p=0.026) had lower levels of social support eight years later at wave two. Those abused by a family member at wave one also experienced higher levels of depressive symptoms at wave two (B=-0.187, p=0.01). Perpetrator type did not predict general health at wave two. These results emphasize the long-term impact of abuse on the lives of older adults and highlight the importance trusted relationships, such as with family members, have on older adult health and wellbeing.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Susanne A. Elsner ◽  
Sam S. Salek ◽  
Andrew Y. Finlay ◽  
Anna Hagemeier ◽  
Catherine J. Bottomley ◽  
...  

Abstract Background The Family Reported Outcome Measure (FROM-16) assesses the impact of a patient’s chronic illness on the quality of life (QoL) of the patient’s partner or family members. The aim of the study was to translate, explore the structure of and validate the FROM-16. Methods The questionnaire was translated from English into German (forward, backward, four independent translators). Six interviews with family members were conducted to confirm the questionnaire for linguistic, conceptual, semantic and experiential equivalence and its practicability. The final German translation was tested for internal consistency, reproducibility and test validity. Criterion validity was tested by correlating the scores of the FROM-16 and the Global Health Scale (GHS). Principal component analysis, factor analysis, and confirmatory factor analysis was used to assess the questionnaire’s structure and its domains. Reliability and reproducibility were tested computing the intraclass correlation coefficient (ICC) using one sample t-test for testing the hypothesis that the difference between the scores was not different from zero. Results Overall, 83 family members (61% female, median age: 61 years) completed the questionnaire at two different times (mean interval: 22 days). Internal consistency was good for the FROM-16 scores (Cronbach’s α for total score = 0.86). In those with stable GHS, the ICC for the total score was 0.87 and the difference was not different from zero (p = 0.262) indicating reproducible results. A bi-factor model with a general factor including all items, and two sub-factors comprising the items from the original 2-factor construct had the best fit. Conclusions The German FROM-16 has good reliability, test validity and practicability. It can be considered as an appropriate and generic tool to measure QoL of a patient’s partner or family member. Due to the presence of several cross-loadings we do not recommend the reporting of the scores of the two domains proposed for the original version of FROM-16 when using the German version. Thus, in reporting the results emphasis should be put on the total score. Trial registration: Retrospectively registered: DRKS00021070.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Huazhen Chen ◽  
Karl Kevala ◽  
Elma Aflaki ◽  
Juan Marugan ◽  
Hee-Yong Kim

Abstract Background Repetitive mild traumatic brain injury (mTBI) can result in chronic visual dysfunction. G-protein receptor 110 (GPR110, ADGRF1) is the target receptor of N-docosahexaenoylethanolamine (synaptamide) mediating the anti-neuroinflammatory function of synaptamide. In this study, we evaluated the effect of an endogenous and a synthetic ligand of GPR110, synaptamide and (4Z,7Z,10Z,13Z,16Z,19Z)-N-(2-hydroxy-2-methylpropyl) docosa-4,7,10,13,16,19-hexaenamide (dimethylsynaptamide, A8), on the mTBI-induced long-term optic tract histopathology and visual dysfunction using Closed-Head Impact Model of Engineered Rotational Acceleration (CHIMERA), a clinically relevant model of mTBI. Methods The brain injury in wild-type (WT) and GPR110 knockout (KO) mice was induced by CHIMERA applied daily for 3 days, and GPR110 ligands were intraperitoneally injected immediately following each impact. The expression of GPR110 and proinflammatory mediator tumor necrosis factor (TNF) in the brain was measured by using real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) in an acute phase. Chronic inflammatory responses in the optic tract and visual dysfunction were assessed by immunostaining for Iba-1 and GFAP and visual evoked potential (VEP), respectively. The effect of GPR110 ligands in vitro was evaluated by the cyclic adenosine monophosphate (cAMP) production in primary microglia isolated from adult WT or KO mouse brains. Results CHIMERA injury acutely upregulated the GPR110 and TNF gene level in mouse brain. Repetitive CHIMERA (rCHIMERA) increased the GFAP and Iba-1 immunostaining of glia cells and silver staining of degenerating axons in the optic tract with significant reduction of N1 amplitude of visual evoked potential at up to 3.5 months after injury. Both GPR110 ligands dose- and GPR110-dependently increased cAMP in cultured primary microglia with A8, a ligand with improved stability, being more effective than synaptamide. Intraperitoneal injection of A8 at 1 mg/kg or synaptamide at 5 mg/kg significantly reduced the acute expression of TNF mRNA in the brain and ameliorated chronic optic tract microgliosis, astrogliosis, and axonal degeneration as well as visual deficit caused by injury in WT but not in GPR110 KO mice. Conclusion Our data demonstrate that ligand-induced activation of the GPR110/cAMP system upregulated after injury ameliorates the long-term optic tract histopathology and visual impairment caused by rCHIMERA. Based on the anti-inflammatory nature of GPR110 activation, we suggest that GPR110 ligands may have therapeutic potential for chronic visual dysfunction associated with mTBI.


2021 ◽  
Vol 28 ◽  
Author(s):  
Lucas Alexandre Santos Marzano ◽  
Fabyolla Lúcia Macedo de Castro ◽  
Caroline Amaral Machado ◽  
João Luís Vieira Monteiro de Barros ◽  
Thiago Macedo e Cordeiro ◽  
...  

: Traumatic brain injury (TBI) is a serious cause of disability and death among young and adult individuals, displaying complex pathophysiology including cellular and molecular mechanisms that are not fully elucidated. Many experimental and clinical studies investigated the potential relationship between TBI and the process by which neurons are formed in the brain, known as neurogenesis. Currently, there are no available treatments for TBI’s long-term consequences being the search for novel therapeutic targets, a goal of highest scientific and clinical priority. Some studies evaluated the benefits of treatments aimed at improving neurogenesis in TBI. In this scenario, herein, we reviewed current pre-clinical studies that evaluated different approaches to improving neurogenesis after TBI while achieving better cognitive outcomes, which may consist in interesting approaches for future treatments.


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