scholarly journals Traumatic brain injury and coping processes – improving outcomes by involving family in the rehabilitation process

2021 ◽  
Vol 27 (03) ◽  
pp. 185-191
Author(s):  
M. Lange-von Szczutowski

Following a traumatic brain injury, many patients struggle to cope with daily activities and experiences, both at the physical and psychological level. In addition to the patient's own coping process, the family's involvement in the heal-ing process is extremely important. Acute care is usually provided by family members and has the potential to either support or hinder rehabilitation and adaptation processes. In addition to new limits of self-care and complaints caused by brain damage, patients face far-reaching psychosocial problems. Despite increasing interest in the management of brain damage and processing of the disease, there is a lack of health-promoting concepts designed to address the impairments and psychosocial relationship difficul-ties suffered by people after traumatic brain injury. In this study, rehabilitation potential was identified by analyzing the results of biographical narrative interviews with men who had suffered a traumatic brain injury in an industrial accident, and their relatives. The selection and qualitative analysis of the rehabilitation process of traumatic brain injury patients reveals the potential for intervention and the need for a holistic integration process between the patient, relatives and physicians, which can be further supported by integrating family members into the treatment process. Keywords: rehabilitation of traumatic brain injury, qualitative social research, reintegration, relatives

Author(s):  
Grace B. McKee ◽  
Laiene Olabarrieta-Landa ◽  
Paula K. Pérez-Delgadillo ◽  
Ricardo Valdivia-Tangarife ◽  
Teresita Villaseñor-Cabrera ◽  
...  

Pediatric traumatic brain injury (TBI) represents a serious public health concern. Family members are often caregivers for children with TBI, which can result in a significant strain on familial relationships. Research is needed to examine aspects of family functioning in the context of recovery post-TBI, especially in Latin America, where cultural norms may reinforce caregiving by family members, but where resources for these caregivers may be scarce. This study examined caregiver-reported family satisfaction, communication, cohesion, and flexibility at three time points in the year post-injury for 46 families of a child with TBI in comparison to healthy control families. Families experiencing pediatric TBI were recruited from a large hospital in Guadalajara, Mexico, while healthy controls were recruited from a local educational center. Results from multilevel growth curve models demonstrated that caregivers of children with a TBI reported significantly worse family functioning than controls at each assessment. Families experiencing pediatric TBI were unable to attain the level of functioning of controls during the time span studied, suggesting that these families are likely to experience long-term disruptions in family functioning. The current study highlights the need for family-level intervention programs to target functioning for families affected by pediatric TBI who are at risk for difficulties within a rehabilitation context.


2012 ◽  
Vol 33 (2) ◽  
pp. 311-318 ◽  
Author(s):  
Nicole A Terpolilli ◽  
Seong-Woong Kim ◽  
Serge C Thal ◽  
Wolfgang M Kuebler ◽  
Nikolaus Plesnila

Ischemia, especially pericontusional ischemia, is one of the leading causes of secondary brain damage after traumatic brain injury (TBI). So far efforts to improve cerebral blood flow (CBF) after TBI were not successful because of various reasons. We previously showed that nitric oxide (NO) applied by inhalation after experimental ischemic stroke is transported to the brain and induces vasodilatation in hypoxic brain regions, thus improving regional ischemia, thereby improving brain damage and neurological outcome. As regional ischemia in the traumatic penumbra is a key mechanism determining secondary posttraumatic brain damage, the aim of the current study was to evaluate the effect of NO inhalation after experimental TBI. NO inhalation significantly improved CBF and reduced intracranial pressure after TBI in male C57 Bl/6 mice. Long-term application (24 hours NO inhalation) resulted in reduced lesion volume, reduced brain edema formation and less blood–brain barrier disruption, as well as improved neurological function. No adverse effects, e.g., on cerebral auto-regulation, systemic blood pressure, or oxidative damage were observed. NO inhalation might therefore be a safe and effective treatment option for TBI patients.


2021 ◽  
Vol 19 ◽  
Author(s):  
Denise Battaglini ◽  
Dorota Siwicka-Gieroba ◽  
Patricia RM Rocco ◽  
Fernanda Ferreira Cruz ◽  
Pedro Leme Silva ◽  
...  

: Traumatic brain injury (TBI) is a major cause of disability and death worldwide. The initial mechanical insult results in tissue and vascular disruption with hemorrhages and cellular necrosis that is followed by a dynamic secondary brain damage that presumably results in additional destruction of the brain. In order to minimize deleterious consequences of the secondary brain damage-such as inflammation, bleeding or reduced oxygen supply. The old concept of the -staircase approach- has been updated in recent years by most guidelines and should be followed as it is considered the only validated approach for the treatment of TBI. Besides, a variety of novel therapies have been proposed as neuroprotectants. The molecular mechanisms of each drug involved in inhibition of secondary brain injury can result as potential target for the early and late treatment of TBI. However, no specific recommendation is available on their use in clinical setting. The administration of both synthetic and natural compounds, which act on specific pathways involved in the destructive processes after TBI, even if usually employed for the treatment of other diseases, can show potential benefits. This review represents a massive effort towards current and novel therapies for TBI that have been investigated in both pre-clinical and clinical settings. This review aims to summarize the advancement in therapeutic strategies basing on specific and distinct -target of therapies-: brain edema, ICP control, neuronal activity and plasticity, anti-inflammatory and immunomodulatory effects, cerebral autoregulation, antioxidant properties, and future perspectives with the adoption of mesenchymal stromal cells.


2018 ◽  
Vol 24 (3) ◽  
pp. 497-499

Moriarty, H., Winter, L., Short, T. H., & True, G. (2018). Exploration of factors related to depressive symptomatology in family members of military veterans with traumatic brain injury. Journal of Family Nursing, 24, 184-216. doi: 10.1177/1074840718773470 .


2012 ◽  
Vol 2 (2) ◽  
pp. 74-76 ◽  
Author(s):  
Jazmin Price ◽  
Amy Price

This article explores some of the trials and tribulations the family members of patients with traumatic brain injury go through. In the first part, Jazmin Price recounts her recollections of the accident which changed her grandparents’ lives and the effect which it had on her interactions with them. In the second part of the article, Dr. Amy Price, Jazmin’s grandmother shares her side of the story and shares how despite the challenges a TBI patient faces, “where there is life, there is hope”


2018 ◽  
Author(s):  
Jessica Bruijel ◽  
Sven Z Stapert ◽  
Annemiek Vermeeren ◽  
Jennie L Ponsford ◽  
Caroline M van Heugten

BACKGROUND Fatigue and sleep problems are common after a traumatic brain injury (TBI) and are experienced as highly distressing symptoms, playing a significant role in the recovery trajectory, and they can drastically impact the quality of life and societal participation of the patient and their family and friends. However, the etiology and development of these symptoms are still uncertain. OBJECTIVE The aim of this study is to examine the development of fatigue and sleep problems following moderate to severe TBI and to explore the changes in underlying biological (pain, brain damage), psychological (emotional state), and social (support family, participation) factors across time. METHODS This study is a longitudinal multicenter observational cohort study with 4 measurement points (3, 6, 12, and 18 months postinjury) including subjective questionnaires and cognitive tasks, preceded by 7 nights of actigraphy combined with a sleep diary. Recruitment of 137 moderate to severe TBI patients presenting at emergency and neurology departments or rehabilitation centers across the Netherlands is anticipated. The evolution of fatigue and sleep problems following TBI and their association with possible underlying biological (pain, brain damage), psychological (emotional state), and social (support family, participation) factors will be examined. RESULTS Recruitment of participants for this longitudinal cohort study started in October 2017, and the enrollment of participants is ongoing. The first results are expected at the end of 2020. CONCLUSIONS To the authors’ knowledge, this is the first study that examines the development of both post-TBI fatigue and sleep longitudinally within a biopsychosocial model in moderate to severe TBI using both subjective and objective measures. Identification of modifiable factors such as mood and psychosocial stressors may give direction to the development of interventions for fatigue and sleep problems post-TBI. CLINICALTRIAL Netherlands Trial Register NTR7162; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=7162 (Archived by WebCite at http://www.webcitation.org/6z3mvNLuy) INTERNATIONAL REGISTERED REPOR RR1-10.2196/11295


Author(s):  
Robert W. Butler ◽  
Donna R. Copeland

It is now generally accepted that the diagnosis of many pediatric cancers and their treatments result in significant and long-lasting neurocognitive, psychological, and psychosocial impairments and difficulties. The current status of research in this field has been addressed by other chapters in this text. We would, however, like to emphasize at the onset of our chapter that we firmly believe pediatric cancer is truly a family affair. The effects of the diagnosis of a life-threatening illness and its often-chronic treatment not only result in significant impact on the child’s or adolescent’s neuropsychological and psychological state, but also cause psychological ramifications for the parents, siblings, and extended family members. In healthy, well-functioning families, this major life obstacle can serve as an impetus to rally family members in support of the child. When this happens, interventions for late effects are beginning to be identified as effective and of potential benefit. This field, however, is clearly in its infancy. If the family is chaotic and struggling with relationship issues, the prognosis is less positive. Our clinical observations of these relationships are supported both by preliminary data from studies conducted by our research group and others, and by published manuscripts in the field of pediatric traumatic brain injury (Yeates et al., 1997, 2001). In one of the only studies investigating the impact of familial variables on psychosocial and neuropsychological outcome in pediatric brain tumor patients, the results are extremely consistent with the traumatic brain injury population (Carlson-Green, Morris, & Krawjecki, 1995). Reduced maternal dependence on external coping resources, higher parental socioeconomic status, dual-parent families, and familial cohesion were all identified as improving long-term outcome in this population, as documented by intellectual and behavioral integrity. The late effects of pediatric cancer and its treatment are physical, cognitive, psychological, and social. When multiple effects are present, they can be expected to result in a synergistic impact not only on the child, but also on other family members. The important point is that late effects should not be viewed in isolation or summated but should be appreciated for their interrelatedness.


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