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Determinants of Effective Caregiver Communication After Adolescent Traumatic Brain Injury
Author(s) -
HobartPorter Laura,
Wade Shari,
Minich Nori,
Kirkwood Michael,
Stancin Terry,
Taylor Hudson Gerry
Publication year - 2015
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2015.02.004
Subject(s) - coping (psychology) , socioeconomic status , clinical psychology , medicine , traumatic brain injury , caregiver burden , psychology , psychiatry , disease , population , dementia , environmental health , pathology
Objective To characterize the effects of caregiver mental health and coping strategies on interactions with an injured adolescent acutely after traumatic brain injury (TBI). Design Multi‐site, cross‐sectional study. Setting Outpatient setting of 3 tertiary pediatric hospitals and 2 tertiary general medical centers. Participants 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. Main Outcomes Measures 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.