Temple Jessica Lynn, Struchen Margaret A, Pappadis Monique R
a Department of Psychology and Neuropsychology , TIRR Memorial Hermann , Houston , TX , USA.
b Department of Physical Medicine and Rehabilitation , Baylor College of Medicine , Houston , TX , USA.
Brain Inj. 2016;30(13-14):1672-1682. doi: 10.3109/02699052.2015.1113561. Epub 2016 Oct 14.
This study investigates the contribution of pre-injury family functioning and resources on self-reported post-concussive symptoms and functional outcomes in persons with mild TBI (mTBI).
Participants with uncomplicated or complicated mTBIs were recruited from consecutive admissions to the emergency department of a level 1 trauma centre. Patients completed baseline assessments within 2 weeks of injury and an outcomes assessment at 3 months post-injury.
One hundred and sixty-six adults with mTBI were included. Baseline measures of pre-injury history, family functioning and resources were obtained. Functional status assessments and self-reported measures of health, common TBI symptoms and psychological problems were administered at 3-months post-injury.
Data reduction of outcome measures using principle components analysis revealed two factors: self-reported post-concussive symptoms and current functional/participation status, explaining 60.53% of the variance. Family resources (β = -0.239, t(150) = -2.84, p = 0.005) and age (β = -0.170, t(150) = -2.19, p = 0.030), but not family functioning, were significant predictors of self-reported post-concussive symptoms at follow-up, R = 0.051, F(5, 150) = 4.09, p = 0.002. Neither family resources nor functioning predicted current functional/participation status.
Fewer family resources and younger age were associated with increased self-reported post-concussive symptoms. Fewer resources may be a potential risk factor to heightened perception of post-concussive symptoms. Providing low-cost counselling or resource facilitation services may improve outcomes for those with limited resources after mTBI.
本研究调查了伤前家庭功能和资源对轻度创伤性脑损伤(mTBI)患者自我报告的脑震荡后症状及功能结局的影响。
从一级创伤中心急诊科连续收治的患者中招募了无并发症或有并发症的mTBI患者。患者在受伤后2周内完成基线评估,并在受伤后3个月进行结局评估。
纳入166例成年mTBI患者。获取伤前病史、家庭功能和资源的基线测量值。在受伤后3个月进行功能状态评估以及健康、常见TBI症状和心理问题的自我报告测量。
使用主成分分析对结局指标进行数据降维后发现两个因素:自我报告的脑震荡后症状和当前功能/参与状态,解释了60.53%的方差。家庭资源(β = -0.239,t(150) = -2.84,p = 0.005)和年龄(β = -0.170,t(150) = -2.19,p = 0.030),而非家庭功能,是随访时自我报告的脑震荡后症状的显著预测因素,R = 0.051,F(5, 150) = 4.09,p = 0.002。家庭资源和功能均未预测当前功能/参与状态。
家庭资源较少和年龄较小与自我报告的脑震荡后症状增加有关。资源较少可能是脑震荡后症状感知增强的潜在风险因素。提供低成本咨询或资源促进服务可能会改善mTBI后资源有限者的结局。