Neurosciences Program, Alberta Children's Hospital, Calgary, Alberta, Canada (Dr Brooks); Departments of Paediatrics (Dr Brooks), Clinical Neurosciences (Dr Brooks), and Psychology (Dr Brooks), Alberta Children's Hospital Research Institute (Dr Brooks and Mr Virani), Hotchkiss Brain Institute (Dr Brooks), Faculty of Nursing (Ms Kumari), and Faculty of Kinesiology (Mr Virani), University of Calgary, Calgary, Alberta, Canada.
J Head Trauma Rehabil. 2022;37(4):230-239. doi: 10.1097/HTR.0000000000000717. Epub 2021 Jul 26.
A significant minority of adolescents will have persistent postconcussion symptoms after an injury, potentially having a negative impact on family functioning. However, the reasons for a family's negative impact are not clearly understood. The objective of this study was to determine whether preinjury/demographic factors, injury characteristics, and/or worse postinjury symptoms are associated with higher levels of family stress in youth with refractory postconcussion symptoms.
Pediatric refractory concussion clinic in a tertiary care center.
A total of 121 adolescents (13-18 years old) who were 1 to 12 months postconcussion.
Primary outcome was the mean stress rating on the Family Burden of Injury Interview (FBII), a 27-item questionnaire rating the impact on a family as a result of an injury. Preinjury/demographic and injury details were collected. Youth and their parents also completed measures of postconcussion symptoms, depression, anxiety, and behavioral problems.
Participants had a mean age of 16.0 years (SD = 1.3), of which, 65% identified as female, and were on an average 5.2 months (SD = 2.4) postconcussion. FBII ratings were not significantly correlated with demographics, preinjury functioning, injury severity, duration of persistent postconcussion problems (ie, time since injury), or self-reported postconcussion symptoms. Greater family burden (higher FBII ratings) significantly correlated with worse parent-reported postconcussion symptoms, worse psychological functioning (self-reported depression, parent-reported anxiety, and depression), and worse behavioral functioning (parent-reported conduct problems and peer problems). A multiple linear regression model revealed that parent-perceived postconcussion cognitive symptoms (β = .292, t = 2.56, P = .012) and parent-perceived peer problems (β = .263, t = 2.59, P = .011) were significantly associated with family burden ( F8,105 = 6.53; P < .001; R2 = 0.35).
Families of youth with refractory postconcussion symptoms can experience a negative impact. The severity of reported family burden in those with slow recovery from concussion was significantly associated with parents' perception of their child's cognitive symptoms and peer problems. These results could provide support for family-based interventions in this population.
在受伤后，少数青少年会持续出现脑震荡后症状，这可能对家庭功能产生负面影响。然而，家庭受影响的原因尚不清楚。本研究的目的是确定青少年脑震荡后难治性患者的损伤前/人口统计学因素、损伤特征和/或更严重的损伤后症状是否与更高水平的家庭应激相关。
在三级护理中心的儿科难治性脑震荡诊所。
共有 121 名青少年（13-18 岁），受伤后 1-12 个月。
主要结果是家庭损伤负担访谈（FBII）的平均应激评分，这是一个 27 项的问卷，评估损伤对家庭的影响。收集损伤前/人口统计学和损伤细节。青少年及其父母还完成了脑震荡后症状、抑郁、焦虑和行为问题的评估。
参与者的平均年龄为 16.0 岁（SD=1.3），其中 65%为女性，平均脑震荡后 5.2 个月（SD=2.4）。FBII 评分与人口统计学、损伤前功能、损伤严重程度、持续脑震荡后问题（即受伤后时间）或自我报告的脑震荡后症状无显著相关性。更大的家庭负担（更高的 FBII 评分）与父母报告的更严重的脑震荡后症状、更差的心理功能（自我报告的抑郁、父母报告的焦虑和抑郁）以及更差的行为功能（父母报告的行为问题和同伴问题）显著相关。多元线性回归模型显示，父母感知的脑震荡后认知症状（β=0.292，t=2.56，P=0.012）和父母感知的同伴问题（β=0.263，t=2.59，P=0.011）与家庭负担显著相关（F8,105=6.53；P<.001；R2=0.35）。
脑震荡后难治性患者的家庭可能会受到负面影响。那些从脑震荡中恢复缓慢的患者报告的家庭负担严重程度与父母对其子女认知症状和同伴问题的感知显著相关。这些结果可为该人群的基于家庭的干预措施提供支持。
