Traumatic Brain Injury Center of Excellence (Drs Brickell, French, and Lange and Mss Wright, Varbedian, Tippett, and Byrd) and National Intrepid Center of Excellence (Drs Brickell, Lippa, French, and Lange and Mss Wright, Varbedian, and Tippett), Walter Reed National Military Medical Center, Bethesda, Maryland; Uniformed Services University of the Health Sciences, Bethesda, Maryland (Drs Brickell and French); General Dynamics Information Technology, Silver Spring, Maryland (Drs Brickell and Lange and Mss Wright, Varbedian, Tippett, and Byrd); Naval Medical Center San Diego, California (Ms Byrd); and University of British Columbia, Vancouver, British Columbia, Canada (Dr Lange).
J Head Trauma Rehabil. 2022;37(6):338-349. doi: 10.1097/HTR.0000000000000802. Epub 2022 Jul 20.
To examine the relationship between service member/veteran (SM/V) traumatic brain injury (TBI) severity with caregiver health-related quality of life (HRQOL).
Military treatment facility.
Caregivers ( N = 316) of SM/Vs following a TBI divided into 2 groups based on SM/V TBI severity: (1) caregivers of SM/Vs following an uncomplicated mild TBI (UnMTBI Caregiver group, n = 246), and (2) caregivers of SM//Vs following a complicated mild, moderate, severe, or penetrating TBI (STBI Caregiver group, n = 70). The STBI Caregiver group was further divided into 2 subgroups: Parent ( n = 21) versus Intimate Partner ( n = 49). The UnMTBI Caregiver group consisted of intimate partners.
Prospective cohort.
Caregivers completed 15 HRQOL measures.
Using analysis of variance and chi-square analysis, the UnMTBI Caregiver group reported worse scores on 12 HRQOL measures and more clinically elevated scores for 6 of 15 comparisons than the STBI Caregiver group. The UnMTBI Caregiver group also reported worse scores on 10 HRQOL measures than intimate partners in the STBI Caregiver group and 5 measures than parents in the STBI Caregiver group. Parents reported worse scores on 3 measures than intimate partners in the STBI Caregiver group. The UnMTBI Caregiver group reported more clinically elevated scores for 7 of 15 comparisons than intimate partners in the STBI Caregiver group.
Intimate partner caregivers of an SM/V following a remote uncomplicated MTBI reported worse HRQOL than intimate partners and parent caregivers of an SM/V following a more severe TBI, mostly likely due to SM/V physical and mental health comorbidities. Interventions that focus on the SM/V's TBI and other comorbidities, the caregiver's behavioral health problems, and the relationship and family factors that interact with each other will likely have the most success in improving individual and family outcomes for military families.
研究军人/退伍军人（SM/V）创伤性脑损伤（TBI）严重程度与照顾者健康相关生活质量（HRQOL）之间的关系。
军事治疗设施。
根据 SM/V TBI 严重程度将照顾者（N=316）分为 2 组：（1）照顾未合并轻度创伤性脑损伤（UnMTBI）SM/V 的照顾者（UnMTBI 照顾者组，n=246），（2）照顾合并轻度、中度、重度或穿透性 TBI（STBI）SM//V 的照顾者（STBI 照顾者组，n=70）。STBI 照顾者组进一步分为 2 个亚组：父母（n=21）与亲密伴侣（n=49）。UnMTBI 照顾者组由亲密伴侣组成。
前瞻性队列研究。
照顾者完成了 15 项 HRQOL 测量。
使用方差分析和卡方分析，UnMTBI 照顾者组在 12 项 HRQOL 测量中报告的分数更差，在 15 项比较中有 6 项的临床评分更高，而 STBI 照顾者组。UnMTBI 照顾者组在 10 项 HRQOL 测量中报告的分数也比 STBI 照顾者组的亲密伴侣差，在 5 项测量中比 STBI 照顾者组的父母差。父母在 3 项测量中报告的分数比 STBI 照顾者组的亲密伴侣差。UnMTBI 照顾者组在 15 项比较中有 7 项的临床评分高于 STBI 照顾者组的亲密伴侣。
经历过远程未合并轻度 MTBI 的 SM/V 的亲密伴侣照顾者报告的 HRQOL 比经历过更严重 TBI 的 SM/V 的亲密伴侣和父母照顾者差，这很可能是由于 SM/V 的身心共病。关注 SM/V 的 TBI 和其他共病、照顾者的行为健康问题以及相互作用的关系和家庭因素的干预措施，很可能会最成功地改善军人家庭的个人和家庭结局。
