在美国现役军人和退伍军人中，不健康的家庭功能与创伤性脑损伤后的军人脑部健康密切相关。
Unhealthy family functioning is strongly associated with warfighter brain health following traumatic brain injury in United States service members and veterans.
作者信息
Brickell Tracey A, French Louis M, Ivins Brian J, Lippa Sara M, Wright Megan M, Baschenis Samantha M, Sullivan Jamie K, Hungerford Lars D, Lange Rael T
机构信息
Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States.
National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States.
出版信息
Front Neurol. 2025 Aug 12;16:1475098. doi: 10.3389/fneur.2025.1475098. eCollection 2025.
OBJECTIVE
To examine the relationship between family functioning and health-related quality of life (HRQOL) outcomes following traumatic brain injury (TBI) in service members and veterans (SMVs).
PARTICIPANTS
Participants were 359 United States SMVs classified into three groups: non-injured controls (NIC, = 62); uncomplicated mild TBI (MTBI; = 189); and complicated mild, moderate, severe, and penetrating TBI (STBI; = 108). Participants completed 10 HRQOL measures from the TBI-QOL and Neuro-QOL, and the Family Assessment Device-General Functioning subscale (FAD-GF) 2-or-more years post-injury. Using the FAD-GF, the NIC, MTBI, and STBI participants were divided into six subgroups: Group 1 = NIC Healthy Family Functioning (HFF) ( = 34); Group 2 = NIC Unhealthy Family Functioning (UnHFF) ( = 28); Group 3 = MTBI HFF ( = 88); Group 4 = MTBI UnHFF ( = 101); Group 5 = STBI HFF ( = 58); and Group 6 = STBI UnHFF ( = 50).
RESULTS
Participants with UnHFF had a significant and meaningfully higher number of clinically elevated HRQOL scores compared to those with HFF in the MTBI ( < 0.001, =0.07) and STBI ( = 0.001, =0.10) groups, but not in the NIC group ( = 0.107, =0.04). There were no differences in the total number of clinically elevated HRQOL scores when comparing the MTBI and STBI HFF groups to controls ( = 0.074 to 0.841). The MTBI and STBI UnHFF groups had a significant and meaningfully higher number of clinically elevated HRQOL scores when compared to controls ( < 0.001 to = 0.018; =0.07 to.14). The MTBI UnHFF group was 10 to 28 times more likely to have poor HRQOL outcome compared to controls. The STBI UnHFF group was 6 to 17 times more likely to have poor HRQOL outcome compared to controls.
CONCLUSION
UnHFF was strongly associated with poor long-term HRQOL. HFF was strongly associated with good long-term HRQOL outcome. Assessment and management of family distress may facilitate better TBI recovery and readiness in warfighters.
目的
探讨军人和退伍军人（SMV）创伤性脑损伤（TBI）后家庭功能与健康相关生活质量（HRQOL）结果之间的关系。
参与者
359名美国军人被分为三组：未受伤对照组（NIC，n = 62）；单纯性轻度TBI（MTBI；n = 189）；以及复杂性轻度、中度、重度和穿透性TBI（STBI；n = 108）。参与者在受伤2年或更长时间后完成了10项来自TBI-QOL和Neuro-QOL的HRQOL测量，以及家庭评估量表-总体功能分量表（FAD-GF）。根据FAD-GF，NIC、MTBI和STBI参与者被分为六个亚组：第1组=NIC健康家庭功能（HFF）（n = 34）；第2组=NIC不健康家庭功能（UnHFF）（n = 28）；第3组=MTBI HFF（n = 88）；第4组=MTBI UnHFF（n = 101）；第5组=STBI HFF（n = 58）；第6组=STBI UnHFF（n = 50）。
结果
与MTBI组（p < 0.001，d = 0.07）和STBI组（p = 0.001，d = 0.10）中具有HFF的参与者相比，具有UnHFF的参与者在临床上HRQOL得分升高的数量显著且有意义地更多，但在NIC组中并非如此（p = 0.107，d = 0.04）。将MTBI和STBI HFF组与对照组进行比较时，临床上HRQOL得分升高的总数没有差异（p = 0.074至0.841）。与对照组相比，MTBI和STBI UnHFF组在临床上HRQOL得分升高的数量显著且有意义地更多（p < 0.001至p = 0.018；d = 0.07至0.14）。与对照组相比，MTBI UnHFF组出现不良HRQOL结果的可能性高10至28倍。与对照组相比，STBI UnHFF组出现不良HRQOL结果的可能性高6至17倍。
结论
不健康家庭功能与长期不良HRQOL密切相关。健康家庭功能与良好的长期HRQOL结果密切相关。对家庭困扰的评估和管理可能有助于军人更好地从TBI中恢复并做好准备。
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