Monday, April 28, 2025
4/28/2025
Comparing Transition Support Interventions for Family Caregivers of ABI Patients - Comparing Transition Support Interventions for Family Caregivers of ABI Patients Project Summary An acquired brain injury (ABI) occurs when there is damage to the brain caused by trauma (accident, fall, sports-related blow to the head, or act of violence) or from stroke, brain tumors, brain hypoxia, and encephalitis. ABI can impact basic activities of daily living, communications, cognitive functioning (e.g., memory, concentration, executive functioning), and personality. ABI can also result in mood changes and depression. Caring for persons with ABI is stressful and demanding. Caregivers cope with their loved ones' memory loss, behavioral and personality changes, chronic care needs and the high costs of care. Caregivers are at increased risk of anxiety, frustration, depression, and burden. The goal of this research is to compare the effectiveness of two interventions that offer support to caregivers of patients with ABI during the transition home from inpatient rehabilitation. The two interventions are Building Better Caregivers (BBC) and Problem-Solving Training (PST). Both interventions include education and support to help family members better manage their loved one’s care needs and manage the stress and rigors of caregiving. Both interventions have evidence of efficacy. However, they also vary in ways that have been identified as important by caregivers, such as group vs. individualized delivery, facilitation by a clinician vs. peer mentor, and in-person vs. on-line participation. There are no comparative effectiveness studies to examine potential strengths and limitations of different interventions for different subgroups of ABI patients and caregivers. Thus, comparative effectiveness research of these two caregiver support interventions would address an important evidence gap. Another important gap in evidence is the lack of interventions to address family needs during the acute/post-acute stages of recovery – before the patient is discharged home. The problem of caregiver distress and lack of preparation for caregiving is widely acknowledged. Evidence points to the long-term adverse impact of caregiver stress/burden on both patient and caregiver. Yet health systems serving ABI patients struggle to find effective strategies to support family caregivers before and after the transition home. Thus, evidence is needed about interventions that may help bridge this gap. We will evaluate the two interventions by measuring the impact on 1) caregiver stress/burden and depression, 2) caregiver self-efficacy in their ability to manage their loved-one’s care needs, and 3) healthcare utilization (hospitalization, emergency room, and doctor office visits) by patients and caregivers in the first 6 months after discharge from the rehabilitation hospital. This research targets high-need patients with ABI, with the hope of reducing the considerable burden placed on family caregivers in managing their acute and chronic care needs. It also addresses a mandate of the 2018-2023 NIDILRR Long Range Plan – “to develop and implement a research agenda on family caregivers of people with disabilities” and provide for their “economic, social, and health-related well-being.”
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