PM&R
Volume 1, Issue 8 , Pages 723-728, August 2009

Caregivers' Concerns about Judgment and Safety of Patients with Brain Injury: A Preliminary Investigation

  • Jeffrey S. Kreutzer, PhD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Box 980542, Richmond, VA 23298-0542†
    • Corresponding Author InformationAddress correspondence to: J.S.K.
    • ,
  • Lee A. Livingston, PsyD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA‡
    • ,
  • Rachel S. Everley, MS

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA§
    • ,
  • Kelli W. Gary, PhD, MPH, OTR/L

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA
    • ,
  • Juan Carlos Arango-Lasprilla, PhD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA∥
    • ,
  • Victoria D. Powell, BA

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA#
    • ,
  • Jennifer H. Marwitz, MA

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA⁎⁎

Received 27 January 2009; accepted 10 July 2009.

Objective

To identify caregivers' most common concerns about the judgment and safety of patients with brain injury in home and community environments. To quantify caregivers' stress levels and their level of comfort leaving patients at home unsupervised and examine the interrelationships between caregivers' safety and judgment ratings, stress levels, and levels of comfort leaving patients unattended.

Design

Retrospective, cross-sectional design.

Setting

Outpatient brain injury neuropsychology clinic at a university medical center.

Participants

A convenience sample of 121 caregivers of traumatic brain injury survivors at least 1 month postinjury and 18 years of age or older.

Main Outcome Measurements

Scores in 9 domains from the Judgment and Safety Screening Inventory; ratings of stress levels and levels of comfort leaving patients at home unattended derived from the General Health and History Questionnaire.

Results

Caregivers' most common judgment and safety-related concerns were in the Travel and Financial domains, with many reflecting patients' memory deficits. Heightened caregiver stress levels were prevalent. Higher levels of concern about judgment and safety were associated with higher stress levels and concerns about leaving patients unattended.

Conclusions

Consistent with research on patients with other types of neurological disorders, concerns about driving and financial management among caregivers are prevalent. Additional research is needed to identify the most cost-effective methods of evaluating patients and enabling them to function at their highest level in the community.

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  • † Disclosure: nothing to disclose
  • ‡ Disclosure: nothing to disclose
  • § Disclosure: nothing to disclose
  •  Disclosure: nothing to disclose
  • ∥ Disclosure: nothing to disclose
  • # Disclosure: nothing to disclose
  • ⁎⁎ Disclosure: nothing to disclose

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org

 Supported by Grant #H133P040006 from the National Institute on Disability and Rehabilitation Research (NIDRR), Office of Special Education and Rehabilitative Services (OSERS), Department of Education, Washington, DC.

PII: S1934-1482(09)00715-1

doi:10.1016/j.pmrj.2009.07.005

PM&R
Volume 1, Issue 8 , Pages 723-728, August 2009

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