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Factors Associated With Strain in Carers of People With Traumatic Brain Injury

Boycott, Naomi BSc(Hons), DClinPsy; Yeoman, Paddy MBBS, FRCA; Vesey, Patrick BSc(Hons), DClinPsy

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP

Journal of Head Trauma Rehabilitation:
doi: 10.1097/HTR.0b013e31823fe07e
Original Articles

Objective: To explore factors associated with strain in carers of patients with traumatic brain injury.

Design: Cross-sectional cohort study.

Participants: Forty-eight carers of patients with traumatic brain injury admitted to a neurosurgical unit over a 9-year period were assessed an average of 9.3 years after injury.

Measures: Caregiver Strain Index (CSI), Neurobehavioral Functioning Inventory (NFI), Glasgow Outcome Scale (GOS), Virginia Prediction Tree Score, and carer and patient demographics.

Procedure: Carers were assessed via postal survey for levels of strain using the CSI and for their perception of the patients' disabilities using the NFI.

Results: Elevated levels of strain were found in 42% of carers. Using logistic regression, outcome as rated by the patients' general practitioner on the GOS and all subscales of the NFI (except Somatic) explained 41% to 57% of the variance in strain and predicted group membership correctly in 72.9% of cases. No individual variable contributed significantly to the explained variance in the model.

Conclusion: A number of factors appear to combine to result in feelings of strain, but the GOS could be used as a crude screening tool. Interventions for cognitive, behavioral, and emotional difficulties may be most useful for carers.

Author Information

CLAHRC, Nottinghamshire Healthcare NHS Trust (Dr Boycott), and Nottingham University Hospitals NHS Trust, Queen's Medical Centre (Drs Yeoman and Vesey), Nottingham, Nottinghamshire, United Kingdom.

Corresponding Author: Naomi Boycott, BSc(Hons), DClinPsy, CLAHRC-NDL, University of Nottingham, Innovation Park, Sir Colin Campbell Building, Triumph Road, Nottingham, NG7 2TU (

The authors thank the research tutors and supervisors at the University of Nottingham for the advice and support they provided. The project was funded as part of doctoral thesis in clinical psychology at the University of Nottingham.

The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.