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Murine Model of Controlled Cortical Impact for the Induction of Traumatic Brain Injury
Published on: August 16, 2019
Traumatic brain injuries in early childhood: initial impact on the family
Terry Stancin1, Shari L Wade, Nicolay C Walz
1Department of Pediatrics, Division of Pediatric Psychology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio 44109, USA. tstancin@metrohealth.org
Insights
Parents of young children with traumatic brain injury (TBI) experience greater burden and distress. Factors beyond injury severity, like pre-existing family stress, influence parental adjustment following pediatric TBI.
Area of Science:
- Pediatric neurology
- Neuroscience
- Child psychology
Background:
- Traumatic brain injury (TBI) in young children presents unique challenges for families.
- Parental burden and distress are significant factors in a child's recovery and long-term outcomes.
- Understanding the factors influencing parental adjustment is crucial for effective support.
Purpose of the Study:
- To investigate factors contributing to parental burden and distress in the initial months after a pediatric TBI.
- To compare parental experiences between children with TBI and those with orthopedic injuries (OI).
Main Methods:
- Longitudinal study involving children aged 3-6 years with TBI or OI requiring hospitalization.
- Parents provided data on pre-injury family environment, caregiver functioning, and injury-related burden.
- Comparison between TBI and OI groups, and analysis of TBI severity and child age effects.
Main Results:
- Parents of children with TBI reported higher overall and injury-related burden compared to OI group.
- Severe TBI was associated with increased stress, parental depression, and global distress.
- Older children (5-6 years) experienced greater burden and distress than younger children (3-4 years).
- Mild TBI with positive neuroimaging showed higher burden than moderate TBI.
- Denial and disengagement coping strategies correlated with increased burden and distress.
Conclusions:
- Chronic life stresses and interpersonal resources impact parental burden and distress in pediatric TBI.
- Traumatic brain injury severity, based solely on Glasgow Coma Scale (GCS) scores, may not fully identify at-risk families.
- Interventions should consider a comprehensive view of risk factors for optimal family adjustment after pediatric TBI.
Objective:
The purpose of this study was to examine factors that affect parental burden and distress during the first few months following a traumatic brain injury (TBI) in young children.
Methods:
Participants were consecutively enrolled children ages 3 through 6 years with either a TBI (n = 89; 21 severe, 22 moderate, and 45 complicated mild) or orthopedic injury (OI; n = 119) requiring hospitalization. During the post-acute period, parents provided information regarding the preinjury family environment and current caregiver functioning and injury-related burden.
Results:
Compared with parents of young children with OI, parents of children with TBI reported greater overall caregiver burden and greater burden related to the injury. Parents of children with severe TBI also reported more stress with spouses and siblings and higher levels of parental depression and global distress relative to the OI comparison group. Parents of 5- to 6-year-old children reported significantly higher levels of both injury-related burden and distress than parents of 3- to 4-year-old children. Parents of children with mild TBI based on the Glasgow Coma Scale (GCS) who also had positive neuroimaging findings reported greater injury-related burden than parents of children with moderate TBI. Parents reported using a variety of coping strategies, with higher levels of denial and disengagement corresponding with greater injury-related burden and distress.
Conclusions:
Consistent with previous research on family adaptation to TBI in school-age children, chronic life stresses and interpersonal resources accounted for significant variance in measures of acute injury-related burden and parental distress in parents of younger children, although differences were small. TBI severity defined by GCS scores alone may not be sufficient to identify families at risk of increased burden. Findings suggest that services aimed at facilitating family adjustment following TBI in young children may need to consider a broader definition of risk factors when identifying families who would benefit from interventions.
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