Marital Stability During the Year After Traumatic Brain Injury in an Ecuadorian Sample: A Repeated-Measures Study

Background: Traumatic brain injury (TBI) is a major cause of death and disability worldwide and often leads to long-lasting emotional, physical, and cognitive changes and results in reduced functioning across multiple domains. These changes often lead to strain in marital relationships as the uninjured spouse grapples with adapting to the changes in their partner. Aims: The purpose of this study was to examine the probability of marital stability after TBI at 6 and 12 months following injury (i.e., probability trajectory across those two time points), as well as predictors of that probability trajectory. Methods: The study design was repeated-measures and observational. Patient recruitment and follow-up took place from January 2018 to March 2020 in Quito, Ecuador. Ninety-seven TBI survivors were recruited while hospitalized in the neurosurgery unit of Hospital Eugenio Espejo, a tertiary care center. Patients were assessed at 6 and 12 months after their injury. Hierarchical linear modeling (HLM) was used to examine baseline predictors of linear marital probability trajectories across 6 and 12 months after injury. A final set of HLMs included each of the previously significant predictors from the first model, time, and the interaction terms between time and the previously significant predictor. Results: The first HLM found that marital probability remained stable between 6 and 12 months after TBI. Individuals who were employed at baseline had higher marital probability trajectories than those who had been unemployed. Older individuals had higher marital probability trajectories than younger individuals, and women had higher marital probability trajectories than men. Conclusions: This is the first study to examine marital probability trajectories for an Ecuadorian adult population with TBI, and the data are of great value to understanding post-TBI outcomes in the region. These results can inform interventions and support systems to bolster marital resilience in the aftermath of TBI. Further research is warranted to explore the nuances of these relationships and to validate these findings in diverse populations.