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Changing Family Needs After Brain Injury

Journal of Rehabilitation, Oct-Dec, 1998 by Peter Stebbins, Paul Leung

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Family Needs During The Early Years After Brain Injury

Kreutzer, Serio, and Berquist (1994) and Serio, Kreutzer, and Gervasio (1995) used the `Family Needs Questionnaire' (FNQ) designed to measure family members' perceived needs after the brain injury of a relative, to investigate family needs. The FNQ (Kreutzer, 1988) contains 40 needs statements in which respondents rank each statement according to its perceived importance and degree to which the need is met or not met.

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Kreutzer et al. (1994) found that family members considered the need for medical information and support from health professionals as most "Important". This is consistent with Mathias's (1984) earlier findings of family needs during acute hospitalization. The apparent similarity between family needs as indicated by Mathias (1984) in the first four months post-injury and needs families experience in the first couple of years post-trauma (Kreutzer et al. (1994) may be due to the long periods of hospitalization and inpatient rehabilitation that people with brain injury often experience. It is not unusual for an individual not to return to living with the family unit for 1 - 2 years (Oakey, 1992). While the emphasis on family needs rated as "Important" appear to focus on the acute hospitalization stage, it is interesting to note that "Important" need number ten (to be shown what to do when the patient is upset or angry) reflects a more long-term care issue. This supports Willer and Linn's (1993) finding that behavioral and emotional support are major needs for relatives caring for and living with a brain injured family member.

Needs perceived by family members to be "Not Important" (Kreutzer et al.'s 1994) included: help with housekeeping, supportive family members, and assistance from friends and relatives in providing care for the brain-injured family member. Kreutzer et al.'s (1994) finding that "help keeping house" and "support in caring" for the brain-injured family member were ranked as "Not Important" raise the possibility that the brain-injured family member was in some form of institutionalized care (e.g. hospital or inpatient rehabilitation) during the time of the study. Kreutzer et al. (1994) also noted that the respondents rated most "emotional support" type needs statements as "Not Important" (e.g. understanding spouse and family members, being reassured about strong negative feelings, expressing opinions to others, etc.) While this appears to contradict Maus-Clum and Ryan's (1981) and Campbell's (1988) view that emotional support was one of the most important needs, the apparent discrepancy between Kreutzer et al.'s (1994) and Maus-Clum & Ryan's (1981), and Campbell's (1988) research may be due to the differences in the time since onset of injury. Family response after sudden injury or illness often places high importance on obtaining information about the injured person's medical status and chances of recovery in the initial stages of hospitalization, with social and emotional supports only becoming more apparent as time post-injury progresses (Smeltzer & Bare, 1992). The need for information on community resources was also ranked highly in the studies conducted by Campbell (1988) and Maus-Clum and Ryan (1981) but did not appear as "Important" in Kreutzer et al.'s (1994) study possibly because the brain-injured individual was in the hospital or inpatient rehabilitation.

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Changing Family Needs After Brain Injury

Journal of Rehabilitation, Oct-Dec, 1998 by Peter Stebbins, Paul Leung

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