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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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Discussion

Changes in family needs

The purpose of this study was to investigate changes in family needs as time since injury progressed. The ranked results of the two groups 0-2 yrs post-injury and 2+yrs post-injury (Tables 1 & 2) suggest that family needs changed from focussed acute medical and professional supports during the first two years to an expanded range of needs (including medical and professional supports) such as community supports, financial resources, care giver supports, and health information.

The findings on family needs during the first two years post-injury (Table 1) clearly indicate the important needs to be health information, medical, and professional supports, and are consistent with both Kreutzer et al.'s (1994) and Mathias' (1984) findings.

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The results of the rank ordering of family needs beyond two years post-injury (Table 2) provide the first "time of onset specific" data beyond the range of the Kreutzer et al. (1994) study. Family needs beyond two years post-injury (Table 2) expand to encompass needs associated with living in the community with a relative who has an acquired brain injury. Needs now include the support of family, financial resources, community supports, care giver supports, long-term planning assistance, health information, and medical and professional supports. As these needs were also reported in Maus-Clum and Ryan's (1981) and Campbell's (1988) research, their sample probably included family members caring for a relative beyond two years post-trauma.

Health information that specifically addresses managing personality and behavior changes and associated difficulties of brain injury was highlighted by Willer and Linn (1993) to be a crucial need for family members. The present study found this (as represented by the statement: "I need to be shown what to do when my relative is upset or acting strange") to be very important to family members in both the short and long term. Behavioral and personality changes are key stressors for family members living with a brain-injured relative.

Changes in the level of unmet need

The literature has suggested that as time since injury increases, family members find it increasingly difficult to cope with the experience of higher levels of stress and burden in the context of longevity. The percentage "Met" data corresponding to the "Important" and "Very Important" needs of the two groups (tabulated in Tables 1 and 2) clearly suggest that Group 2 (2+yrs post injury) has a much lower average of "Met" needs than Group 1 (0-2 yrs).

The Chi-Square analysis of need-response patterns (see Table 3) highlights the statistically significant nature of the different need response patterns between the two groups. In order to confirm the pattern suggested, Spearman's correlation coefficient showed a positive relationship between time since injury and unmet need.

Table 3. Total Frequencies for Family Members caring for a relative who has an acquired brain injury during the first two years and beyond the first two years post trauma.

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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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