Mental health services and related factors in health care of traumatic brain injury survivors

Figures & data

Table 1. Characteristics of the patients with traumatic brain injury

Number of study participants	62
Sex	Male: 49 (79.0%); female: 13 (21.0%)
Age	12–73 years (mean age, 37.3 mean 11.9 years)
Age at the time of injury	8–67 years old (mean age at the time of injury, 26.4 ± 12.7 years)
Measure of disability	Level 1, 0 patients; level 2, 1 patient; level 3, 13 patients; level 4, 20 patients; level 5, 12 patients; level 6, 9 patients; level 7, 3 patients; level 8, 0 patients; and unknown level, 4 patients
Activity of daily living	5–100 point (mean point, 73.2 ± 32.5)
Presence of physical disability certificate	Present, 43 (69.4%) patients; not present, 19 (30.6%) patients
Presence of mental health welfare booklet	Present, 35 (56.5%) patients; not present, 27 (43.5%) patients

Table 2. Characteristics of caregivers

Number of patients	62
Sex	Male, 3 (4.8%) caregivers; female, 59 (95.2%) caregivers
Age	39–88 years old (mean age, 58.6 ± 9.2 years)
Relationship to the patient	Mother, 43 (69.4%) caregivers; wife, 10 (16.1%) caregivers; father, 3 caregivers (4.8%)
	Younger sister, 2 (3.2%) caregivers; older sister, 1 (1.6%) caregiver; and unknown, 3 (4.8%) caregivers
Nursing care period	2–33 years (mean period, 10.9 ± 6.4 years)
Occupation	Inoccupation, 37 caregivers; full-time worker, 8 caregivers; part-time worker, 9 caregivers; others, 5 caregivers; and unknown, 3 caregivers
Daily sleep time	3–8.0 hours (mean sleep time, 6.0 ± 1.2 h)
Number of persons living together with the patient and caregiver	0 people, 19 caregivers; 1 person, 20 caregivers; 2 people, 11 caregivers; 3 people, 4 caregivers; 5 people, 2 caregivers; and unknown, 6 caregivers
Presence of a helper living with a caregiver	Present, 24 caregivers; not present, 31 caregivers; and unknown, 7 caregivers

Table 3. Symptoms of cognitive dysfunction

		None	Almost none	Present	Frequently present (%)
Memory impairment	Cannot fulfill a promise, or forget a promise	0.0	12.3	49.1	38.6
	Forget where a valuable item was placed	3.4	12.1	39.7	44.8
	Make up a story	21.4	30.4	23.2	25.0
	Repeatedly asks the same question	1.8	16.4	36.4	45.5
	Cannot remember a new thing	0.0	6.9	50.0	43.1
Attentional disorder	Get interested in others, and always follow a person around	46.4	35.7	7.1	10.7
	Bother the work of a neighbor	37.7	32.1	20.8	9.4
	Tend to perform an action with little regard to surrounding situations	5.5	20.0	34.5	40.0
	Cannot continue a task for a long period of time	1.8	14.5	45.5	38.2
	React to talk about someone else in the misguided belief that it was about the patient	11.8	50.0	19.1	19.1
Executive dysfunction	Being late for appointments	13.5	19.2	25.0	42.3
	Cannot finish a task as promised	2.3	11.6	34.9	51.2
	Cannot complete any work	2.3	23.3	48.8	25.6
	Cannot appropriately organize records in a notebook for supplementing memory impairment	17.8	46.7	20.0	15.6
	Cannot achieve a task, which is different from a previous task	4.3	21.3	44.7	29.8
Social behavior impairment	Get excited, speak loudly, and conduct violence	17.5	26.3	29.8	26.3
	Speak loudly always when things do not go as the patient wants	16.1	32.1	28.6	23.2
	Take on mischievous behavior by following someone around	52.7	36.4	5.5	5.5
	Conduct nasty and sloppy things	38.2	29.1	23.6	9.1
	Not satisfied if the focus is not on the patient	30.9	36.4	18.2	14.5

Table 4. The correlation between patient/caregiver characteristics and the GHQ-30 score

		n	GHQ-30 (n = 57)
			r	p
Patient characteristics	Age	57	−0.059	0.662
	Age at the time of injury	62	0.066	0.627
	Measure of disability	58	−0.225	0.105
Caregiver characteristics	Age	58	−0.011	0.936
	Nursing care period	62	−0.271	0.045	^*
	Daily sleep time	57	−0.439	0.001	^**
	Number of persons living together	56	0.049	0.729

Notes:

The number in the parentheses is the number of patients, excluding the nonresponders.

GHQ-30, General Health Questionnaire 30-item.

* Indicates significance at p < 0.05, based on Pearson and Spearman coefficients.

** Indicates significance at p < 0.01.

Table 5. Difference in the mean GHQ-30 score between the patient and caregiver characteristics

			n	GHQ-30
				Mean	Standard deviation	t	p
Patient characteristics	Sex	Male	46	14.0	7.5	−1.494	0.141
		Female	11	17.8	7.5
	Presence of physical disability certificate	Present	41	14.6	9.1	0.193	0.848
		Not present	16	15.1	9.1
	Presence of mental health welfare booklet	Present	33	14.8	8.3	0.017	0.986
		Not present	27	14.8	6.8
Caregiver characteristics	Presence of occupation	Present	20	13.9	6.7	0.403	0.688
		Not present	35	14.7	7.9
	Presence of a helper for the caregiver	Present	23	14.3	7.2	−0.217	0.828
		Not present	29	14.8	7.7

Notes:The number in the parenthesis is the number of patients, excluding the nonresponders; n.s., based on the t test.

GHQ-30, General Health Questionnaire 30-item.

Table 6. Difference in the median GHQ-30 score in caregiver characteristics

			n	Mean	GHQ-30
					Standard deviation	p
Caregiver characteristics	Relationship with patient	Mother	40	43.4	15.6	0.175
		Wife	10	40.7	16.8
		Father	3	61.7	27.5
		Younger sister	1	70
		Older sister	1	44

Notes: The number in the parentheses is the number of patients, excluding the nonresponders; n.s., based on the Kruskal Wallis test.

GHQ-30, General Health Questionnaire 30-item.

Table 7. Relationship between the presence of cognitive dysfunction symptoms and mental health status

			Unit: n (%)
			GHQ-30
			8 points or higher	7 points or lower
Memory impairment	Cannot fulfill a promise or forget a promise	No	6 (85.7)	1 (14.3)
		Yes	36 (80.0)	9 (20.0)
	Forget where a valuable item was placed	No	7 (77.8)	2 (22.2)
		Yes	36 (81.8)	8 (18.2)
	Make up a story	No	20 (74.1)	7 (25.9)
		Yes	21 (87.5)	3 (12.5)
	Repeatedly ask the same question	No	6 (66.7)	3 (33.3)
		Yes	34 (82.9)	7 (17.1)
	Cannot remember a new thing	No	3 (75.0)	1 (25.0)
		Yes	40 (81.6)	9 (18.4)
Attentional disorder	Get interested in others, and always follow a person around	No	33 (76.7)	10 (23.3)
		Yes	9 (100)	0 (0.0)
	Bother the work of a neighbor	No	25 (73.5)	9 (26.5)
		Yes	14 (93.3)	1 (6.7)
	Tend to make an action with little regard to surrounding situations	No	10 (76.9)	3 (23.1)
		Yes	31 (83.8)	6 (16.2)
	Cannot continue a task for a long period of time	No	6 (66.7)	3 (33.3)
		Yes	36 (85.7)	6 (14.3)
	React to talk about someone else in the misguided belief that it was about the patient	No	22 (75.9)	7 (24.1)
		Yes	19 (90.5)	2 (9.5)
Executive dysfunction	Being late for an appointment	No	12 (75.0)	4 (25.0)
		Yes	27 (84.4)	5 (15.6)
	Cannot finish a task as promised	No	5 (83.3)	1 (16.7)
		Yes	28 (80.0)	7 (20.0)
	Cannot complete any task	No	8 (80.0)	2 (20.0)
		Yes	25 (80.6)	6 (19.4)
	Cannot appropriately organize records in a notebook for the supplement of memory impairment	No	18 (69.2)	8 (30.8)	*
		Yes	15 (93.8)	1 (6.3)
	Cannot achieve a task that is different from a previous task	No	4 (40.0)	6 (60.0)	*
		Yes	31 (91.2)	3 (8.8)
Social behavioral impairment	Get excited, speak loudly, and act violently	No	15 (68.2)	7 (31.8)	*
		Yes	29 (93.5)	2 (6.5)
	Always speak loudly when things do not go as the patient wants	No	16 (69.6)	7 (30.4)	*
		Yes	27 (93.1)	2 (6.9)
	Takes on mischievous behavior by following someone around	No	37 (80.4)	9 (19.6)
		Yes	5 (100)	0 (0.0)
	Conduct nasty and sloppy things	No	27 (77.1)	8 (22.9)
		Yes	15 (93.8)	1 (6.3)
	Not satisfied if the focus is not on the patient	No	27 (79.4)	7 (20.6)
		Yes	15 (88.2)	2 (11.8)

Notes: The data are presented as n (%). GHQ-30, General Health Questionnaire 30-item.

* Indicates significance at p < 0.05, based on Fisher’s exact test.

Table 8. Relationship between the activities of daily living and mental health status

		GHQ-30
		8 points or higher	7 points or lower
Diet	Independent	28 (75.5)	9 (24.3)
	Care required	17 (94.4)	1 (5.6)
Transfer	Independent	33 (78.6)	9 (21.4)
	Care required	12 (92.3)	1 (7.7)
Cosmetic preparation	Independent	22 (71.0)	9 (29.0)	*
	Care required	23 (95.8)	1 (4.2)
Use of toilet	Independent	30 (76.9)	9 (23.1)
	Care required	15 (93.8)	1 (6.3)
Bath	Independent	22 (73.3)	8 (26.7)
	Care required	23 (92.0)	2 (8.0)
Walking on a flat surface	Independent	30 (78.9)	8 (21.1)
	Care required	15 (88.2)	2 (11.8)
Use of stairs	Independent	22 (73.3)	8 (26.7)
	Care required	23 (92.0)	2 (8.0)
Dressing	Independent	21 (70.0)	9 (30.0)	*
	Care required	23 (95.8)	1 (4.2)
Bowel management	Independent	23 (74.2)	8 (25.8)
	Care required	22 (91.7)	2 (8.3)
Urination management	Independent	24 (77.4)	7 (22.6)
	Care required	21 (87.5)	3 (12.5)

Note:

The data are presented as n (%).

^* Indicates significance at p < 0.05, based on Fisher’s exact test.