Family and TBI: an investigation using the Family Outcome Measure – FOM-40

ABSTRACT

Introduction: The Family Outcome Measure (FOM-40) captures multidimensional data about well-being and capacity of family member as well as the relative with brain injury. This study aimed to produce a profile (positive and negative) of families supporting relatives with traumatic brain injury (TBI) and high support needs.

Methods: Thirty-eight dyads (family member plus relative with TBI and high daily support needs) participated in this cross-sectional survey-based pilot study. The survey comprised several published scales, as well as a range of demographic and clinical characteristics of the relative. Non-parametric bivariate analyses were conducted.

Results: Independence of the FOM-40 domains was confirmed. Place of residence (shared supported accommodation (SSA)/family home) was an important predictor variable. SSA was strongly associated with lower levels of burden in families. Family home was strongly associated with better adjustment of the relative. Family resilience was positively associated with sustainability of support and comorbidity in the relative.

Discussion: Family outcomes were associated with a variety of demographic and clinical characteristics of the relative with TBI including residence, behaviour and mental health symptoms. The results provide meaningful evidence for service providers given the increasing investment in independent living in people with disabilities, and the ongoing reliance on families to supplement paid support.

KEYWORDS:

• Traumatic brain injury
• caregivers
• resilience
• adjustment
• coping
• challenging behaviour

Financial Support

This project was funded by the Transport Accident Commission, through the Institute for Safety, Compensation and Recovery Research.

Conflict of Interest

All authors had financial support via a grant from the Transport Accident Commission via the Institute for Safety, Compensation and Recovery Research for the submitted work; no other financial relationships with any organizations that might have an interest in the submitted work; no other relationships or activities that could appear to have influenced the submitted work.

Disclosure Statement

The authors report no conflicts of interest.

Ethical Standards

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. The Monash University Human Ethics Committee approved the research project.

Additional information

Notes on contributors

Christine Migliorini

Christine Migliorini is a Social Worker, Mental Health Clinician and Research Fellow whose focus over the past 15 years has been the mental health and wellbeing of people living with significant neurological impairment.

Libby Callaway

Libby Callaway is an Occupational Therapist who, for over 25 years in the field of neurological rehabilitation in both Australia and the USA. Libby is also the director and principal occupational therapist at Neuroskills, a community based practice providing rehabilitation services to people with neurological disability. In addition to this clinical work, Libby is a senior lecturer and researcher in the Occupational Therapy department at Monash University. Libby has published in a range of international peer-reviewed journals and presents regularly at both national and international conferences in the field of neurology.

Sophie Moore

Sophie Moore is a Speech Pathologist with over 12 years clinical experience working in a variety of clinical roles with mixed caseloads, of which the focus over the past 5 years has been research targeting people living with significant neurological impairment.

Grahame K Simpson

Grahame K Simpson is Director of the Brain Injury Rehabilitation Research Group at the Ingham Institute of Applied Medical Research in Sydney Australia and has worked for the past 30 years as a clinician and researcher in the area of traumatic brain injury.