Impact of pre-injury family functioning and resources on self-reported post-concussive symptoms and functional outcomes in persons with mild TBI

Abstract

Objective: This study investigates the contribution of pre-injury family functioning and resources on self-reported post-concussive symptoms and functional outcomes in persons with mild TBI (mTBI).

Design: Participants with uncomplicated or complicated mTBIs were recruited from consecutive admissions to the emergency department of a level 1 trauma centre. Patients completed baseline assessments within 2 weeks of injury and an outcomes assessment at 3 months post-injury.

Methods and procedures: One hundred and sixty-six adults with mTBI were included. Baseline measures of pre-injury history, family functioning and resources were obtained. Functional status assessments and self-reported measures of health, common TBI symptoms and psychological problems were administered at 3-months post-injury.

Results: Data reduction of outcome measures using principle components analysis revealed two factors: self-reported post-concussive symptoms and current functional/participation status, explaining 60.53% of the variance. Family resources (β = –0.239, t(150) = –2.84, p = 0.005) and age (β = –0.170, t(150) = –2.19, p = 0.030), but not family functioning, were significant predictors of self-reported post-concussive symptoms at follow-up, R² = 0.051, F(5, 150) = 4.09, p = 0.002. Neither family resources nor functioning predicted current functional/participation status.

Conclusions: Fewer family resources and younger age were associated with increased self-reported post-concussive symptoms. Fewer resources may be a potential risk factor to heightened perception of post-concussive symptoms. Providing low-cost counselling or resource facilitation services may improve outcomes for those with limited resources after mTBI.

Keywords:

• Mild TBI
• postconcussive symptoms
• functional status
• family functioning
• family resources

Acknowledgements

We wish to thank the patients and staff of Harris County Hospital District’s Ben Taub General Hospital for their invaluable contributions to this study, particularly, Dr. Claudia Robertson, Dr. Shankar Gopinath and Dr Alex Valadka. Thanks also to the research assistants who have worked on this project, including Analida Ingraham, Nizete-Ly Valles, Luis Gonzalez and Diana Mazzei. We would also like to express our sincere appreciation to co-investigators on these projects, including Dr. Angelle Sander, Dr. H. Julia Hannay, Dr. Allison Clark and Dr. Walter M. High, Jr., who served as the Principal Investigator for the overall grant for which these data were collected.

Declarations of interest

The authors report no conflicts of interest. This work was supported by grants from the National Institute on Disability and Rehabilitation Research, US Department of Education (grant nos. H133B990014, H133B090023 and H133A070043).