Lack of a social network, feeling loneliness, and patient's functional status are predictors of caregiver burden. General strain, disappointment, and isolation were identified as areas in which caregiver burden is high.

OBJECTIVE:To assess burden and life satisfaction in family members of patients with severe traumatic brain injury (sTBI) at 1 and 2 years post-injury, examine if change in burden can be predicted by family member and patient demographics, patient's functional status, family members social network or level of burden at 1 year. METHODS:Prospective national multicenter study. Self-report from family members, patient data collected from a national cohort study on patients with sTBI. 80 family members participated. MAIN OUTCOME MEASURE:The Caregiver Burden Scale (CBS), life satisfaction. RESULTS:Total burden increased between years 1 and 2 post-injury (P=0.04). Thirty percent of the family members reported an increased burden, 55% were stable, and 15% had a decrease in burden between the two follow-up times. Logistic regression analyses revealed that experiencing loneliness was an independent predictor of increased burden from 1 to 2 years post-injury (OR=4.35, P<0.05). Life Satisfaction was lower at the 2 year follow-up than at 1 year (p=0.03). CONCLUSIONS:The results demonstrate a need for long-term follow-up of patients and family members that focuses on professional support to relieve burden and risk of loneliness or social isolation. This group may benefit from additional follow-up interventions tailored to their needs.

Northern Norway. E-Mail: Elin.Damsgard@fagmed.uit.no 1 AbstractPurpose. Activity related pain may be a barrier to rehabilitation in patients with chronic musculoskeletal disorders. This study investigated patients' reports of increased pain during activity, and the association between such pain and psychological factors and pain variables.Method. Questionnaires from 232 adults with chronic musculoskeletal pain measured pain intensity, spread of pain and pain duration. Pain during activity was assessed both on a 11 point Numeric Rating Scale (NRS), and operationalized as a dichotomous measure, where responders defined if they experienced pain during general activity and exercise.Psychological factors were measured by the Hopkins Symptom Check List 25, the Tampa Scale for Kinesiophobia and a subscale of the Arthritis Self -Efficacy Scale. Multiple and logistic regression was used to analyse associations between increased pain during activity and associated variables.Results. Increased pain during activity was reported by 69 % of participants. Fear of movement was a significant factor for reporting increased pain during activity, both general activity and exercise, also in a subsample with low psychological distress. Other significant factors were spread of pain and a low sense of self efficacy. Conclusion.Patients with high fear of movement, large spread of pain and low self efficacy were more likely to report increased pain during activity even in the absence of psychological distress.2

BackgroundFamily member’s experience and satisfaction of health care in the acute care and in-patient rehabilitation are important indicators of the quality of health care services provided to patients with severe traumatic brain injury (TBI). The objective was to assess family members’ experience of the health care provided in-hospital to patients with severe TBI, to relate experiences to family member and patient demographics, patients’ function and rehabilitation pathways.MethodsProspective national multicentre study of 122 family members of patients with severe TBI. The family experience of care questionnaire in severe traumatic brain injury (FECQ-TBI) was applied. Independent sample t-tests or analysis of variance (ANOVA) were used to compare the means between 2 or more groups. Paired samples t-tests were used to investigate differences between experience in the acute and rehabilitation phases.ResultsBest family members` experience were found regarding information during the acute phase, poorest scores were related to discharge. A significantly better care experience was reported in the acute phase compared with the rehabilitation phase (p < 0.05). Worst family members` experience was related to information about consequences of the injury. Patient’s dependency level (p < 0.05) and transferral to non-specialized rehabilitation were related to a worse family members` experience (p < 0.01).ConclusionsThis study underscores the need of better information to family members of patients with severe TBI in the rehabilitation as well as the discharge phase. The results may be important to improve the services provided to family members and individuals with severe TBI.

The findings provide insights that may improve the educational rehabilitation of patients with musculoskeletal pain.