Factors Influencing Burden in Spouse-Caregivers of Patients with Chronic-Acquired Brain Injury

Laratta, Stefania; Lucca, Lucia Francesca; Tonin, Paolo; Cerasa, Antonio

doi:10.1155/2020/6240298

Cited by 6 publications

(6 citation statements)

References 29 publications

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“…The BI has been widely used as a measurement instrument in patients with sABI in several kinds of researches. 3 , 4 Moreover, BI psychometric properties were confirmed in several neurologic patients as stroke, 5 Parkinson’s disease, 6 and brain injury. 3 As its administration and total score calculation are straightforward, BI is widely used in clinical practice.…”

mentioning

confidence: 88%

The structure of the Early Rehabilitation Barthel Index (ERBI) should be modified: evidence from a Rasch analysis study

Pellicciari

Lucca

Tanti

et al. 2023

Eur J Phys Rehabil Med

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BACKGROUND The Early Rehabilitation Barthel Index (ERBI) comprises seven items of the Early Rehabilitation Index and ten items of the Barthel Index. The ERBI is usually used to measure functional changes in patients with severe acquired brain injury (sABI), but its measurement properties have yet to be extensively assessed. AIM To study the unidimensionality and internal construct validity (ICV) of the ERBI through Confirmatory Factor Analysis (CFA), Mokken Analysis (MA), and Rasch Analysis (RA). DESIGN Multicenter prospective study. SETTING Inpatients from five intensive rehabilitation centers. POPULATION Two hundred and forty-seven subjects with sABI. METHODS ERBI was administered on admission and discharge to study its unidimensionality through CFA and MA and its ICV, reliability, and targeting through RA. RESULTS The preliminary analyses showed a lack of unidimensionality (RMSEA=0.460 >0.06; SRMR=0.176 >0.06; CFI=1.000 >0.950; TLI=1.000 >0.950). According to CFA, “Confusional state” and “Behavioral disturbance” items showed low factor loadings (<0.40), whereas these two items composed a separate scale within the MA. Furthermore, the baseline RA showed that three items misfitted (“Mechanical ventilation,” “Confusional state,” “Behavioral disturbances”) and a lack of conformity of several ICV requirements. After deletion of three misfitting items and further non-structural modifications ( i.e. , testlets creation to absorb local dependence between items and item misfit), the solution obtained showed adequate ICV, adequate reliability for measurements at the individual level (PSI>0.85), although with a frank floor effect. This final solution was successfully replicated in a total sample of the subjects. After post-hoc modifications of the score structure of two out of three misfitting items, the subsequent CFA (RMSEA=0.044 <0.06; SRMR=0.056 <0.06; CFI=1.000 >0.950 TLI=1.000 >0.950) and MA showed the resolution of the unidimensional issues. CONCLUSIONS Although the ERBI is a potentially valuable tool for measuring functioning in the coma-to-community continuum, our analyses suggested its lack of ICV, partly due to an incorrect scoring design of some items. A new perspective multicenter study is proposed to validate a modified version of the ERBI that overcomes the problems highlighted in this analysis. CLINICAL REHABILITATION IMPACT Our results do not support the use of the original structure of the ERBI in clinical practice and research, as a lack of ICV was highlighted.

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mentioning

confidence: 88%

The structure of the Early Rehabilitation Barthel Index (ERBI) should be modified: evidence from a Rasch analysis study

Pellicciari

Lucca

Tanti

et al. 2023

Eur J Phys Rehabil Med

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“…Italian research showed that spouses of patients with moderate to severe brain injury had a high level of burden. The more severe the injury, the greater the negative impact on the family routine and the greater burden on the spouse ( 12 ) . In the Brazilian scenario, a study with informal caregivers of older people identified a greater burden on spouses.…”

Section: Introductionmentioning

confidence: 99%

A longitudinal study of burden among spouse and non-spouse caregivers of older adults with stroke-induced-dependency

Day,

Bierhals,

Pizzol

et al. 2023

Rev. Bras. Enferm.

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Objective: to assess the burden of spouse and non-spouse caregivers of older adults with stroke-induced-dependency after discharge from a university hospital’s Specialized Care Stroke Unit in southern Brazil. Methods: a longitudinal survey. The sample consisted of 48 consenting caregivers, among which 20 were spouse caregivers. Data were collected between May 2016 and July 2018. One week after discharge, caregivers completed a sociodemographic profile, the Functional Independence Measure, and the Caregiver Burden Scale. Burden was also measured two months after discharge. Data were analyzed using Multivariate Analyses of Variance. Results: regarding time 1, non-spouse caregivers experienced greater burden with respect to social isolation (p = .01). Along with a persistently greater sense of isolation (p=.04), non-spouse caregivers felt far greater general strain (p =.01). Conclusion: statistically significant differences in burden over time highlight the importance of assessing caregiver burden after discharge and the need for a formal support program.

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“…Considering a shorter period after injury (2 years) Laratta et al. (2020) recently identified injury severity being associated with a higher level of spouse‐caregiver burden. Similarly, the CONOCES study concluded that both the burden borne by informal caregivers and the likelihood of them being at a high risk of burnout (at 3 and 12 months post event) were associated with the severity of the stroke (Oliva Moreno et al., 2018).…”

Section: Introductionmentioning

confidence: 99%

The impact of coronavirus disease 2019 on emotional and behavioral stress of informal family caregivers of individuals with stroke or traumatic brain injury at chronic phase living in a Mediterranean setting

et al. 2021

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Introduction Even in nonpandemic times, persons with disabilities experience emotional and behavioral disturbances which are distressing for them and for their close persons. We aimed at comparing the levels of stress in emotional and behavioral aspects, before and during coronavirus disease 2019 (COVID‐19), as reported by informal family caregivers of individuals with chronic traumatic brain injury (TBI) or stroke living in the community, considering two different stratifications of the recipients of care (cause and injury severity). Methods We conducted a STROBE‐compliant prospective observational study analyzing informal caregivers of individuals with stroke (IC‐STROKE) or traumatic brain injury (IC‐TBI). IC‐STROKE and IC‐TBI were assessed in‐person before and during COVID‐19 online, using the Head Injury Behavior Scale (HIBS). The HIBS comprises behavioral and emotional subtotals (10 items each) and a total‐HIBS. Comparisons were performed using the McNemar's test, Wilcoxon signed‐rank test or t‐test. Recipients of care were stratified according to their injury severity using the National Institutes of Health Stroke Scale (NIHSS) and the Glasgow Coma Scale (GCS). Results One hundred twenty‐two informal caregivers (62.3% IC‐STROKE and 37.7% IC‐TBI) were assessed online between June 2020 and April 2021 and compared to their own assessments performed in‐person 1.74 ± 0.88 years before the COVID‐19 lockdown. IC‐STROKE significantly increased their level of stress during COVID‐19 in five emotional items (impatience, frequent complaining, often disputes topics, mood change and overly sensitive) and in one behavioral item (overly dependent). IC‐TBI stress level only increased in one behavioral item (impulsivity). By injury severity, (i) mild (14.7%) showed no significant differences in emotional and behavioral either total‐HIBS (ii) moderate (28.7%) showed significant emotional differences in two items (frequent complaining and mood change) and (iii) severe (56.6%) showed significant differences in emotional (often disputes topics) and behavioral (impulsivity) items. Conclusions Our results suggest specific items in which informal caregivers could be supported considering cause or severity of the recipients of care.

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Factors Influencing Burden in Spouse-Caregivers of Patients with Chronic-Acquired Brain Injury

Abstract: In this cross-sectional study, we assess associated factors of burden in spouse-caregivers of patients with acquired brain injury (ABI) in the chronic phase. 35 spouse-caregivers (71% female, mean age±SD: 55.7±11.1<… Show more

Cited by 6 publications

References 29 publications

The structure of the Early Rehabilitation Barthel Index (ERBI) should be modified: evidence from a Rasch analysis study

The structure of the Early Rehabilitation Barthel Index (ERBI) should be modified: evidence from a Rasch analysis study

A longitudinal study of burden among spouse and non-spouse caregivers of older adults with stroke-induced-dependency

The impact of coronavirus disease 2019 on emotional and behavioral stress of informal family caregivers of individuals with stroke or traumatic brain injury at chronic phase living in a Mediterranean setting

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