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Journal of Pediatric Psychology Advance Access published online on September 8, 2005
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsj077
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Journal of Pediatric Psychology © The Author 2005. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oupjournals.org
Received July 14, 2004
Revised April 26, 2004
Accepted May 5, 2005

Article

Long-term Parental and Family Adaptation Following Pediatric Brain Injury

Shari L. Wade PhD1*, H. Gerry Taylor PhD2, Keith Owen Yeates PhD3, Dennis Drotar PhD3, Terry Stancin PhD4, Nori M. Minich BA2, and Mark Schluchter PhD1

1 Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine
2 Department of Pediatrics, Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine
3 Department of Pediatrics, Columbus Children’s Hospital, The Ohio State University
4 Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University School of Medicine

* To whom correspondence should be addressed.
Shari L. Wade, E-mail: shari.wade{at}cchmc.org


  Abstract

Objective To determine whether parents of children with traumatic brain injuries (TBI) report increased injury-related burden, distress, and family dysfunction and to examine the effects of attrition on the results. Methods Children with severe TBI, moderate TBI, and orthopedic injuries were followed at six time points from baseline to 6 years after injury. Parents completed measures of injury-related burden, psychological distress, and family functioning at each assessment. Mixed model analysis was used to examine long-term changes. Results Attrition was higher among families in the severe TBI group with lower burden thereby amplifying group differences. The severe TBI group reported higher injury-related burden over time after injury than the other groups. Family functioning was moderated by social resources. Families of children with severe TBI and low resources reporting deteriorating functioning over the follow-up interval. Conclusions Although environmental advantages moderate long-term effects on family functioning, families of children with severe TBI experience long-standing injury-related burden.

Keywords: brain injury; family adaptation; stressors; support.
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