Is Helping Really Helping? Health-Related Quality of Life after TBI Predicting Caregiver Depression Symptom Trajectories in Latin America

Chimdindu Ohayagha,Annahir N Cariello,Paul B Perrin,Juan Carlos Arango-Lasprilla

doi:10.3390/ijerph18031247

Abstract

Previous research connecting health-related quality of life (HRQoL) in people with traumatic brain injury (TBI) and caregiver mental health has primarily been conducted cross-sectionally in the U.S. and Western Europe. This study, therefore, examined how HRQoL in individuals immediately after their TBI predicts longitudinal caregiver depression symptom trajectories in Latin America. A sample of 109 patients with an acute TBI and 109 caregivers (total n = 218) was recruited from three hospitals in Mexico City, Mexico, and in Cali and Neiva, Colombia. TBI patients reported their HRQoL while they were still in hospital, and caregivers reported their depression symptoms at the same time and at 2 and 4 months later. Hierarchal linear models (HLM) found that caregiver depression symptom scores decreased over time, and lower patient mental health and pain-related quality of life at baseline (higher pain) predicted higher overall caregiver depression symptom trajectories across the three time points. These findings suggest that in Latin America, there is an identifiable relationship between psychological and pain-related symptoms after TBI and caregiver depression symptom outcomes. The results highlight the importance of early detection of caregiver mental health needs based in part upon patient HRQoL and a culturally informed approach to rehabilitation services for Latin American TBI caregivers.

Highlights

Individuals with traumatic brain injury (TBI) met the following inclusion criteria: (a) have a physician-confirmed diagnosis of moderate or severe TBI (Glasgow Coma Scale
Results suggested that caregiver depression symptom scores decreased over time, and lower sults suggested that caregiver depression symptom scores decreased over time, and lower patient mental health and pain-related quality of life at baseline predicted patient mental health and pain-related quality of life at baseline predicted higher overall caregiver depression symptom trajectories across the three time points
There was no differential change over time in caregiver depression symptom trajectories a function of patient mental health, though there was as a function of pain

Summary

Introduction

Traumatic Brain Injury in the U.S and Latin American Countries. Traumatic brain injury (TBI) is one of the major contributors to death and disability around the world [1]. TBI is defined as an alteration to brain functioning as a result of externally applied forces [2]. The extent to which the pattern of damage is assessed is informed by the external mechanical force, its nature, direction, intensity, and duration [3]. Delayed non-mechanical damage, typically involves pathological processes initiated after the impact that can result in delayed clinical presentations [4]. Secondary damage to the brain often includes cerebral ischemia, intracranial hypertension, increased intracranial pressure, hypoxia, oxidative stress, ecotoxicity, and apoptosis [5]. TBI can be a life-altering experience, with an estimated annual occurrence in the U.S of 1.4 million people [8], or

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