Abstract

Sources of stress and perceptions of patients' psychosocial adjustment were comparatively examined in the family members of patients who had sustained moderate to severe closed head injury (CHI) or spinal cord injury (SCI). The family members of the patients with CHI reported significantly greater stress in relation to lack of social support, overcommitment, and difficult personality characteristics of the patient. Physical incapacitation of the patient was the principal source of stress that significantly differentiated the family members of the patients with SCI. Family members' perceptions of patients' psychosocial adjustment, as assessed across a broad range of dimensions that included the domestic and social environments, did not differ significantly between the groups. In both groups, the level of personal psychological distress reported by the family members was the most significant and consistent correlate of their perceived stress and perceptions of patients' psychosocial adjustment. The results are discussed In terms of the need to expand the traditional scope of rehabilitative efforts following head and spinal cord injury to directly address family-related issues.

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