Norup, Anne4; Kristensen, Karin Spangsberg1; Poulsen, Ingrid1; Nielsen, Christina Löfvquist5; Mortensen, Erik Lykke3
1 Klinik for Højt Specialiseret Neurorehabilitering/Traumatisk Hjerneskade, Neurocentret, Rigshospitalet, The Capital Region of Denmark2 Afdeling for Neurorehabilitering HVH, Neurocentret, Rigshospitalet, The Capital Region of Denmark3 Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark4 Neurologisk Klinik, Neurocentret, Rigshospitalet, The Capital Region of Denmark5 unknown
Objective: To investigate clinically significant change in the emotional condition of relatives of patients with severe traumatic brain injury during sub-acute rehabilitation. Methods: Participants were 62 pairs of relatives and patients. Relatives completed the anxiety and depression scales from the Symptom Checklist-90-R (SCL-90-R) when the patients were admitted to sub-acute rehabilitation and at discharge. Improvement in emotional condition was investigated using the following criteria: (i) statistically reliable improvement; and (ii) clinically significant change (CSC). Results: At admission, 53.2% and 58.1% of relatives had scores above cut-off values on the anxiety and depression scales, respectively. On the anxiety scale 69.7% of these experienced a reliable improvement according to the Reliable Change Index (RCI) and 45.5% also obtained CSC, as their end-point was below the cut-off value. On the depression scale the corresponding figures were 44.4% and 41.7%, respectively. When comparing relatives with and without CSC, we found that CSC in symptoms of anxiety was associated with significantly better functional improvement during rehabilitation and a shorter period of post-traumatic amnesia in the patients. Conclusion: Of the relatives who reported scores above cut-off values on the anxiety and depression scales at patient's admission, approximately 40% experienced CSC in anxiety and depression during the patient's rehabilitation. Relatives of patients experiencing improvement during inpatient rehabilitation are more likely to experience CSC in anxiety.
Journal of Rehabilitation Medicine : Official Journal of the Uems European Board of Physical and Rehabilitation Medicine, 2013, Vol 45, Issue 8, p. 820-6