Multisite randomized feasibility study of Problem-Solving Training for care partners of adults with traumatic brain injury during inpatient rehabilitation

Issue title: Thematic Issue: Setting a Research Agenda for Caregiving after Neurotrauma and Neurological Disability

Guest editors: Paul B. Perrin

Article type: Research Article

Authors: Juengst, Shannon B.^{a; *} | Wright, Brittany^b | Driver, Simon^c | Calhoun, Stephanie^c | Muir, Aimee^c | Dart, Georgianna^d | Goldin, Yelena^d | Lengenfelder, Jean^e | Bell, Kathleen^b

Affiliations: [a] TIRR Memorial Hermann, Houston, TX, USA | [b] Department of Physical Medicine and Rehabilitation, North Texas TBI Model System, UT Southwestern Medical Center, Dallas, TX, USA | [c] North Texas TBI Model System, Baylor Scott and White Research Institute, Dallas, TX, USA | [d] Hackensack Meridian JFK Johnson Rehabilitation Institute, Edison, NJ, USA | [e] Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark, NJ, USA

Correspondence: [*] Address for correspondence: Shannon Juengst, PhD, CRC, TIRR Memorial Hermann, Houston, TX, USA. E-mail: Shannon.Juengst@memorialhermann.org.

Abstract: BACKGROUND:Problem-Solving Training (PST) during inpatient rehabilitation could provide care partners the skills needed to manage their life roles after discharge. OBJECTIVE:Determine the feasibility of PST+ Education versus Education for care partners of adults with traumatic brain injury (TBI) during inpatient rehabilitation. METHODS:We conducted a multisite randomized feasibility trial across three sites. We present recruitment rates, reasons for refusal to participate, and reasons for non-completion of interventions. We measured client satisfaction, participant engagement, and fidelity for both interventions. We compared change in depressive symptoms and caregiver burden between PST and Education groups. RESULTS:Though the interventions were generally feasible, recruitment and retention rates were lower than anticipated largely due to the COVID-19 pandemic. Participants who completed >3 sessions were less likely to be employed full-time and more often spouses and co-residing. Length of inpatient rehabilitation stay was correlated with number of sessions completed. We observed potential benefits of PST over Education, specifically for reducing depression symptoms and caregiver burden. CONCLUSION:High satisfaction, engagement, and fidelity, overall recruitment and retention, and positive change in outcomes suggest that PST is generally feasible and beneficial for care partners of persons with TBI. Adaptations, such as developing a 3-session version of PST, could improve feasibility.

Keywords: Caregiver, care partner, problem-solving training, brain injuries, behavioral intervention

DOI: 10.3233/NRE-220129

Journal: NeuroRehabilitation, vol. 52, no. 1, pp. 109-122, 2023