Early Family Education to Help Minimize Stress in the Context of TBI Inpatient Rehabilitation

Research Objectives: To investigate opportunities and develop key points when family education is necessary to mitigate patients’ perceived stress.

Design: Descriptions of two cases when the presence and interactions of family members and patients with TBI contributed to perceived patient stress during early recovery and rehabilitation; identification of key points to be included for just-in-time family education.

Setting: Hospital A is a public acute care hospital and Level I Trauma Center serving a predominantly rural population with limited rehabilitation options. Hospital B is a public hospital specializing in medical rehabilitation. This facility mainly serves diverse patient populations (>50% Hispanic) in a metropolitan city.

Participants: Two patients with TBI experienced stressful encounters with family members. Patient 1 was a woman in her early 30s who had multiple fractures and a complicated mild TBI due to a high-speed motorcycle ride. Patient 2 was a man in his early 20s with severe TBI and significant agitation after a motor vehicle accident.

Interventions: Evidence-based family education focused on minimizing stress experienced by patients with TBI in the acute and inpatient rehabilitation settings.

Main Outcome Measures: Patient-family interactions lead to stressful encounters that detracted from TBI recovery. These patient cases demonstrate opportunities for improving evidence-based family education during acute and subacute TBI care.

Results: Key points included in family education to reduce stressful environments for patients with TBI include:
- TBI can make people easily tired, agitated, confused, and forgetful.
- Psychological stressors may impede or delay TBI recovery and even damage the structure of the brain.
- Tips should be emphasized to avoid reinforcing problematic behavior by identifying and addressing links between stress and emotional outbursts.
- Building a familiar and calming context during family visits will be augmented.
- Strategies are underscored to de-escalate and re-direct confrontations.

Conclusions: Family education should be addressed through progressive, longitudinal sessions with an emphasis on stress reduction and brain recovery.

Author(s) Disclosures: Nothing to disclosure