Perceptions of family environment among severely head injured patients and their relatives
Date
1987
Authors
Douglas, Mary Jacinta
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Abstract
This study assessed the perceived family environments of 20 severely head injured patients (post traumatic amnesia, PTA>? days), 2.5-10 years post injury. Descriptive data, including pretraumatic, injury-related, and postinjury characteristics were presented in order to provide a context in which to evaluate long-term postinjury family environment. Severely head injured patients and their close adult relatives were interviewed, and completed questionnaires independently, in their homes. All subjects had returned to the same family environment in which they had lived immediately prior to injury. Eight were living with both parents, four with a single parent, and eight with their wives.
Persistent symptoms of depression were common to both patients and relatives. The changes in patients reported most frequently by patients and their relatives included impaired memory and concentration, vulnerability to fatigue, and emotional and behavioural changes.
Using the Family Environment Scale. perceived family environments among severely head injured patients and their relatives were compared to those of a normative and a distressed sample. The family environments of severely head injured patients were characterized by significantly more control, less expressiveness and less active-recreational orientation than the normative sample. They reported significantly higher emphasis on cohesion and organization than a sample of distressed families with one dysfunctional member.
Group comparisons were conducted between families of severely head injured husbands and families of severely head injured adult children. Evidence suggested that severely head injured husbands and their wives are more vulnerable to persistent depression than severely injured adult children and their parents. Results concerning the perceived family environments of the two groups indicated that severe head injury is associated with different outcome for the family unit, dependent upon the role of the injured member. Families of severely head injured adult children were less disrupted and functioned more effectively than families of severely injured husbands. The family environments of severely head injured husbands were characterized by significantly less cohesion and more conflict than was evident in families of severely head injured adult children. They were also significantly less likely to participate in activities outside the immediate family environment and appeared to be more socially isolated than families where the head injured member was an adult child. Their perceptions of family environment were consistent with a high level of continuing distress and friction. Possible reasons for these differences are discussed.