Randomized Trial to Evaluate Effects of Peer- and Clinician-Led Interventions for Caregivers of Individuals With Acquired Brain Injury

Archives of Rehabilitation Research and Clinical Translation, 2024 · DOI: https://doi.org/10.1016/j.arrct.2024.100351 · Published: January 1, 2024

Rehabilitation Social Support Brain Injury

Simple Explanation

This study evaluates two interventions for caregivers of individuals with acquired brain injury (ABI) as they transition home after inpatient rehabilitation. The goal was to help caregivers prepare for their role and reduce their stress and depression. The interventions included clinician-delivered Problem-Solving Training (PST) and peer-led Building Better Caregivers (BBC) training, both initiated during inpatient rehabilitation and delivered virtually. These interventions aimed to manage stress and build caregiving skills. The results showed some positive effects, but were limited by low enrollment and engagement, partly due to COVID-19 restrictions. The findings suggest the need for further research in this area.

Study Duration

22 Months

Participants

169 caregivers of patients with ABI

Evidence Level

Level II: Randomized Controlled Trial

Key Findings

1
Statistically significant improvements in caregiver stress were noted between the usual care (UC) and PST groups.
2
Positive differences in caregiver self-efficacy were found between the UC and BBC intervention groups, approaching significance at 30 days after discharge.
3
Patient unplanned hospital readmissions and days hospitalized were higher for UC participants than both intervention groups, although not statistically significant.

Research Summary

This study aimed to assess the effectiveness of clinician-led (PST) and peer-led (BBC) interventions for caregivers of ABI patients transitioning home, focusing on reducing stress and improving self-efficacy. The interventions were initiated during inpatient rehabilitation and delivered virtually. Results showed statistically significant improvements in caregiver stress in the PST group compared to usual care. Although positive findings were noted, the study faced limitations, including low enrollment and engagement due to COVID-19 restrictions, which may have affected the interventions' effectiveness. Further research is needed.

Practical Implications

Flexible Intervention Delivery

Interventions must be flexible and tailored to individual caregiver needs and concerns to improve engagement and effectiveness.

Peer-Led PST Variation

A peer-led variation of the PST intervention may be a promising next step for research, given the effectiveness of PST in reducing caregiver stress.

Early Intervention

Continued research into delivery of interventions during the acute phase of ABI is needed to mitigate caregiver stress and improve problem-solving strategies.

Study Limitations

1
The most notable limitation of the present study was not achieving the desired sample size owing to restrictions imposed by the COVID-19 pandemic.
2
The percentage of participants in the intervention groups who failed to initiate treatment or complete the optimal “dose” of 6 sessions was disappointingly low, further diminishing the effectiveness of the interventions.
3
Rate of dropouts and those lost to follow-up was also much higher than expected, with only half of the enrolled participants completing all outcomes surveys.

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