Associations between protective resources and family functioning after traumatic brain injury: A cross-sectional study using a structural equation modeling approach

NeuroRehabilitation. 2023;52(1):47-58. doi: 10.3233/NRE-220131.


Background: A strength-based approach in the rehabilitation after traumatic brain injury (TBI) is recommended for patients and their families. However, further exploration of the complexity of individual and family factors is needed.

Objective: To explore the associations between individual protective resources in patients and family members and the overall family functioning using a strength-based approach.

Methods: Secondary analysis of data collected at baseline in a randomized controlled trial. Structural equation modeling with two latent constructs and six observed variables was performed. Outcome measures included the Resilience Scale for Adults, the Mental Component Summary (SF-36), the General Self-Efficacy Scale, and the Family Adaptability and Cohesion Evaluation Scale-IV.

Results: Hundred and twenty-two participants (60 patients, 62 family members) with a mean age of 43 years were included at a median of 11 months post-injury. The final model demonstrated a strong covariance (coefficient = 0.61) between the latent Protective construct and Family functioning. Model-fit statistics indicated an acceptable fit to the data.

Conclusion: Higher levels of protective resources (resilience, self-efficacy, and mental HRQL) were positively associated with family functioning. These resources should be further assessed in patients and their families, to identify factors that can be strengthened through TBI rehabilitation intervention.

Keywords: Traumatic brain injury; family; mental health; psychological; resilience; self-efficacy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Brain Injuries, Traumatic* / rehabilitation
  • Cross-Sectional Studies
  • Family
  • Humans
  • Latent Class Analysis
  • Outcome Assessment, Health Care