Coping with Traumatic Brain Injury Using the Preparation Program among Caregivers of Patients in the Intensive Care Unit

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Rungnapha Khiewchaum
Orapan Thosingha
Prangtip Chayaput
Ketsarin Utriyaprasit


Background: After sustaining severe traumatic brain injury (TBI), most patients suffer both physical and mental disabilities.
Caregivers of those critically ill patients have to deal with crises not only from unexpected injury, but also from difficult
situations in giving care to them. The preparation program (PP) which assists caregivers to cope by enhancing the participation
in care during intensive episode is needed.
Objective: To examine differences between mean coping scores of TBI patientsั caregivers who received the PP and those
receiving the usual nursing care.
Methods: A quasi-experimental research design was conducted. The sample included 40 caregivers of ICU patients with severe
TBI, 20 for a control group and 20 for an experimental group, was recruited. The Preparation Program (PP) implemented in
the experimental group was developed based on an extensive review of related literature. The Thai version of the Coping and
Adaptation Processing ScaleึShort Form (TCAP-SF) was administered before and after the training of caregivers with PP to
determine their coping abiility. Data were analyzed using Chi-square and t-test.
Results: Caregivers who received the PP had a higher mean of coping score (x= 98.50, SD = 8.32) than those receiving the
usual care did (x = 79.55, SD = 12.20) at p <.001.
Conclusion: Caregivers were able to cope better after receiving the PP. The PP facilitated them to deal with a crisis episode
of a family member with TBI in the ICU by getting more participation in their care. However, the coping of caregivers after
patient discharge from the ICU to ward and after returning home should be evaluated.


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Khiewchaum, R. ., Thosingha, O. ., Chayaput, P. ., & Utriyaprasit, K. . (2020). Coping with Traumatic Brain Injury Using the Preparation Program among Caregivers of Patients in the Intensive Care Unit. Siriraj Medical Journal, 63(4), 128–131. Retrieved from
Original Article


1. Verhaeghe S, Defloor T, Grypdonck MG. Stress and coping among families
of patients with traumatic brain injury: a review of the literature. J
Clin Nurs. 2005 Sep;14(8):1004-12.
2. Yang S. A mixed methods study on the needs of Korean families in the
intensive care unit. Aus J Adv Nurs. 2008;25(4):79-86.
3. Roy C. The Roy adaptation model. (3rd ed). Upper Saddle River (NJ):
Pearson; 2008.
4. Bond AE, Draeger CR L, Mandleco B, Donnelly M. Need of family
members of patients with severe traumatic brain injury. Crit Care Nurse.
2003 Aug;23(4):63-72.
5. Morris KC. Psychological distress in carer of head injured individuals:
the provision of written information. Brain Inj. 2001 Mar;15(3):239-54.
6. Chien WT, Chiu YL, Lam LW, Ip WY. Effects of a needs-based education
program for family carers with a relative in an intensive care unit:
a quasi-experimental study. Int J Nurs Stud. 2006 Jan;43(1):39-50.
7. Sinnakaruppan I, Downey B, Morrison S. Head injury and family carers:
a pilot study to investigate an innovative community-based educational
program for family carers and patients. Brain Inj. 2005 Apr;19(4):283-308.
8. Glass GV, McGaw B, Smith ML. Meta-analysis in social research. Beverly
Hills (CA): Sage; 1981.
9. Cohen J. Statistical power analysis for the behavioral sciences (2nd ed).
Hillsdale (NJ): Lawrence Erlbaum; 1988.
10. Khiewchaum R. The development of a clinical nursing practice guideline
for preparation of caregivers of patients with traumatic brain injury.
J Nurs Sci. 2011;29(1):18-25.
11. Roy C, Chayaput P. The coping and adaptation processing scale: English
and Thai version. RAA Rev. 2004;6(2):4-6.
12. Chayaput P, Roy C. Psychometric Testing of the Thai version of Coping
and Adaptation Processing Scale-Short Form (TCAPS-SF). Thai J Nurs
Council. 2007;22(3):29-39.
13. Chayaput, P. Coping strategies of medical and surgical patients toward
hospitalization: Roy adaptation model as a conceptual framework. Thai
J Nurs Council. 2007;22(2):87-98.
14. Azoulay E, Pochard F, Chevret S, Jourdain M, Bornstain C, Wernet A,
et al. Impact of a family information leaflet on effectiveness of information
provided to family members of intensive care unit patients: a multicenter,
prospective, randomized, controlled trial. Am J Respir Crit Care
Med. 2002 Feb 15;165(4):438-42.
15. Casarini KA, Gorayeb R, Basile Filho A. Coping by relatives of critical
care patients. Heart Lung. 2009 May-Jun;38(3):217-27.
16. Shyu YI. Role tuning between caregiver and care receiver during discharge
transition: an illustration of role function mode in Roy’s adaptation theory.
Nurs Sci Q. 2000 Oct;13(4):323-31.
17. DeSanto-Madeya SA. A secondary analysis of the meaning of living with
spinal cord injury using Roy’s adaptation model. Nurs Sci Q. 2006 Jul;19
18. Wade SL, Walz NC, Cassedy A, Taylor HG, Stancin T, Yeates KO.
Caregiver functioning following early childhood TBI: do moms and dads
respond differently? NeuroRehabilitation. 2010;27(1):63-72.
19. Mitchell ML, Courtney MD. Reducing family memberัs anxiety and uncertainty
in illness around transfer from intensive care: an intervention study.
Intensive Crit Care Nurs. 2004 Aug;20(4):223-31.
20. Cypress BS. The intensive care unit: experiences of patients, families,
and their nurses. Dimens Crit Care Nurs. 2010 Mar-Apr;29(2):94-101.
21. Verhaeghe ST, van Zuuren FJ, Defloor T, Duijnstee MS, Grypdonck
MH. How does information influence hope in family members of traumatic
coma patients in intensive care unit? J Clin Nurs. 2007 Aug;16(8):1488-97.
22. Nelms TP, Eggenberger SK. The essence of the family critical illness
experience and nurse-family meetings. J Fam Nurs. 2010 Nov;16(4):462-
23. Lee L-Y, Lau Y-L. Immediate needs of adult family members of adult
intensive care patients in Hong Kong. J Clin Nurs. 2003 Jul;12(4):490-500.
24. Auerbach SM, Kiesler DJ, Wartella J, Rausch S, Ward KR, Ivatury R.
Optimism, satisfaction with needs met, interpersonal perceptions of the
healthcare team, and emotional distress in patientsั family members during
critical care hospitalization. Am J Crit Care. 2005 May;14(3):202-10.
25. Paul F, Rattray J. Short- and long-term impact of critical illness on relatives:
literature review. J Adv Nurs. 2008 May;62(3):276-92.
26. Miracle VA. Strategies to meet the needs of families of critically ill
patients. Dimens Crit Care Nurs. 2006 May-Jun;25(3):121-5.

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