Peer-Reviewed
Psychosocial factors and cortisol rhythmicity in close relatives of patients with severe acquired and traumatic brain injury
J.M. Turner-Cobb
University of Bath
J. Palmer
University of Bath
D. Aronson
National Hospital for Rheumatic Diseases
L. Russell
National Hospital for Rheumatic Diseases
S. Purnell
National Hospital for Rheumatic Diseases
Preliminary findings from a pilot study being carried out at Bath Neuro-Rehabilitation Services, Royal National Hospital for Rheumatic Diseases.
Background
The family is vital to patient rehabilitation after brain injury. Existing research has been in relation to psychological rather than physical health, and the present study addressed both to help inform decisions relating to provision of family support. The study examined diurnal cortisol levels (indicating hypothalamic pituitary adrenal axis activity) and psychosocial factors among relatives of patients with severe/traumatic brain injuries undergoing treatment in a neuro-rehabilitation unit. It was hypothesised that cortisol levels would be disrupted in relatives and these disruptions attenuated by psychosocial coping resources.
Methods
Participants (n = 16) were relatives of patients who had suffered a severe/very severe brain injury. Psychosocial factors were measured through eight self-report questionnaires. Diurnal cortisol levels were measured through saliva samples provided over two consecutive days. Statistical analysis included ANOVA, T-Tests and correlations.
Findings
An overall raised cortisol level in the relatives was indicated (F(1,24) = 4.49, p<.05). A positive correlation for the Impact of Events Scale avoidance with evening cortisol (p< .05) was also found. Further results from the evening cortisol samples suggest religious or spiritual beliefs are associated with reduced stress levels (p= .05), and carer strain is associated with increased stress levels (p< .05).
Discussion
This study shows a link between psychological factors and potential down regulation of the immune system due to a close relative’s health status. This has implications for rehabilitation for both the patient and the family.
