The effectiveness of post-discharge head injury facilities on family adaptability and differentiation

When a traumatically brain injured person is discharged from the hospital and begins to reside with a family member, can the services of a post-discharge facility enhance family functioning? In this research, a quasi-experimental design was employed to study a treatment group of thirty two families of head injured persons from eight facilities and a control group of the same number of families not attending any post-discharge treatment facility. The treatment group (N=32) and control group (N=32) were compared on the dependent variables of family adaptability and differentiation at two different times: at the discharge of the head injured person from the inpatient facility and four months later while the injured relative was residing with the family member. Family adaptability and differentiation were measured by the Family Relations Scale of Barbarin (1992), while coma days, patient functional ability and family stress, which were used as covariates, were measured by the Patient Functional Ability Scale of the author and the Family Well-Being Assessment Scale of Caldwell (1988). Although there were significant group differences from pretest to posttest with higher family adaptability in the treatment group, group differences on differentiation scores proved to be non-significant. Nevertheless, the families in the treatment group who attended family education and therapy sessions at post-discharge head injury facilities had higher family differentiation scores at the posttest. The findings also suggest that the "head injured" family is characterized by a moderately high degree of flexibility and moderately low level of differentiation or a type of overprotective enmeshment.