3 - (OP29) Effectiveness of Brain Injury Family Intervention (BIFI) in Improving Psychological Well-being of Traumatic Brain Injury Caregivers in Malaysia: A Randomized Controlled Trial

Introduction: Traumatic Brain Injury (TBI) is a major cause of death and disability worldwide (Johnson & Grisworld, 2017). After a TBI, family members often take on caregiving roles (Azman et al., 2020). In Malaysia, there are limited programs supporting the psychological well-being of these caregivers (Hassan et al., 2011; Arulsamy & Shaikh, 2020). This study assessed the effectiveness of the Brain Injury Family Intervention (BIFI) in enhancing TBI caregivers' mental health in selected Malaysian hospitals. This module is based on Cognitive Behavior Therapy and Family Systems Theories. It is a structured module developed by Prof Dr. Jeffry Kreutzer and colleagues from Virginia Commonwealth University, USA. It was designed as an intervention module guide for TBI caregivers (Kreutzer et al., 2015)

Methods: This study was a two-armed, single-blinded randomized controlled trial conducted at Hospital Sungai Buloh and Hospital Rehabilitasi Cheras. One hundred TBI caregivers were randomly assigned to either an intervention group, which participated in the BIFI program over 5 sessions (90-120 minutes each), or a control group receiving usual treatment. Eligible participants were caregivers aged 18 and older caring for TBI patients for over three months post-injury. All caregivers and co-investigators were blinded to group allocation, except the principal investigator. Outcomes measured included emotional distress (Beck Depression Inventory), caregiver burden (Caregiver Strain Index), and life satisfaction (Satisfaction with Life Scale), assessed at pre-test, post-test, 3-month, and 6-month follow-ups. ANOVA was conducted to compare outcome variables (emotional distress, caregiver burden, life satisfaction, and family needs) across four time points (pre-, post-, 3-month, and 6-month follow-up). Mauchly’s Test of Sphericity was used to assess the assumption of sphericity; where violated, the Greenhouse-Geisser correction was applied. Between-group comparisons (intervention vs. control) were included as between-subjects factors. For any significant differences observed at the baseline data, the ANCOVA was employed. This is to ensure that the treatment effects were not due to the differences in the pre-existing conditions.

Results: This study found significant improvements in emotional distress (F (1.97, 193.38) = 446.01, p < 0.05) and caregiver burden (F (1, 97) = 89.165, p < 0.05) in the intervention group compared to the control group at post-intervention and at the 3-month and 6-month follow-ups. However, there were no significant changes in caregivers' life satisfaction in either group.

Conclusions: This study offers valuable insights for TBI caregivers to enhance their psychological well-being. Incorporating the BIFI into TBI management is recommended.