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Objective: To describe the development and the implementation of a Web-based, videoconferencing training program for caregivers of adults with traumatic brain injury in rural areas to manage cognitive and behavioral changes in the person with the injury., Design: Feasibility study, with satisfaction and perceived utility assessed., Intervention: Six Web-based videoconference sessions, combining didactic education and interactive problem-solving., Participants: Fifteen caregivers of persons with complicated mild, moderate, or severe traumatic brain injury, who were admitted to a level III trauma center in a rural area of Texas., Measures: Satisfaction survey and perceived utility questions conducted immediately following training and at an average of 18 months after training., Results: Participants' overall satisfaction and comfort with the training was high. They perceived that they gained knowledge that was applicable to the everyday problems being experienced. At follow-up, all participants reported having used the knowledge gained to help cope with problems and all had referred to the written materials at least once since the training., Conclusions: Web-based videoconferencing can be used to provide training to caregivers to manage cognitive and behavioral problems resulting from traumatic brain injury. However, there are obstacles related to willingness to seek help among persons in rural areas that must be overcome.

Objective: To investigate the factor structure and concurrent validity of the Caregiver Appraisal Scale (CAS) in a sample of caregivers of adults with traumatic brain injury (TBI)., Design: Prospective cohort study., Setting: Two sites: (1) Outpatient clinics associated with a comprehensive inpatient brain injury rehabilitation program and (2) a comprehensive residential postacute rehabilitation program in the Southern United States., Participants: One hundred forty-nine caregivers of adults with TBI enrolled in the TBI Model Systems Project and 92 caregivers of adults with TBI admitted to a residential postacute rehabilitation program. Most caregivers were women and either parents or spouses of the injured person., Main Outcome Measures: Caregiver Appraisal Scale (CAS); Subjective Burden Scale (SBS); Objective Burden Scale (OBS); General Health Questionnaire (GHQ)., Results: Principal components analysis with varimax rotation yielded four factors: perceived burden (PB), caregiver relationship satisfaction (CRS), caregiving ideology (CI), and caregiving mastery (CM), which were found to be fairly stable across treatment settings. Adequate concurrent validity was demonstrated for the perceived burden factor, and adequate internal consistency was found for three of four scales., Conclusions: Preliminary support for the use of the CAS in caregivers of adults with TBI was obtained. However, further scale development, particularly for the CM factor, will likely improve the stability and usefulness of this instrument.