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Primary objective: To examine the predictive associations of family satisfaction, functional impairment, pain, and depression on health-related quality-of-life (HRQoL) among persons with traumatic brain injury (TBI) through structural equation modelling (SEM). Research design: Participants were part of a larger longitudinal study of adjustment following TBI. Direct and indirect effects of predictor variables on HRQoL were analyzed through SEM. Methods and procedures: The sample included 131 participants with TBI (89 men, 42 women) who had been discharged from an acute care hospital. The Sickness Impact Profile was administered to measure HRQoL at or beyond 24 months post-discharge. Predictor variable measures included the Functional Independence Measure, Family Satisfaction Scale and single items assessing the presence of pain and depression. Main outcomes and results: SEM revealed direct effects of functional impairment ( p < 0.001), family satisfaction ( p < 0.01), depression ( p < 0.05) and pain ( p < 0.01) on HRQoL. Indirect effects from functional impairment ( p < 0.05) and pain ( p < 0.05) to HRQoL through depression were also present. Conclusions: The presence of pain and depression, greater functional impairment and lower family satisfaction were predictively associated with lower HRQoL. Depression further mediated the effects of pain and functional impairment on HRQoL. The present study advances understanding of the ways in which pain, depression and functional impairment predict HRQoL. [ABSTRACT FROM AUTHOR]

Objective: The use and quality of longitudinal research designs has increased over the past 2 decades, and new approaches for analyzing longitudinal data, including multilevel modeling (MLM) and latent growth modeling (LGM), have been developed. The purpose of this article is to demonstrate the use of MLM and its advantages in analyzing longitudinal data. Research Method: Data from a sample of individuals with intra-articular fractures of the lower extremity from the University of Alabama at Birmingham's Injury Control Research Center are analyzed using both SAS PROC MIXED and SPSS MIXED. Results: The authors begin their presentation with a discussion of data preparation for MLM analyses. The authors then provide example analyses of different growth models, including a simple linear growth model and a model with a time-invariant covariate, with interpretation for all the parameters in the models. Implications: More complicated growth models with different between- and within-individual covariance structures and nonlinear models are discussed. Finally, information related to MLM analysis, such as online resources, is provided at the end of the article. [ABSTRACT FROM AUTHOR]

Objectives: The relations of caregiver attributions about care-recipient's problem behaviour to caregiving relationship satisfaction and caregiver distress were examined., Design: This is a cross sectional study. Seventy-five family caregivers of individuals diagnosed with various disabling health conditions were recruited and interviewed. Caregiver attributions (internality, intentionality, responsibility, and controllability), caregiving relationship satisfaction, and caregiver distress variables were measured., Results: Structural equation techniques tested an a priori model of the latent constructs of caregiver attributions and caregiver relationship satisfaction to caregiver distress. Maladaptive caregiver attributions (i.e., more trait, higher intentionality, higher responsibility, and higher controllability) about care-recipients' problem behaviours predicted lower caregiving relationship satisfaction, which in turn was predictive of higher caregiver distress. Unexpectedly, caregiver attributions were not directly related to caregiver distress. However, attributions had an indirect effect on distress through relationship satisfaction. Younger caregivers experienced higher caregiver distress., Conclusions: Caregivers' explanations about care-recipient's problem behaviour are indicative of their satisfaction in the relationship with the care recipient, and poor caregiving relationship satisfaction is predictive of caregiver distress. Caregiver attributions and relationship quality may be considered in interventions with family caregivers., (©2010 The British Psychological Society.)