Date of Award


Degree Type


Degree Name

Doctor of Philosophy


School of Nursing and Public Health


Faculty of Computing, Health and Science

First Advisor

Dr David Roberts

Second Advisor

Professor Linda Kristjanson


Background: This longitudinal study explored the impact on the family caregivers caring for a victim of a moderate or severe traumatic head injury (THI). The study used both quantitative and qualitative method and involved data calculation at three times points: one-month post injury, six months post injury, and one year later. Study Population: The study population comprised 45 family caregivers aged 21 to 72 years old. Thirty-four of the same caregivers were followed at six months and twenty five one year respectively. Methods: Both quantitative and qualitative methods were used to assess the family caregivers. The quantitative dimension comprised the Psychological General Well•Being Schedule (PGWBS, Dupy, 1984), the General Functioning Scale of the Family Assessment Device (FAD-GFS, Epstein, Baldwin, &Bishop, 1983), and the Stanford Acute Stress Reaction Questionnaire (SASRQ, Cardem1, et at., 2000), as well as a range of demographic variables. The PGWBS and the FAD-GFS were completed by family caregivers at three times during the study, and the SASRQ was completed by family caregivers at Time 1. Results: Findings from quantitative method revealed that in the terms of the impact on family functioning, no significant differences were found between the initial stages of injury, six months, and one year post injury at the 0.05 level of significance. Especially in the initial stages of injury, family caregivers of both moderate and severe THI patients were likely to be at risk of developing an acute stress disorder after exposure to the traumatic event. However, the family caregiver's psychological general well-being showed significant difference among three times at the 0.01 level of significance. The qualitative findings showed that most of family caregivers gave the meaning of THI as causing disability and severe injury. The major sources of distress were financial problems and victims’ prognosis or reactions. These caused an impact on caregivers’ financial situations, psychological and health problems, and loss of social interactions. Family caregivers used both problem-focused and emotion-focused coping strategies to deal the traumatic event. The coping strategies and resources that caregivers used to deal with the THI were consistent with the caregiver’s way of life and culture. For example, they used religious coping mechanisms and belief in God or traditional medicine and local wisdom combined with the professional health care sector to help them cope. Conclusion: The results of this study provide insights into the family caregivers experiences, understand how they cope with the crisis event and the impact of THI on their health. Health policy and local government should pay attention and promote the family caregivers’ well-being and welfare to support the family caregivers during their take role as caregivers.