Evidence map›Paper›PMID 40481284›Full record

ArticleNeurocritical care2026

Characterizing Stressors and Coping Strategies Among Caregivers of Patients with Severe Acute Brain Injury by Level of Distress.

Katherine J Meurer, Alexander M Presciutti, Sarah M Bannon, Rina Kubota, Nithyashri Baskaran, Jisoo Kim, Qiang Zhang, Mira Reichman, Nathan S Fishbein, Kaitlyn Lichstein and 11 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Katherine J Meurer *Albert Einstein College of Medicine, New York, NY, USA.
Alexander M Presciutti *Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Sarah M BannonDepartment of Rehabilitation and Human Performance, Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA.
Rina KubotaYale University, New Haven, CT, USA.
Nithyashri BaskaranColumbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
Jisoo KimYale University, New Haven, CT, USA.
Qiang ZhangDavid Geffen School of Medicine at the University of California, Los Angeles, CA, USA.
Mira ReichmanDepartment of Psychology, University of Washington, Seattle, WA, USA.
Nathan S FishbeinDepartment of Psychiatry, Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Kaitlyn LichsteinDepartment of Psychiatry, Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Melissa MottaProgram in Trauma, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA.
Susanne MuehlschlegelDepartments of Neurology, Anesthesiology & Critical Care Medicine, and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Michael E ReznikDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Matthew N JaffaDepartment of Neurointensive Care, Hartford Hospital, Hartford, CT, USA.
Claire J CreutzfeldtDepartment of Neurology, Harborview Medical Center, University of Washington, Seattle, WA, USA.
Corey R FehnelDepartment of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Amanda D TomlinsonDepartment of Critical Care Medicine, College of Medicine, Mayo Clinic, Jacksonville, FL, USA.
Craig A Williamson *Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
Ana-Maria Vranceanu *Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
David Y HwangDivision of Neurocritical Care, Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC, USA. david_hwang@med.unc.edu.ORCID 0000-0002-2150-4289
COMA-F Investigators

Funding

Recovering Together: Building resiliency in dyads of patients with an acute brain injury admitted to the Neuroscience Intensive Care Unit and their informal caregiversR01NR019982 · NINR · MASSACHUSETTS GENERAL HOSPITAL · PI VRANCEANU, ANA-MARIA · 2021 to 2025
$3.3M
Mentoring in technology enhanced mind body and lifestyle interventionsK24AT011760 · NCCIH · MASSACHUSETTS GENERAL HOSPITAL · PI Ana-Maria Vranceanu · 2022 to 2026
$911k
NCCIH NIH HHS K24 AT011760NINR NIH HHS R01 NR019982
6 · The paper itself

Abstract

backgroundFamily caregivers of patients with severe acute brain injury (SABI) who commit to tracheostomy and/or percutaneous endoscopic/surgical gastrostomy for the patient often develop chronic emotional distress. To inform future interventions to mitigate this distress, we characterized the stressors and coping strategies of caregivers of patients with SABI with varying levels of emotional distress during the acute and postacute stages of treatment.

methodsWe conducted semistructured interviews with family caregivers of patients with SABI around the time of neurological intensive care unit discharge (T1) and at 2-month follow-up (T2). All caregivers included in this current study completed the Hospital Anxiety and Depression Scale at T1 and/or T2. We then stratified transcripts by caregiver distress level, characterizing caregivers who scored > 11 on at least one Hospital Anxiety and Depression Scale subscale as "high distress" and ≤ 11 as "low distress." We conducted deductive, conceptual content analysis to compare perceived stressors and coping strategies employed at both time points.

resultsCaregivers in both strata reported many similar stressors at each time point, including ongoing uncertainty. However, there were also differences in stressors by level of distress and time point of assessment. At T1, high-distress caregivers reported pronounced stress related to navigating the health care system and communicating with providers, staff, and the patient. At T2, high-distress caregivers noted heightened difficulty with transitioning to long-term caregiving, co-occurring complex emotions, and communication with family and friends. Conversely, low-distress caregivers focused on challenges with team-based medical decision making at T2. Clear differences in coping strategies also emerged, such that high-distress caregivers relied primarily on avoidance at both points, whereas low-distress caregivers incorporated more problem-solving and self-care strategies.

conclusionsPsychosocial interventions for caregivers of patients with SABI are needed to reduce emotional distress. Skills should be applied to relevant topics based on time since neurological intensive care unit discharge and distress level. Skills should focus on reducing avoidance, promoting active coping, and targeting the perceived stressors specific to high-distress versus low-distress caregivers revealed here.

Indexed as

Adaptation, PsychologicalAnxietyBrain InjuriesCaregiversDepressionPsychological DistressStress, PsychologicalAdultAgedCoping SkillsFemaleHumansIntensive Care UnitsMaleMiddle AgedQualitative ResearchCaregiverComaEmotional distressQualitativeSevere acute brain injury

Identifiers

PMID40481284
PMCPMC13128255

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.