{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:10:03Z","timestamp":1793329803955,"version":"4.5.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Traumatic brain injury (TBI) has been known to cause physical and psychological dysfunction among patients. Most family members face numerous physical and psychological difficulties in caregiving, yet effective interventions remain limited. This study aims to (a) identify the effects of caregiver interventions on caregiver burden for traumatic brain injury patients, (b) evaluate the effects of these programs on caregivers' psychological distress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search was conducted in Pubmed, Medline and PsycINFO to search for randomized control trials (RCTs) that report the effects of caregiver interventions on care partners of TBI patients above the age of 18. The primary outcome was caregiver burden, which was measured mainly using the Zarit Burden Interview (ZBI). The secondary outcome was psychological distress, with the Brief Symptom Inventory-18 (BSI-18) as the main assessment used. The RoB-2 tool was used to assess the risk of bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen RCTs were identified after screening. Meta-analysis of the primary outcome (ZBI) showed significant improvements (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05) favoring intervention despite high heterogeneity in the 5 studies. Meta-analysis of the secondary outcome (BSI-18) indicated smaller but significant improvement (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.02) with low heterogeneity in 3 studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Results suggest that caregiver interventions are effective in improving caregiver burden and psychological distress in the future. However, due to high risk of bias in studies, the conclusion should be interpreted with caution before clinical application. Higher quality research should be conducted to ensure the effectiveness of caregiver programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1698592","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T05:20:38Z","timestamp":1764739238000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of caregiver interventions on caregiver burden in adult traumatic brain injury: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Chung Yan","family":"Ting","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zubair","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1089\/neu.2025.0039","article-title":"Global, regional, and national burden of traumatic brain injury, 1990\u20132021: a systematic analysis for the global burden of disease study 2021","volume":"42","author":"Gu","year":"2025","journal-title":"J Neurotrauma"},{"key":"B2","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1016\/S1474-4422(23)00065-0","article-title":"Traumatic brain injury as a chronic disease: insights from the United States Traumatic Brain Injury Model Systems Research Program","volume":"22","author":"Dams-O'Connor","year":"2023","journal-title":"Lancet Neurol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"6386","DOI":"10.3390\/ijerph17176386","article-title":"Burden and preparedness amongst informal caregivers of adults with moderate to severe traumatic brain injury","volume":"17","author":"Lieshout","year":"2020","journal-title":"Int J Environ Res Public Health."},{"key":"B4","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1037\/rep0000306","article-title":"Severity of military traumatic brain injury influences caregiver health-related quality of life","volume":"65","author":"Brickell","year":"2020","journal-title":"Rehabil Psychol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e1590","DOI":"10.7759\/cureus.1590","article-title":"Caregiver's burden of the patients with traumatic brain injury","volume":"9","author":"Qadeer","year":"2017","journal-title":"Cureus."},{"key":"B6","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1080\/09602011.2015.1051056","article-title":"Traumatic brain injury caregivers: a qualitative analysis of spouse and parent perspectives on quality of life","volume":"27","author":"Kratz","year":"2017","journal-title":"Neuropsychol Rehabil."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1080\/02699052.2016.1274778","article-title":"Impact of TBI on caregivers of veterans with TBI: burden and interventions","volume":"31","author":"Malec","year":"2017","journal-title":"Brain Inj."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1016\/j.apmr.2025.01.464","article-title":"Caregiver resilience through the first 2 years after traumatic brain injury: a traumatic brain injury model systems study","volume":"106","author":"Klyce","year":"2025","journal-title":"Arch Phys Med Rehabil."},{"key":"B9","doi-asserted-by":"publisher","first-page":"S65","DOI":"10.1016\/j.apmr.2018.07.422","article-title":"A randomized controlled pilot study of a manualized intervention for caregivers of patients with traumatic brain injury in inpatient rehabilitation","volume":"100","author":"Niemeier","year":"2019","journal-title":"Arch Phys Med Rehabil."},{"key":"B10","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.wneu.2024.01.078","article-title":"Mobile health transitional care intervention delivered by nurses improves postdischarge outcomes of caregivers of patients with traumatic brain injury: a randomized controlled trial","volume":"184","author":"Ganefianty","year":"2024","journal-title":"World Neurosurg."},{"key":"B11","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1097\/HTR.0000000000000167","article-title":"A telehealth approach to caregiver self-management following traumatic brain injury: a randomized controlled trial","volume":"31","author":"Powell","year":"2016","journal-title":"J Head Trauma Rehabil."},{"key":"B12","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1037\/rep0000402","article-title":"Effectiveness of remote interventions in improving caregiver stress outcomes for caregivers of people with traumatic brain injury","volume":"66","author":"Suntai","year":"2021","journal-title":"Rehabil Psychol."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1037\/rep0000632","article-title":"Reducing burden and anxiety for caregivers of veterans with traumatic brain injury and dementia: randomized controlled trial of the resources for enhancing all caregivers' health\u2014Hope intervention","author":"Nichols","year":"2025","journal-title":"Rehabil Psychol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1016\/j.apmr.2024.12.022","article-title":"Improving outcomes for care partners of individuals with traumatic brain injury: results for a mHealth randomized control trial of the CareQOL app","volume":"106","author":"Carlozzi","year":"2025","journal-title":"Arch Phys Med Rehabil."},{"key":"B15","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1097\/HTR.0b013e31824e1d43","article-title":"Web-based training in family advocacy","volume":"28","author":"McLaughlin","year":"2013","journal-title":"J Head Trauma Rehabil."},{"key":"B16","doi-asserted-by":"publisher","first-page":"746","DOI":"10.1080\/02699052.2023.2208881","article-title":"\u201cIf you respect me, you are respecting my culture\u201d: methods and recommendations for personalizing a TBI transitional care intervention","volume":"37","author":"Oyesanya","year":"2023","journal-title":"Brain Inj."},{"key":"B17","doi-asserted-by":"publisher","first-page":"137","DOI":"10.5463\/dcid.v23i3.120","article-title":"Efficacy of family intervention in acquired head-injury cases in India","volume":"23","author":"Vranda","year":"2012","journal-title":"Disabil CBR Incl Dev."},{"key":"B18","doi-asserted-by":"publisher","first-page":"137","DOI":"10.3233\/NRE-220121","article-title":"Multi-site, multi-country randomized clinical trial of an acute traumatic brain injury caregiver transition assistance program in Latin America","volume":"52","author":"Perrin","year":"2023","journal-title":"NeuroRehabilitation."},{"key":"B19","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/j.dhjo.2017.04.009","article-title":"A pilot study of Trabajadora de salud, a lay health worker intervention for Latinas\/os with traumatic brain injuries and their caregivers","volume":"11","author":"Linton","year":"2018","journal-title":"Disabil Health J."},{"key":"B20","doi-asserted-by":"publisher","first-page":"2342","DOI":"10.1016\/j.apmr.2018.04.016","article-title":"Systematic review of caregiver and dyad interventions after adult traumatic brain injury","volume":"99","author":"Kreitzer","year":"2018","journal-title":"Arch Phys Med Rehabil."},{"key":"B21","unstructured":"PRISMA Statement\n          \n          2025"},{"key":"B22","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1177\/0269215516639357","article-title":"Caregiver outcomes and interventions: a systematic scoping review of the traumatic brain injury and spinal cord injury literature","volume":"31","author":"Baker","year":"2017","journal-title":"Clin Rehabil."},{"key":"B23","doi-asserted-by":"publisher","first-page":"685","DOI":"10.3389\/fneur.2017.00685","article-title":"Anatomical and physiological differences between children and adults relevant to traumatic brain injury and the implications for clinical assessment and care","volume":"8","author":"Figaji","year":"2017","journal-title":"Front Neurol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1186\/s13643-019-1074-9","article-title":"Toward systematic review automation: a practical guide to using machine learning tools in research synthesis","volume":"8","author":"Marshall","year":"2019","journal-title":"Syst Rev."},{"key":"B25","doi-asserted-by":"publisher","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"The cochrane collaboration's tool for assessing risk of bias in randomised trials","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1297","DOI":"10.1016\/j.apmr.2012.04.027","article-title":"Randomized controlled trial of peer mentoring for individuals with traumatic brain injury and their significant others","volume":"93","author":"Hanks","year":"2012","journal-title":"Arch Phys Med Rehabil."},{"key":"B27","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1016\/j.pmrj.2015.10.008","article-title":"A randomized controlled trial to evaluate the veterans' in-home program for military veterans with traumatic brain injury and their families: report on impact for family members","volume":"8","author":"Moriarty","year":"2016","journal-title":"PM&R."},{"key":"B28","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1016\/j.apmr.2007.12.032","article-title":"Problem-solving training for family caregivers of persons with traumatic brain injuries: a randomized controlled trial","volume":"89","author":"Rivera","year":"2008","journal-title":"Arch Phys Med Rehabil."},{"key":"B29","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1186\/s12883-024-03841-7","article-title":"Family member reported symptom burden, predictors of caregiver burden and treatment effects in a goal-oriented community-based randomized controlled trial in the chronic phase of traumatic brain injury","volume":"24","author":"L\u00f8vstad","year":"2024","journal-title":"BMC Neurol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1080\/02699050400003924","article-title":"Head injury and family carers: A pilot study to investigate an innovative community-based educational programme for family carers and patients","volume":"19","author":"Sinnakaruppan","year":"2005","journal-title":"Brain Inj"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1428","DOI":"10.1177\/02692155211010369","article-title":"The effectiveness of a family-centred intervention after traumatic brain injury: a pragmatic randomised controlled trial","volume":"35","author":"Rasmussen","year":"2021","journal-title":"SAGE J Clin Rehabil."},{"key":"B32","doi-asserted-by":"publisher","first-page":"302","DOI":"10.2340\/16501977-0511","article-title":"Factor analysis and Rasch analysis of the Zarit Burden Interview for acquired brain injury carer research","volume":"42","author":"Siegert","year":"2010","journal-title":"J Rehabil Med."},{"key":"B33","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1037\/rep0000295","article-title":"Reliability and validity data to support the clinical utility of the Traumatic Brain Injury Caregiver Quality of Life (TBI-CareQOL)","volume":"65","author":"Carlozzi","year":"2020","journal-title":"Rehabil Psychol."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1698592\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T05:20:39Z","timestamp":1764739239000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1698592\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,3]]},"references-count":33,"alternative-id":["10.3389\/fpubh.2025.1698592"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1698592","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,3]]},"article-number":"1698592"}}