Effectiveness of Brain Injury Family Intervention (BIFI) in Improving Psychological Well-Being of Traumatic Brain Injury Caregivers in Malaysia: A Randomized Controlled Trial

Objective: Traumatic Brain Injury (TBI) is a major cause of death and disability worldwide, with a global incidence of approximately 69 million annually1. Following a TBI, family members often assume caregiving roles. Despite their critical role in supporting individuals with TBI, this group remains underserved in nursing and healthcare settings. In Malaysia, there are limited structured-supported programs within nursing and healthcare settings targeting the psychological well-being of these caregivers. This study assessed the effectiveness of the Brain Injury Family Intervention (BIFI) in improving the psychological well-being of TBI caregivers in selected Malaysian hospitals.
Methods: This study was a two-armed, single-blinded randomized controlled trial conducted at Hospital Sungai Buloh and Hospital Rehabilitasi Cheras, Malaysia. One hundred TBI caregivers were randomly assigned to either an intervention group, which participated in the psychologist-led BIFI program over 5 sessions (90-120 minutes each), or a control group receiving usual care. Eligible participants were caregivers aged 18 and older caring for TBI patients for over three months post-injury.Outcomes measured included emotional distress (Beck Depression Inventory-BDI), caregiver burden (Caregiver Strain Index- CSI), and life satisfaction (Satisfaction With Life Scale- SWLS), assessed at pre-test, post-test, 3-month, and 6-month follow-ups.
Results: This study showed significant improvements in emotional distress (F (1.97, 193.38) = 446.01, p < 0.05) and caregiver burden (F (1, 97) = 89.17, p < 0.05) in the intervention group compared to the control group at post-intervention and at the 3-month and 6-month follow-ups. However, there were no significant changes in caregivers' life satisfaction in either group.
Conclusions: This study demonstrated the effectiveness of the BIFI program in improving the psychological well-being of TBI caregivers, with sustained outcomes up to six months. The findings support the integration of structured psychoeducational programs into TBI care protocols.

traumatic brain injury (TBI), caregiver burden, randomized controlled trial, psychological well-being, Malaysia

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