Document Type



Doctor of Philosophy



Date of Defense


Graduate Advisor

Susan L. Dean-Baar, College of Nursing


Susan L. Dean-Baar, R.N., Ph.D., FAAN, Chair

Anne F. Fish, R.N., Ph.D., FAHA, FAAN

Umit Tokac, Ph.D.

Yuanlu Sun, R.N., Ph.D.


Purpose: This study aimed to examine the effect of a self-management support program for individuals with mild traumatic brain injury (mTBI) and their family caregivers.

Design: The study design was a two-group randomized control trial.

Method: A total of 73 mTBI patients and their primary family caregivers were randomly assigned to either the intervention group (n=36) receiving the self-management support program plus usual care or the control group (n=37) receiving only usual care. The self-management program was developed based on the Individual and Family Self-management theory, and relevant clinical practice guidelines. The program consisted of self-management support assessment at the hospital, and four weekly telephone follow-ups to the patients’ home to provide mTBI-related education, symptom monitoring and management, emotional support to individuals with mTBI tailored to the patients’ needs assessed. The primary outcomes including post-concussion symptom severity, individuals’ self-management behaviors, health-related quality of life, and family caregivers’ self-management support behaviors were measured at baseline and week 6 after hospital discharge. Chi-square and t-tests were used to compare demographic data at baseline. Independent sample t-tests were used to compare outcome variables.

Findings: There were no significant difference in post-concussion symptom severity between the intervention and the control groups, but the number of post-concussion symptoms. The intervention group had significantly greater individuals’ self-management behaviors, health-related quality of life, and caregivers’ self-management support behaviors than the control group (p < .001).

Conclusions: The self-management support program had beneficial effects on reducing the number of post-concussion symptom severity and improving individuals’ self-management behaviors, and health-related quality of life and caregivers’ self-management support behaviors.

Clinical Relevance: The scope of care for individuals with mTBI should be expanded beyond acute care settings to their home to promote proper self-management behaviors and improved outcomes, especially during the transition from hospital to home care.

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