Associations between protective resources and family functioning after traumatic brain injury: A cross-sectional study using a structural equation modeling approach.

Everything was measured at a single point in time, so the study can show that resilience, self-efficacy and mental health go together with family functioning, but not which one drives the other. 82% of the patients had a mild injury with a slow recovery, so the authors themselves say the results may not apply to families facing more severe injuries. The people who took part were doing comparatively well: three-quarters had a college or university education and most described healthy family functioning. Families in crisis may have decided not to join a trial of an eight-week family programme, so they are probably missing from these numbers. The authors note that 122 people is on the small side for this kind of modelling, though their own calculation put the minimum needed at 90. Almost all the family members were spouses or partners (92%), so the study says little about parents, siblings or adult children caring for someone after a brain injury.

The text supplied contains no funding statement and no declaration of competing interests. The trial was registered on ClinicalTrials.gov and approved by the Norwegian Medical Research Ethics Committee, and all participants gave written consent.

Do not read this as evidence that raising a patient's resilience or self-efficacy will improve how their family functions. Every measure was taken at the same time point, so the study shows only that the two go together and cannot show which one leads to which. The report also carries the label of a randomised controlled trial, but it analyses only the measurements taken before the family programme began, so nothing here shows that the programme works.