Stevens Lillian Flores, Pickett Treven C, Wilder Schaaf Kathryn P, Taylor Brent C, Gravely Amy, Van Houtven Courtney Harold, Friedemann-Sánchez Greta, Griffin Joan M
Hunter Holmes McGuire VAMC, Psychology Section (116B), 1201 Broad Rock Boulevard, Richmond, VA 23249, USA; Departments of Psychology, Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA.
Hunter Holmes McGuire VAMC, Psychology Section (116B), 1201 Broad Rock Boulevard, Richmond, VA 23249, USA; Departments of Psychology, Psychiatry, Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA.
Behav Neurol. 2015;2015:185941. doi: 10.1155/2015/185941. Epub 2015 Dec 7.
This was a hypothesis-generating exploration of relationships between caregiver training during TBI/polytrauma rehabilitation and caregiver mental health. In this cross-sectional study, 507 informal caregivers to US service members with TBI who received inpatient rehabilitation care in a Veterans Affairs' Polytrauma Rehabilitation Center from 2001 to 2009 completed a retrospective, self-report survey. Embedded in the survey were measures of caregiver mental health, including the National Institutes of Health's Patient Reported Outcome Measurement Information System (PROMIS) Anxiety and Depression Short Forms, the Rosenberg Self-Esteem scale, and the Zarit Burden Short Form. Though no groups endorsed clinical levels, mental health symptoms varied by caregiver training category (Trained, Not Trained, and Did Not Need Training). Caregivers who did not receive training on how to navigate healthcare systems endorsed higher depression and burden and lower self-esteem than those who did. Caregivers who did not receive training in supporting their care recipients' emotions endorsed higher anxiety, depression, and burden and lower self-esteem than those who did. Analyses also suggested a different association between training and mental health based on caregivers' relationship to the care recipient and the intensity of care recipient needs. Potential hypotheses for testing in future studies raised by these findings are discussed.
这是一项关于创伤性脑损伤/多发伤康复期间护理者培训与护理者心理健康之间关系的产生假设的探索性研究。在这项横断面研究中,2001年至2009年期间在退伍军人事务部多发伤康复中心接受住院康复治疗的507名美国创伤性脑损伤军人的非正式护理者完成了一项回顾性的自我报告调查。调查中包含护理者心理健康的测量指标,包括美国国立卫生研究院的患者报告的结果测量信息系统(PROMIS)焦虑和抑郁简表、罗森伯格自尊量表以及扎里特负担简表。虽然没有一组达到临床水平,但心理健康症状因护理者培训类别(受过培训、未受过培训和不需要培训)而异。未接受过关于如何应对医疗保健系统培训的护理者比接受过培训的护理者表现出更高的抑郁水平和负担感以及更低的自尊。未接受过支持护理对象情绪培训的护理者比接受过培训的护理者表现出更高的焦虑、抑郁和负担感以及更低的自尊。分析还表明,根据护理者与护理对象的关系以及护理对象需求的强度,培训与心理健康之间存在不同的关联。讨论了由这些发现提出的未来研究中有待检验的潜在假设。