Griffin Joan M, Lee Minji K, Bangerter Lauren R, Van Houtven Courtney Harold, Friedemann-Sánchez Greta, Phelan Sean M, Carlson Kathleen F, Meis Laura A
Division of Health Care Policy and Research (HCPR), Mayo Clinic.
Mayo Clinic.
Am J Orthopsychiatry. 2017;87(2):139-148. doi: 10.1037/ort0000207.
Veterans who survive multiple traumatic injuries, including traumatic brain injuries (TBI), must often rely on family caregivers for ongoing care and support with reintegration. Understanding factors associated with caregiving that help or harm caregivers' health is critical for identifying appropriate and effective interventions that support caregiver health and promote the provision of quality care to veterans. This study utilized cross-sectional data from the Family and Caregiver Experiences Study, a survey of 564 caregivers caring for veterans who served after September 11, 2001, survived TBI/polytrauma during service, and received inpatient rehabilitation care in a Veterans Affairs Polytrauma Rehabilitation Center. Structural equation modeling was used to examine the relationship between caregiver stress (i.e., veterans' neurobehavioral problems and intensity of care required), and caregiver well-being (i.e., caregiver burden and mental health). Analyses also examined how intrapersonal, family or social, and financial resources mediate and moderate the relationship between caregiver stress and well-being. Results indicate that veterans' neurobehavioral problems and intensity of required care were associated with more caregiver burden, and more burden was associated with poor mental health. Intrapersonal and family or social resources mediated the relationship between veteran functioning and mental health. Family or social resources also moderated the relationship between care intensity and burden. The model explained a moderate amount of variability in burden (59%) and a substantial amount in mental health (75%). We conclude that caregivers of veterans with neurobehavioral problems who require intense care are at risk for burden and poor mental health. Increasing resources to bolster family or social resources may reduce risks. (PsycINFO Database Record
在包括创伤性脑损伤（TBI）在内的多次创伤性损伤中幸存下来的退伍军人，往往必须依靠家庭照料者来获得持续护理以及重新融入社会方面的支持。了解那些对照料者健康有益或有害的照护相关因素，对于确定支持照料者健康并促进为退伍军人提供优质护理的适当有效干预措施至关重要。本研究利用了来自家庭与照料者经历研究的横断面数据，该研究对564名照料者进行了调查，这些照料者所照料的退伍军人在2001年9月11日之后服役，在服役期间遭受了创伤性脑损伤/多发伤，并在退伍军人事务部多发伤康复中心接受了住院康复治疗。采用结构方程模型来检验照料者压力（即退伍军人的神经行为问题和所需的护理强度）与照料者幸福感（即照料者负担和心理健康）之间的关系。分析还考察了个人、家庭或社会以及经济资源如何中介和调节照料者压力与幸福感之间的关系。结果表明，退伍军人的神经行为问题和所需护理强度与更多的照料者负担相关，而更多的负担又与心理健康不佳相关。个人以及家庭或社会资源中介了退伍军人功能与心理健康之间的关系。家庭或社会资源也调节了护理强度与负担之间的关系。该模型解释了相当一部分负担方面的变异性（59%）以及心理健康方面的大量变异性（75%）。我们得出结论，需要高强度护理的患有神经行为问题的退伍军人的照料者有负担和心理健康不佳的风险。增加资源以加强家庭或社会资源可能会降低风险。（PsycINFO数据库记录
