Brickell Tracey A, Cotner Bridget A, French Louis M, Carlozzi Noelle E, O'Connor Danielle R, Nakase-Richardson Risa, Lange Rael T
Defense and Veterans Brain Injury Center.
Rehabilitation Outcomes Research Section.
Rehabil Psychol. 2020 Jan 23. doi: 10.1037/rep0000306.
PURPOSE/OBJECTIVE: To examine the influence of traumatic brain injury (TBI) severity on the health-related quality of life of caregivers providing care to service members/veterans (SMV) following a TBI. Research Method/Design: Thirty caregivers (90.0% female; 70.0% spouse; age: = 39.5 years, = 10.7) of SMVs who sustained a mild, moderate, severe, or penetrating TBI were recruited from Walter Reed National Military Medical Center and via community outreach to participate in one of six focus groups. Caregivers were classified into 3 TBI severity/caregiver groups: (a) moderate/severe/penetrating TBI caregiver group ( = 11); (b) mild TBI caregiver group ( = 10); and (c) equivocal TBI caregiver group ( = 9). Thematic analysis using a constant comparative approach was conducted with qualitative analysis software to identify common themes across the 3 severity/caregiver groups.
Eleven themes emerged: no time for self/needs last (83.3%), poor physical health (80.0%), increased stress/anxiety (76.7%), social isolation/loneliness (66.7%), lack of access to services (50.0%), impact on family life (46.7%), sleep issues (46.7%), finances/employment (36.7%), depression (30.0%), exhaustion (30.0%), and anger (16.7%). Exploratory pairwise comparisons revealed a higher proportion of the moderate/severe/penetrating TBI group endorsed 7 of the 11 themes (no time for self/needs last, increased stress/anxiety, impact on family life, sleep issues, finances/employment, exhaustion, anger, and increased stress/anxiety) compared with the other 2 groups.
CONCLUSIONS/IMPLICATIONS: It is important that caregivers of SMVs receive long-term support in their caregiving and parenting roles. Further work is required to understand the challenges caregivers experience in accessing services they need and how to effectively meet their needs across the care continuum. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
目的/目标:探讨创伤性脑损伤(TBI)严重程度对为遭受TBI的军人/退伍军人(SMV)提供护理的照料者健康相关生活质量的影响。研究方法/设计:从沃尔特·里德国家军事医疗中心并通过社区宣传招募了30名照料遭受轻度、中度、重度或穿透性TBI的SMV的照料者(90.0%为女性;70.0%为配偶;年龄:=39.5岁,=10.7),以参与六个焦点小组中的一个。照料者被分为3个TBI严重程度/照料者组:(a)中度/重度/穿透性TBI照料者组(=11);(b)轻度TBI照料者组(=10);以及(c)疑似TBI照料者组(=9)。使用恒定比较法并借助定性分析软件进行主题分析,以识别3个严重程度/照料者组中的共同主题。
出现了11个主题:无暇顾及自身/需求排在最后(83.3%)、身体健康欠佳(80.0%)、压力/焦虑增加(76.7%)、社会孤立/孤独感(66.7%)、难以获得服务(50.0%)、对家庭生活的影响(46.7%)、睡眠问题(46.7%)、财务/就业(36.7%)、抑郁(30.0%)、疲惫(30.0%)以及愤怒(16.7%)。探索性成对比较显示,与其他两组相比,中度/重度/穿透性TBI组中有较高比例的人认可11个主题中的7个(无暇顾及自身/需求排在最后、压力/焦虑增加、对家庭生活的影响、睡眠问题、财务/就业、疲惫、愤怒以及压力/焦虑增加)。
结论/启示:重要的是,SMV的照料者在其护理和养育角色中应获得长期支持。需要进一步开展工作,以了解照料者在获取所需服务方面所面临的挑战,以及如何在整个护理连续过程中有效满足他们的需求。(《心理学文摘数据库记录》(c)2020美国心理学会,保留所有权利)