Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney NSW, Australia.
John Walsh Centre of Rehabilitation Research, Kolling Institute, Sydney University, Sydney NSW, Australia.
NeuroRehabilitation. 2020;46(1):3-15. doi: 10.3233/NRE-192945.
A deficits approach to understanding psychological adjustment in family caregivers of individuals with a neurological disability is extensive, but further research in the field of positive psychology (spirituality, resilience, hope) may provide a potential avenue for broadening knowledge of the family caregiver experience after traumatic brain injury (TBI) or spinal cord injury (SCI).
To test a proposed model of spirituality among family caregivers of individuals with TBI or SCI, using structural equation modelling (SEM).
A cross-sectional design was employed to survey ninety-nine family participants (TBI = 76, SCI = 23) from six rehabilitation units from NSW and Queensland. Assessments comprised Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale-Expanded, Connor -Davidson Resilience Scale, Herth Hope Index, and three measures of psychological adjustment including Caregiver Burden Scale, Positive and Negative Affect Scale, and Depression Anxiety Stress Scale.
SEM showed the proposed model was a good fit. The main findings indicated spirituality had a direct negative link with burden. Spirituality had a direct positive association with hope which, in succession, had a positive link with resilience. Spirituality influenced positive affect indirectly, being mediated by resilience. Positive affect, in turn, had a negative association with depression in caregivers.
This study contributes to better targeting strength-based family interventions.
从缺陷角度理解神经功能障碍患者家庭成员的心理适应已较为广泛，但积极心理学领域（灵性、韧性、希望）的进一步研究可能为拓宽创伤性脑损伤（TBI）或脊髓损伤（SCI）后家庭照顾者体验的知识提供潜在途径。
使用结构方程模型（SEM）检验 TBI 或 SCI 患者家庭照顾者灵性的拟议模型。
采用横断面设计，对来自新南威尔士州和昆士兰州 6 个康复单位的 99 名家庭参与者（TBI = 76，SCI = 23）进行调查。评估包括慢性疾病治疗-灵性幸福感量表扩展版、Connor-Davidson 韧性量表、Herth 希望指数，以及三种心理调整措施，包括照顾者负担量表、积极和消极情感量表、抑郁焦虑应激量表。
SEM 显示所提出的模型拟合良好。主要发现表明灵性与负担直接呈负相关。灵性与希望直接呈正相关，希望又与韧性呈正相关。灵性通过韧性间接影响积极情感。积极情感反过来与照顾者的抑郁呈负相关。
本研究有助于更有针对性地开展基于优势的家庭干预措施。
