Brickell Tracey A, French Louis M, Lippa Sara M, Wright Megan M, Lange Rael T
Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, Maryland.
National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland.
Mil Psychol. 2020 Jul 28;32(4):341-351. doi: 10.1080/08995605.2020.1754149. eCollection 2020.
This study examined factors related to poor mental health in caregivers assisting service members and Veterans (SMV) following traumatic brain injury (TBI). Participants were 201 military caregivers (96.0% female; Age: M = 39.2 years, SD = 10.2) of SMVs following a mild, moderate, severe, or penetrating TBI. The SF-36v2 Health Survey, Caregiver Appraisal Scale, Mayo-Portland Adaptability Inventory-4, and Caregiver Questionnaire were completed. Caregivers were divided into two mental health groups: Poor Mental Health (n = 108) and Good Mental Health (n = 93). Factors related to poor caregiver mental health were worse general health and stress appraisal, less personal time, unmet needs, and greater financial and employment strain. Factors also related to poor caregiver mental health included assisting a SMV who had sustained a mild TBI, did not have significant hospital care, had post-traumatic stress disorder, depression, and/or anxiety, was experiencing greater functional disability, and was experiencing physical expressions of irritability, anger, and aggression (all p's<.05; d =.29 to d =.64; OR = 1.911 to OR = 4.984). For many military caregivers, poor mental health may be related to the SMVs ongoing comorbid mental health symptoms and less so neurological impairment related to the brain injury. TBI treatment programs require a holistic approach that addresses the behavioral health concerns of both SMVs and their caregivers.
本研究调查了在协助创伤性脑损伤（TBI）后的军人和退伍军人（SMV）的护理人员中，与心理健康不佳相关的因素。参与者为201名军人护理人员（女性占96.0%；年龄：M = 39.2岁，标准差 = 10.2），他们所护理的SMV患有轻度、中度、重度或穿透性TBI。完成了SF - 36v2健康调查、护理人员评估量表、梅奥 - 波特兰适应性量表 - 4和护理人员问卷。护理人员被分为两个心理健康组：心理健康不佳组（n = 108）和心理健康良好组（n = 93）。与护理人员心理健康不佳相关的因素包括总体健康状况较差、压力评估较高、个人时间较少、需求未得到满足以及更大的经济和就业压力。与护理人员心理健康不佳相关的因素还包括协助患有轻度TBI、未接受重大医院护理、患有创伤后应激障碍、抑郁症和/或焦虑症、功能残疾程度较高以及出现易怒、愤怒和攻击性行为表现的SMV（所有p值 <.05；效应量d = 0.29至d = 0.64；比值比OR = 1.911至OR = 4.984）。对于许多军人护理人员来说，心理健康不佳可能与SMV持续存在的共病心理健康症状有关，而与脑损伤相关的神经损伤关系较小。TBI治疗项目需要一种整体方法，解决SMV及其护理人员的行为健康问题。
