title: Burden and mental health among caregivers of veterans with traumatic brain injury/polytrauma.
abstract: 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
authors.affiliation: Division of Health Care Policy and Research (HCPR), Mayo Clinic.
authors.forename: Joan M
authors.identifier: 0000-0001-8120-3229
authors.initials: JM
authors.lastname: Griffin
authors.affiliation: Mayo Clinic.
authors.forename: Minji K
authors.initials: MK
authors.lastname: Lee
authors.affiliation: Department of Human Development and Family Studies, The Pennsylvania State University.
authors.forename: Lauren R
authors.initials: LR
authors.lastname: Bangerter
authors.affiliation: Center for Health Services Research in Primary Care, Durham VA Medical Center.
authors.forename: Courtney Harold
authors.initials: CH
authors.lastname: Van Houtven
authors.affiliation: Humphrey School of Public Affairs, University of Minnesota.
authors.forename: Greta
authors.initials: G
authors.lastname: Friedemann-Sánchez
authors.affiliation: Mayo Clinic.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Phelan
authors.affiliation: Center to Improve Veteran Involvement in Care, VA Portland Health Care System.
authors.forename: Kathleen F
authors.initials: KF
authors.lastname: Carlson
authors.affiliation: Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Meis
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000070642:Brain Injuries, Traumatic / Q000451:nursing*; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015233:Models, Statistical; D009104:Multiple Trauma / Q000451:nursing*; D011795:Surveys and Questionnaires; D014728:Veterans / Q000523:psychology*