Resilience is associated with health-related quality of life in caregivers of service members and veterans following tra
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Resilience is associated with health‑related quality of life in caregivers of service members and veterans following traumatic brain injury Tracey A. Brickell1,2,3,5 · Megan M. Wright1,2,5 · Sara. M. Lippa1,2,5 · Jamie K. Sullivan1,2,5 · Jason M. Bailie4,5 · Louis M. French1,2,3 · Rael T. Lange1,2,5,6 Accepted: 12 May 2020 © Springer Nature Switzerland AG 2020
Abstract Purpose To examine factors related to resilience in military caregivers across caregiver health-related quality of life (HRQOL), caregiver sociodemographic variables, and service member/veteran (SMV) injury and health status. Methods Caregivers (N = 346, Female = 96.2%; Spouse = 91.0%; Age: M = 40.6 years, SD = 9.3) of SMVs following a mild, moderate, severe, or penetrating TBI were recruited from U.S. military treatment facilities and via community outreach. Caregivers completed select TBI-CareQOL and NIH Toolbox scales, the Caregiver Appraisal Scale, Caregiver Questionnaire, and Mayo-Portland Adaptability Inventory-4. Caregivers were divided into three groups using the TBI-QOL Resilience scale: (1) Low-Moderate Resilience (n = 125), (2) Moderate Resilience (n = 122), and (3) Moderate-High Resilience (n = 99). Results Factors related to low caregiver resilience were strain on employment, financial burden from out-of-pocket expenses, caring for children, less personal time, caring for both verbal and physical irritability, anger, and aggression, and lower SMV functional ability (all p’s 3
In cases where more than one category was selected, participants were coded as “other”
The last two categories were combined for the pairwise comparisons
d
Answers have ≤ 5 missing or “Don’t Know” responses
c
b
Fisher’s Exact Test used due to small count in some cells
a
Mod moderate, ADL activities of daily living, IADL instrumental activities of daily living, PTSD post-traumatic stress disorder
No Caring for verbal irritability, anger, aggression Yes No Caring for physical irritability, anger, aggression Yes No Hours per day for self 1 h/per day or less More than 2 h/per day
Table 1 (continued)
.283
.019
.420
p
.003
.009
.005
p
.056
.709
.043
p
Quality of Life Research
Quality of Life Research
with the exception of Resilience, Ability to Participate Social Roles, and Emotional Support; Ability to Participate Social Roles and Emotional Support, but not Resilience, were recoded so that higher scores reflect worse functioning. Resilience was assessed using the TBI-QOL Resilience short form [24–26]. Based on the distribution of scores, caregivers were divided into three groups using T-scores on the Resilience scale as follows: (1) Low-Moderate Resilience: 20 T to Mod-High). The largest effect sizes were found for the Caregiving Relationship Satisfaction, Anxiety, Depression, Anger, Social Isolation, Perceived Stress, Caregiver Strain, and Feelings of Loss-Self scales (d = .85–1.60). It should be noted however that there were significant pairwise comparisons also found between the Moderate and Moderate-High Resilience group
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