Perceived caregiving demands, family resiliency factors, and quality of life outcomes for family caregivers of traumatic brain injury victims during acute hospitalization

Abstract

This study was designed to examine predictors of quality of life (QOL) outcomes in family caregivers of traumatic brain injury (TBI) victims and empirically test the Resiliency Model of Family Stress, Adjustment, and Adaptation. A cross-sectional design was utilized. Family members (N=52) completed a worksheet measuring anticipated TBI victim care needs and anticipated caregiver roles. Caregiver demands were measured by the Family Inventory of Life Events (FILE). Resiliency factor indicators included the Family Hardiness Index (FHI), Family Crisis Oriented Personal Evaluation Scale (FCOPES), Family Inventory of Resources for Management (FIRM), Family Problem Solving Communications Index (FPSC). Caregiver QOL was measured with the Family Member Well Being Index (FMWB) and the Ladder of Life (LOL) Current Life Satisfaction tool. Data analysis using the Statistical Package for the Social Sciences included descriptive statistics, relationships among variables, and regression analyses. The majority of caregivers were female (65.4%), parents or spouses (59.6%), with at least an associate degree (51.9%), and co-resided with the TBI victim (57.7%). FILE was related to FHI (r = -.286, p<.05) and FIRM (r = -.508, p<.001). FILE was related to FMWB (r = -.346, p<.05). FHI was related to FCOPES (r = .462, p<.01), FIRM (r = .754, p<.001), and FPSC (r = .565, p<.001). FCOPES was related to FIRM (r = .385, p<.01) and FPSC (r = .422, p<.01). FHI was related to current life satisfaction (r = .277, p<.05). FIRM was related to both FMWB (r = .279, p<.05) and current life satisfaction (r = .375, p<.01). Caregiver well being was best predicted by FILE and LOS [Adjusted R2 .16,F(2,49) = 5.83, p<.01]. Current life satisfaction was best predicted by caregiver educational level, spousal relationship, and FIRM [Adjusted R2 .31, F(3,47) = 8.46, p<.001]. Decreased family demands and shorter hospitalizations were predictive of higher family caregiver well being. Lower educational levels, non-spousal relationships, and increased resources were predictive of higher caregiver current life satisfaction. This study validated the hypothesized relationships of the resiliency model and provided support for future use of this theoretical framework for health care providers working with family caregivers of TBI victims.