A predictive model of resilience among family caregivers supporting relatives with traumatic brain injury (TBI): A structural equation modelling approach

ABSTRACT

Constructs from positive psychology were employed to create an explicit model of caregiver resilience. Predictive and mediating relationships among resilience and related variables (personality, coping, self-efficacy, hope, social support) were then tested for their association with burden and psychological adjustment among family members caring for relatives with severe TBI. Family participants (n = 131) from six rehabilitation units from New South Wales and Queensland completed assessments which elicited explanatory (Eysenck Personality Questionnaire, Ways of Coping Questionnaire), mediating (Connor-Davidson Resilience Scale, General Self-Efficacy Scale, Herth Hope Scale, Medical Outcome Study Social Support Survey), and caregiver outcome (Caregiver Burden Scale, Mental Health sub-Scale-SF36, General Health Questionnaire, and Positive and Negative Affect Scale) variables. Structural Equation Modeling (SEM) showed that resilience had a direct effect on positive affect in caregivers. Resilience also played a protective role in relation to two variables associated with caregiver vulnerability: an indirect association with caregiver burden mediated through social support; a direct effect on hope, which, in turn, was associated with positive mental health. Positive mental health then played a buffering role in relation to psychological distress and negative affect. Resilience, in combination with other psychological attributes, was associated with reduced morbidity among family caregivers after severe TBI.

KEYWORDS:

• Traumatic brain injury
• family caregivers
• resilience
• personality
• psychological adjustment

Acknowledgements

The researchers acknowledge the social workers from the Brain Injury Rehabilitation Programmes in New South Wales and Queensland for their kind assistance with this project. Further we thank Dr Peter Morey for his advice on the analysis of the data. We are also grateful to the families who participated in this study.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by Avondale College of Higher Education: [Grant Number 170-00-7857].