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Testing a Model of Resilience in Family Members of Relatives with Traumatic Brain Injury vs Spinal Cord Injury: Multigroup Analysis

Published:August 02, 2021DOI:https://doi.org/10.1016/j.apmr.2021.06.016

      Abstract

      Objective

      To test a model comprising explanatory (neurologic impairment, coping, personality) and mediating (resilience, self-efficacy, hope, social support) variables on psychological adjustment and burden among family caregivers of individuals with traumatic brain injury (TBI) vs spinal cord injury (SCI).

      Design

      Structural equation modeling with multigroup analysis.

      Setting

      Six rehabilitation centers across New South Wales and Queensland, Australia.

      Participants

      A total of 181 family members (N=181; 131 TBI, 50 SCI).

      Interventions

      Not applicable.

      Main Outcome Measures

      Connor-Davidson Resilience Scale, Eysenck Personality Questionnaire, Ways of Coping Questionnaire, General Self-Efficacy Scale, Herth Hope Scale, Medical Outcome Study Social Support Survey; and 4 measures of psychological adjustment including: Caregiver Burden Scale, Medical Outcomes Survey Short Form-36 (SF-36), General Health Questionnaire-28, and Positive and Negative Affect Scale.

      Results

      The model for the aggregated sample demonstrated a very good model fit (χ2=47.42, df=39, ρ=0.167, normed fit index=.962, incremental fit index=.993, Tucker-Lewis index=.985, comparative fit index=.993, root-mean-squared error of approximation=.035). Multi-group analysis found significant commonalities in the pattern of relationships among variables across the 2 groups. In the only differences found, neuroticism was significantly more influential on burden in family members supporting individuals with TBI than family members of individuals with SCI. Furthermore, problem-focused coping was statistically more influential on positive affect in family members of individuals with TBI when compared with family members of individuals with SCI.

      Conclusions

      The study found significant similarities in the patterns of resilience and psychological adjustment among family caregivers of individuals with TBI and SCI.

      Keywords

      List of abbreviations:

      CR (critical ratio), SCI (spinal cord injury), SF-36 (Medical Outcomes Survey Short Form-36), SEM (structural equation modeling), TBI (traumatic brain injury)
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