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Resilience is associated with health-related quality of life in caregivers of service members and veterans following traumatic brain injury

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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 < .05). The Low-Moderate Resilience group had consistently worse HRQOL scores compared to the Moderate and Moderate-High Resilience groups (ps < .001; d = .50–1.60), with the exception of Caregiving Ideology.

Conclusion

Lower resilience among caregivers of SMVs following TBI is associated with poorer caregiver HRQOL. Programs aimed at promoting and maintaining resilience in military caregivers long-term is important for their own health, the health of the SMV, and the health of their children.

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Acknowledgements

Portions of these data were presented at the National Academy of Neuropsychology conference, San Diego, California: November 2019. The authors would like to express gratitude to the caregivers for their time and commitment each year to participating in the study, and the community organizations who offer their time and services to publicize the studies to the caregiver and military community. The authors would like to acknowledge the efforts of the larger team of research coordinators, research associates, research assistants, program managers, and senior management.

Funding

This work is supported by the Defense and Veterans Brain Injury Center (DVBC). The views expressed in this manuscript are those of the authors and do not necessarily represent the official policy or position of the Defense Health Agency, Department of Defense, or any other U.S. government agency. This work was prepared under Contract HT0014-19-C-0004 with DHA Contracting Office (CO-NCR) HT0014, and therefore, is defined as U.S. Government work under Title 17 U.S.C.§101. Per Title 17 U.S.C.§105, copyright protection is not available for any work of the U.S. Government. For more information, please contact dha.DVBICinfo@mail.mil.

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Authors and Affiliations

  1. Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD, USA

    Tracey A. Brickell, Megan M. Wright, Sara. M. Lippa, Jamie K. Sullivan, Louis M. French & Rael T. Lange

  2. National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Building 51, 4954 N Palmer Road, Bethesda, MD, 20889, USA

    Tracey A. Brickell, Megan M. Wright, Sara. M. Lippa, Jamie K. Sullivan, Louis M. French & Rael T. Lange

  3. Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Tracey A. Brickell & Louis M. French

  4. Defense and Veterans Brain Injury Center, Camp Pendleton, 2016 San Jacinto Rd, Camp Pendleton, CA, 92055, USA

    Jason M. Bailie

  5. General Dynamics Information Technology, Silver Spring, MD, USA

    Tracey A. Brickell, Megan M. Wright, Sara. M. Lippa, Jamie K. Sullivan, Jason M. Bailie & Rael T. Lange

  6. University of British Columbia, Vancouver, BC, Canada

    Rael T. Lange

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  1. Tracey A. Brickell
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Correspondence to Tracey A. Brickell.

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Brickell, T.A., Wright, M.M., Lippa, S.M. et al. Resilience is associated with health-related quality of life in caregivers of service members and veterans following traumatic brain injury. Qual Life Res 29, 2781–2792 (2020). https://doi.org/10.1007/s11136-020-02529-y

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