Browsing by Author "Simpson, Grahame K."
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Item A Predictive Model of Resilience Among Family Caregivers Supporting Relatives with Traumatic Brain Injury (TBI) in Australia: A Structural Equation Modelling Approach(2017-01-01) Daher, Maysaa; Simpson, Grahame K.; Anderson, MalcolmObjectives: Developing a comprehensive understanding of resilience in family caregivers supporting relatives with TBI is important for mental health promotion, yet resilience has been vastly understudied compared to deficits and vulnerability based research. In response a paradigm shift into family research is underway in the field of rehabilitation, with a new emphasis on investigating positive adaption rather than psychological vulnerability among family caregivers of people with TBI. In the current study, a model based on previous empirical research and resilience theory was devised to examine the predictive and mediating relationships among caregiver resilience, personality, coping, self – efficacy, hope, social support and the outcome variables of caregiver burden and psychological adjustment among family members caring for relatives with TBI.
Item A Predictive Model of Resilience Among Family Caregivers Supporting Relatives with Traumatic Brain Injury (TBI): A Structural Equation Modelling Approach(2020-11-25) Simpson, Grahame K.; Daher, Maysaa; Anderson, MalcolmConstructs 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.
Item A Study of Whether Individual and Dyadic Relations Between Spirituality and Resilience Contribute to Psychological Adjustment Among Individuals with Spinal Cord Injuries and their Family Members(2019-09-01) Anderson, Malcolm; Dorsett, Pat; Briggs, Lynne; Simpson, Grahame K.; Jones, Kate FionaObjective:
To test a model of spiritual well-being and resilience among individuals with spinal cord injuries and their family members.
Design:
Prospective cross-sectional observational data were analyzed by structural equation modelling.
Setting:
Inpatient and community services at one rehabilitation hospital.
Subjects:
Individual with spinal cord injury (n = 50) and family member (n = 50) dyads.
Interventions:
Standard rehabilitation, both inpatient and community.
Main measure(s):
Functional assessment of chronic illness therapy – spiritual well-being scale – expanded, Connor–Davidson resilience scale, positive and negative affect scale, depression anxiety and stress scale–21, satisfaction with life scale.
Results:
Median time post-injury was 8.95 months (IQR (interquartile range) = 14.15). Individuals with spinal cord injury and family members reported high scores for both spiritual well-being (66.06 ± 14.89; 68.42 ± 13.75) and resilience (76.68 ± 13.88; 76.64 ± 11.75), respectively. Analysis found the model had acceptable fit (e.g. chi-square goodness of fit statistic = 38.789; P = .263). For individuals with spinal cord injury, spiritual well-being was positively associated with resilience which, in turn, was associated with increasing positive affect and satisfaction with life. Among family members, spiritual well-being was positively associated with resilience. Resilience was then associated with lowered levels of depression and mediated the impact of depression on satisfaction with life. Limited evidence was found for mutual dyadic links, with the only significant pathway finding that resilience in the individual with spinal cord injury was associated with increased satisfaction with life among family members.
Conclusion:
Increased spirituality and resilience make a significant contribution (both independently and in combination) to positive psychological outcomes for both individuals with spinal cord injury and their family members.
Item Developing a Model for Suicide Ideation after Severe Traumatic Brain Injury Using Structural Equation Modelling(2016-05-19) Morey, Peter; Anderson, Malcolm; Tate, Robyn; Simpson, Grahame K.Objectives: The risk of suicide ideation (SI) after severe traumatic brain injury (TBI) is double the level within the general population. Little is known about the mechanisms underlying this elevated risk. This study aimed to develop an explanatory model of SI after severe TBI, based on the interaction among distal (predisposing) and proximal (precipitating) risk factors, protective factors and SI.
Methods: Participants (n = 90) with very severe TBI (Post Traumatic Amnesia > 7 days) were recruited from the Liverpool Brain Injury Rehabilitation Unit in Sydney Australia. Participants completed a battery of neuropsychological tests targeting executive functions as well as self-report measures of SI, positive and negative mood states, stress, self-awareness, self-esteem and problem-solving. Treating clinicians rated participants on measures of aggression, frontal systems dysfunction and participation. Data were analysed using structural equation modelling.
Results: The final model demonstrated good fit indices (NFI = 0.924, IFI = 0.994, TLI = 0.986, CFI = 0.993, RMSEA = 0.03). The model accounted for 34% of the variance in SI. One distal risk factor, poor problem-solving, had a direct relationship to SI. Other distal risk factors including post-injury aggression and disinhibition had direct and indirect links to depression (a proximal risk factor), which in turn mediated their relationship to hopelessness and SI. The protective factors (social support, hope, community participation, self-esteem) mediated the relationship between distal/proximal risk factors, hopelessness and SI. The protective effect of social support and community participation was mediated through their association with increased levels of hope and self-esteem.
Conclusions: The current model demonstrates the direct and indirect effects of risk factors and protective factors associated with SI after severe TBI. The model provides several suggested targets for clinical intervention to build positive mental health and reduce suicide risk. The model can now be tested prospectively to evaluate its predictive validity.
Item Differential Pathways of Psychological Distress in Spouses Versus Parents of People with Severe Traumatic Brain Injury (TBI): Multigroup Analysis(2009-10-15) Gillett, Lauren; Gosling, Tamera; Mok, Magdalena; Morey, Peter; Simpson, Grahame K.; Anderson, MalcolmPrimary objective: A contemporary model of psychological stress based on an amalgamation of Conservation of Resources theory and the McMaster Model of Family Functioning was devised to compare the effects of neurobehavioural impairments on family functioning and psychological distress in spouses and parents caring for relatives with TBI.
Method: Participants were 64 spouses and 58 parents. They completed the Neurobehavioral Problem Checklist, Family Assessment Device and the Brief Symptom Inventory. Structural equation modelling (SEM) was used to test the model for the combined (spouses and parents) sample. Multi-group analysis was then employed for examining differences in structural weights for spouses and parents.
Main results: SEM supported the model for the combined sample. Multi-group analysis showed for spouses cognitive and behavioural impairments significantly disrupted family functioning, which in turn increased psychological distress. In contrast, cognitive and behavioural impairments did not significantly disrupt family functioning in parents. For parents, however, cognitive impairments increased psychological distress. Furthermore, parents who reported disrupted family functioning also experienced higher levels of psychological distress. The effect of cognitive impairments was statistically more influential on the level of distress in parents when compared to spouses.
Conclusions: Understanding these differences can assist in better targeting family support interventions.
Read More: http://informahealthcare.com/doi/abs/10.3109/02699050903302336Item Do Spirituality, Resilience and Hope Mediate Outcomes among Family Caregivers After Traumatic Brain Injury or Spinal Cord Injury? A Structural Equation Modelling Approach(2020-02-26) Gopinath, Bamini; Genders, Michelle; Jones, Kate Fiona; Anderson, Malcolm; Simpson, Grahame K.BACKGROUND: A deficits approach to understanding psychological adjustment in family caregivers of individuals with a neurological disability is extensive, but further research in the field of positive psychology (spirituality, resilience, hope) may provide a potential avenue for broadening knowledge of the family caregiver experience after traumatic brain injury (TBI) or spinal cord injury (SCI). OBJECTIVE: To test a proposed model of spirituality among family caregivers of individuals with TBI or SCI, using structural equation modelling (SEM). METHODS: A cross-sectional design was employed to survey ninety-nine family participants (TBI = 76, SCI = 23) from six rehabilitation units from NSW and Queensland. Assessments comprised Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale-Expanded, Connor –Davidson Resilience Scale, Herth Hope Index, and three measures of psychological adjustment including Caregiver Burden Scale, Positive and Negative Affect Scale, and Depression Anxiety Stress Scale. RESULTS: SEM showed the proposed model was a good fit. The main findings indicated spirituality had a direct negative link with burden. Spirituality had a direct positive association with hope which, in succession, had a positive link with resilience. Spirituality influenced positive affect indirectly, being mediated by resilience. Positive affect, in turn, had a negative association with depression in caregivers. CONCLUSIONS: This study contributes to better targeting strength-based family interventions.
Item Does Resilience Influence Ways of Coping among Families Supporting Relatives With Severe Traumatic Brain Injury or Spinal Cord Injury?(2016-06-01) Daher, Maysaa; Anderson, Malcolm; Simpson, Grahame K.Resilience contributes to the individual adjustment of family members providing support to relatives with a traumatic brain injury (TBI) or spinal cord injury (SCI).
Item Impact of Resilience on the Longer-term Well-being of Family Caregivers, Service Utilisation and Client Community Participation(2016-01-01) Cameron, Ian; Gopinath, Bamini; Anderson, Malcolm; Simpson, Grahame K.Item Model of Resilience in Family Caregivers of Relatives with Neurotrauma (Traumatic Brain Injury or Spinal Cord Injury): A Multigroup Analysis(2019-05-05) Morey, Peter; Jones, Kate Fiona; Daher, Maysaa; Simpson, Grahame K.; Anderson, MalcolmObjective. In a previous study, we found mediating variables (resilience, self-efficacy, hope, social support) were strongly associated with both positive and negative psychological outcomes among family caregivers of people with traumatic brain injury (TBI). Building on these results, the comparability of the model between caregivers for relatives with TBI and family caregivers of individuals with Spinal Cord Injury (SCI) was tested.
Methods. Structural equation modelling with multigroup analysis was conducted in a cross-sectional sample to test a hypothesised model of resilience. A total of 181 family members were recruited (131 TBI, 50 SCI) from 6 specialist rehabilitation services in New South Wales and Queensland, Australia. Assessments comprised the 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 four measures of psychological adjustment including: Caregiver Burden Scale, Medical Outcomes Survey, General Health Questionnaire, 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, NFI = .962, IFI = .993, TLI = .985, CFI = .993, RMSEA = .035). The model accounted for 59% of the variance in resilience. Resilience was directly associated with caregiver positive affect and also played a protective role in relation to caregiver burden, as mediated through social support. Multi-group analysis showed neuroticism was significantly more influential on burden in family members supporting relatives with TBI than family members of individuals with SCI. Further, problem-focused coping was statistically more influential on positive affect in family members of individuals with TBI when compared to family members of individuals with SCI.
Conclusions. This is the first study to show neurological disability specific pathways underlying resilience and psychological adjustment in family caregivers of individuals with TBI or SCI. This study makes a contribution to better targeting strength based family support interventions.
Item Neurobehavioural Predictors of Family Functioning and Psychological Distress in Spouses vs. Parents of Relatives with Severe Traumatic Brain Injury (TBI) in Australia(2009-07-03) Gillett, Lauren E.; Morey, Peter J.; Gosling, Tamera J.; Mok, Magdalena C.; Simpson, Grahame K.; Anderson, Malcolm I.Item Spirituality and Resilience among Family Caregivers of Survivors of Stroke: A Scoping Review(2020-02-26) Jones, Kate Fiona; Simpson, Grahame K.; Anderson, Malcolm; Gibbs, LetetiaBACKGROUND: Stroke is the leading cause of disability in Australia and the third-leading cause of disability worldwide and a significant burden on caregivers. OBJECTIVE: To map the extent, range and nature of the literature investigating spirituality and resilience among family caregivers of survivors of stroke. METHOD: A scoping review. RESULTS: Six studies were identified, conducted in the United States, United Kingdom, China and Turkey. These included two quantitative, one experimental and three qualitative designs. No studies linked spirituality to resilience. For the qualitative studies, spirituality was the primary focus of one, and the secondary focus of two others. Qualitative data reflected the lived experience of caregivers drawing upon spirituality to help cope with the burden of caregiving. For the two quantitative studies, spirituality was measured as a secondary focus and showed no significant links between spirituality or adjustment in caregivers. The one experimental study comprised a psycho-educational intervention focused on building resilience, finding a significant increase in social support not reflected in a matched control group. Clinical implications suggested the need for strength-based interventions, including spiritual needs and religious beliefs of the family caregiver. CONCLUSIONS: Spirituality and resilience following stroke are essential factors in caregiver adjustment following stroke. Further research with a focus on causality and the link between spirituality, resilience and adjustment in this population is needed.
Item Spirituality, Hope, and Resilience in the Recovery and Adaptation Process Following Spinal Cord Injury(2022-05-10) Simpson, Grahame K.; Care-Unger, Candice; Anderson, Malcolm; Pryor, Julie; Jones, Kate FionaMuch of the research which has investigated adaptation after spinal cord injury (SCI) has focused upon the physical and psychological challenges confronting the injured person. There is a growing body of evidence however which suggests that many people with SCI and their family members can overcome these challenges and move forward, drawing upon a range of resources and strengths. Spirituality, hope, and resilience are three constructs that have been associated with positive outcomes after SCI. This chapter outlines the research findings to date about these constructs within the field of SCI. The relationship between these variables will be examined and explored. Implications for SCI practice will be discussed, and the findings from the trial of one intervention program conducted with rehabilitation staff outlined.
Item Testing a Model of Resilience in Family Members of Relatives with Traumatic Brain Injury vs Spinal Cord Injury: Multigroup Analysis(2021-12-01) Morey, Peter; Jones, Kate Fiona; Daher, Maysaa; Anderson, Malcolm; Simpson, Grahame K.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.
Item The Impact of Neurobehavioural Impairment on Family Functioning and the Psychological Well-Being of Male Versus Female Caregivers of Relatives with Severe Traumatic Brain Injury: Multigroup Analysis(2013-11-01) Morey, Peter; Simpson, Grahame K.; Anderson, MalcolmObjective: To examine the differential effect of neurobehavioral impairments (cognitive, behavioral, and social) on family functioning, family roles, and psychological distress in male versus female caregivers of relatives with severe traumatic brain injury (TBI).
Design: Structural equation modeling with multigroup analysis conducted in a cross-sectional sample to test an established theoretical model.
Participants: An aggregated sample of 122 caregivers (46 male, 76 female) of people with severe TBI. The sample comprised 64 spouses and 58 parents (29 parental couples) of 93 persons with TBI.
Measures: Neurobehavioral Problem Checklist; Family Assessment Device; and Brief Symptom Inventory.
Results: Structural equation modeling showed that the proposed model had acceptable fit indices for the combined sample. Multigroup analysis indicated that both male and female caregivers (i) responded similarly to the neurobehavioral impairments experienced by the injured relative and (ii) reported behavior having a direct effect on family functioning, which, in turn, increased psychological distress. However, the effect of disrupted family functioning was more influential on the level of distress in male caregivers than in female caregivers.
Conclusion: Evidence was found for gender-specific pathways underlying the psychological distress of male versus female caregivers. Such findings can assist in tailoring family support strategies so that they cater for caregivers of both genders.[from publisher's website].
Item The Relationship Between Coping and Psychological Adjustment in Family Caregivers of Individuals with Traumatic Brain Injury: A Systematic Review(2015-05-01) Matheson, Lucinda; Daher, Maysaa; Simpson, Grahame K.; Anderson, MalcolmA systematic review was conducted to evaluate the association between coping (as measured by the Ways of Coping Questionnaire) and psychological adjustment in caregivers of individuals with traumatic brain injury. Reviews were conducted in accordance with the American Academy of Neurology Guidelines. The major finding across the better rated studies was that the use of emotion focused coping and problem focused coping was possibly associated with psychological adjustment in caregivers. Future studies need to employ carefully crafted designs, adhere to statistical procedure, apply advanced analytic techniques and employ explicit models of coping, which will increase the accuracy and generalizability of the findings.