Model of Resilience in Family Caregivers of Relatives with Neurotrauma (Traumatic Brain Injury or Spinal Cord Injury): A Multigroup Analysis

Abstract

Objective. 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.