Family Caregivers of Veterans: A Critical Review of the Empirical Literature and Recommendations for Future Research

Uphold, Constance R.; Jordan, Meggan M.; Freytes, Magaly

doi:10.1891/0739-6686.32.155

Cited by 11 publications

(8 citation statements)

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“…High caregiving burden was associated with caring for a SMV with PTSD and receiving mental health treatment. Poor health and well-being outcomes have been reported among caregivers assisting post-9/11 SMVs with PTSD (Beks, 2016; Caska & Renshaw, 2011; Easom, Wang, Moore, Wang, & Bauer, 2018; Manguno-Mire et al, 2007; Mansfield, Schaper, Yanagida, & Rosen, 2014; Pinciotti et al, 2017; Renshaw & Campbell, 2011; Uphold, Jordan, & Freytes, 2014; Yambo & Johnson, 2014; Yambo et al, 2016). Considering all these factors, it is highly likely that many caregivers in the current study who were caring for a SMV after a mild TBI were caring for symptoms associated with PTSD, and it is these symptoms that represent the greatest burden for caregivers.…”

Section: Discussionmentioning

confidence: 99%

Factors related to perceived burden among caregivers of service members/veterans following TBI.

Brickell¹,

French²,

Gartner³

et al. 2019

Rehabilitation Psychology

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To examine factors related to perceived caregiving burden in a sample of caregivers assisting service members and veterans (SMVs) across four areas: SMV injury and health status; caregiver life circumstances; caregiver duty and responsibilities; and caregiver needs. Research Method/Design: Participants were 214 caregivers (95.8% female; 86.0% spouse/partner; Age: M ϭ 38.6 years [SD ϭ 10.4]) of SMVs who sustained a mild, moderate, severe, or penetrating traumatic brain injury (TBI). Caregivers were recruited from Walter Reed National Military Medical Center and via community outreach. Participants completed the Caregiver Appraisal Scale, Mayo-Portland Adaptability Inventory-4, and Caregiver Questionnaire. The sample was divided into 2 Caregiver Burden groups: High (n ϭ 138) and Low Burden (n ϭ 76). Results: Factors significantly related to higher levels of perceived burden were (a) experiencing a greater caregiving time commitment now and over time, (b) caring for activities of daily living/instrumental activities of daily living, (c) experiencing an impact of caregiving on employment, income, and out of pocket expenses, (d) parenting more than 1 child, (e) having less time to devote to one's self now and over time, (f) having caregiver needs, and/or (g) assisting a SMV who had incurred a mild TBI; was experiencing greater functional disability; had a posttraumatic stress disorder (PTSD) diagnosis; received mental health and rehabilitation treatment; and/or used an assistive device (all p Ͻ .05; odds ratios [ORs] ϭ 1.13 to 14.57; ds ϭ .02 to 1.30). Conclusions/Implications: Providing care for a SMV after a TBI can impose a heavy burden, particularly for caregivers who provide support to SMVs with comorbid mental health problems, such as PTSD.

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Section: Discussionmentioning

confidence: 99%

Factors related to perceived burden among caregivers of service members/veterans following TBI.

Brickell¹,

French²,

Gartner³

et al. 2019

Rehabilitation Psychology

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“…Given that care recipients would rather be at home than in healthcare facilities [12], "days in the community" represents a useful recipient-centered outcome of interest. Third, the sparse work on care recipient outcomes have neglected the large population of "military caregivers" who care for wounded, ill, and injured military personnel and veterans [13][14][15]. Finally, the majority of caregiver trials developed to reduce emergency department visits, hospitalizations, and nursing home placements have focused on efficacy and effectiveness of the intervention itself, which Guralnick [16] refers to as first-generation research; with one exception [17], all have failed to show significant reductions in either hospitalization or nursing home placement [18,19].…”

Section: Significant Gaps In Caregiver Researchmentioning

confidence: 99%

Moderators of Treatment Outcomes from Family Caregiver Skills Training: Secondary Analysis of a Randomized Controlled Trial

Cary¹,

Smith²,

Shepherd‐Banigan³

et al. 2019

obm geriatr

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Background: Moderator analyses may be helpful for evaluating intervention effects. The objective of this study was to evaluate whether the effect of a caregiver skills training intervention-Helping Invested Families Improve Veterans' Experience Study (HI-FIVES)-on care recipient outcome and caregiver outcome is moderated by the veteran's risk for hospitalization or level of functional impairment. Methods: Secondary data analysis of HI-FIVES. Outcomes included veteran days in the community (cumulative days in the community at 12 months alive and not in the emergency department, hospital, or post-acute facility) and caregiver burden (Zarit Burden Interview at baseline, 3, 6, and 12 months). Moderators, risk for hospitalization and functional impairment, was assessed using their Care Assessment Need (CAN) score and the Older Americans Resources and Services (OARS) Questionnaire, respectively. Negative binomial and linear mixed models were used to assess intervention effects on community days and caregiver burden, respectively. Results: Of 241 dyads, veteran (caregiver) mean age was 73 (61) years, 53% (54%) were Black, and 4% (89%) were female. Medium hospitalization-risk (91-98 CAN score) participants who received HI-FIVES had 3.75 times more community days vs. medium risk participants in the control group. By contrast, the high hospitalization-risk (99+ CAN score) participants who received HI-FIVES had 4.39 times fewer community days vs. high-risk participants in the control group. The CAN score did not have a significant moderating effect on caregiver burden. OARS did not have a significant moderating effect on community days or caregiver burden. Conclusions: Targeting the HI-FIVES based on hospitalization risk may be an effective strategy for keeping veterans in the community longer.

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“…Another gap in the stroke caregiving literature is that only a handful of studies have evaluated interventions and programs aimed at improving the lives of caregivers of veterans. 27 This is important because there are differences between veteran and non-veteran caregivers. 27 While caregivers of veterans face similar challenges as non-veteran caregivers, they also must contend with the issues related to combat-related injuries or disability, posttraumatic stress disorder (PTSD), depression, and greater health risks than the general population.…”

Section: Introductionmentioning

confidence: 99%

A telephone problem-solving intervention for Spanish-speaking caregivers of veterans post-stroke: an 8-session investigator-blinded, two-arm parallel (intervention vs usual care), randomized clinical trial

Freytes

Schmitzberger

Rivera-Rivera

et al. 2022

Preprint

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Background: Stroke is one of the leading causes of death and the main cause of long-term disability in the United States. The significant risk factors of stroke among Hispanics are well-documented. The majority of stroke survivors return home following a stroke and are cared for by family caregivers. Due to the abrupt nature of strokes, caregivers experience unexpected changes and demands that oftentimes lead to caregiver burden and depression. Given the significant risk factors for stroke in Hispanics and the influence of culture in family norms and family management, we developed a telephone and online problem-solving intervention for Spanish-speaking stroke caregivers. This study tests the impact of a telephone and online problem-solving intervention for Spanish-speaking stroke caregivers on caregiver outcomes. Methods: The design is a two-arm parallel randomized clinical trial with repeated measures. We will enroll 290 caregivers from 3 Veterans Affairs (VA) medical centers. Participants randomized into the intervention arm receive a problem-solving intervention that uses telephone and online education and care management tools on the previously developed and nationally available RESCUE en Español Caregiver website. In the usual care group, participants receive the information and/or support caregivers of veterans with stroke normally receive through existing VA resources (e.g., stroke-related information and support). The primary outcome is change in caregiver’s depressive symptoms at 1- and 12-weeks post-intervention. Secondary outcomes include changes in stroke caregivers’ burden, self-efficacy, problem-solving, and health-related quality of life (HRQOL) and veterans’ functional abilities. We will also determine the budgetary impact, the acceptability of the intervention and participation barriers and facilitators for Spanish-speaking stroke caregivers. Discussion: This is an ongoing study. It is the first known randomized controlled trial testing the effect of a telephone and online problem-solving intervention in Spanish for caregivers of veterans post-stroke. If successful, findings will support an evidence-based model that can be transported into clinical practice to improve the quality of caregiving post-stroke. Trial registration: ClinicalTrials.gov: NCT03142841— Spanish Intervention for Caregivers of Veterans with Stroke (RESCUE Español). Registered on February 23, 2018. Protocol version 8. 08.11.2022

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Family Caregivers of Veterans: A Critical Review of the Empirical Literature and Recommendations for Future Research

Cited by 11 publications

References 0 publications

Factors related to perceived burden among caregivers of service members/veterans following TBI.

Factors related to perceived burden among caregivers of service members/veterans following TBI.

Moderators of Treatment Outcomes from Family Caregiver Skills Training: Secondary Analysis of a Randomized Controlled Trial

A telephone problem-solving intervention for Spanish-speaking caregivers of veterans post-stroke: an 8-session investigator-blinded, two-arm parallel (intervention vs usual care), randomized clinical trial

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