Angelle M Sander1, Robin A Hanks2, Phillip A Ianni3, Nicholas R Boileau3, Anna L Kratz3, Elizabeth A Hahn4, David S Tulsky5, Noelle E Carlozzi3. 1. H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine & Harris Health System, Houston, TX; Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX. Electronic address: asander@bcm.edu. 2. Rehabilitation Institute of Michigan, Department of Psychology and Neuropsychology, Detroit, MI; Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI. 3. Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI. 4. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL. 5. Center for Health Assessment Research and Translation, and the Departments of Physical Therapy and Psychological and Brain Sciences, University of Delaware, Newark, DE.
Abstract
OBJECTIVE: To investigate the association of the sociocultural variables race/ethnicity, education, and poverty level to caregivers' positive and negative appraisals following traumatic brain injury. DESIGN: Survey. SETTING: Community. PARTICIPANTS: Caregivers (N=344; 216 white; 69 black; 39 Hispanic) of persons with complicated mild to severe TBI at least 1-year postinjury. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Modified Caregiver Appraisal Scale (M-CAS); Zarit Burden Interview (ZBI). RESULTS: Black caregivers reported lower levels of perceived burden on both the M-CAS and the ZBI. Black and Hispanic caregivers reported more traditional caregiver ideology (caregiving as a responsibility) than did whites. Greater poverty was associated with higher burden on the M-CAS, lower caregiver satisfaction, and less mastery. Higher education was associated with higher burden on the ZBI and with lower caregiver mastery. CONCLUSIONS: Treatment professionals should be culturally sensitive to the different perspectives that caregivers may have based on sociocultural factors. Sociocultural factors should be considered in research investigating caregiver outcomes, including appraisals.
OBJECTIVE: To investigate the association of the sociocultural variables race/ethnicity, education, and poverty level to caregivers' positive and negative appraisals following traumatic brain injury. DESIGN: Survey. SETTING: Community. PARTICIPANTS: Caregivers (N=344; 216 white; 69 black; 39 Hispanic) of persons with complicated mild to severe TBI at least 1-year postinjury. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Modified Caregiver Appraisal Scale (M-CAS); Zarit Burden Interview (ZBI). RESULTS: Black caregivers reported lower levels of perceived burden on both the M-CAS and the ZBI. Black and Hispanic caregivers reported more traditional caregiver ideology (caregiving as a responsibility) than did whites. Greater poverty was associated with higher burden on the M-CAS, lower caregiver satisfaction, and less mastery. Higher education was associated with higher burden on the ZBI and with lower caregiver mastery. CONCLUSIONS: Treatment professionals should be culturally sensitive to the different perspectives that caregivers may have based on sociocultural factors. Sociocultural factors should be considered in research investigating caregiver outcomes, including appraisals.
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