SurveyArchives of physical medicine and rehabilitation2019

Sociocultural Factors Influencing Caregiver Appraisals Following Traumatic Brain Injury.

Angelle M Sander, Robin A Hanks, Phillip A Ianni and 5 others

PMID 30365926

WHAT IT FOUND

Black caregivers of people with traumatic brain injury reported less strain than White caregivers, while poverty was linked to more strain, lower satisfaction, and lower mastery.

Higher education was linked to lower mastery and more total strain.

Key findings

01Black caregivers reported less strain than White caregivers on both the modified caregiver appraisal scale and the Zarit Burden Interview.

02Poverty was associated with more perceived burden, lower satisfaction, and lower mastery.

03Higher education was associated with lower perceived mastery and higher burden on the Zarit Burden Interview.

STILL TO COME

How it was doneWhat they found

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What it does not show

Caregivers were not randomly assigned to groups, so associations cannot show that race, education, or poverty caused differences. The analyses were exploratory and multiple comparison correction was not applied, so some significant associations could be chance findings. The sociodemographic variables explained only small portions of score differences across the five outcomes. The sample had higher educational attainment than the U.S. average, so findings may not apply to less educated caregiver groups. Household size was estimated from number of children plus the injured person and caregiver, so other adults in the home were not counted. Income was self-reported and grouped in brackets that did not match poverty thresholds exactly, so poverty classification was approximate. Participants identifying as multiracial or other races were excluded, so findings do not cover those groups. Some caregivers were excluded from models because they lacked poverty information, which may have changed the analyzed sample. The study measured caregiver perceptions, not patient function, therapy outcomes, or caregiver intervention effects.

Declared interests

The supplied text lists NIH extramural research support. It does not include a separate author conflict of interest declaration.

The easy way to misread this

Do not conclude that caregiver strain can be predicted from race, education, or poverty for an individual patient. This was an observational survey, and the social factors explained only small portions of score differences.

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The study

Participants
344 caregivers; 19 were excluded from race/ethnicity analyses and 13 were excluded from models for missing poverty data
Certainty of evidence
Low

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    Cite

    Angelle M Sander, Robin A Hanks, Phillip A Ianni, et al. Sociocultural Factors Influencing Caregiver Appraisals Following Traumatic Brain Injury. Archives of physical medicine and rehabilitation. 2019.

    Read the original

    Sociocultural Factors Influencing Caregiver Appraisals Following Traumatic Brain Injury. — Applied Evidence