| Institution: | 1. Robert D. and Patricia E. Kern Mayo Clinic Center for the Science of Health Care Delivery, Mayo Clinic, College of Medicine, Rochester, Minnesota;2. Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota;3. Hubert H. Humphrey School of Public Affairs, University of Minnesota, Minneapolis, Minnesota;4. Adult and Child Consortium for Health Outcomes Research and Delivery Science, Anschutz Medical Campus, University of Colorado Aurora, Colorado;5. Durham Veterans Affairs Health Care System, Durham, North Carolina;6. Department of Population Health Sciences, School of Medicine, Duke University, Durham, North Carolina;g. Veterans Affairs Portland Health Care System, Portland, Oregon;h. Oregon Health & Science University, Portland, Oregon |
| Abstract: | ObjectiveTo assess the association between perceived stigma and discrimination and caregiver strain, caregiver well-being, and patient community reintegration.DesignA cross-sectional survey study of 564 informal caregivers of U.S. military service veterans of wars in Iraq and Afghanistan who experienced traumatic brain injuries or polytrauma (TBI/PT).SettingCare settings of community-dwelling former inpatients of U.S. Department of Veterans Affairs Polytrauma Rehabilitation Centers.ParticipantsCaregivers of former inpatients (N=564), identified through next-of-kin records and subsequent nominations.InterventionsNot applicable.Main Outcome MeasuresCaregiver strain, depression, anxiety, loneliness, and self-esteem; as well as care recipient community reintegration, a key aspect of TBI/PT rehabilitation.ResultsFamily stigma was associated with strain, depression, anxiety, loneliness, lower self-esteem, and less community reintegration. Caregiver stigma-by-association was associated with strain, depression, anxiety, loneliness, and lower self-esteem. Care recipient stigma was associated with caregiver strain, depression, anxiety, loneliness, lower self-esteem, and less community reintegration.ConclusionsPerceived stigma may be a substantial source of stress for caregivers of U.S. military veterans with TBI/PT, and may contribute to poor outcomes for the health of caregivers and for the community reintegration of the veterans for whom they provide care. |
