Relationship of race/ethnicity to caregivers' coping, appraisals, and distress after traumatic brain injury

Issue title: Brain Injury and the Family

Guest editors: A.M. Sander

Article type: Research Article

Authors: Sander, Angelle M.^{a; b; *} | Davis, Lynne Cole^{a; b} | Struchen, Margaret A.^{a; b} | Atchison, Timothy^c | Sherer, Mark^{d; e} | Malec, James F.^f | Nakase-Richardson, Risa^d

Affiliations: [a] Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA | [b] The Institute for Rehabilitation and Research, Houston, TX, USA | [c] Department of Behavioral Sciences, West Texas A&M University, Canyon, TX, USA | [d] Methodist Rehabilitation Center, Jackson, MS, USA | [e] Departments of Neurology and Psychiatry, University of Mississippi Medical Center, Jackson, MS, USA | [f] Mayo Medical Center and Medical School, Rochester, MN, USA | Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA

Correspondence: [*] Address for correspondence: Angelle M. Sander, Ph.D., Brain Injury Research Center, 2455 South Braeswood, Houston, TX 77030, USA. E-mail: asander@bcm.tmc.edu

Abstract: The objective of the current study was to determine the relationship between race/ethnicity and caregivers' coping, appraisals of the caregiving role, and distress after traumatic brain injury (TBI). Participants were 195 caregivers (75% white; 25% black/Hispanic) of persons with TBI who were admitted to comprehensive inpatient rehabilitation at one of three participating centers and were followed up at 1 year after injury. Caregivers completed interview and self-report questionnaires, including the Ways of Coping Questionnaire, Caregiver Appraisal Scale, and Brief Symptom Inventory. Compared to whites, blacks/Hispanics reported lower levels of education, lower annual household income, and were more likely to be caring for an extended family member. After adjusting for relationship to the person with injury, age, education and income, race/ethnicity significantly predicted caregivers' use of the coping strategies distancing and accepting responsibility. Blacks/Hispanics made greater use of these strategies compared to whites. Blacks/Hispanics also showed more traditional beliefs regarding the caregiving role. Race/ethnicity was not predictive of distress. However, an interaction was noted between race/ethnicity and caregiver ideology. For Blacks/Hispanics, more traditional ideology was associated with increased distress. Future research using a larger sample of non-whites and including measures of acculturation is warranted.

Keywords: Traumatic brain injury, caregiving, race/ethnicity

DOI: 10.3233/NRE-2007-22103

Journal: NeuroRehabilitation, vol. 22, no. 1, pp. 9-17, 2007