A DESCRIPTIVE NURSING STUDY OF PRIMARY FAMILY CARE-GIVERS OF SEVERELY HEAD INJURED ADULTS IN THE POST-HOSPITALIZATION PHASE: DEMOGRAPHIC AND PERSONAL CHARACTERISTICS, ILLNESS RELATED FACTORS, FAMILY CHARACTERISTICS, DEPRESSION, AND ANXIETY.

Description

This descriptive study investigated demographic/personal characteristics, illness related factors, family environment characteristics, anxiety, depression, and family function of primary family caregivers of severely head injured adults in the post-hospitalization phase of recovery. The purpose was to describe characteristics of family caregivers, and quantitatively measure family support, anxiety, and depression. Eighty-five participants completed mailed questionnaires which included: Caregiver Data Sheet; Barthel Index; Family Relationships Inventory; Beck Depression Inventory; and State-Trait Anxiety Inventory. Descriptive data profiled the sample. Forty-two percent reported varying depression levels, and 58 percent exceeded normative state anxiety data. Family cohesion, expressiveness, conflict (FRI subscales), and family support (FRI) were consistent with normal families. Using the.05 significance level for analysis, no differences were found between time since injury and anxiety, depression, family function, or Barthel scores. ANOVAs revealed significant relationships between FRI/FRI subscales and anxiety/depression (except conflict). Leisure, groups, income, and helpers correlated significantly with anxiety/depression, and became covariates. Multiple ANCOVAs between FRI/FRI subscales and anxiety and depression with one, and then four covariates, were conducted. With income, all main effects were significant except for depression/conflict. With four covariates, no main effects were significant except for depression/FRI. Multiple regression designated predictors: FRI and expressiveness for anxiety; and expressiveness for depression. Significant correlation existed between anxiety and depression. Predictaor variables were: leisure and helpers for anxiety; and leisure for depression. There were no differences between anxiety/depression in mothers/wives using ANOVA and ANCOVA. Conclusions include depression/anxiety were elevated and stable over time since injury suggesting ongoing stress related to the caregiver role. Family function appeared resilient to stress suggesting most caregivers perceived healthy family function and support. Head injured physical deficits did not increase stress on families or caregivers. Cognitive/behavioral deficits did affect caregivers' leisure. Major predictors were: anxiety, leisure and helpers; and depression, leisure. No differences were found between wives/mothers on anxiety/depression. The implications for health professionals are: increased awareness of family caregivers' characteristics; recognition of elevated, stable anxiety/depression; and identification of anxiety/depression predictors that are helpful for screening and supporting family caregivers.

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