Moderated Mediation Path Analysis of Mexican Traumatic Brain Injury Patient Social Functioning, Family Functioning, and Caregiver Mental Health

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• 作者：Anthony E. Coy ; MS^a ; Paul B. Perrin ; PhD^a ; Lillian F. Stevens ; PhD^b ; Rebecca Hubbard ; MS^a ; Dulce Marí ; a Dí ; az Sosa ; BA^c ; Irma Guadalupe Espinosa Jove ; MD^d ; Juan Carlos Arango-Lasprilla ; PhD^e ; ^{jcarango@deusto.es" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Brain injuries ; Caregivers ; Depression ; Family ; Mexico ; Reha-bilitation
• 刊名：Archives of Physical Medicine and Rehabilitation
• 出版年：2013
• 出版时间：February 2013
• 年：2013
• 卷：94
• 期：2
• 页码：362-368
• 全文大小：233 K

文摘

To examine the system of connections among traumatic brain injury (TBI) patient social functioning, family functioning, and caregiver depression and burden in Mexico.

Design

Cross-sectional survey.

Setting

A public medical facility.

Participants

Mexican TBI patient-caregiver dyads (N=84) participated in this study. Most of the patients with TBI were men (81%), with an average age ± SD of 38.83±13.44 years. The majority of caregivers (86%) were women, with an average age ± SD of 51.74±11.29.

Intervention

Not applicable.

Main Outcome Measures

Outcomes assessed included family functioning (Family Satisfaction Scale), patient social functioning (Medical Outcomes Study 36-Item Short-Form Health Survey), and caregiver mental health (Patient Health Questionnaire-9 and Zarit Burden Interview).

Results

A moderated mediation path model found that patient social functioning and family functioning predicted caregiver burden, and caregiver burden mediated the effect of family functioning on caregiver depression. Caregivers with strong family functioning tended to have low burden, no matter the level of patient social functioning. This path model provided an excellent fit and explained 47% of the variance in caregiver burden and 36% of the variance in caregiver depression.

Conclusions

In Mexico, strong family functioning is an important buffer in the relationship between TBI patient social functioning deficits and caregiver mental health, especially because familism is a core value in Latino culture. Rehabilitation interventions designed to strengthen family functioning may improve caregiver mental health, thereby influencing the quality of informal care that caregivers are able to provide.