Sociocultural Factors Influencing Caregiver Appraisals Following Traumatic Brain Injury

Arch Phys Med Rehabil. 2019 Apr;100(4S):S58-S64. doi: 10.1016/j.apmr.2018.08.193. Epub 2018 Oct 23.


Objective: To investigate the association of the sociocultural variables race/ethnicity, education, and poverty level to caregivers' positive and negative appraisals following traumatic brain injury.

Design: Survey.

Setting: Community.

Participants: Caregivers (N=344; 216 white; 69 black; 39 Hispanic) of persons with complicated mild to severe TBI at least 1-year postinjury.

Intervention: Not applicable.

Main outcome measures: Modified Caregiver Appraisal Scale (M-CAS); Zarit Burden Interview (ZBI).

Results: Black caregivers reported lower levels of perceived burden on both the M-CAS and the ZBI. Black and Hispanic caregivers reported more traditional caregiver ideology (caregiving as a responsibility) than did whites. Greater poverty was associated with higher burden on the M-CAS, lower caregiver satisfaction, and less mastery. Higher education was associated with higher burden on the ZBI and with lower caregiver mastery.

Conclusions: Treatment professionals should be culturally sensitive to the different perspectives that caregivers may have based on sociocultural factors. Sociocultural factors should be considered in research investigating caregiver outcomes, including appraisals.

Keywords: Brain injuries, traumatic; Caregivers; Cultural competency; Rehabilitation; Surveys and questionnaires.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Aged
  • Black or African American / psychology*
  • Black or African American / statistics & numerical data
  • Brain Injuries, Traumatic / psychology*
  • Brain Injuries, Traumatic / rehabilitation
  • Caregivers / psychology*
  • Caregivers / statistics & numerical data*
  • Cost of Illness
  • Educational Status
  • Female
  • Hispanic or Latino / psychology*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Poverty / psychology
  • Surveys and Questionnaires
  • White People / psychology*
  • White People / statistics & numerical data