Testing the stability of a family resilience model at 2 and 5 years after traumatic brain injury or spinal cord injury: A longitudinal study

Malcolm Ikin Anderson; Bamini Gopinath; Kate Fiona Jones; Peter Morey; Grahame Kenneth Simpson

doi:10.1016/j.rehab.2023.101734

Testing the stability of a family resilience model at 2 and 5 years after traumatic brain injury or spinal cord injury: A longitudinal study

Ann Phys Rehabil Med. 2023 Sep;66(6):101734. doi: 10.1016/j.rehab.2023.101734. Epub 2023 Apr 6.

Authors

Malcolm Ikin Anderson¹, Bamini Gopinath², Kate Fiona Jones³, Peter Morey⁴, Grahame Kenneth Simpson⁵

Affiliations

¹ School of Nursing and Health, Avondale University, Sydney, NSW, Australia. Electronic address: malcolm.anderson@avondale.edu.au.
² Macquarie University Hearing, Macquarie University, North Ryde, NSW, Australia.
³ Institute for Ethics and Society, The University of Notre Dame, Sydney, NSW Australia; Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.
⁴ School of Nursing and Health, Avondale University, Sydney, NSW, Australia.
⁵ Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney, NSW, Australia.

PMID: 37030248
DOI: 10.1016/j.rehab.2023.101734

Abstract

Background: Recent studies have tested models of resilience and caregiver adjustment in individuals with traumatic brain injury (TBI) or spinal cord injury (SCI). Few studies have examined the role of adaptive variables over time.

Objective: Conduct a longitudinal study to test a model of caregiver resilience with caregiver outcomes at 2- and 5-years post-injury.

Method: Caregivers of relatives with TBI or SCI were surveyed at 2 years (Time 1) and 5 years (Time 2) post-injury. Stability of the resilience model across the 2 time-points was tested using structural equation modeling with multi-group analysis. Measures included resilience related variables (Connor-Davidson Resilience Scale, General Self-Efficacy Scale, Herth Hope Scale, Social Support Survey) and outcome variables (Caregiver Burden Scale, General Health Questionnaire-28, Medical Outcome Study Short Form -36 [SF-36] and Positive and Negative Affect Scale).

Results: In total, 100 caregivers were surveyed at both 2 and 5 years (TBI =77, SCI =23). Scores for resilience (Time 1, 75.9 SD 10.6; Time 2, 71.5 SD 12.6) and self-efficacy (Time 1, 32.51 SD 3.85; Time 2, 31.66 SD 4.28) showed significant minor declines, with other variables remaining stable. The resilience model for the pooled responses (Time 1+ Time 2) demonstrated a good fit (Goodness of Fit Index [GFI] = 0.971; Incremental Fit Index [IFI] = 0.986; Tucker-Lewis Index [TLI] = 0.971; Comparative Fit Index [CFI] = 0.985 and Root Mean Square Error of Approximation [RMSEA] = 0.051). Multi-group analysis then compared Time 1 to Time 2 responses and found that a variant (compared to invariant) model best fitted the data, with social support having stronger associations with mental health and positive affect at Time 2 than Time 1. Hope reduced from Time 1 to Time 2.

Conclusions: The model suggests that resilience-related variables can play an important role in positive caregiver adjustment over time.

Keywords: Burden; Caregiver; Family; Resilience; Spinal cord injury; Traumatic brain injuries.