A Model of Factors Influencing Depressive Symptoms among Caregivers of Survivors with Traumatic Brain Injury

Abstract

Caring for moderate to severe traumatic brain injury survivors with physical disability and cognitive dysfunction is challenging for caregivers, and it can lead to depression. Understanding the factors influencing depressive symptoms is necessary to develop specific interventions to reduce depression among caregivers. This cross-sectional correlational study examined the causal relationships among behavioral problems, role strain, preparedness, family hardiness, and depressive symptoms among caregivers of survivors with moderate to severe traumatic brain injury. Two hundred caregivers from three university hospitals in Thailand were recruited. Questionnaires used for collecting data were the Revised Memory and Behavioral Problems Checklist; the Preparedness for Caregiving Scale; the Family Hardiness Index; the Caregiver Role Strain Scale; and the Center for Epidemiologic Studies Depression Scale. Descriptive statistics and path analysis were used to analyze data. The results revealed that the hypothesized model fitted the empirical data and explained 17.2% of the variance of depressive symptoms. Preparedness had an indirect effect on depressive symptoms through decreased role strain and increased family hardiness. Behavioral problems had a significant direct effect on depressive symptoms. These results can help nurses work to develop effective nursing interventions to prepare the caregivers and decrease behavioral problems by using a combination of providing health education, counseling, and skill building. This will increase capability of caregivers to provide quality home-based care and to manage health behavioral problems for survivors of moderate to severe traumatic brain injury.