The Impact of Stigma on Community Reintegration of Veterans With Traumatic Brain Injury and the Well-Being of Their Caregivers

Sean M. Phelan, Lauren R. Bangerter, Greta Friedemann-Sanchez, Kandace A. Lackore, Megan A. Morris, Courtney H. Van Houtven, Kathleen F. Carlson, Michelle van Ryn, Kristin J. Harden, Joan M. Griffin

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objective: To assess the association between perceived stigma and discrimination and caregiver strain, caregiver well-being, and patient community reintegration. Design: A cross-sectional survey study of 564 informal caregivers of U.S. military service veterans of wars in Iraq and Afghanistan who experienced traumatic brain injuries or polytrauma (TBI/PT). Setting: Care settings of community-dwelling former inpatients of U.S. Department of Veterans Affairs Polytrauma Rehabilitation Centers. Participants: Caregivers of former inpatients (N=564), identified through next-of-kin records and subsequent nominations. Interventions: Not applicable. Main Outcome Measures: Caregiver strain, depression, anxiety, loneliness, and self-esteem; as well as care recipient community reintegration, a key aspect of TBI/PT rehabilitation. Results: Family stigma was associated with strain, depression, anxiety, loneliness, lower self-esteem, and less community reintegration. Caregiver stigma-by-association was associated with strain, depression, anxiety, loneliness, and lower self-esteem. Care recipient stigma was associated with caregiver strain, depression, anxiety, loneliness, lower self-esteem, and less community reintegration. Conclusions: Perceived stigma may be a substantial source of stress for caregivers of U.S. military veterans with TBI/PT, and may contribute to poor outcomes for the health of caregivers and for the community reintegration of the veterans for whom they provide care.

Original languageEnglish (US)
Pages (from-to)2222-2229
Number of pages8
JournalArchives of Physical Medicine and Rehabilitation
Volume99
Issue number11
DOIs
StatePublished - Nov 2018

Bibliographical note

Funding Information:
Supported by the U.S. Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, and a grant from the Health Services Research and Development Service (U.S. Department of Veteran Affairs) (grant no. SDR-07-044). The findings and conclusions presented in this manuscript are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or the Health Services Research and Development Service. The sponsor was not involved in any aspect of the study’s design and conduct; data collection, management, analysis, or interpretation of data; or preparation, review, or approval of the manuscript.

Publisher Copyright:
© 2018 American Congress of Rehabilitation Medicine

Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.

Keywords

  • Caregiving
  • Mental health prejudice
  • Rehabilitation
  • Stigma
  • Traumatic brain injury

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