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

3 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

Keywords

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

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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