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 Carlson, Michelle van Ryn, Kristin J. Harden, Joan M. Griffin

Research output: Contribution to journalArticle

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, 67%), 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)
JournalArchives of Physical Medicine and Rehabilitation
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Veterans
Caregivers
Loneliness
Multiple Trauma
Self Concept
Anxiety
Depression
Inpatients
Cross-Sectional Studies
Independent Living
Traumatic Brain Injury
Afghanistan
Iraq
United States Department of Veterans Affairs
Rehabilitation Centers
Rehabilitation
Outcome Assessment (Health Care)
Health

Keywords

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

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

Phelan, S. M., Bangerter, L. R., Friedemann-Sanchez, G., Lackore, K. A., Morris, M. A., Van Houtven, C. H., ... Griffin, J. M. (Accepted/In press). The Impact of Stigma on Community Reintegration of Veterans With Traumatic Brain Injury and the Well-Being of Their Caregivers. Archives of Physical Medicine and Rehabilitation. https://doi.org/10.1016/j.apmr.2018.04.007

The Impact of Stigma on Community Reintegration of Veterans With Traumatic Brain Injury and the Well-Being of Their Caregivers. / Phelan, Sean M.; Bangerter, Lauren R.; Friedemann-Sanchez, Greta; Lackore, Kandace A.; Morris, Megan A.; Van Houtven, Courtney H.; Carlson, Kathleen; van Ryn, Michelle; Harden, Kristin J.; Griffin, Joan M.

In: Archives of Physical Medicine and Rehabilitation, 01.01.2018.

Research output: Contribution to journalArticle

Phelan, Sean M. ; Bangerter, Lauren R. ; Friedemann-Sanchez, Greta ; Lackore, Kandace A. ; Morris, Megan A. ; Van Houtven, Courtney H. ; Carlson, Kathleen ; van Ryn, Michelle ; Harden, Kristin J. ; Griffin, Joan M. / The Impact of Stigma on Community Reintegration of Veterans With Traumatic Brain Injury and the Well-Being of Their Caregivers. In: Archives of Physical Medicine and Rehabilitation. 2018.
@article{82527e56f19b4a0ba32a11c3ad6c1e6e,
title = "The Impact of Stigma on Community Reintegration of Veterans With Traumatic Brain Injury and the Well-Being of Their Caregivers",
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, 67{\%}), 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.",
keywords = "Caregiving, Mental health prejudice, Rehabilitation, Stigma, Traumatic brain injury",
author = "Phelan, {Sean M.} and Bangerter, {Lauren R.} and Greta Friedemann-Sanchez and Lackore, {Kandace A.} and Morris, {Megan A.} and {Van Houtven}, {Courtney H.} and Kathleen Carlson and {van Ryn}, Michelle and Harden, {Kristin J.} and Griffin, {Joan M.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.apmr.2018.04.007",
language = "English (US)",
journal = "Archives of Physical Medicine and Rehabilitation",
issn = "0003-9993",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - The Impact of Stigma on Community Reintegration of Veterans With Traumatic Brain Injury and the Well-Being of Their Caregivers

AU - Phelan, Sean M.

AU - Bangerter, Lauren R.

AU - Friedemann-Sanchez, Greta

AU - Lackore, Kandace A.

AU - Morris, Megan A.

AU - Van Houtven, Courtney H.

AU - Carlson, Kathleen

AU - van Ryn, Michelle

AU - Harden, Kristin J.

AU - Griffin, Joan M.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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, 67%), 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.

AB - 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, 67%), 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.

KW - Caregiving

KW - Mental health prejudice

KW - Rehabilitation

KW - Stigma

KW - Traumatic brain injury

UR - http://www.scopus.com/inward/record.url?scp=85048488751&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048488751&partnerID=8YFLogxK

U2 - 10.1016/j.apmr.2018.04.007

DO - 10.1016/j.apmr.2018.04.007

M3 - Article

C2 - 29729228

AN - SCOPUS:85048488751

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

ER -