Relationship satisfaction among spouse caregivers of service members and veterans with comorbid mild traumatic brain injury and post‐traumatic stress disorder

Abstract

This study examined relationship satisfaction and health‐related quality of life (HRQOL) among spouse caregivers assisting service members and veterans (SMV) with comorbid uncomplicated mild traumatic brain injury (MTBI) and post‐traumatic stress disorder (PTSD). Spouse caregivers (N = 205) completed the Couples Satisfaction Index (CSI), 12 HRQOL measures, and the Mayo‐Portland Adaptability Inventory 4th Edition (MPAI‐4). T‐scores were classified as “clinically elevated” using a cutoff of ≥60T. The sample was also classified into “Satisfied” (≥13.5, n = 113, 55.0%) or “Dissatisfied” (<13.5, n = 92, 44.0%) relationship categories. Using stepwise regression analysis, Anxiety, Family Disruption, Vigilance, Emotional Support, Feeling Trapped, and MPAI‐4 Adjustment were identified as the strongest predictors of CSI total scores (p < 0.001), accounting for 41.6% of the variance. Squared semi‐partial correlations revealed that 18.1% of the variance was shared across all six measures, with 7.8% to 1.5% of unique variance accounted for by each measure separately. When comparing the number of clinically elevated measures simultaneously, the Dissatisfied group consistently had a higher number of clinically elevated scores compared to the Satisfied group (e.g., 3‐or‐more clinically elevated scores: Dissatisfied = 40.2%, Satisfied = 8.8%, OR = 6.93, H = 0.76). Caring for a SMV with comorbid TBI and PTSD can have a profound impact on the spouse caregiver's HRQOL, relationship satisfaction, and family functioning. The findings from the current study continue to support the need for family involvement in the SMV’s treatment plan, but more effort is needed to integrate behavioral health treatment that focuses on the family member's own issues into military TBI and PTSD systems of care.

Short‐term effects of comprehensive caregiver supports on caregiver outcomes

“…It is unknown whether additional care responsibilities differed by treatment and comparison group, even though our methods did achieve balance in relation to the care‐recipient (e.g., similar proportion partnered). In addition, adjusting to life post‐injury/initial diagnosis for caregivers means that a future they expected may not be there in terms of life choices and life experiences 37–39 . While unobserved in secondary claims data, caregiver outcomes (e.g., family strain, quality of relationship between caregiver/care‐recipient, or school performance and emotional well‐being of children) may also be modifiable by PCAFC and have significant implications for quality of care and quality of life for the care‐recipient and caregiver, respectively.…”

Mediating role of dyadic satisfaction on social support and health outcomes in a sample of military family care-givers

“…22 More over, caring for a military or Veteran spouse or partner was associated with dyadic dissatisfaction and worse quality of life and family functioning. 8 In addition, a recent systematic review on caregivers of those with traumatic brain injury and dyad interventions found that many of the studies that explored caregiver out comes found improvements in a series of health-related outcomes, including depressive symptoms, health com plaints, and distress. 23 Overall, it is clear that a strong relation exists between DS and HOs in military couples.…”

“…5,6 Moreover, research has indicated that caring for a spouse or partner can have a negative effect on a relationship, leading to mental and physical health problems for the caregiver. 7,8 Some of the physical and psychological costs of caregiving can be mitigated by effective programs addressing the needs of caregivers. Although MFC intervention research is in its infancy, there is a need to better under stand the unique needs of MFCs and identify targets for intervention.…”

Mediating role of dyadic satisfaction on social support and health outcomes in a sample of military family caregivers

“…22 Moreover, caring for a military or Veteran spouse or partner was associated with dyadic dissatisfaction and worse quality of life and family functioning. 8 In addition, a recent systematic review on caregivers of those with traumatic brain injury and dyad interventions found that many of the studies that explored caregiver outcomes found improvements in a series of health-related outcomes, including depressive symptoms, health complaints, and distress. 23 Overall, it is clear that a strong relation exists between DS and HOs in military couples.…”

“…5,6 Moreover, research has indicated that caring for a spouse or partner can have a negative effect on a relationship, leading to mental and physical health problems for the caregiver. 7,8 Some of the physical and psychological costs of caregiving can be mitigated by effective programs addressing the needs of caregivers. Although MFC intervention research is in its infancy, there is a need to better understand the unique needs of MFCs and identify targets for intervention.…”