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Title: Family caregiving of individuals with traumatic brain injury in Botswana.
Epworth Authors: Downing, Marina
Ponsford, Jennie
Other Authors: Mbakile-Mahlanza, Lingani
Manderson, Lenore
Keywords: Traumatic Brain Injury
Psychological Distress
Structured Head Injury Outcome Questionnaire
Hospital Anxiety and Depression Scale
Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Victoria, Australia
Rehabilitation, Mental Health and Chronic Pain Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Mar-2016
Publisher: Taylor and Francis
Citation: Disabil Rehabil. 2016 Mar 13:1-9
Abstract: Background: The impairments that affect survivors of TBI impact the person's independence, and family members frequently have to take on a caregiver role. This study examined the experience of caregiving for individuals with TBI in Botswana and its impact on psychological distress in caregivers. Methods: Using a mixed methods study design, qualitative data from semi-structured interviews were thematically analyzed and triangulated with data regarding functional status from the Structured Head Injury Outcome Questionnaire and the Hospital Anxiety and Depression Scale (HADS). Results: The study included 26 participants with moderate to severe TBI, and a total of 18 caregivers were recruited. Caregivers commonly reported receiving limited information regarding their relatives' injuries and management methods. Heavy caregiving demands were placed on them, with little support from the healthcare system. A significant proportion of caregivers experienced anxiety and depression, which was associated with lower functional independence in their injured relative. Somewhat more spouses than parents reported clinically significant anxiety levels. Other consequences of caregiving included social isolation and limited support from the wider community as well as financial difficulties. Despite these stresses caregivers tended to accept their caregiving role. Cultural factors such devotion to their families and faith and belief in God moderated burden and distress. Conclusions: Carers of individuals with TBI in Botswana face significant challenges. Rehabilitation efforts need to take these into account. Specifically, more information and support needs to be provided to survivors and their families. Psychological, economic and health needs of the care providers also should be addressed in the planning of rehabilitation interventions. Implications for Rehabilitation Caregivers of individuals with TBI in under-resourced countries carry much of the burden of care, face many challenges and experience significant stress. More information and support needs to be provided to survivors of TBI and their families in countries such as Botswana in a culturally sensitive manner. Psychological, economic and health needs also need to be addressed in the planning of rehabilitation interventions, which are currently non-existent in Botswana.
DOI: 10.3109/09638288.2016.1152605
PubMed URL:
ISSN: 0963-8288
Journal Title: Disability and Rehabilitation
Type: Journal Article
Affiliated Organisations: School of Psychological Sciences , Monash University , Melbourne , Australia
School of Public Health , University of the Witwatersrand , Johannesburg , South Africa
Type of Clinical Study or Trial: Cohort Study
Appears in Collections:Rehabilitation

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