UCLA

Background: Family caregivers are the cornerstone of support for our nation's wounded. While caregiver burden has been studied extensively in caregivers of patients with dementia, stroke, and cancer, little is known about the burden of caregiving in the context of service-related injuries like traumatic brain injury(TBI) and Post Traumatic Stress Disorder (PTSD). Studies have shown that depression, anxiety, and caregiver strain are associated with lifestyle risk factors for coronary heart disease (CHD).

Purpose: The purpose of this descriptive study was to examine the effects of caregiving on cardiovascular health in mothers and wives caring for veterans with invisible wounds of war.

Methods: The study utilized a sequential, exploratory, mixed method design with convergent results. Participants completed an online survey. Analysis included descriptive and correlational statistics. The qualitative interviews used a semi-structured interview guide that explored the daily experience of the caregiver and facilitators and inhibitors to heart health self-care. The interviews were transcribed and coded and content analysis was conducted.

Results: Caregivers reported spending the greatest amount of time providing emotional support for the veteran and managing behavioral problems. Neurobehavioral symptoms most frequently reported by caregiver as being severe included forgetfulness and anxiousness. Many caregivers demonstrated anxiety that would be classified as needing further evaluation and depressive symptoms consistent with major depression. Overall, poorer heart health was correlated with higher scores for depressive symptoms and perceived stress. Thematic content analysis was used to identify seven major themes: (1) Neurobehavioral Symptoms: Managing the Unpredictable; (2) Home as the Safe Place; (3) VA Healthcare System: Fighting to Navigate a Complex System (4) Self-Care: Finding Time to Care for Self; (5) Caregiver Peers: Creating a New Community (6) Post Traumatic Growth: Learning to Become a PTSD Expert; (7) Motivation: Sacrificial, Unconditional Love

Conclusions: Results of this study will be used to design a health promotion intervention for caregivers utilizing principles of community based participatory research and trauma informed care.