title: Caregiver Health Related Quality of Life and Burden When Caring for Children with Traumatic Brain Injury

authors: Rose, Wallis

subjects: Caregiver Burden

abstract: Often family members take on the responsibility of caregiver when another family member sustains a traumatic brain injury (TBI). The caregiving role is a stressful task which may impact negatively upon caregivers’ psychological and physical health. Variables which may contribute to caregiver burden include: caregiver age, educational attainment, income, gender, ethnicity, marital status, supports, time post-injury, and child clinical variables: TBI severity, behavioural functioning and adaptive functioning. The literature varies in its reporting of which areas of health are most affected, and the degree to which sociodemographic and child variables impact upon negative health related quality of life (HRQoL) and burden. To address this the current study explored health outcomes for TBI caregivers using a battery of measures (Medical Study Short Form-36, Hospital Anxiety and Depression Scale, DSM-IV Depression Diagnostic Scale, BAKAS Caregiving Outcomes Scale); questionnaires were also used to collect sociodemographic information and information relating to supports and services used in the rehabilitation of the TBI child. The Behavioural Assessment System for Children was used to collect behavioural and adaptability information from the caregivers about the child. Assessments were carried out at baseline, 1-month, 6-months and 12-months post TBI from a sample of 94 TBI caregivers and at baseline from a sample of 43 Control caregivers.

TBI caregivers experienced poorer overall health and higher levels of depression and were less likely to report positive life changes compared to Control caregivers. Older age and higher income predicted positive life changes. In addition to this higher income predicted better physical and overall health. Ethnicity was found to predict depression with the Māori/‘other ethnicity’ group suffering higher levels of depression. Children’s dysfunctional behaviour was found to predict poorer caregiver health outcomes across several domains; these include physical health, overall health, and depression; while the child’s adaptive functioning was not found to be a predictive factor in any caregiver health domains. New Zealand European and Māori TBI caregivers experienced similar health outcomes and received similar levels of support. However, Māori experienced more positive life changes than New Zealand Europeans. Caregivers’ physical and psychological well-being was found to improve over time, these changes were the greatest between the 1-month and 12-month period.
As a high percentage of children’s TBI’s occur in the home and at school, education aimed at schools and parents to inform of the effects of TBI upon children and families will bring an awareness which may encourage families to seek medical help. In doing so will offer the opportunity to receive or seek support in the initial period post TBI in the hope of reducing the burden for caregivers and producing better health outcomes. Bringing these families into contact with medical services may also help in identifying caregivers at higher risk of poorer health outcomes. Findings of more positive life changes for Māori may suggest cultural ideology is a protective factor in caregiver burden, further investigation may be necessary to understand these cultural differences and how they impact upon the caregiving role.

text: Caregiver Health Related Quality of Life and Burden When Caring for Children with Traumatic Brain Injury Often family members take on the responsibility of caregiver when another family member sustains a traumatic brain injury (TBI). The caregiving role is a stressful task which may impact negatively upon caregivers’ psychological and physical health. Variables which may contribute to caregiver burden include: caregiver age, educational attainment, income, gender, ethnicity, marital status, supports, time post-injury, and child clinical variables: TBI severity, behavioural functioning and adaptive functioning. The literature varies in its reporting of which areas of health are most affected, and the degree to which sociodemographic and child variables impact upon negative health related quality of life (HRQoL) and burden. To address this the current study explored health outcomes for TBI caregivers using a battery of measures (Medical Study Short Form-36, Hospital Anxiety and Depression Scale, DSM-IV Depression Diagnostic Scale, BAKAS Caregiving Outcomes Scale); questionnaires were also used to collect sociodemographic information and information relating to supports and services used in the rehabilitation of the TBI child. The Behavioural Assessment System for Children was used to collect behavioural and adaptability information from the caregivers about the child. Assessments were carried out at baseline, 1-month, 6-months and 12-months post TBI from a sample of 94 TBI caregivers and at baseline from a sample of 43 Control caregivers.

TBI caregivers experienced poorer overall health and higher levels of depression and were less likely to report positive life changes compared to Control caregivers. Older age and higher income predicted positive life changes. In addition to this higher income predicted better physical and overall health. Ethnicity was found to predict depression with the Māori/‘other ethnicity’ group suffering higher levels of depression. Children’s dysfunctional behaviour was found to predict poorer caregiver health outcomes across several domains; these include physical health, overall health, and depression; while the child’s adaptive functioning was not found to be a predictive factor in any caregiver health domains. New Zealand European and Māori TBI caregivers experienced similar health outcomes and received similar levels of support. However, Māori experienced more positive life changes than New Zealand Europeans. Caregivers’ physical and psychological well-being was found to improve over time, these changes were the greatest between the 1-month and 12-month period.
As a high percentage of children’s TBI’s occur in the home and at school, education aimed at schools and parents to inform of the effects of TBI upon children and families will bring an awareness which may encourage families to seek medical help. In doing so will offer the opportunity to receive or seek support in the initial period post TBI in the hope of reducing the burden for caregivers and producing better health outcomes. Bringing these families into contact with medical services may also help in identifying caregivers at higher risk of poorer health outcomes. Findings of more positive life changes for Māori may suggest cultural ideology is a protective factor in caregiver burden, further investigation may be necessary to understand these cultural differences and how they impact upon the caregiving role.

year: 2012

title: Māori & Psychology Research Unit Annual Report 2014

authors: Waitoki, Waikaremoana

abstract: Annual report of the Māori and Psychology Research Unit (MPRU) 2014. The unit was established in August of 1997. The unit is designed to provide a catalyst and support network for enhancing research concerning the psychological needs, aspirations, and priorities of Maori people. The MPRU is well situated to draw together skilled and experienced interdisciplinary research groups by networking and establishing working relationships with staff and students within the Faculty of Arts and Social Sciences, the University, and the wider community.

text: Māori & Psychology Research Unit Annual Report 2014 Annual report of the Māori and Psychology Research Unit (MPRU) 2014. The unit was established in August of 1997. The unit is designed to provide a catalyst and support network for enhancing research concerning the psychological needs, aspirations, and priorities of Maori people. The MPRU is well situated to draw together skilled and experienced interdisciplinary research groups by networking and establishing working relationships with staff and students within the Faculty of Arts and Social Sciences, the University, and the wider community.

year: 2014

title: Transition to professional social work practice: the initial year

authors: Hunt, Sonya

subjects: newly qualified social workers

abstract: This paper presents the findings of the first year of a three-year longitudinal study of new graduate social workers from a Bachelor of Social Work (BSW) program in Aotearoa New Zealand. We compare work outcomes and graduates’ perceptions of their readiness for practice against the New Zealand Social Workers Registration Board’s (SWRB’s) 10 core competencies. This study’s impetus came from an increase in the professionally accepted minimum qualification benchmark, recent political commentary on the preparedness of social work graduates, and associated roles of the SWRB and Aotearoa New Zealand Association of Social Work (ANZASW). The aim of this longitudinal research is to track paid and unpaid work outcomes and identify the support needs of social work graduates as they transition from students into professional practitioners. An on-line questionnaire offered graduates the opportunity to comment annually on their professional progress. The respondents all found paid employment as social workers in that first year and identified transitional challenges. Supports to ease this transition included supervision, mentoring, collegiality, coaching, case-load protection (both volume and complexity), continuing professional development, and professional networking. Concluding that the first year of practice is a highly demanding one, we highlight the need for new graduates to have reduced case-loads and additional levels of support. This article is highly relevant for the profession in Aotearoa New Zealand and elsewhere, particularly for countries such as Australia where there is no legislated registration process for social workers.

text: Transition to professional social work practice: the initial year This paper presents the findings of the first year of a three-year longitudinal study of new graduate social workers from a Bachelor of Social Work (BSW) program in Aotearoa New Zealand. We compare work outcomes and graduates’ perceptions of their readiness for practice against the New Zealand Social Workers Registration Board’s (SWRB’s) 10 core competencies. This study’s impetus came from an increase in the professionally accepted minimum qualification benchmark, recent political commentary on the preparedness of social work graduates, and associated roles of the SWRB and Aotearoa New Zealand Association of Social Work (ANZASW). The aim of this longitudinal research is to track paid and unpaid work outcomes and identify the support needs of social work graduates as they transition from students into professional practitioners. An on-line questionnaire offered graduates the opportunity to comment annually on their professional progress. The respondents all found paid employment as social workers in that first year and identified transitional challenges. Supports to ease this transition included supervision, mentoring, collegiality, coaching, case-load protection (both volume and complexity), continuing professional development, and professional networking. Concluding that the first year of practice is a highly demanding one, we highlight the need for new graduates to have reduced case-loads and additional levels of support. This article is highly relevant for the profession in Aotearoa New Zealand and elsewhere, particularly for countries such as Australia where there is no legislated registration process for social workers.

year: 2016