Perceived stress and caregiver burden after brain injury: A theoretical integration (original) (raw)

1992, Rehabilitation Psychology

A theoretical integration of the literature examining burden among caregivers of brain-injured persons is presented. The present article examines various conceptualizations of caregiver burden, suggesting that the most parsimonious definition for burden is that of perceived stress, or the perception that the caregiving situation exceeds the caregiver's resources with which to cope. Using traditional stress theory as a framework, relationships are suggested between variables identified in the brain injury literature. Particularly, perceived stress might be expected to mediate the effects of other variables identified in the literature. Viewing caregiver burden in this way, as a complex process involving a number of variables, should aid our understanding of burden and suggest areas for future research. Illness and injury can exert a profound effect on the family of the patient. The broad range of negative phenomena associated with caring for victims of illness and injury has been called caregiver burden. In fact, the negative physical and psychological effects of caregiving have been so frequently documented that caregivers have been called the "hidden patients" (Fengler & Goodrich, 1979). The incidence of closed head injury has been estimated between 120 and 240 per 100,000 population per year (Kraus & Nourjah, 1989), leaving a significant number of these hidden victims. A great deal of research has been devoted to studying the effects of brain injury, but relatively little attention has been devoted to the caregivers of brain-injured persons. As in any young field of scientific inquiry, much of the research has been devoted to describing the phenomena, searching for relevant variables, and examining simple relationships among those variables. A recent methodological review of the caregiver burden literature noted that there has been a great degree of variability in how caregiver burden has been conceptualized and measured and a lack of theoretical focus which has made it difficult to interpret results across studies (Raveis, Siegel, & Sudit, 1989). The present paper presents a theoretical integration to help move