Journal of Rehabilitation Research & Development (JRRD)

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Volume 53 Number 6, 2016
   Pages 669 — 680

Abstract — Caring for our wounded warriors: A qualitative examination of health-related quality of life in caregivers of individuals with military-related traumatic brain injury

Noelle E. Carlozzi, PhD;1* Tracey A. Brickell, DPsych;2–3 Louis M. French, PsyD;2–4 Angelle Sander, PhD;5 Anna L. Kratz, PhD;1 David S. Tulsky, PhD;6 Nancy D. Chiaravalloti, PhD;7 Elizabeth A. Hahn, MA;8 Michael Kallen, PhD;8 Amy M. Austin, BS;1 Jennifer A. Miner, MBA;1 Rael T. Lange, PhD2,9

1Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, MI; 2Defense and Veterans Brain Injury Center and Walter Reed National Military Medical Center, Bethesda, MD; 3Uniformed Services University of the Health Sciences, Bethesda, MD; 4Center for Neuroscience and Regenerative Medicine, Bethesda, MD; 5Brain Injury Research Center, TIRR Memorial Hermann and Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, and Harris Health System, Houston, TX; 6Department of Physical Therapy, University of Delaware, Newark, DE; 7Neuropsychology and Neuroscience Laboratory, Traumatic Brain Injury Laboratory, Kessler Foundation Research Center, West Orange, NJ; 8Department of Medical Social Sciences, Northwestern University, Chicago, IL; 9University of British Columbia, Vancouver, BC, Canada

Abstract — The purpose of this study was to develop a conceptual framework that captures aspects of health-related quality of life (HRQOL) for caregivers of individuals with military-related traumatic brain injury (TBI). We analyzed qualitative data from nine focus groups composed of caregivers of wounded warriors with a medically documented TBI. Focus group participants were recruited through hospital-based and/or community outreach efforts at the Walter Reed National Military Medical Center, the University of Michigan, and Hearts of Valor support groups (Tennessee and Washington). Participants were the caregivers (n = 45) of wounded warriors who had sustained a mild, moderate, severe, or penetrating TBI. Qualitative frequency analysis indicated that caregivers most frequently discussed social health (44% of comments), followed by emotional (40%) and physical health (12%). Areas of discussion that were specific to this population included anger regarding barriers to health services (for caregivers and servicemembers), emotional suppression (putting on a brave face for others even when things are not going well), and hypervigilance (controlling one's behavior/environment to prevent upsetting the servicemember). Caring for wounded warriors with TBI is a complex experience that positively and negatively affects HRQOL. While some aspects of HRQOL can be evaluated with existing measures, evaluation tools for other important components do not exist. The development of military-specific measures would help facilitate better care for these individuals.

Key words: caregiver, health-related quality of life, outcome assessment (health care), quality of life, rehabilitation, servicemembers, traumatic brain injury, underserved populations, Veterans, wounded warriors.


View HTML ¦ View PDF ¦ Contents Vol. 53, No.6

This article and any supplementary material should be cited as follows:
Carlozzi NE, Brickell TA, French LM, Sander A, Kratz AL, Tulsky DS, Chiaravalloti ND, Hahn EA, Kallen M, Austin AM, Miner JA, Lange RT. Caring for our wounded warriors: A qualitative examination of health-related quality of life in caregivers of individuals with military-related traumatic brain injury. J Rehabil Res Dev. 2016; 53(6):669–80.
http://dx.doi.org/10.1682/JRRD.2015.07.0136
ORCID: Noelle E. Carlozzi, PhD: 0000-0003-0439-9429
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