Caring for someone with acquired brain injury: the role of psychological flexibility and a systematic review of remotely delivered interventions
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Date
31/07/2021Author
Rickardsson Olsson, Nils
Metadata
Abstract
To care for someone with an Acquired Brain Injury (ABI) can be a valued role in one’s
life, and caregivers play a key role in the rehabilitation process. Unfortunately, caregivers of
people with ABI have also been found to report greater levels of psychological distress and
worse wellbeing compared to the general population.
The first chapter of this thesis reports findings from a cross-sectional study exploring
the role of psychological flexibility in depression, anxiety and satisfaction with life amongst
ABI carers. The aim of the study was to investigate the relative strength of psychological
flexibility in explaining caregiver outcomes compared to established constructs, namely
cognitive appraisals, coping, social support and the perceived functional disability of the
care-recipient. Psychological flexibility was found to predict most of the variance in
depression and anxiety, whilst cognitive appraisal was the strongest predictor of satisfaction
of life. Cognitive appraisal mediated the influence of functional disability on all outcomes,
and this mediating effect was moderated by psychological flexibility on depression. Chapter
one concluded that psychological flexibility appears to have a central role in psychological
distress amongst ABI carers, which is adding to our understanding of how to support this
population.
Chapter two presents a systematic review of the evidence for remotely delivered
interventions to improve the wellbeing of ABI carers. Twelve studies were identified from
systematic searches. These studies evaluated a wide range of interventions that were being
offered to caregivers remotely using various modes of delivery. Promising results were
found on primary and secondary wellbeing outcomes. However, due to a limited number of
studies it was concluded that it is currently not feasible to make any general conclusions on
the efficacy of specific interventions being delivered remotely for this population. Besides,
in many studies low-intensity support was potentially as effective as a structured
programme. Methodological issues were discussed, and specific recommendations for
future research and developments in the field were provided.
Combined, the two chapters of this thesis have identified that psychological
flexibility appears to play a central role for outcomes amongst ABI carers, and that remote
delivery is a promising field with the potential to improve wellbeing for this population.