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Pain interference and health-related quality of life in caregivers of service members and veterans with traumatic brain injury and mental health comorbidity

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Abstract

Purpose

To examine (1) the relationship between caregiver pain interference with caregiver health-related quality of life (HRQOL), caregiver age, and service member/veteran (SMV) functional ability, and (2) change in caregiver pain interference longitudinally over 5 years.

Method

Participants were 347 caregivers of SMVs diagnosed with traumatic brain injury (TBI). Caregivers completed the SF-12v2 Health Survey Bodily Pain scale at an initial baseline evaluation and up to four annual follow-up evaluations. Caregivers were divided into three pain interference groups: High Pain Interference (n = 104), Neutral Pain Interference (n = 117), and Low Pain Interference (n = 126). Caregivers also completed 15 HRQOL measures and a measure of SMV functional ability.

Results

The High Pain Interference group reported more clinically elevated scores on 13 measures compared to the Low Pain Interference group, and seven measures compared to the Neutral Pain Interference group. The Neutral Pain Interference group had more clinically elevated scores on three measures compared to the Low Pain Interference group. The High and Neutral Pain Interference groups were older than the Low Pain Interference group. Parent caregivers were older than intimate partner/sibling caregivers, but did not report worse pain interference. Caregiver age, and measures of Fatigue, Strain, Perceived Rejection, and Economic QOL were the strongest predictors of pain interference (p < .001), accounting for 28.2% of the variance. There was minimal change in Bodily Pain scores over five years. The interaction of time and age was not significant (X2 = 2.7, p = .61).

Conclusion

It is important to examine pain in the context of HRQOL in caregivers, regardless of age.

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Funding

This research was supported by funding from Traumatic Brain Injury Center of Excellence. The views expressed in this manuscript are those of the authors and do not necessarily represent the official policy or position of the Defense Health Agency, Department of Defense, or any other U.S. government agency. This work was prepared under Contract HT0014-21-C-0012 with DHA Contracting Office (CO-NCR) HT0014 and, therefore, is defined as U.S. Government work under Title 17 U.S.C.§101. Per Title 17 U.S.C.§105, copyright protection is not available for any work of the U.S. Government. For more information, please contact dha.TBICOEinfo@mail.mil. The authors have no relevant financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA

    Tracey A. Brickell, Megan M. Wright, Louis M. French & Rael T. Lange

  2. National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA

    Tracey A. Brickell, Megan M. Wright, Louis M. French & Rael T. Lange

  3. Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Tracey A. Brickell & Louis M. French

  4. General Dynamics Information Technology, Silver Spring, MD, USA

    Tracey A. Brickell, Megan M. Wright, Hamid Ferdosi & Rael T. Lange

  5. Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA

    Hamid Ferdosi

  6. The George Washington University, Washington, DC, USA

    Hamid Ferdosi

  7. University of British Columbia, Vancouver, BC, Canada

    Rael T. Lange

Authors
  1. Tracey A. Brickell
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  3. Hamid Ferdosi
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  4. Louis M. French
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  5. Rael T. Lange
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by TAB, MMW, RTL, and HF. The first draft of the manuscript was written by TAB and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Tracey A. Brickell.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Review Board (IRB) of Walter Reed National Military Medical Center (WRNMMC, 2012, EIRB #367721).

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Informed consent was obtained from all individual participants included in the study. The authors affirm that human research participants provided informed consent for publication.

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Brickell, T.A., Wright, M.M., Ferdosi, H. et al. Pain interference and health-related quality of life in caregivers of service members and veterans with traumatic brain injury and mental health comorbidity. Qual Life Res 31, 3031–3039 (2022). https://doi.org/10.1007/s11136-022-03153-8

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  • DOI: https://doi.org/10.1007/s11136-022-03153-8

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