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"Family caregiving after acquired brain injury in Singapore - strengths, reciprocity and resilience"

"Family caregiving after acquired brain injury in Singapore - strengths, reciprocity and resilience" . NUS Research Grant R-134-000-050-112 Department of Social Work Dr Allison Rowlands/ National University of Singapore Yao Zhurong Tan Tock Seng Hospital Alisa Tan/ Steven Chua.

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"Family caregiving after acquired brain injury in Singapore - strengths, reciprocity and resilience"

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  1. "Family caregiving after acquired brain injury in Singapore - strengths, reciprocity and resilience" NUS Research Grant R-134-000-050-112 Department of Social Work Dr Allison Rowlands/ National University of Singapore Yao Zhurong Tan Tock Seng Hospital Alisa Tan/ Steven Chua

  2. Overview • Research question • Literature • Study design • Findings and discussion

  3. Literature review • Impacts of cognitive impairment therefore experiences of caring for people with brain injuries • Strengths and resilience view • 90% of caregivers do, in fact, report positive feelings associated with caregiving (Berg-weger et al) • Is it methodological weaknesses or theoretical orientation that obscures this?

  4. Study design • Resilience and reciprocity in caregiving relationships • Mixed method • Nolan, Grant & Keady scales CAMI and CASI (1998) • In-depth, semi-structured interviews with the caregivers of adults with ABI, through TTSH Rehabilitation Centre • Experiences of respondents directly (phenomenological approach) • Audio-taped, transcribed, Nvivo • Largely English speaking sample • Part of larger study – Family Caregiving in Singapore

  5. Study design • Research questions • How do family caregivers experience caregiving? • What are the positive aspects of family caregiving? • How do carers look after themselves? • What do carers and other family members gain from caring? • In what ways does their relative contribute to the family or broader community (what does he/she give back?) • What are the strengths and skills used by caregivers? • What resources, services, training or support are most helpful to carers? • What are the rewards of caregiving?

  6. Marital status of caregivers Histogram Married 5 Single 4 Widowed Divorced Frequency 3 2 1 Mean =48.47 0 Std. Dev. =10.204 20 40 60 N =15 Age of the caregivers Caregiver demographics

  7. Direct action sub scale items (n = 15)

  8. Bar Chart Help from professionals 12 I do not use this 10 Not really helpful Quite helpful 8 Count Very helpful 6 4 2 0 Chinese Malay Indian Ethnicity Direct action – help from professionals

  9. Reframing (% of participants)

  10. Managing stress (% of participants) (numbers are rounded)

  11. Believing in myself and my ability Bar Chart Believing in myself and my ability I do not 12 use this I do not use Quite this 10 helpful Quite helpful Very Very helpful 8 helpful Count 6 4 2 0 Chinese Malay Indian Ethnicity Variables related to resilience – Believing in myself and my ability

  12. Self-help group Bar Chart Self-help group I do not 10 use this I do not use this Quite 8 Quite helpful helpful Count Very helpful 6 Very helpful 4 Missing 2 0 Chinese Malay Indian Ethnicity Things not found helpful – Self Help groups

  13. Qualitative findings • Carer • Caring relationship • Family member • Resources • Society • Feelings

  14. Carer • Demands of caring; commitment • Skills and knowledge • Faith/beliefs • Qualities • Rewards • Self care/relaxation • Other carers • Other responsibilities • Finances • Loss, hope, humour

  15. Caring relationship • Tie of caring • Communication • Protectiveness

  16. Family member • Ability/capacity • Limitations/losses • Activities/employment • Social network • Difficult behaviour

  17. Implications and reflections • Balance • Intervention across all levels • Importance of hope • Strengths approach appropriately integrated • Reflection and supervision

  18. Big picture – community building and social inclusion • Are all citizens valued? • Critical view of medical paradigm and its influence on disability policy, services and training • Is it about human rights?

  19. It requires recognition that society, through its government at all levels, is responsible for the well-being of all its citizens, including those with acquired brain injury. This is not only an individual or family responsibility but also a social responsibility.

  20. References • Berg-Weger, Rubio & Tebb, 2000; 2001 • Douglas & Spellacy, 1996 • Dunst, Trivetts, Gordon & Pletcher, 1989 • Elsass, 1991 • Greenberg, Greenley, & Benedict, 1994 • Knight, Devereux, & Godfrey, 1998 • Kosciulek, 1997; Kosciulek & Pichette, 1996 • Kozloff, 1987 • Lezak, 1978; 1988 • Liss & Willer, 1990 • Marsh, Kersel, Havill & Sleigh,1998

  21. Nolan, Lundh, Grant, & Keady, 1998; 2003 • Ow, Tan, & Goh, 2004 • Perlesz, Furlong & McLachlan, 1992 • Ponsford, Sloan & Snow, 1995 • Prigitano, 1988 • Resnick, 1993 • Ross, Holliman & Dixon, 2003 • Rowlands, 1995; 1999 • Saleebey, 1996 • Sanders, 2005 • Schwartz, 2003 • Schwartz & Gidron, 2002

  22. Serio, Kreutzer & Witol, 1997 • Tate, Lulham, Broe, Strettles & Pfaff, 1989 • Thomsen, 1984 • Wallace, Bogner, Corrigan, Clinchot, Mysiw & Fugate, 1998 • Willer, Allen, Durnan & Ferry, 1990 • Zeigler, 1989

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