Providing long-term personal assistance to a loved one can be demanding and stressful, and, for some caregivers, adversely affect their health and wellbeing. Over the next two years, researchers at RIM will be conducting a study that focuses exclusively on caregivers who provide personal assistance to a relative with a traumatic spinal cord injury (SCI). The study is being funded by a $150,000 grant from the Paralyzed Veteran's of America Foundation (#2412). Given the crucial role that caregivers play in the lives of people with SCI and the physical, emotional, social and economic costs of care giving, it is important that researchers explore more fully the linkages between the specific demands of SCI care giving and the health responses of family caregivers.

The overall objective of this qualitative/quantitative investigation is to describe the impact of SCI care giving on the family caregiver's health-related quality of life (QOL) and psychosocial well-being. Using a qualitative social research methodology, complemented by quantitative measures, this study will (a) document the ways in which SCI caregivers perceive and respond to stressful life situations, (b) explore, in depth, the varied strategies they use to reduce distress, and (c) assess the impact that stress appraisals and coping methods have on caregiver QOL.

The objective of the study is to document from a contextual life perspective, the linkages between the specific demands of caregiving and its health consequences. The study targets three groups of SCI caregivers: (a) unpaid (family) caregivers; paid caregivers hired directly by the consumer, and (c) paid employees of home health care agencies

The specific aims of the study are to: (a) conduct a comparative study of these three caregiver groups; (b) analyze this information with specific attention to the connections between aspects of the work environment, stress, physical health and psychosocial well-being, and (c) disseminate this information to SCI consumers and their families, rehabilitation researchers and clinicians, and to agencies charged with the responsibility of establishing health care policies.

The study employs a mixed (qualitative/quantitative) methodology and is guided by a set of exploratory hypotheses that incorporate concepts about the disablement process, the stress-coping process, the stress-health/illness relationship, and the dynamics of quality of life assessments. Criterion-based purposive sampling will be used to recruit and interview 84 caregivers of community-dwelling persons with SCI.

Purposes: The primary purpose of this study is to assess the comprehensiveness, sensitivity/responsiveness, practicality, and patient acceptance of a constellation of selected outcome measures to document change in persons with SCI who are participating in the innovative, intensive intervention program utilized by the RIM CSCIR. The second purpose of this study will be to examine the effectiveness of the CSCIR intervention program in promoting recovery of function below the level of the SCI specifically comparing the outcomes for clients have undergone versus not undergone one of the new surgical interventions aimed at spinal cord recovery.

The study is funded by the Del Harder Research Fund/ United Way of Southeastern Michigan in the amount of $54,602 for two years (2006-2007) and is currently active.

Understanding The Health Care Needs of Publicly Insured Recipients With Tetraplegia: A Family Perspective

Investigator: Colette H. Duggan, BSN, MSN, Ph.D.


Using a family-centered perspective, experienced researchers at the Rehabilitation Institute of Michigan (RIM) propose a pilot study of the health care needs of Medicaid/Medicare recipients with tetraplegia. This two-year study is being funded by a $112, 500 grant from the Blue Cross Blue Shield of Michigan Foundation (Grant 105.II).The long-term goals of the study are to better understand the complexities and policy implications of providing health care to publicly-insured persons with tetraplegia and to provide pilot data for a larger, more comprehensive study of their needs.