143 - Trauma Symptom Severity and Subjective Well-being in Caregivers of Children with Medically Complex Needs

Publication Number: 1133.143

Courtney Holmes, Children's Hospital of Richmond at VCU, Richmond, VA, United States; Tiffany Kimbrough, Children's Hospital of Richmond at VCU, richmondd, VA, United States; Heather A.. Jones, Virginia Commonwealth University, Richmond, VA, United States; Marcia A. Winter, Virginia Commonwealth University, Richmond, VA, United States; Kanako Iwanaga, Virginia Commonwealth University, Richmond, VA, United States

Background: Children with multiple chronic health conditions require specialized care, which places extra demands on caregivers (Teicher et al., 2023). Their caregivers report increased symptoms of post-traumatic stress disorder (Carmassi et al., 2020). Families with CMC are at significant risk of poor mental health and family functioning, indicating a relationship between lower levels of family functioning and increasingly intensive medical requirements (Bayer et al., 2021; Pilapil et al., 2017). Despite sustaining critical levels of physical, mental, and social burdens, parents often do not seek support (Caicedo, 2014; Gilson et al., 2018).

Objective: To better understand the experiences of caregivers of medically complex children, this study’s specific aims were (1) to describe the relationship between trauma symptom severity and subjective well-being in this population, and (2) to investigate potential mediators (i.e., resilience, emotional support, informational support, adaptive coping) of this relationship.

Design/Methods: Caregivers (N = 125, 52% White, 28% Black, 91% female) of children with complex medical needs were recruited from an integrated care clinic in the Southeastern US. Participants completed the Structured Trauma-Related Experiences and Symptoms Screener (Grasso et al., 2018), the Satisfaction with Life Scale (Diener et al., 1985), the Coping Flexibility Scale (Kato, 2012), the Brief Resilience Scale (Smith et al., 2008), and the PROMIS Social Support Measure (Hahn et al., 2014).

Results: The total effect of trauma symptom severity on subjective well-being was significant and negative (c = -0.33, p < .01), indicating that higher levels of trauma symptom severity were associated with lower subjective well-being. When accounting for the mediating variables, the direct effect remained significant but was reduced in magnitude (c’ = -0.18, p < .05), suggesting partial mediation. Bootstrap analyses revealed that resilience (point estimate = -.05, [95% CI: -.01, -.11]) and informational support (point estimate = -.12, [95% CI: -.02, -.25]) were significant mediators.

Conclusion(s): Findings highlight resilience and informational support as mediators of the relationship between caregiver trauma symptom severity and well-being. Interventions that enhance caregiver resilience and access to informational support may help buffer the negative impact of trauma. Limitations include the cross-sectional design and single-source measurement. Future research should investigate interventions that target caregiver resilience and informational support.