Rehabilitation Psychology最新文献

Objective: People with disabilities continue to cope with high levels of stress, such as disability-related stress and sociopolitical stress. Helping people with disabilities engage in regular physical activity to improve health and reduce stress is more important than ever. This study evaluated demographic covariates, the health action process approach (HAPA) constructs (action self-efficacy, outcome expectancy, risk perception, intention/commitment, maintenance and recovery self-efficacy, and action and coping planning), and positive person-environment variables (autonomous motivation, resilience, hope, and social support) as motivators for regular physical activity in a sample of people with disabilities.

Methods: People with disabilities participated in an online study (N = 266). Hierarchical regression analysis was used to determine the incremental variance in physical activity scores accounted for by variables in the regression model.

Results: Demographic covariates, HAPA constructs, and positive person-environment variables accounted for 38% of the total variance in physical activity scores (a large effect size). Low income was a risk factor that significantly and negatively associated with regular physical activity, while self-efficacy, action and coping planning, and social support were significantly and positively associated with reular physical activity after controlling for other variables. Autonomous motivation, resilience, and hope were significantly associated with regular physical activity at the zero-order correlation level, but not significant in the regression model.

Conclusions: This study provides strong empirical support for the HAPA constructs, which can be used to inform the development of theory-driven and empirically supported physical activity interventions to improve health, stress management, and well-being of people with disabilities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose/objective: There is a significant gap in the literature with regards to the synthesis of qualitative research that explores the parenting experiences of parents with physical disabilities. This systematic review aims to synthesize the evidence regarding the experiences of parents with acquired and congenital physical disabilities.

Research method/design: This article presents a thematic synthesis of qualitative research carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were identified through searches of Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PubMed, Scopus, and Web of Science databases and backward snowballing. The Critical Appraisal Skills Programme qualitative checklist was used as a quality assessment tool.

Results: Eleven articles were included in this review, and all were deemed to be high quality. Seven themes were identified: stigmatization and the need to prove competence as a parent; feeling underrepresented as a parent with a physical disability; environmental limitations; experiences of accessing support; using skills and strategies to fulfill parenting role; children's roles and reactions, and changes as they grow; and safety, wellness, and health when parenting with a physical disability.

Conclusions/implications: The findings emphasize the adaptability and resourcefulness of parents with physical disabilities in navigating environments that can be unsupportive, while continuing to prioritize their children's safety and well-being. The need for community peer-support groups and health care professionals who can provide emotional support, further public education with regards to the capabilities of parents with physical disabilities, prioritization of accessibility in public and private spaces, and the development of adapted childcare equipment, were all highlighted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose/objective: Brain injuries are often "invisible" injuries that can have lifelong consequences including changes in identity, functional independence, relationships, and reduced participation in daily activities. Survivors of brain injury experience stigma and challenges related to the misattribution of symptoms to other causes that are significant barriers to recovery and adjustment. Changes in policy and other large-scale interventions are cited as an underexplored, yet critical path to reducing the impact of brain injury. The present study sought to comprehensively characterize the impact of one such initiative-Brain Injury Identification Cards-among survivors to further refine the resource.

Research method/design: In this cross-sectional qualitative focus group study, we recruited 16 individuals with a history of brain injury via email listservs of individuals who registered for a Brain Injury Identification Card. We used rapid data analysis with a hybrid of deductive and inductive analytic strategies to identify themes within a priori domains.

Results: We extracted themes within four domains: (a) process and reasons for obtaining cards; (b) overall impressions of the cards; (c) uses of the cards; and (d) feedback and proposed changes. Participants described the process of obtaining cards as straightforward and shared wide-ranging benefits across domains, including improving survivors' sense of safety, self-advocacy, and ability to participate in daily activities.

Conclusions/implications: Findings highlight the utility of Brain Injury Identification Cards for improving community understanding of brain injury symptoms and how injury-related challenges may manifest in daily life. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose/objective: People with disabilities often achieve lower educational attainments and face worse employment outcomes compared to the general population, a disparity partially due to the insufficient development of self-advocacy skills in academic and professional environments where targeted interventions are limited. This study designed and evaluated a 6-week self-advocacy program (SAP) enhanced with solution-focused brief therapy techniques for college students with disabilities (SWDs).

Research method/design: A program evaluation on process and outcomes was conducted using a pilot randomized controlled trial with college SWD (n = 28). Process evaluations included feasibility, fidelity, and acceptability, whereas the preliminary impact was determined by comparing the outcome assessments of SAP and the control groups.

Results: Process findings indicated that the SAP was conducted as planned, with facilitators effectively employing solution-focused techniques. The program gained traction among SWD and proved feasible for implementation in college settings. SWD reported satisfaction with their participation and shared SAP's strengths as well as areas for improvement. Results indicated that SAP significantly increased SWDs' confidence in disclosing their disabilities and requesting accommodations in the workplace compared to their peers in the waitlist control group. However, no group differences were observed in self-advocacy and self-determination.

Conclusions/implications: The findings suggest that SAP offers benefits in various aspects of self-advocacy for college SWD, informing future implementations of SAP or similar initiatives targeting this group. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose: The societal response and constraints of the COVID-19 pandemic reinforced ableism for disabled people who were yet again treated as an afterthought in society. Systemic ableism impacted their well-being, access, and ability to be active members of their community. Disabled experiences and voices must be heard and amplified to improve preparedness and address ableism. Disability Twitter is one avenue where the disability community can collectively listen and support one another. These voices can and should be used to influence policy and practice. This study used Disability Twitter to represent and honor the experiences of the disability community, using the COVID-19 pandemic as a moment in time.

Research method/design: Qualitative thematic analysis of U.S.-based Twitter posts was conducted using retrospective social media posts. A total of 238 initial tweets from January 1, 2020 and September 30, 2022 were analyzed by the research team.

Results: Five themes were observed including ableism, devaluation, worthiness, act of reclaiming, and emotion. Disabled people reported instances of ableism, devaluation, and victimization by individuals, systems, and government entities throughout the pandemic. Disabled individuals utilized Twitter to share their collective experiences, urging society to address and respond to the needs of the disability community.

Conclusions: Using social media to center the perspectives of the disability community can invoke system-wide change and inform policies. Implications for combating systemic ableism and promoting allyship for clinical professionals, research scholars, and educators are provided. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Pulmonary rehabilitation (PR) is the gold standard treatment for improving the health status of individuals with chronic respiratory diseases (CRD). However, to achieve lasting results, the adoption and maintenance of a physically active lifestyle are necessary. Unfortunately, the trajectories of change in physical activity (PA) and sedentary behavior (SB) following PR are marked by a high degree of heterogeneity between patients. This study aimed to better understand the factors underlying this variability by investigating the role played by the personality as defined by the five-factor model.

Design: Eighty eight CRD patients were assessed on personality upon PR admission (Time 1). PA and SB were assessed at Time 1 and 6 months post-PR (Time 2) using questionnaires.

Results: Multiple regression analyses revealed that "healthy neuroticism" is associated with an increase in PA 6 months after PR (β = .20, p < .05) independently of the PA at Time 1. A high level of neuroticism, when it is paired with a low level of conscientiousness, is related to an increase in SB 6 months after PR (β = -.20, p < .01), when the SB and exercise tolerance at Time 1 were controlled for.

Conclusion: These findings highlight that investigating the interaction between personality traits is relevant to a better understanding of the interindividual differences in changes in PA and SB after PR in patients with CRD. The behavioral effects of PR could be improved if patients' personality traits were taken into account in the design of behavior-change interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose/objective: Experiences of disability-based discrimination among adults with disabilities (AWD) span individual, interpersonal, and structural domains that are implicated in mental health disparities. Ableist microaggressions, a subtle and contemporary form of disability-based discrimination, are positively associated with psychological distress. Additionally, disability characteristics may impact mental health outcomes differently. This study investigated (a) the association between lifetime experiences of ableist microaggressions and psychological distress and (b) the moderating effect of disability visibility.

Research method/design: A cross-sectional survey-based online study through Amazon's Mechanical Turk was conducted among 995 AWD whose ages ranged from 18 to 70 (M = 34.73, SD = 9.45).

Results: After adjusting for confounds linear regression analyses revealed a significant, positive relationship between ableist microaggressions and depressive, anxiety, and stress symptoms. Models explained approximately 18%-23% of the variance in psychological distress. Moderation analyses indicated that associations were stronger among participants with less visible disabilities.

Conclusions/implications: Findings underscore disability visibility as an important correlate in AWD mental health disparities. Results should be interpreted within the scope of the sampling procedures and sample demographics. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Multiple sclerosis is associated with impairments in working memory functioning. Lifestyle physical activity interventions show promise in improving cognitive functioning; however, the evidence is limited. We examined the efficacy of a lifestyle physical activity intervention, involving step tracking and psychoeducational materials, on improving step counts, working memory functioning, and network strength in a whole-brain network of working memory.

Method: Participants (n = 75) were randomly assigned to a group tracking steps with a pedometer (step-track), or a group tracking water intake with a smart water bottle (water-track), for 6 months. At baseline, mid, and postintervention, we assessed weekly physical activity (GT3X+ accelerometer), weekly water intake (H20 Pal Smart Bottle), and working memory functioning. Additionally, the combined network strength of a validated working memory connectome was calculated.

Results: We ran random intercept linear mixed models to examine differences between the groups, over time. A significant Group × Time interaction effect with steps and water intake indicated that the step-track group increased their steps, and the water-track group increased their water intake, in comparison to each other, from baseline to postintervention (p < .05). Both groups improved in behavioral working memory over time (p < .05). No significant differences were found on the network strength.

Conclusion: Our 6-month randomized controlled trial involving physical activity tracking showed increased step count in the intervention group. Behavioral working memory improved in both groups, potentially due to practice effects. Future studies should include both active and passive control groups to discern practice effects from intervention impact. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose/objective: Individuals with a spinal cord injury (SCI) may experience posttraumatic stress disorder (PTSD) at a higher rate, which is associated with worse psychiatric comorbidity, decreased quality of life, and greater disability. Yet, effective PTSD interventions remain understudied for individuals with SCI. We conducted the first randomized controlled trial (RCT) of an evidence-based psychotherapy (prolonged exposure [PE]) with survivors of SCI during acute rehabilitation. We examined the efficacy, feasibility, and secondary outcomes.

Research method/design: Participants (n = 29) were adults recruited from 2018 to 2021 1-month postinjury with PTSD randomized into either PE therapy or treatment as usual. The primary outcome was PTSD assessed at baseline, 6, 10, and 32 weeks postenrollment.

Results: An overall group-by-time interaction was not statistically significant (p = .102), but effect sizes demonstrated moderate and large improvements in PTSD for the PE group at 6 (-19.4 vs. -9.7) and 10 (-25.8 vs. -5.7), respectively. Similarly, moderate to large effect sizes were observed for depression, maladaptive posttraumatic cognitions, disruptive nocturnal behaviors, SCI-related quality of life, and risky alcohol consumption. Low rates of enrollment (50%) and treatment completion (25%) suggest feasibility challenges; however, treatment completers did report high satisfaction (100%).

Conclusions/implications: Results suggest that individuals who received PE had a quicker and clinically meaningful reduction in PTSD symptoms, but delivery during acute rehabilitation is not feasible for many individuals. Future research should examine abbreviated versions of PE for PTSD to enhance the feasibility of treatment in this setting. (PsycInfo Database Record (c) 2024 APA, all rights reserved).