Rehabilitation Psychology最新文献

Purpose/objective: To report on a randomized controlled trial of Zest, a highly innovative psychological health promotion group intervention designed specifically for women with spinal cord injury (SCI), a population at risk for adverse psychological health.

Research method/design: A national sample of 175 women with SCI were randomized to either the Zest intervention or a control group that received intervention materials at the end of the study. The Zest group participated in a psychological health promotion intervention that met weekly for 10 weeks in the free, online, three-dimensional virtual world of Second Life. The novel use of this technology afforded delivery to participants with SCI without requiring them to leave their homes. Both groups completed online surveys at baseline, at program end, and at 6 months assessing the primary outcomes (depression, self-esteem, and life satisfaction) and the proposed mediators (self-efficacy, connectedness, and perceived stress).

Results: Zest was well received by participants. We found significant group differences supporting the efficacy of the intervention on the primary outcomes of depression, self-esteem, and life satisfaction. Analyses also supported self-efficacy and perceived stress as important mediators of the impact of the intervention on the primary outcomes.

Conclusion/implications: Zest, a group program offered on a virtual world platform, offers promise as an intervention for enhancing the psychological health of women with SCI. More attention should be devoted to the psychosocial health needs of people with SCI by developing and implementing affordable, accessible, and widely available programming. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Disability acceptance is an evolving process influenced by personal and contextual predictors, with gender potentially playing a role. This study aimed to examine gender differences in the trajectory of disability acceptance and its predictors among individuals with disabilities in the Republic of Korea (hereafter, Korea).

Research method/design: We analyzed 4-year longitudinal data (2016-2019) from the Panel Survey of Employment for Persons With Disabilities using multigroup latent growth modeling. The sample consisted of 1,007 men and 1,040 women with disabilities.

Results: The research model of disability acceptance demonstrated a good fit, influenced by personal and contextual factors. No significant gender differences were found in intercepts (F = 0.05, p = .83) and slopes of disability acceptance (F = 0.15, p = .70). Multigroup latent growth modeling results indicated that perceived socioeconomic status, disability-related stress, self-efficacy, self-esteem, and satisfaction with friend relationships significantly predicted disability acceptance over most years, with no gender differences in these predictors.

Conclusion/implications: Gender did not predict longitudinal changes in disability acceptance. However, modifiable factors, such as perceived socioeconomic status, disability-related stress, self-efficacy, self-esteem, and satisfaction with friend relationships, were associated with disability acceptance. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose: Individuals living with amputations following intensive functional rehabilitation (IFR) represent an under-researched group in Quebec. This pilot study aimed to examine the health experiences of adults living with an amputation in Quebec by exploring their personal narratives. Design/Research Method: A qualitative descriptive design was adopted aiming to capture and convey the lived experiences of people with lower limb amputations or upper limb amputations who, at any point of their lives, followed IFR. Individual qualitative interviews with 10 adult amputees were conducted between 2018 and 2019.

Results: Thematic analysis revealed seven key themes: (a) overcoming public scrutiny; (b) intrapersonal challenges; (c) stakeholders as sources of motivation; (d) the role of play; (e) recognizing normality in situations of disability; (f) acceptance and personal development; and (g) shortcomings in IFR services.

Conclusion: This research stresses the impact IFR and long-term follow-up can pose on physical and psychosocial development and on going back to a normalized lifestyle. As such, fostering stakeholders for motivational support, strengthening work and sports activities focused on challenging and playful activities to improve limb-loss-affected skills, and providing sustained rehabilitation support, appear to facilitate recovery, postamputation development, and psychosocial adaptation. Improved access to information on postrehabilitation aids, including financial rights and prosthetics, appears important. Although the study sample was restricted in terms of representation, the findings may support the consideration of diverse patient perspectives and distinct types of amputations to better understand the impact of IFR and follow-up throughout the lifespan. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: This study investigated the development of posttraumatic growth (PTG) in relatively young persons with stroke. It examined the contribution of potential predictive variables and their changes over time.

Research method/design: Participants completed questionnaires at baseline (n = 78, median time since injury = 47 days) and 3 (n = 53) and 6 months (n = 47) later. Each assessment included the Posttraumatic Growth Inventory, the COPE Inventory, and the Centrality of Event Scale. Data were analyzed using a sequence of linear mixed effect models.

Results: PTG was evident at baseline, but did not significantly increase over time. Higher event centrality, approach-oriented coping, and lower coping flexibility at baseline were associated with higher PTG 6 months later. Higher coping flexibility at baseline and an increase in event centrality were associated with a more positive trend in PTG over time. The final model explained 67% of variance in PTG. Time since injury, age, gender, social support seeking, and avoidance coping did not contribute significantly.

Conclusion/implications: Individual changes in the predictors contributed to high and stable PTG. How central the stroke was perceived to one's identity was the most important predictor for the absolute level of PTG as well as its change over time. This illustrates the complex and dynamic development of PTG. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Disability stigma has been linked with adverse chronic and acute health outcomes in people with disabilities. The present study updated the widely used Attitudes Toward Disabled Persons measure (to the revised Attitudes Toward People With Disabilities [ATPD] scale) among health care professionals and validated the measure using a disability stigma framework.

Design: A survey with 272 health care professionals and students was conducted.

Results: Regression analyses revealed that men, compared to women and nonbinary people, scored higher on disability stigma. Quality of contact, but not quantity of contact nor disability status was associated with less stigmatized attitudes. Those who scored higher on agreeableness, openness, and conscientiousness also scored lower on stigmatizing attitudes about people with disabilities. Furthermore, psychological inflexibility, social dominance orientation, and authoritarianism were all positive predictors of stigmatizing attitudes about people with disabilities. Finally, we found that medical model endorsement, but not social model endorsement positively predicted stigmatizing attitudes as measured by the revised ATPD scale.

Conclusion: Our findings validate the revised ATPD scale and illuminate disability stigma as expressed by a diverse sample of health care professionals. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Moderate-to-severe traumatic brain injury (TBI) often results in cognitive deficits that hinder the ability to drive an automobile, which in turn hinders independence and quality of life. Determinants affecting the relationship between impaired cognition and return to driving have been understudied. The current study examined the relationship between cognition and driving status following moderate-to-severe TBI.

Research method/design: Participants were 585 adults aged 19-96 (70% male) who sustained a moderate-to-severe TBI and were enrolled in the TBI Model System. Cross-sectional data were obtained (2018-2019) 1-30 years post injury (M = 8.2 years). Relationships were examined between driving status (active drivers vs. nondrivers), cognitive function (verbal memory, executive function), and covariates (demographics; injury factors including motor function; social factors).

Results: About 70% were driving at interview. Higher memory (OR = 1.36, p < 0.05) and executive function (OR = 1.38, p < .001) scores predicted active driving status; however, the relationships were not significant when the covariates were included. Family income, motor function, and history of seizure were related to driving status (all p < .05). Income and motor function were related to memory and executive function (all p < .001), whereas seizure history was not.

Conclusion/implications: Memory and executive function are significantly associated with driving status following TBI, but these relationships dissipate after accounting for sociodemographic/injury factors, particularly family income and motor function. Further research is needed to understand the interplay of cognition with other factors in return to driving decisions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Posttraumatic growth (PTG) refers to positive changes that individuals experience in the wake of a stressful or traumatic event. Though growth and adaptation are considered ideal outcomes of rehabilitation, the extent to which PTG captures the unique experience of individuals with traumatic brain injury (TBI) has not been empirically evaluated. The purpose of the current study was to establish construct validity of PTG for individuals following moderate-severe TBI.

Research method: Forty participants who received inpatient or outpatient rehabilitation services for moderate-severe TBI and who were > 1 year postinjury completed a one-time phone interview of mental health and quality of life assessments, and answered a free-response question about significant life changes after injury. Using convergent parallel design, scores on the Posttraumatic Growth Inventory (PTGI) were compared to other assessments and themes of PTG and posttraumatic depreciation derived through thematic analysis.

Results: PTGI total scores (M = 66.60, SD = 21.79) were similar to other brain injury populations respective to time since injury (M = 11.20 years). Qualitatively derived themes of PTG aligned with domains of the PTGI, and endorsement of PTG was significantly associated with greater mental health and social support.

Discussion: This study provides evidence of the existence of PTG and posttraumatic depreciation in a sample of individuals with moderate-severe TBI, supporting its construct validity using mixed-methods data. Our findings may be helpful in identifying what significant changes may indicate significant growth and depreciation during the rehabilitation process, and be critical mechanisms for optimal psychosocial adjustment following brain injury. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objectives: This study aimed to identify important mental health topics for people with spinal cord injuries (PwSCI) and garner insights from health care clinicians working with this population. In doing so, we identified psychosocial adaptations in the context of sexuality, intimacy, and reproductive health.

Method: A qualitative, phenomenological approach was used, with 60-90-min virtual focus groups involving PwSCI, rehabilitation clinicians, and psychologists. Themes were identified through deductive and inductive transcript analysis. Eligibility for PwSCI included: (a) SCI for ≥ 1 year, (b) 18+ years, (c) U.S. residency, (d) conversational English skills, and (e) cognitive capacity to provide informed consent. Clinicians required ≥ 5 years of rehabilitation experience.

Results: Sixteen PwSCI, eight rehabilitation clinicians, and four psychologists participated. Three major themes emerged: (1) The effects of SCI on relationships with noninjured significant others with subthemes of (a) internalized and partnered ableism in intimate relationships and (b) navigating care partner dynamics and resource gaps; (2) sexual self-esteem with subthemes of (a) gender role adaptation and (b) body image concerns; and (3) challenges in sexual and reproductive health with subthemes of (a) family planning and self-advocacy in health care settings, (b) access to specialized care, and (c) health care provider competence.

Conclusions: This report illuminates the complex effects of SCI on their relationships with noninjured partners, revealing how internalized and partnered ableism can heighten feelings of inadequacy and alter relationship dynamics. These findings underscore the need for more research, support, and services in sexual and reproductive health for all PwSCI. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Disability has traditionally been viewed as a deficit in psychology research; however, accruing work suggests that viewing disability as an identity may be protective for mental health and well-being among disabled individuals. Therefore, developing disability identity measures that comprehensively capture this view of disability as an identity is an important step for promoting disabled individuals' flourishing.

Research method/design: To address this, we conducted two studies aimed at developing and validating a new scale to measure physical disability identity among adults with physical disability. In Study 1 (N = 104), we solicited feedback on our new scale from adults with physical disabilities and revised our scale to ensure that it captured their lived experiences. In Study 2 (N = 296), we tested the factor structure of the new Physical Disability Identity Scale. All data were collected in 2023.

Results: Most participants reported that our scale was easy to comprehend and comprehensively captured their lived experiences. We found evidence for a six-factor structure of the new Physical Disability Identity Scale, which assessed the following dimensions: Connection, Satisfaction, Centrality, Openness, Individual Self-Stereotyping, and Disability Lens. In addition, results suggested that Connection, Satisfaction, and Openness were adaptively related to well-being and health, whereas Centrality, Individual Self-Stereotyping, and Disability Lens were mostly adversely related to well-being and health.

Conclusion/implications: This research suggests that our Physical Disability Identity Scale is valid among adults with physical disabilities and that physical disability identity dimensions may be valuable to consider in future work on well-being and health among individuals with physical disabilities. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Self-awareness (SA) is a crucial component of the neurorehabilitation processes for persons with acquired brain injury. Specific intervention programs to improve SA have been developed and implemented with heterogeneous results. The current study was undertaken to summarize this evidence by conducting a systematic review of relevant literature and to perform a meta-analysis of the most reliable and important results.

Method: A systematic literature search made in May 2023 across three databases (Web of Science, PubMed, and PsycINFO) resulted in a final selection of 16 primary studies based on 17 different groups.

Results: In an initial meta-analysis, the effect sizes were calculated as the standardized d, that is, pre-post change scores corrected for bias. Using a random-effects model, we obtained a significant mean effect size for the interventions, k = 17, g = 0.6404 [0.411, 0.870] with significant heterogeneity among the studies, Q(16) = 43.06, p < .001, and a significant, but modest publication bias. Moderator analysis showed that the SA intervention efficacy could be improved by "metacognition" as an intervention technique. A second meta-analysis was carried out considering the seven studies with between-subjects designs, and again a significant mean effect size was obtained, k = 7, g = 0.6713 [0.403, 0.94].

Conclusion: Overall, the present study provided positive evidence to support the efficacy of specific SA interventions in adults with acquired brain injury. Further studies are warranted to explore the mechanisms by which SA interventions exert their effects. (PsycInfo Database Record (c) 2025 APA, all rights reserved).