Rehabilitation Psychology最新文献

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).

Purpose/objective: People often view individuals with disabilities as incapable of working, contributing to society, and forming relationships. Therefore, it is important to develop interventions to reduce those negative stereotypes. Increasing accurate disability representation is one way to counteract those stereotypes. The present study's aim was to examine the impact of disability representation on disability stigma.

Research method/design: Participants consisted of 246 people from the U.S. general population who were randomized into one of three vignette groups: counterstereotypical representation (read about individuals with disabilities who were thriving), stereotypical representation (read about individuals with disabilities who were struggling), and a control group (read about able-bodied individuals who were thriving). Visual analog scales assessing disability stigma were completed pre- and postexposure to the vignettes.

Results: Disability stigma significantly decreased in the counterstereotypical group, significantly increased in the stereotypical group, and did not change in the control group from pre- to postexposure. At postexposure, the counterstereotypical group had significantly lower disability stigma than the stereotypical group, and the stereotypical group had significantly higher disability stigma than the control group.

Conclusion/implications: It would be valuable for the media to increase counterstereotypical representations and decrease stereotypical representations of individuals with disabilities. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: To evaluate an online intervention to support family members of individuals who sustained a traumatic brain injury (TBI).

Research design: Randomized control trial. Parallel assignment to TBI Family Support (TBIFS) intervention or enhanced usual care control (TAU). Three testing timepoints: pretest baseline (T1), posttest within 2 weeks of assignment (T2), and follow-up 1 month after posttest (T3).

Setting: Online.

Participants: Sixty-eight caregivers recruited nationally: 18 years of age or older, English speaking, providing primary caregiving to an adult family member with TBI and mild to moderate disability.

Intervention: Eight interactive modules providing information about cognitive, behavioral, and social consequences of TBI, training in problem-solving framework, and application exercises (N = 35). TAU was an informational website (N = 33).

Measures: Proximal outcomes-program use, usability, and user satisfaction for TBIFS participants. Primary outcomes-TBI content knowledge, strategy application objective response and open-ended response, and strategy-application confidence. Secondary outcomes-appraisals of burden, satisfaction, uncertainty in mastery, guilt, and negative environment.

Results: Proximal outcomes-about 80% of TBIFS participants completed the posttest assessment, and 91% reported moderate to high usability and user satisfaction. Primary outcomes-greater posttest gains in TBI content knowledge for TBIFS than TAU (t = 3.53, p = .0005, adjusted p = .0090, d = 0.91). Gains maintained through follow-up (t = 2.89, p = .0038, adjusted p = .0342, d = 0.90). No other effects for the primary or secondary outcomes.

Conclusion: TBIFS improved TBI content knowledge relative to TAU. Modifications might be needed to improve application and distal outcomes for caregivers. (PsycInfo Database Record (c) 2025 APA, all rights reserved).