Rehabilitation Psychology最新文献

Purpose/objectives: The fear-avoidance model is a well-established framework for understanding the transition from acute to chronic pain. However, its applicability to concussions is not yet well understood. Here, we conduct the first mixed methods analysis of the fear-avoidance model in young adults with a recent concussion and co-occurring anxiety and assess the model's alignment with their lived experience.

Research method/design: We conducted a mixed methods analysis using a cross-sectional parallel design. Seventeen participants completed questionnaires corresponding with the elements in the fear-avoidance model (e.g., pain catastrophizing, avoidance, disability, anxiety, depression, etc.) and participated in semistructured interviews probing their experiences following their concussion between March 2021 and February 2022. We calculated bivariate correlations for quantitative data and analyzed the qualitative data using hybrid inductive-deductive thematic analysis.

Results: Quantitative results demonstrated strong and medium-sized correlations among theorized relationships within the fear-avoidance model (rs = .40-.85) with the majority being statistically significant. Qualitative results provided substantial convergent and complementary support (e.g., bi-directionality of some relationships, associations between nonadjacent model components, centrality of anxiety in symptom persistence) for the application of the fear-avoidance model to concussions. Findings highlighted additional factors (social factors and post-injury endurance patterns) relevant to this population.

Conclusion/implications: The fear-avoidance model is a useful lens for understanding the lived experience of young adults with a recent concussion and co-occurring anxiety. Psychosocial treatment for this population would benefit from focusing on the interplay of concussion symptoms, anxiety, depression, disability, and pain-related fear, offering adaptive confrontation strategies, and addressing the interpersonal impact of concussion. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose/objective: Individuals with spinal cord injuries and disorders (SCI/D) are at increased risk for experiencing loneliness and social isolation. The aim is to describe facilitators identified by individuals living with SCI/D to alleviate loneliness and perceived social isolation.

Research method/design: Descriptive qualitative design using in-depth interviews with veterans with SCI/D (n = 23). Descriptive statistics was used to calculate demographic and injury characteristics. Audio-recorded and transcribed verbatim transcripts were coded and analyzed using Braun and Clarke's (2006) six thematic analysis phases.

Results: Participants were male (70%), white (78%), and not currently married (35%), with an average age of 66 years (42-88). Participants had paraplegia (61%), with traumatic etiology (65%) and were injured 14 years (1-45) on average. Eight themes were identified by participants living with SCI/D that described facilitators to alleviate loneliness and perceived social isolation. (a) Engage in/pursue interests; (b) Interact with/spend time with others; (c) Embrace acceptance; (d) Take part in reciprocity; (e) Find a purpose/accomplish goals; (f) Get out of residence, get outside; (g) Connect with SCI/D community/SCI/D peers; and (h) Seek help from (mental) healthcare professionals.

Conclusions/implications: Individuals with SCI/D identified facilitators to alleviate loneliness that encompasses changes in ways of thinking, actions to expand participation in life, and efforts focused on involving others. Findings can be used to guide healthcare delivery and develop interventions to target feelings of loneliness and social isolation in persons with SCI/D, which may be particularly impactful if they involve reciprocal interactions with peers with SCI/D. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose: Unmanaged mental health problems following a stroke can be detrimental to recovery. We aimed to explore the lived experience of (a) poststroke mental health difficulties, (b) help-seeking for mental health, including factors that influenced treatment access and utilization, and (c) receiving treatment and support.

Research method: Individual semistructured interviews were conducted in 2022 with 13 participants (62% female, age at stroke 35-76 years) who had experienced mental health difficulties following their stroke. Data were analyzed using reflexive thematic analysis with a critical realist approach.

Results: Six themes were identified. Mental health challenges poststroke were diverse in nature. Attitudes and previous experiences relating to mental health influenced the inclination to seek help. Participants valued an individualized approach to the provision and timing of psychoeducation. Accessibility of services was impacted by financial and transportation barriers, as well as availability of services and appropriately trained clinicians. Participation in support groups was a positive experience for most participants. Lived experience of mental health treatment ranged from positive to negative, and participants conveyed helpful and unhelpful aspects.

Conclusions: Findings highlight the importance of early screening and psychoeducation provision for poststroke mental health difficulties, alongside accessible community-based mental health support services throughout the stroke recovery journey. Having varied options for mental health support and treatment may aid stroke survivors in finding an approach that personally works for them. Additionally, it may be helpful to train clinicians to tailor mental health treatment to accommodate stroke-related impairments (e.g., cognitive, sensorimotor). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: To describe the training process for teen online problem solving (TOPS) for acquired brain injury (ABI) in adolescence. We evaluated feedback from training participants and therapists delivering the intervention to assess facilitators and barriers to adoption into clinical practice.

Method: Therapist trainings took place between February 2020 and December 2021 and were primarily virtual due to the COVID-19 pandemic. We surveyed 190 trainees and 27 active therapists regarding their experiences with the training process and with delivering the intervention to families, respectively. Descriptive statistics were reported for Likert scale items. Open-ended survey responses were summarized using inductive thematic analysis by two independent coders, and themes were compared by profession.

Results: The majority of trainees reported that they felt comfortable or very confident using the TOPS intervention with patients following the training. Trainees reported that they benefited from clinician-centered and applied training components. Active therapists identified facilitators to TOPS implementation including the family-based therapeutic approach, virtual format, and the broad generalizability of the problem-solving framework. Barriers to implementation included low family engagement, comorbid mental health or language difficulties, and external family stressors.

Conclusions: The implementation process for TOPS highlights the importance of and challenges to the dissemination of psychosocial interventions. As pediatric ABI remains an underserved population within behavioral health, future implementation work should address barriers in integrating evidence-based therapies within clinical practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose/objective: Mobility aids are important to disabled people as a functional tool that can enhance their participation in leisure activities and work; however, mobility aids may also have implications for how disabled people are viewed by others. Using theories from social psychology, this study aimed to understand how mobility aids contribute to the perception of mobility aid users.

Research method: A total of 259 participants without disabilities, who were primarily young, Caucasian, female-identifying university students, completed the questionnaires. The primary questionnaires of interest included the Multidimensional Attitudes Scale Toward Persons with Disabilities and the Stereotype Content Model. Every participant completed three conditions of the questionnaires to examine their attitudes and stereotypes associated with three mobility aid conditions: a wheelchair, a cane, and a control condition without a specified mobility aid.

Results: Affective attitudes toward the unspecified mobility aid condition and the manual wheelchair condition were more negative than the cane condition. Perceived warmth was higher for the manual wheelchair condition compared to the unspecified mobility aid condition and perceived competence was higher for the cane and manual wheelchair conditions compared to the unspecified mobility aid condition.

Conclusion: This study explored how young women without disabilities, and potentially nondisabled people more generally, may hold a range of attitudes and stereotypes about the use of mobility aids by disabled people. These findings have implications for the design of effective attitudinal change programs and for rehabilitation professionals who work with individuals as they adopt mobility aids following the onset of disability. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose: The coronavirus disease 2019 pandemic and postpandemic era have significantly impacted the physical, mental, and social health (global health) of people with multiple sclerosis (MS). Extensive evidence highlights the positive relationships among global health, employment, and subjective well-being. For rehabilitation psychologists and health professionals serving individuals with MS, it is crucial to incorporate a global health measure into their assessment toolkit. The Patient-Reported Outcomes Measurement Information System Global Health (PROMIS^©GH) Scale is widely used and validated for diverse patient populations worldwide. However, there is no study that validates the PROMIS^©GH for people with MS.

Research method: We conducted an exploratory factor analysis with a sample of U.S. adults with MS (N = 495) to examine the measurement structure of the PROMIS^©GH.

Results: Exploratory factor analysis results indicated a two-factor measurement structure (physical health and mental-social health) that accounted for 67.80% of the total variance. All items loaded highly onto their respective factors (ranging from 0.59 to 0.93). The Cronbach's α of the two subscales was .85 and .86, which is high for very brief measures. The two factors were significantly and positively associated with employment, subjective well-being, resilience, core self-evaluations, and social support, and negatively associated with stress and depression in the theoretically expected directions, supporting its construct validity.

Conclusions: The findings of this study indicated that PROMIS^©GH is a psychometrically sound global health measure for people with MS and should be included as a health assessment tool for rehabilitation psychologists and health professionals who provide services to people with MS. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose/objective: To examine, among survivors of stroke: (a) the prevalence of and most frequently reported unmet needs; and (b) the sociodemographic and clinical factors associated with higher counts of unmet needs.

Research method/design: A cross-sectional study was undertaken with survivors of stroke recently discharged from eight hospitals in Australia, with institutional board approval. Survivors were mailed one survey for completion after their discharge from hospital. Unmet needs were measured by the Longer-Term Unmet Needs After Stroke (LUNS) tool. The number and percentage of participants who reported unmet needs were calculated. The association of sociodemographic factors, type of stroke, and thrombolysis treatment to total LUNS scores was examined using mixed ordinal logistic regression.

Results: A total of 402 survivors (35% of those approached) between April 2018 to December 2019 returned a completed survey. 83% reported at least one unmet need. The most frequently reported unmet need was needing more information about their stroke (n = 239, 61%). Those who identified as Aboriginal and/or Torres Strait Islander had approximately 5.6-fold higher odds (OR = 5.59, p = .025) of having more longer-term unmet needs compared to those who did not identify as Aboriginal and/or Torres Strait Islander.

Conclusions/implications: Unmet needs are common in recently discharged survivors of stroke. These findings may be used to inform strategies that support recovery. Providing more information may help reduce unmet needs among survivors of stroke. Enhanced hospital discharge planning and enhanced community services for survivors may help better prepare them and their caregivers for the return home. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose/objective: Many qualitative studies have focused on sex and spinal cord injury (SCI), often taking a deficit lens to interpretation and reporting. However, it is important to understand what can facilitate positive sexuality for people with SCI; therefore this study examines facilitators of sexuality for people with SCI.

Research method/design: A systematic review and metasynthesis of 38 qualitative papers (published before February 2024) on sexuality for people with SCI was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Thematic synthesis was conducted in three stages: line-by-line coding; the identification of common descriptive themes across papers; and the generation of novel analytical themes.

Results: Thirty-eight eligible papers were analyzed. Thematic synthesis resulted in four common descriptive themes that were linked to positive sexuality: (a) being sexually active; (b) trying new and other ways of sexual expression; (c) having a positive relationship with a partner; and (d) peer support. These descriptive themes were interrelated and incorporated in two in-depth analytical themes: (a) redefining sexuality and (b) establishing a sexual identity.

Conclusions/implications: This study highlights facilitators to sexuality post-SCI. In order to maintain a sex-positive approach to sexuality rehabilitation for people with SCI, sexuality facilitators should remain at the forefront of sexual rehabilitation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose: Peer support has been identified as an important aspect of rehabilitation for visually impaired adults. However, there is a limited exploration in rehabilitation studies literature of the identity-related impact of these interventions, both at an individual and collective level. Through attending to the discourses on blindness, well-being, and social inclusion that circulate in organization cultures, this article considers the role that peer support plays in forming "blind communities" with particular characteristics, and what these communities might model about life with blindness, both to newly blind persons and to society.

Research method: Foucauldian discourse analysis was conducted on semi-structured interviews with 18 visual impairment rehabilitation service users and eight rehabilitation practitioners at four organizations providing services in the Western Cape, South Africa.

Results: Formal peer support is lacking in the sampled organizations, suggesting that relational aspects are not a priority in rehabilitation practice. The formal and informal peer support that does exist in these services is shadowed by largely negative sociocultural beliefs about blindness. Participants described a culture of comparison, othering, and surveillance within which, the article suggests, they are unable to explore and embrace authentic and positive blind identities. This has implications for both individual and collective empowerment.

Conclusions: Greater attention must be paid to both rehabilitation practitioner training and the design and implementation of rehabilitation services to the identity-level impact of rehabilitation. This is essential to develop services that promote individual and collective empowerment and that respond to the multilayered practical, social, and psychoemotional needs of blind adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).