Rehabilitation Psychology最新文献

Objective: During the COVID-19 pandemic, anxiety in people with multiple sclerosis (PwMS) may have increased; however, little is known about the various factors which influenced this. We aimed to (a) identify the psychosocial modifiable associates of anxiety in PwMS in Ireland and the United Kingdom and (b) explore experiences of anxiety during the pandemic.

Method: A cross-sectional survey was developed using public and patient involvement in 2021. This included measures of anxiety (Hospital Anxiety and Depression Scale [HADS-A]), social support (Multidimensional Scale of Perceived Social Support [MSPSS]), multiple sclerosis control self-efficacy (Multiple Sclerosis Self-Efficacy scale [MSSE]), exercise habits (Godin Leisure-Time Exercise Questionnaire [GLTEQ]), MS acceptance (Acceptance of Chronic Health Conditions scale [ACHC]), and intolerance of uncertainty (Intolerance of Uncertainty Scale-12 [IUS-12]), with open-ended questions asking about experiences of anxiety during COVID-19. A hierarchical regression analysis investigated the extent to which anxiety could be predicted by psychosocial modifiable factors after controlling for sociodemographic factors and multiple sclerosis (MS) type, while reflective thematic analysis was used to analyze open-ended responses.

Results: 287 PwMS completed the survey, with 58% reporting that their anxiety had increased during the pandemic. In order of magnitude, self-efficacy (β = -.41), intolerance of uncertainty (β = .35), social support (β = -.21), and exercise habits (β = .19) significantly predicted variance in HADS-A scores (p < .01). Themes describing sources of anxiety included personal health concerns, social concerns, and responsibilities/additional external burdens. In contrast, some PwMS reported that anxiety had decreased during COVID-19.

Conclusions: While the generality of findings may be limited due to a predominately female sample of PwMS living in the United Kingdom and Ireland, results have the potential to inform the development of targeted interventions in rehabilitation psychology to reduce anxiety in this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose/objective: We lack critical information regarding promoting resilience in people with spinal cord injury (SCI). Living according to one's values may increase resilience. The aims of this study were to: (a) determine whether the degree to which individuals with SCI are living according to their values is associated with resilience; (b) identify values endorsed as most important; and (c) examine whether the importance of these values differs significantly by high vs. low resilience.

Research design: Individuals with SCI (N = 202, M_age = 47.32) completed an online survey. Two linear regression analyses were performed to evaluate the extent to which domains of valued living (measured using the Valuing Questionnaire [VQ] and its subdomains, progress and obstruction, and the Valued Living Questionnaire [VLQ]) were associated with resilience. To explore whether resilience was associated with ratings of the perceived importance of specific types of values, we identified the top 10 most important values endorsed in the sample and performed independent sample t tests to analyze whether high (top quartile) versus low (bottom quartile) resilience groups differed on their importance ratings of specific types of values.

Results: Successful pursuit of values (VQ-progress) positively predicted resilience (B = 0.67, p < .001) while barriers in pursuit of values (VQ-obstruction) negatively predicted resilience (B = -0.16, p < .05). The VLQ score (living according to particular values) positively predicted resilience (B = 0.18, p < .001). Participants with high resilience levels rated the following values as significantly more important relative to those low in resilience: caring, respect, compassion, gratitude, responsibility, and contribution.

Conclusions: Individuals with SCI who are able to pursue their values with intention had higher levels of resilience. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objectives: Neurocognitive deficits in schizophrenia have a major impact on functioning; however, they remain poorly targeted by available treatment offerings. Cognitive remediation (CR) is effective in improving neurocognition and functioning. Despite clinical guidelines for schizophrenia recommending CR, it is still not readily available in clinical services and sizeable attrition rates are reported in clinical trials.

Method: To elucidate the barriers and facilitators of CR access and engagement, we conducted a mixed methods qualitative-dominant study with 12 clinicians in Australia, in 2021, with 1 hr interviews and additional rating scales completed.

Results: Thematic analysis highlighted four themes (cognitive symptoms, CR intervention, motivation and engagement in CR, and CR implementation), and 14 subthemes. Clinicians emphasized the broad impact of cognitive deficits and outlined pros and cons of different CR approaches. Several factors were suggested as impacting engagement, including motivation assessments/techniques, neurocognitive insight, illness, and demographic factors. Lack of routine implementation in Australia was unanimously espoused and partly explained by a need for cost-effectiveness analyses, remote and flexible delivery, and increasing service resource provision and staff training in CR.

Conclusions: This study offers key insights into CR access, while recommending methods for optimizing CR implementation and dissemination to improve recovery outcomes of people diagnosed with schizophrenia. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose/objective: In schizophrenia, insight, the recognition that one has a medical illness that requires treatment, has long been related to deteriorated quality of life. Yet, insight and quality of life are broad constructs that encompass several dimensions. Here, we investigated differential associations between insight and quality-of-life dimensions using a psychological network approach.

Research method/design: We extracted data from the French network of rehabilitation centers REHABase (January 2016 to December 2022, N = 1,056). Our psychological network analysis modeled insight and quality of life as a network of interacting dimensions: three insight dimensions (awareness of illness, reattribution of symptoms to the disease, and recognition of treatment need) and eight quality-of-life dimensions (autonomy, physical and psychosocial well-being, relationships with family, friends and romantic partners, resilience, and self-esteem).

Results: Insight was negatively associated with quality of life. Our psychological network analysis revealed a strong negative association between awareness of disease and self-esteem. Both dimensions were the strongest nodes in the overall network. Our network analysis also revealed a significant but positive connection between recognition of treatment needs and resilience.

Conclusion/implications: While insight and quality of life are overall negatively associated, we found both negative and positive connections between insight and quality-of-life dimensions. The negative relationship between insight and quality of life may reflect the deleterious effects of diagnostic labeling on a patient's self-esteem. Yet, acknowledgment of treatment needs may have positive effects on quality of life and may promote recovery, perhaps because it emphasizes the need for support rather than labels and abnormalities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: To identify the prevalence of suicidal ideation (SI) and its correlates among an aging cohort of people with spinal cord injury (SCI) with an average of more than three decades of having lived with SCI.

Research method: The study was a cross-sectional analysis of self-report assessment data. These data were collected from 2018 to 2019 during the most recent data collection period of the 45-year SCI Longitudinal Aging Study. Participants (n = 553) were identified from specialty and university hospitals in the southeastern and midwestern United States. The participants averaged 31 years since SCI onset, with an average age of 58 years. Participants were predominantly non-Hispanic, White (79%), male (70.1%), and had a cervical level SCI (51%). Approximately 23% of participants were ambulatory. SI was assessed using a nonzero response to the ninth item on the Patient Health Questionnaire-9.

Results: Over 14% of the sample endorsed experiencing recent SI. Bivariate analyses indicated that those with SI had greater pain severity, pain interference, depressive symptom severity, and frequency of anxiety. Having a cervical injury level, lower self-reported general health, instrumental social support, emotional social support, and fewer days spent outside the home were also associated with SI. Logistic regression analysis indicated that when all biopsychosocial variables were considered simultaneously, having a cervical-level injury and greater depressive symptom severity remained significantly associated with SI.

Conclusion: The results of this study highlight the importance of continued assessment of depressive symptoms and SI as individuals age with SCI. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose/objective: Lack of patient participation and engagement remains a barrier to implementing effective online self-management and behavioral health interventions. Identifying patient characteristics associated with engagement rates may lead to interventions that improve engagement in traditional and online self-management programs. In this study, two online self-management and recovery programs were evaluated to identify factors that predict patient engagement.

Research method/design: Predictors were collected in a questionnaire at baseline before 435 participants started either of the two interventions. One or two online lessons were completed per week with seven or eight total lessons to complete in each program, and each lesson took about 20-30 min to finish. Full patient engagement was defined as completing all lessons and assessments in the program and partial engagement as attempting at least one lesson or assessment.

Results: Predictors of full patient engagement were self-rated confidence in completing the program or being over 60 years of age. Predictors of at least partial patient engagement were experienced ordering online or being over 50 years of age.

Conclusions/implications: Identifying profiles of individuals who predict poor engagement may improve implementation and the health outcomes of intervention programs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).