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).

Objective: To characterize how mentorship has been perceived, received, and practiced by individuals in the field of rehabilitation psychology across the career lifespan.

Method: Current members of the American Psychological Association Division 22 (Rehabilitation Psychology) were invited to complete an electronic survey via REDCap assessing individual experiences and perspectives on mentorship. Thematic analysis was used to identify key constructs and themes.

Results: 39 participants (n = 25 mentors) completed the survey with valid responses. Participants spanned the career lifespan, ranging from predoctoral trainees to late-senior psychologists. Mentorship was generally perceived as helpful for both mentors and mentees. Several important qualities of mentors (e.g., availability, communication skills, self-disclosure, and emotional support) and mentees (e.g., flexibility, motivation, and openness to feedback) were identified. Among both groups, mentorship was viewed as especially beneficial for obtaining American Board of Professional Psychology (ABPP) board certification, which may reflect an aspect of mentoring unique to Division 22. Existing gaps in mentorship and key areas for improvement were also identified; access to mid- to late-career mentorship emerged as a notable gap in mentorship. Increased program structure, networking opportunities, and research mentorship were also identified as possible areas of growth.

Conclusions: This study provides meaningful insights into mentorship within the field of rehabilitation psychology. Our findings demonstrate the value of mentorship across the career lifespan, and the beneficial role of mentorship in obtaining ABPP board certification. In addition, we identify key areas of growth that can inform and improve mentorship within the field. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objectives: This study used the behavior change wheel to identify the priority behavioral factors for a tailored intervention to support (re-)engagement in sexual activity following a spinal cord injury (SCI).

Research method/design: Forty-eight semistructured interviews were conducted with participants from three outpatient/carer/clinician populations in the United Kingdom: people living with SCI, their partners/spouses, and healthcare professionals working in SCI rehabilitation. To identify potential strategies to facilitate (re-)engagement in sexual activity, the behavior change wheel (BCW) and behavior change technique taxonomy Version 1 were applied to code behavior change techniques (BCTs) present in interview transcripts.

Results: Six intervention functions, three policy categories, and 21 BCTs were identified as primary targets for interventions to support sexual (re-)engagement post-SCI. Increasing physical-related skills and training would promote physical capability, while sex-related knowledge and the understanding of sex-related health consequences would elevate psychological capability. A supportive healthcare team, alongside peer support and targeted environmental resources about sexual activity/well-being facilitate physical and social opportunities for sex. Motivation to (re-)engage in sexual activity comprised goal-driven reflective motivation to enhance beliefs about capabilities, and automatic motivation via emotional support and reward-based reinforcement.

Conclusions: This study outlines the key BCW and theoretically-derived intervention targets which now provide the foundation for innovative future interventions in SCI and sexual activity. Targeting these highly specific BCTs increases the likelihood that sexual satisfaction can become universally accessible after SCI. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose: Research has examined peer mentorship to understand how it may help people with spinal cord injury (SCI) adapt and thrive. We still lack an in-depth understanding of the perspectives of SCI peer mentors and mentees on their dyadic relationship. This study was to explore the dyadic interactions and relationships between SCI peer mentors and mentees in a peer mentorship program delivered at a rehabilitation center.

Research method: Between 2016 and 2017, we recruited two dyads of peer mentor and mentee with SCI (N = 4). Each participant completed three one-on-one interviews (N = 12). Data were analyzed using a creative nonfiction approach.

Results: Three unique dialogical stories were developed. Story 1 (A slow and steady start) described how mentors took a mentee-centered approach in building the relationship. Story 2 (Mentorship and friendship: negotiating the "grey zone") highlighted how mentees and mentors experienced challenges in navigating the boundaries between mentorship and friendship. Story 3 (The "endless" job for mentor) showcased how the relationship could enter a phase in which it could affect mentors' well-being.

Conclusions: The stories highlighted important attributes to the relationships between SCI mentors and mentees. Considerations were suggested for community-based SCI organizations to integrate peer mentorship into rehabilitation settings, including optimizing mentorship introductions and matching, defining mentors' role explicitly, and building support systems for mentors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Although numbers of youth with disabilities (YWD) are increasing, this population continues to be poorly represented in psychological and developmental research. There is a demonstrated need to better understand identity development in YWD.

Objective: The purpose of this review was to determine the applicability of a contemporary developmental model, positive youth development (PYD), for YWD. PYD describes six "Cs" that contribute to thriving in youth: competence, confidence, connection, character, caring/compassion, and contribution. We explored which "Cs" contribute to identity development in YWD, what appears to be unique, and how PYD could be adapted to better include this population.

Method: Through a qualitative metasynthesis, we explored how PYD emerged across the qualitative literature from psychology and related fields for YWD. We coded 18 qualitative articles according to the original definitions of the "Cs" of PYD and tracked emerging constructs across included studies.

Results: Findings reveal evidence for four out of six of the original "Cs" in YWD. Two emerging "Cs," coping and constraints, may be unique to this population.

Conclusions: PYD may be applicable for YWD, but an expanded version may be more relevant to this group. The addition of newly defined "Cs" could contribute to a better understanding of positive development in YWD and other marginalized populations. (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).