Pharyngeal Residues Scoring through the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS): Efficacy of Training.

The assessment of pharyngeal residues during fiberoptic endoscopic evaluation of swallowing (FEES) is based on visual-perceptual scales that involve clinical subjectivity. Training might be helpful to increase agreement among clinicians. This paper aims to assess the efficacy of training for the assessment of pharyngeal residue in FEES frames and videos through the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS). Twenty-nine clinicians (Phoniatricians, Otorhinolaryngologists, Speech and Language Pathologists) and 47 students in Speech and Language Pathology participated in this study. Fourteen clinicians were randomly allocated to the training group, whilst the remaining 15 served as a control group; all the students participated in the training. Participants scored 30 pairs of videos and frames using the YPRSRS twice, before and after the training for the training groups and at least two weeks apart for the control group. Construct validity, defined as the agreement between each rater and the experts' scores, and inter-rater reliability were compared among the groups and between the first and the second assessments to verify the efficacy of the training. Construct validity significantly improved at the second assessment in the training group for the pyriform sinuses videos (baseline 0.71 ± 0.04, post-training 0.82 ± 0.05, p = .049) and in the students' group for the valleculae (baseline 0.64 ± 0.02, post-training 0.84 ± 0.02, p < .001) and pyriform sinuses videos (baseline 0.55 ± 0.03, post-training 0.77 ± 0.02, p < .05). No significant differences were found in the inter-rater reliability in any group. In conclusion, the training seems to improve participants' agreement with experts in scoring the YPRSRS in FEES videos.

Analyzing data in complicated 3D domains: Smoothing, semiparametric regression, and functional principal component analysis.

In this work, we introduce a family of methods for the analysis of data observed at locations scattered in three-dimensional (3D) domains, with possibly complicated shapes. The proposed family of methods includes smoothing, regression, and functional principal component analysis for functional signals defined over (possibly nonconvex) 3D domains, appropriately complying with the nontrivial shape of the domain. This constitutes an important advance with respect to the literature, because the available methods to analyze data observed in 3D domains rely on Euclidean distances, which are inappropriate when the shape of the domain influences the phenomenon under study. The common building block of the proposed methods is a nonparametric regression model with differential regularization. We derive the asymptotic properties of the methods and show, through simulation studies, that they are superior to the available alternatives for the analysis of data in 3D domains, even when considering domains with simple shapes. We finally illustrate an application to a neurosciences study, with neuroimaging signals from functional magnetic resonance imaging, measuring neural activity in the gray matter, a nonconvex volume with a highly complicated structure.

Post-traumatic stress symptoms and benefit finding: a longitudinal study among Italian health workers during the COVID-19 pandemic.

PURPOSE: Research has highlighted that the exposure of healthcare professionals to the COVID-19 pandemic for over two years can lead to the development and persistence of symptoms characteristic of Post-Traumatic Stress Disorder (PTSD), with serious consequences on both the individual well-being and the quality of care provided. The present study was aimed at investigating the role of benefit finding in moderating post-traumatic stress symptoms (PTSS) over time. METHODS: The longitudinal study, conducted between April and October 2020, involved 226 Italian health workers (44.7% nurses and midwives, 35% doctors, 20.3% technical and rehabilitation professionals), who filled out an online survey at the beginning of the study (T1), after three months (T2), and after six months (T3). Participants (77.4% women; mean age = 41.93, SD = 12.06) completed the PTSD Checklist for DSM-5 (PCL-5) and Benefit Finding, a 17-item questionnaire measuring the perceived level of positive consequences derived from stressful experiences. A hierarchical regression analysis highlighted the moderating effect of benefit finding (T2) on the association between PTSS values at T1 and T3. RESULTS: A buffering effect was observed, with higher benefit finding levels reducing the magnitude of the bivariate association between PTSS assessed at the beginning and at the end of the study. CONCLUSION: Findings suggest the potential mental health related benefits of interventions allowing health professionals to identify positive aspects in the experience of working under prolonged emergency circumstances, such as the pandemic ones.

Job satisfaction among physicians and nurses involved in the management of multiple sclerosis: the role of happiness and meaning at work.

OBJECTIVE: Health professionals caring for persons with multiple sclerosis (MS) are faced with increasingly complex working conditions that can undermine their job satisfaction and the quality of their healthcare services. The aim of this study was to delve into health professionals' job satisfaction by assessing the predictive role of happiness and meaning at work. Specifically, it was hypothesized that job meaning would moderate the relationship between job happiness and satisfaction. METHODS: The study hypothesis was tested among 108 healthcare professionals (53 physicians and 55 nurses) working in eight MS centers in Italy. Participants were administered the Eudaimonic and Hedonic Happiness Investigation and the Job Satisfaction Questionnaire. Hierarchical regression analysis was performed to test the moderating role of job meaning between job happiness and satisfaction. RESULTS: A significant interaction effect of job happiness and meaning on job satisfaction was identified for both physicians and nurses. When work was attributed low meaning, participants experiencing high job happiness were more satisfied with their work than those reporting low happiness; by contrast, when work was perceived as highly meaningful, participants' levels of job happiness did not significantly contribute to job satisfaction. CONCLUSIONS: Focusing on the interplay between job happiness and meaning, findings bring forward practical suggestions for the preservation and promotion of job satisfaction among health professionals working with MS patients. Particularly, they suggest the need to strengthen those job-related aspects that may enhance job meaning, thus providing health professionals with significant reasons to persevere in their work in the face of daily challenges.

The Contribution of Illness Beliefs, Coping Strategies, and Social Support to Perceived Physical Health and Fatigue in Multiple Sclerosis.

This study investigated the relationship of illness beliefs with perceived physical health and fatigue among persons with multiple sclerosis. Besides direct effects between illness beliefs and outcome measures, the mediational role of coping strategies and social support was examined. Six hundred and eighty persons with multiple sclerosis completed the Revised Illness Perception Questionnaire evaluating illness beliefs; the Brief COPE measuring problem-focused, meaning-focused, and avoidant strategies; the Multidimensional Scale of Perceived Social Support assessing social support; MS Quality of Life-54 investigating perceived physical health; and the Fatigue Severity Scale assessing physical fatigue. Mediation analyses were performed controlling for disability level. Direct effects were identified for both perceived physical health and fatigue, whereas indirect effects were observed only for physical health through avoidant strategies and social support. Based on present findings, psychological intervention may primarily target illness beliefs to address fatigue, and beliefs and coping strategies to improve perceived physical health.

Italian validation of the caregiving tasks in multiple sclerosis scale (CTiMSS).

OBJECTIVES: Informal caregivers provide fundamental help to persons with multiple sclerosis through a variety of tasks ranging from practical assistance to psychological support. Caregiving Tasks in Multiple Sclerosis Scale (CTiMSS) is a reliable and valid measure assessing the complex structure of caregiving tasks within the context of multiple sclerosis. The present study was aimed to test the validity and reliability of the Italian translation of CTiMSS in a sample of informal caregivers of persons with multiple sclerosis. METHODS: A total of 580 caregivers (51.4% women, aged 18-81, M = 46.47, SD = 12.8) together with their care recipients (63.1% women, aged 19-60, M = 40.08, SD = 9.9) were involved in this study. Exploratory and confirmatory factor analyses with a split-sample approach were employed to evaluate construct validity. Convergent and discriminant validity were assessed using correlation indices with scales from Short Form Health Survey-36 and Positive and Negative Affect Schedule. Cronbach's alphas were used as a measure of reliability. RESULTS: Compared with the original CTiMSS 4-factor structure, a more stable and valid solution with 3 first-order factor loading on a single second-order factor was evaluated and confirmed; convergent and discriminant validity were also supported, and Cronbach's alpha values highlighted good-to-excellent reliability levels. CONCLUSION: Results supported the validity and reliability of the Italian CTiMSS. Thanks to its ability to assess specific caregiving tasks, the measure can be a useful instrument for tailoring intervention focused on the promotion of both caregivers' and care recipients' quality of life.

Perceived well-being and mental health in haemophilia.

The investigation of mental health among persons with haemophilia is mostly focused on negative and disease-related indicators. Literature however shows that psychosocial resources and optimal daily functioning can co-exist with chronic disease. The Dual Continua Model operationalizes positive mental health as 'flourishing', a condition comprising emotional, psychological, and social well-being dimensions. In the present study physical and mental health were comparatively assessed through positive and negative indicators in adults with haemophilia and a control group. Participants included 84 Italian persons with severe haemophilia (Mage = 43.44; SDage = 13.04) and 164 adults without history of chronic illness (Mage = 40.98; SDage = 12.26), who completed the Short Form Health Survey, the Positive and Negative Affect Schedule, and the Mental Health Continuum Short Form. MANOVA and post-hoc t-tests provided evidence of worse general health, lower negative affect and higher psychological well-being among participants with haemophilia compared with the control group. Moreover, the percentage of flourishing individuals was higher among participants with haemophilia. Results support previous evidence suggesting that a chronic disease does not prevent mental well-being attainment. The identification of assets and strengths allowing people with haemophilia to flourish can be fruitfully used to design resource-centered interventions.

Mental health and psychosocial functioning in adolescence: an investigation among Indian students from Delhi.

While developmental studies predominantly investigated adolescents' mental illness and psychosocial maladjustment, the present research focused on positive mental health of Indian adolescents within the Mental Health Continuum model. Aims were to estimate their prevalence of mental health and to examine its associations with mental distress and psychosocial functioning, taking into account age and gender. A group of 539 students (age 13-18; 43.2% girls) in the National Capital Territory of Delhi completed Mental Health Continuum Short Form, Depression Anxiety and Stress Scales-21, Strengths and Difficulties Questionnaire. Findings showed that 46.4% participants were flourishing, 51.2% were moderately mentally healthy, and only 2.4% were languishing. A higher number of girls and younger adolescents were flourishing compared to boys and older adolescents. Moreover, flourishing youths reported lower prevalence of depression and adjustment difficulties, and more prosocial behavior. Findings support the need to expand current knowledge on positive mental health for well-being promotion in adolescence.

Towards a knowledge-based decision support system to foster the return to work of wheelchair users.

Accidents at work may force workers to face abrupt changes in their daily life: one of the most impactful accident cases consists of the worker remaining in a wheelchair. Return To Work (RTW) of wheelchair users in their working age is still challenging, encompassing the expertise of clinical and rehabilitation personnel and social workers to match the workers' residual capabilities with job requirements. This work describes a novel and prototypical knowledge-based Decision Support System (DSS) that matches workers' residual capabilities with job requirements, thus helping vocational therapists and clinical personnel in the RTW decision-making process for WUs. The DSS leverages expert knowledge in the form of ontologies to represent the International Classification of Functioning, Disability, and Health (ICF) and the Occupational Information Network (O*NET). These taxonomies enable both workers' health conditions and job requirements formalization, which are processed to assess the suitability of a job depending on a worker's condition. Consequently, the DSS suggests a list of jobs a wheelchair user can still perform, exploiting his/her residual abilities at their best. The manuscript describes the theoretical approach and technological foundations of such DSS, illustrating its development, its output metric, and application. The developed solution was tested with real wheelchair users' health conditions provided by the Italian National Institute for Insurance against Accidents at Work. The feasibility of an approach based on objective data was thus demonstrated, providing a novel point of view in the critical process of decision-making during RTW.

Vocal fatigue perceived in remote working by teachers of different school grades during COVID-19 pandemic.

OBJECTIVE: Teachers have an increased prevalence of voice disorders. The present study aimed to investigate the impact of remote teaching on perceived voice fatigue among Italian teachers of all grades during the lockdown due to the COVID-19 pandemic. METHOD: s The participants were 195 female teachers (Mage=48.77; SDage=9.61) in primary, secondary, and high schools. They completed the Vocal Fatigue Index (VFI) through an online survey. The tool includes 19 items grouped into three dimensions: tiredness of voice and avoidance of voice use (TA); physical discomfort (PD); and improvement of symptoms with rest (IS). The participants reported their perceived voice fatigue during remote teaching. They were also asked to provide data about voice fatigue as perceived in previous classroom teaching. The data were analyzed through two sets of independent one-way ANOVAs, with voice fatigue subscales as criterion variables and school grade as a between-subjects factor. RESULTS: The teachers involved in the study reported higher voice fatigue scores than vocally healthy adults from the general population. Primary school teachers showed higher voice fatigue during remote teaching than both secondary and high school teachers, specifically for the TA and PD dimensions, whereas no difference emerged for IS. The VFI scores of primary school teachers were similar to those of dysphonic individuals. CONCLUSION: The results of the study confirm that primary school teachers are more vulnerable to developing voice disorders and suggest the need for specific vocal health interventions in case of prolonged remote work.

Proposal for an ICF-based methodology to foster the return to work of persons with disability.

BACKGROUND: Employment is an essential component of life as it provides income, sense of engagement and opportunities for personal development. Unemployment due to disability following an accident may have dramatic social and psychological consequences on individuals; it is thus fundamental to foster return to work of these persons. OBJECTIVE: The present work was aimed to develop a methodology determining suitable jobs for people living with disability after a job-related accident. METHODS: The Occupational Information Network (O*NET) taxonomy was combined with the International Classification of Functioning, Disability and Health (ICF) to match individual resources with specific job requirements. ICF Linking Rules were employed by two independent groups of researchers to associate ICF codes to O*NET skill and ability descriptors. RESULTS: O*NET descriptors were linked to 92 unique ICF codes. A "Criticality score" combining ICF and O*NET features to assess suitability of selected jobs for persons with disabilities was also proposed. CONCLUSIONS: The proposed methodology represents a novel instrument to support return to work; the capability to assess specific work-related facets through the lens of both the ICF model and O*NET taxonomy would conceivably provide vocational rehabilitation specialists and occupational therapists with a useful tool fostering job placement of workers with disability.

Predicting sense of coherence among caregiving partners of persons with multiple sclerosis.

PURPOSE/OBJECTIVE: Within the framework of the Salutogenic Model of Health, this study aimed to investigate sense of coherence among caregiving partners of persons with multiple sclerosis (PwMS), and its relationship with perceived social support and illness beliefs conceived as generalized resistance resources in tension management. RESEARCH METHOD/DESIGN: In this cross-sectional study, 398 caregiving partners of PwMS (Mage = 44.62; 34.9% women and 65.1% men) filled in questionnaires measuring sense of coherence (Sense of Coherence Scale-13), perceived social support from family, friends and significant others (Multidimensional Scale of Perceived Social Support), and illness beliefs (Revised Illness Perception Questionnaire). Hierarchical linear regression analysis was performed to assess the contribution of perceived support and illness beliefs to sense of coherence, controlling for sociodemographic and clinical variables. RESULTS: Perceived support from family and beliefs concerning illness-related emotional representations, illness coherence, and treatment control emerged as significant predictors of participants' sense of coherence. Higher perceived support from family and stronger beliefs in illness coherence and treatment control were associated with higher sense of coherence, while more negative emotional representations were related to lower sense of coherence values. CONCLUSIONS/IMPLICATIONS: Findings lend support to the relevance of a salutogenic approach to caregiving in multiple sclerosis. They further suggest the usefulness of interventions that can promote caregivers' sense of coherence and successful coping in life by benefitting from family support, favoring the construction of a coherent illness view, offering comprehensive information and expert guidance on treatment and rehabilitation opportunities, and promoting adaptive management of negative emotions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Reliability and Construct Validity of the Yale Pharyngeal Residue Severity Rating Scale: Performance on Videos and Effect of Bolus Consistency.

The Yale Pharyngeal Residue Severity Rating Scale (YPRSRS) provides an image-based assessment of pharyngeal residue in the fiberoptic endoscopic evaluation of swallowing (FEES). Its performance was investigated only in FEES frames. This study analyzed the reliability and construct validity of the YPRSRS in FEES videos and the influence of bolus consistency. Thirty pairs of FEES videos and frames, 8 thin liquids (<50 mPa·s), 11 pureed (2583.3 mPa·s at 50 s−1, 697.87 mPa·s at 300 s−1), and 11 solid food; were assessed by 29 clinicians using the YPRSRS; 14 raters re-assessed materials at least 15 days from the first evaluation. Construct validity and intra-rater reliability were assessed using weighted Cohen's Kappa. Inter-rater reliability was assessed using weighted Fleiss Kappa. Construct validity and inter-rater reliability were almost perfect or excellent for frames (0.82 ≤ k ≤ 0.89) and substantial or intermediate to good for videos (0.67 ≤ k ≤ 0.79). Intra-rater reliability was almost perfect for both frames and videos (k ≥ 0.84). Concerning bolus consistency, thin liquids had significantly lower values of construct validity, intra-, and inter-rater reliability than pureed and solid food. Construct validity and inter-rater reliability were significantly lower for solid food than for pureed food. The YPRSRS showed satisfactory reliability and construct validity also in FEES videos. Reliability was significantly influenced by bolus consistency.

Flow Experience and Emotional Well-Being among Italian Adolescents during the COVID-19 Pandemic.

Research highlighted the negative consequences of the COVID-19 pandemic on adolescents' emotional well-being worldwide. In the attempt to identify resources which could facilitate adolescents' adjustment, this study examined the occurrence of flow experience and related activities, and the association between flow and emotional well-being among Italian teenagers. In Spring 2021, 150 students (40.7% girls) aged 15-19 completed instruments assessing flow and related activities before and during the pandemic, and current positive and negative affect. Findings revealed that only 24.7% of the participants currently reported flow; over half of those reporting flow before the pandemic did not experience it subsequently, and only 6.5% of those not reporting flow before the pandemic currently experienced it. Participants with flow both before and during the pandemic reported higher positive affect than teens who never experienced flow (p = .011), or lost it (p = .006). No group differences were detected for negative affect. Learning, structured leisure, and interpersonal relations were the domains most frequently associated with flow before and during the pandemic, but after the pandemic onset a reduction in the variety of flow activities and limited identification of new flow domains were observed. The association of flow with higher emotional well-being even in pandemic times suggests the potential usefulness of interventions promoting flow retrieval under adverse circumstances.

Translation, Cross-Cultural Adaptation, and Preliminary Validation of the Transsexual Voice Questionnaire for Male-to-Female Transsexuals (I-TVQMtF) Into Italian.

OBJECTIVE: To perform a cross-cultural adaptation into Italian and to analyse reliability and validity of the Transsexual Voice Questionnaire for male-to-female transsexuals (I-TVQMtF). STUDY DESIGN: Cross-sectional nonrandomized survey study. METHODS: For item-generation, a cross-cultural adaptation and translation process was performed following standard guidelines. Transgender women were consecutively recruited and asked to fill out the I-TVQMtF and a form on social, demographic and transition-related variables. Firstly, data collected from participants were used to perform confirmatory factor analysis, and to evaluate internal consistency and test-retest reliability Subsequently, convergent validity was evaluated comparing I-TVQMtF total scores with the two extra items addressing self-perception (SPVF) and aspiration (AVF) of voice femininity. To evaluate convergent validity, scores of the Italian version of the Voice Handicap Index were considered for comparisons. A correlation analysis was performed to verify potential association between I-TVQMtF scores and social, demographic and transition-related variables. RESULTS: Confirmatory factor analysis demonstrated that a two-factor model fits data better than the unidimensional one. Both internal consistency and test retest reliability of the I-TVQMtF were satisfactory. Negative correlations were highlighted between I-TVQMtF scores on one side and self-perception vocal functioning and aspiration vocal functioning on the other. Positive correlations between I-TVQMtF and Italian version of the Voice Handicap Index scores were also found. Finally, negative correlations were demonstrated between I-TVQMtF scores and time spent living in the female role. CONCLUSION: The I-TVQMtF appears to be a reliable and valid instrument for the assessment of voice-related quality of life in transgender women.

The relationship between post-traumatic stress and positive mental health symptoms among health workers during COVID-19 pandemic in Lombardy, Italy.

BACKGROUND: The COVID-19 pandemic is exposing health workers (HW) worldwide to extreme burden and risk of developing post-traumatic stress disorder (PTSD). This problem emerged in Lombardy, the Italian region where the pandemic exacted the heaviest toll. Study aims were to assess mental health of HW in Lombardy after the peak of COVID-19 related hospitalizations, through the joint evaluation of PTSD and positive mental health; and to explore the potential role of positive mental health in PTSD development. METHODS: HW completed an online survey including demographic and work-related information; PTSD Checklist for DSM-5; Mental Health Continuum Short-Form. Analyses comprised calculation of percentages of participants meeting a provisional PTSD and mental health diagnosis (flourishing, moderate, languishing); a binary logistic regression with demographics, work-related features, and positive mental health as predictors, and provisional PTSD diagnosis as outcome. RESULTS: Out of 653 participants, 39.8% received a provisional PTSD diagnosis; 33.4% reported flourishing, 57.7% moderate, and 8.9% languishing mental health. Regression analysis highlighted that women vs. men, nurses vs. technical/rehabilitation HW, frontline vs. second-line workers and languishing vs. moderately mentally healthy HW were more likely to receive a provisional PTSD diagnosis, whereas flourishing participants were more likely not to receive it. No role emerged for job seniority. LIMITATIONS: Self-reported PTSD scores, stress symptoms related to COVID-19 considered as a global stressor, cross-sectional study design. CONCLUSIONS: Findings suggest the potential usefulness of supporting vulnerable HW categories during massive disease outbreaks through emergency-focused professional training and psychological intervention addressing both positive mental health promotion and PTSD prevention.

The caring experience in multiple sclerosis: Caregiving tasks, coping strategies and psychological well-being.

Informal caregivers play a crucial role in supporting persons with multiple sclerosis (MS), a neurodegenerative disease resulting in progressive worsening of physical and cognitive functioning. While research extensively showed that caregiving workload can be perceived as burdensome, little attention was devoted to the relation connecting workload and caregivers' well-being. Building on previous literature on stress and coping, the aim of this study was to test the mediational role of coping between caregivers' tasks and well-being. A group of 680 caregivers of persons with MS (M age = 46.45; 51.2% women) was recruited in eight Italian MS centres between June 2015 and December 2016. Caregiving tasks related to basic activities of daily living (ADL), instrumental ADL, psycho-emotional and social-practical care were assessed through the Caregiving Tasks in MS Scale; coping strategies (avoidance, criticism and coercion, practical assistance, supportive engagement, positive reframing) were investigated through the Coping with MS Caregiving Inventory; well-being was evaluated through the Psychological Well-Being Scales. Analyses substantiated a multi-mediation model including tasks in basic ADL, psycho-emotional and social-practical care, and the coping strategies avoidance, criticism/coercion, supportive engagement, positive reframing. Basic ADL care was negatively related to psychological well-being through lower use of supportive engagement and positive reframing. By contrast, psycho-emotional and social-practical tasks were both negatively and positively related to psychological well-being, through higher use of avoidance and criticism/coercion as well as supportive engagement and positive reframing. Findings suggest that caregiving tasks are not solely detrimental to well-being, but they may also provide a positive contribution through the adaptive coping strategies supportive engagement and positive reframing. Findings also highlighted task-specific areas that could be targeted in intervention in order to effectively lighten burden and promote well-being among caregivers.

The adult carer quality of life questionnaire (AC-QoL): comparison with measures of burden and well-being, and Italian validation.

PURPOSE: Family caregivers are essential assets in the rehabilitation process, and their psychophysical health should represent a concern for healthcare services. This study aims to investigate the psychometric properties of the Adult Carer Quality of Life Questionnaire, Italian version, and its convergent-discriminant validity with measures of caring burden, resilience, health, and well-being. MATERIALS AND METHODS: Participants were 591 parents (89.2% females; aged 25-69) of children treated as outpatients in 14 centers of "Istituto Medea - La Nostra Famiglia", an Italian rehabilitation institution. They completed: Adult Carer Quality of Life Questionnaire, a 40-item scale assessing care-related challenges, resources, and benefits; Caregiver Burden Inventory; Resilience Scale for Adults; Satisfaction With Life Scale; Health Survey SF-36. The psychometric properties of the Adult Carer Quality of Life Questionnaire were investigated through exploratory and confirmatory factor analyses and reliability evaluation; correlation coefficients assessed convergent and discriminant validity with burden and well-being measures. RESULTS: The original eight-factor structure of the Adult Carer Quality of Life Questionnaire showed good adequacy and internal consistency; convergent and discriminant validity with measures of burden, resilience, satisfaction, physical and mental health were satisfactory. CONCLUSIONS: The Italian version of the Adult Carer Quality of Life Questionnaire is a reliable and valid instrument to assess caregivers' perceived challenges and resources. As a parsimonious and easily administrable tool, it can be used to evaluate caregivers' quality of life and related interventions. Implications for Rehabilitation Family caregivers are essential assets for the rehabilitation process, and their challenges and resources need to be considered by healthcare services. Information on caregivers' frailties to be reduced and strengths to be empowered allows to design interventions promoting well-being and social integration of people with disabilities and their families. The Adult Carer Quality of Life is a comprehensive measure of burden and well-being dimensions that can be easily administered to caregivers of any age.