ABSTRACT
People with serious mental illness (SMI) encounter restrictions in the quantity of their community participation. Less is known about the quality of their participation. We aimed to explore the relationship between symptoms of SMI and the daily experience (i.e., loneliness and enjoyment) of community participation. We examined daily community participation among people with SMI using ecological momentary assessment surveys. We built multilevel models to examine the associations between symptoms of SMI and loneliness or enjoyment during community participation. Our analysis included 183 people among four participant groups: bipolar disorder (n = 44), major depressive disorder (n = 46), schizophrenia/schizoaffective disorder (n = 40), and control (n = 53). People with schizophrenia engaged in more unstructured activities (e.g., socializing) than people among other groups. Symptom association varied across diagnostic groups. To support tailored intervention development, researchers and practitioners should consider the context of participation and the clinical characteristics of the client.
People with Serious Mental Illness Have Different Patterns and Emotions Related to Community ParticipationWhy was this study done?Adults with serious mental illness engage in less community participationactivities done with another personthan their peers. In addition, it is possible that people with serious mental illness do not experience the emotions that we expect during community participation. This study explored the subjective experience of community participation among people with serious mental illness.What did the researchers do?Researchers collected information about participants' mental health symptoms and daily activity participation. Participants completed surveys that were sent to their cell phone multiples times per day. On the survey, participants described the kind of activity they were doing, whether or not they were doing the activity with someone else, and how much loneliness or enjoyment they were experiencing. Researchers looked at which activities were most often done with someone else. Researchers also looked at which mental health symptoms were related to loneliness and enjoyment during community participation.What did the researchers find?People with schizophrenia or schizoaffective disorder did less community participation at work or school than the other groups. Mental health symptoms, especially depression, negative symptoms (i.e., lack of pleasure and motivation), and defeatist beliefs, were related to less enjoyment and more loneliness across the groups.What do the findings mean?People with schizophrenia or schizoaffective disorder may have less opportunities for community participation. Different symptoms may affect community participation in different ways. Researchers and practitioners should consider these findings when developing intervention plans.
ABSTRACT
Stroke survivors face participation restrictions, yet little is known regarding how social support affects the association between an individual's abilities and participation. Through a Person-Environment-Occupation-Performance (PEOP) model lens, social support was examined as a potential mediator between ability and participation in cognitively and mobility-demanding activities for stroke survivors with aphasia (persons with aphasia [PWA]) and without aphasia (persons without aphasia [PWOA]). A cross-sectional design, including PWA (n = 50) and PWOA (n = 59) examined associations among person factors (physical impairment, cognition), an environmental factor (social support), and occupational participation through cognitively- and mobility-demanding activity subscales of the Activity Card Sort. Cognition was associated with participation in cognitively demanding activities for both groups, though social support was a mediator only for PWA. Physical impairment was associated with participation in mobility-demanding activities for PWOA, though social support did not mediate that relationship. Social support is key to PWA participating in cognitively demanding activities post-stroke.
Social Support's Role in Tasks that Require Cognition or Mobility for Stroke Survivors with and without AphasiaAfter a stroke, people can face difficulties doing the things they need and want to do in their daily life. Sometimes a stroke can cause aphasia, a disorder that can make it hard for someone to communicate. Social support occurs when one person helps someone do the things they need and want to do. Certain tasks may require different skills, like cognition (being able to think) or mobility (being able to move). Results showed that cognition is important to do tasks that require a lot of thinking for people who experience a stroke and social support is essential for people with aphasia to do tasks that require a lot of thinking. In addition, mobility is important to do tasks that require walking or movement for people without aphasia.
Subject(s)
Aphasia , Social Support , Stroke Rehabilitation , Humans , Male , Cross-Sectional Studies , Female , Middle Aged , Aged , Stroke Rehabilitation/psychology , Aphasia/psychology , Aphasia/etiology , Stroke/psychology , Stroke/complications , Cognition , Social Participation/psychology , Activities of Daily LivingABSTRACT
BACKGROUND: People post-stroke experience increased loneliness, compared to their healthy peers and loneliness may have increased during COVID due to social distancing. How social distancing affected loneliness among people after stroke is unknown. Bandura's self-efficacy theory suggests that self-efficacy may be a critical component affecting individuals' emotions, behaviors, attitudes, and interpretation of everyday situations. Additionally, previous studies indicate that self-efficacy is associated with both loneliness and social participation. This study investigates relationships among self-efficacy, social participation, and loneliness in people with stroke. OBJECTIVES: Determine how social participation affects the relationship between self-efficacy and loneliness in people with stroke during the COVID-19 pandemic. METHODS: 44 participants were community-dwelling individuals, ≥ 6 months post-stroke who participated in a 2-hour phone interview. A regression-based mediation analysis was conducted using these measures: Participation Strategies Self-Efficacy Scale, Activity Card Sort for social participation, and UCLA Loneliness Scale for loneliness. RESULTS: The total effect of self-efficacy on loneliness was significant (b = -0.36, p = .01). However, social participation fully mediated the relationship between self-efficacy and loneliness (indirect effect, b = -0.11, 95% CI [-0.24, -0.01]; direct effect, b = -0.25, 95% CI [-0.03, 0]). CONCLUSIONS: Self-efficacy is associated with both social participation and loneliness in people with stroke in this cross-sectional study. Mediation analysis findings suggest that interventions focused on increasing social participation may prevent or potentially alleviate loneliness in people with stroke who have low self-efficacy.
Subject(s)
COVID-19 , Loneliness , Self Efficacy , Social Participation , Stroke , Humans , Loneliness/psychology , Male , Female , Cross-Sectional Studies , COVID-19/psychology , Aged , Stroke/psychology , Middle Aged , Aged, 80 and overABSTRACT
Previous research has reported that residual neurological impairment and emotional factors play a role in regaining successful participation post-stroke. The objective of this study was to investigate the mediating impact of anxiety on the association between residual neurological impairment and participation in survivors with and without post-stroke depressive symptoms. Participants (N = 79) were classified into 2 categories, those with post-stroke depressive symptoms (N = 40) and those without post-stroke depressive symptoms (N = 39). Variables measured in this study: residual neurological impairment (NIH Stroke Scale Score), participation (Reintegration to Normal Living Index), depressive symptoms (Patient Health Questionnaire-9), and trait anxiety (State-Trait Anxiety Inventory). A regression-based mediation analysis was conducted for each group of participants. The majority of participants had some level of anxiety. Residual neurological impairment predicted participation in stroke survivors both with (ß = -.45, p = .003) and without (ß = -.45, p = .004) post-stroke depressive symptoms. Anxiety mediated this relationship in participants with depressive symptoms (ß = -.19, 95% CI = -.361 â¼ -.049), but not in participants without depressive symptoms (ß = -.18, 95% CI = -.014 â¼ .378). Depressive and anxious symptoms should both be addressed to best facilitate participation by stroke survivors.
Subject(s)
Stroke Rehabilitation , Stroke , Humans , Depression/psychology , Stroke/complications , Stroke/psychology , Anxiety/etiology , Anxiety/psychology , EmotionsABSTRACT
Increased attention to the rehabilitation needs of children with cancer is vital to enhance health, quality-of-life, and productivity outcomes. Among adults with cancer, rehabilitation recommendations are frequently incorporated into guidelines, but the extent to which recommendations exist for children is unknown. Reports included in this systematic review are guideline or expert consensus reports containing recommendations related to rehabilitation referral, evaluation, and/or intervention for individuals diagnosed with cancer during childhood (younger than 18 years). Eligible reports were published in English from January 2000 to August 2022. Through database searches, 42,982 records were identified; 62 records were identified through citation and website searching. Twenty-eight reports were included in the review: 18 guidelines and 10 expert consensus reports. Rehabilitation recommendations were identified in disease-specific (e.g., acute lymphoblastic leukemia), impairment-specific (e.g., fatigue, neurocognition, pain), adolescent and young adult, and long-term follow-up reports. Example recommendations included physical activity and energy-conservation techniques to address fatigue, referral to physical therapy for chronic pain management, ongoing psychosocial surveillance, and referral to speech-language pathology for those with hearing loss. High-level evidence supported rehabilitation recommendations for long-term follow-up care, fatigue, and psychosocial/mental health screening. Few intervention recommendations were included in guideline and consensus reports. In this developing field, it is critical to include pediatric oncology rehabilitation providers in guideline and consensus development initiatives. This review enhances the availability and clarity of rehabilitation-relevant guidelines that can help prevent and mitigate cancer-related disability among children by supporting access to rehabilitation services.
Subject(s)
Exercise , Neoplasms , Adolescent , Humans , Child , Consensus , Delivery of Health Care , Medical OncologyABSTRACT
BACKGROUND: The authors' objective in this systematic review was to describe the evidence for preventive and rehabilitative interventions for musculoskeletal disorders in oral health care. TYPES OF STUDIES REVIEWED: The authors conducted systematic search, screening, and eligibility processes to identify experimental, quasiexperimental, observational, and survey research studies in which the investigators either directly evaluated or predicted the effects of preventive or rehabilitative interventions on the reduction of musculoskeletal symptoms in oral health care professionals. RESULTS: The authors identified and screened 3,571 unique abstracts, assessed 256 full-text articles for eligibility, and included 34 articles in the review. Investigators in 17 experimental studies described the results of preventive or rehabilitation interventions and in 17 survey research studies predicted or correlated preventive or protective techniques to a reduction in musculoskeletal symptoms. The primary techniques evaluated in the studies included equipment modification, ergonomic training, and physical exercise. CONCLUSIONS AND PRACTICAL IMPLICATIONS: The evidence suggests that magnification loupes and indirect-vision techniques have a positive effect on the reduction of musculoskeletal symptoms. In terms of evaluating intervention efficacy, other techniques have mixed evidence or are limited by low-level study design.