Psychosocial Adaptation to Disability Within the Context of Positive Psychology: Philosophical Aspects and Historical Roots

The association between hope and employment among individuals with multiple sclerosis: A hierarchical logistic regression model

BACKGROUND

Most people with multiple sclerosis (MS) are employed at the time of their diagnosis; however, due to the unpredictable nature of MS, most exit the workforce shortly thereafter. A plethora of research has examined factors that negatively affect employment outcomes for people with MS. However, little is known about how hope, a modifiable positive psychology factor, affects employment.

OBJECTIVE

This study examined the role of hope and its association with employment outcomes for people with MS.

METHODS

Two-hundred and fifty-five adults with MS (mean ± SD age, 45.45 years ± 10.28) completed surveys about their MS, employment, disability-related stress, and hope. A three-step hierarchical logistic regression was conducted to examine the extent to which hope explains the variance in employment, over and above demographic and disability related covariates.

RESULTS

The final model explained 28% of the variance in employment, suggesting that the model was able to distinguish people with MS who were employed versus those who were unemployed. Higher levels of hope were associated with an increased probability of being employed (OR = 4.65; 95% CI [1.98, 10.92]).

CONCLUSION

This study supports that hope is associated with favorable employment outcomes for people with MS. Persons with MS may benefit from working with rehabilitation professionals to enhance their hope, and this study provides a foundation for the development of hope-based interventions to improve employment outcomes among this population.

Predictors of Psychosocial Adaptation and Mental Well-Being Among People With Chronic Illnesses and Disabilities in Hong Kong

Psychosocial adaptation to chronic illness and disability (CID) involves a complex interplay of the client’s background factors with resilience and coping. To date, there have been few studies on psychosocial adaptation to CID in the Chinese context. To examine the predictors of psychosocial adaptation, we surveyed people with CID from community-rehabilitation settings and self-help groups ( N = 224). The research questionnaire collected information on demographics, health-related factors, social support, resilience, coping strategies, psychosocial adaptation, and mental well-being. Resilience, coping strategies, health-related factors, and sex were found to be important predictors of psychosocial adaptation. Using structural equation modeling (SEM), we tested a conceptual model on how social support and health-related factors predict adjustment variables (resilience and coping strategies), which further affect psychosocial adaptation and mental well-being. All the variables are closely linked and the path coefficients are all significant. An overall fair model fit (comparative fit index [CFI] = 0.89; root mean square error of approximation [RMSEA] = 0.089) was obtained. The results provide support for the conceptual model we proposed based on health-related coping and the phase model of psychosocial adaptation. The key predictors of psychosocial adaptation and mental well-being in Chinese people with CID in Hong Kong are similar to those identified in non-Chinese studies.

Evaluating the Psychometric Properties of the Psychological Capital Questionnaire (PCQ) in Patients with Parkinson's Disease

BACKGROUND

Positive personality resources have demonstrated the ability to positively impact health outcomes.

OBJECTIVE

To examine the psychometric properties of the original Psychological Capital Questionnaire (PCQ-24) in patients with Parkinson's disease (PD).

METHODS

A sample of 114 individuals with PD completed the PCQ-24, and via a latent factor modeling framework exploratory and confirmatory factor analyses were conducted to evaluate the psychometric properties in people with PD.

RESULTS

Exploratory factor analysis (EFA) revealed that both the efficacy and hope scales were reliable (Cronbach's alpha = 0.87 and 0.86, respectively) and had statistically acceptable validity with strong factor loadings all above the practical threshold of 0.60. The resilience and optimism scales were also reliable (Cronbach's alpha = 0.78 and 0.73, respectively) but had only moderately acceptable validity in part due to three reverse-scored items (i.e., No. 13, 20, & 23) with weak factor loadings of 0.26, 0.46, and 0.50, respectively. After excluding these at-risk items, the overall factor loadings for resilience and optimism were significantly improved at the acceptable above 0.60. The CFA results confirm a statistically acceptable model fit for the modified version (only 21-items) of the PCQ in the PD sample.

CONCLUSION

Both EFA and CFA analyses provide statistical evidence supporting the modified PCQ version and demonstrate better test validity and reliability in the PD population. The refined PCQ form is both effectively shorter and psychometrically superior to the original and has promise in investigating health outcomes in people with PD.

Exploring psychosocial adaptation among people with chronic skin disease: A grounded theory study

AIM

Chronic skin disease (CSD) often has devastating effects on the physiological, psychological and social aspects of patients, who must adapt to them. However, it is not clear how patients adapt, especially with regard to their psychosocial adaptation (PSA). This research explored a theoretical model of PSA among people with CSD.

DESIGN

Following constructivist grounded theory methodology, a qualitative study was undertaken between August 2018 and June 2019.

METHODS

Observation and semi-structured interview were conducted with included participants (n=19). Data were iteratively coded and analyzed by constant comparison following the key stages of initial, focused, axial and theoretical coding until saturation was achieved.

RESULTS

When individuals face the impacts of disease, they try to adjust to adapt it. The findings showed the core category (self-cognitive) and the contributing categories (impacts of chronic skin disease, contextual factors, physiological experiences, psychological experiences, social experiences, and positive and negative psychosocial adaptations) of the PSA among people with CSD. The process of PSA among people with CSD was not linear throughout the disease and was instead entwined within a set of complexes (contextual factors-experience) interactions. The consequences of PSA included positive and negative aspects. The theoretical model of PSA among people with CSD will provide us with information needed to develop accurate assessment and effective intervention strategies. Understanding that PSA among people with CSD is a complex, dynamic, and interactional process may provide evidence for further assessing and meeting the needs of people.

Psychometric Validation of Adapted Inventory of Virtues and Strengths

The purpose of this study was to validate the Adapted Inventory of Virtues and Strengths (AIVS). AIVS is a unique instrument that operationalizes virtues in terms of character traits that are specially designed for psychosocial adaptation and rehabilitation. Data were collected from 464 individuals with disabilities and analyzed via the combination of exploratory ( n = 256) and confirmatory analyses ( n = 208). Although the results suggest dropping some items, the original five-virtue structure was supported and confirmed via both analyses. The construct validity of AIVS was further analyzed via correlation analyses between AIVS and other measures including Values in Action Inventory of Strengths 72-Item, Satisfaction with Life Scale, Connor-Davison Resilience Scale, and General Self-Efficacy Scale. The results suggest that with continuing research to document reliability and validity, AIVS has potential in the context of rehabilitation research. Further discussion on psychometric information of AIVS and future implications were presented.

Strengths based rehabilitation assessment: Adapted Inventory of Virtues and Strengths

BACKGROUND

The Values in Action Inventory of Strengths (VIA-IS) operationalizes 24 character strengths that compose the six virtues proposed in Peterson and Seligman's classification theory. Though the utility of the VIA-IS has been demonstrated in the general population, its applicability to the study of psychosocial adaptation in rehabilitation for individuals with disabilities has been controversial.

OBJECTIVE

The present study was to develop a measure of rehabilitation clients' positive traits, the Adapted Inventory of Virtues and Strengths (AIVS) designed to complement the applicability issues of the VIA-IS.

METHOD

Step-by-step AIVS development procedures are presented, and the AIVS factor structure identified via factor analysis is interpreted from a psychosocial adaptation perspective and compared to the VIA-IS factor structure.

RESULTS

AIVS subscales include Courage, Integrity, Practical Wisdom, Committed Action, and Emotional Transcendence. Construct validity was assessed by correlating AIVS factors with measures of resilience, life satisfaction, and well-being.

CONCLUSIONS

The AIVS offers a reliable framework that has clinical utility for strengths-based rehabilitation practice.

Both positive and negative beliefs are important in patients with spine pain: findings from the Occupational and Industrial Orthopaedic Center registry

BACKGROUND CONTEXT

Negative beliefs are known to influence treatment outcome in patients with spine pain (SP). The impact of positive beliefs is less clear.

PURPOSE

We aimed to assess the influence of positive and negative beliefs on baseline and treatment responses in patients with SP.

STUDY DESIGN/SETTING

A retrospective cross-sectional and longitudinal analysis of prospectively collected data of outpatient physical therapy patients with SP was carried out. Questionnaires administered before and during treatment included the STarT Back distress scale (negative beliefs), and expectation and self-efficacy questions (positive beliefs).

PATIENT SAMPLE

Patients with SP with a baseline assessment and follow-up assessment comprised the study sample.

OUTCOME MEASURE

Perceived disability was measured using the Oswestry Disability Index (ODI) or the Neck Disability Index (NDI). A clinical meaningful change (minimum clinically important difference [MCID]) was defined as decrease in ODI or NDI of ≥30%.

METHODS

We used the Akaike Information Criterion from the first imputed dataset of the prediction model to select predictor variables. Prediction models were fitted to the outcome variables.

RESULTS

In the cross-sectional analysis, 1,695 low back pain (LBP) episodes and 487 neck pain (NP) episodes were analyzed. STarT Back Screening Tool (SBST)-distress was positively associated with perceived disability in both LBP (beta 2.31, 95% confidence interval [CI] 1.75-2.88) and NP (beta 2.57, 95% CI 1.47-3.67). Lower self-efficacy was negatively associated with more perceived disability for LBP (beta 0.50, 95% CI 0.29-0.72) but not for NP, whereas less positive expectations was associated with more perceived disability in NP (beta 0.57, 95% CI 0.02-1.12) but not in LBP. In the longitudinal analysis, 607 LBP episodes (36%) and 176 (36%) NP episodes were included. SBST-distress did not predict treatment outcome in spine patients. In LBP, patients with a lower positive expectation were less likely to experience an MCID in perceived disability (odds ratio [OR] per point increase 0.89, 95% CI 0.83-0.96), and there was a similar trend in NP (OR per point increase 0.90, 95% CI 0.79-1.03). In patients with LBP, lower self-efficacy at baseline was associated with a higher likelihood that an MCID was achieved (OR per point increase 1.09, 95% CI 1.01-1.19). In NP, self-efficacy was not included in the final model.

CONCLUSIONS

Our study demonstrates that both negative and positive beliefs are associated with perceptions of disability. However, in this study, only positive beliefs were associated with treatment outcome.

A Needs Driven Model of Workplace Social Effectiveness in Adults With Disabilities

Social effectiveness is central to workplace success. Yet, surprisingly little is known about the factors that influence effectiveness in managing the social requirements of the workplace. This study provides a preliminary analysis of a model of workplace social effectiveness for adults with disabilities. A total of 330 adults with disabilities participated in an online, cross-sectional research study. Researchers used several measures to assess the extent to which latent variables representing communal and positive approaches to social situations influenced workplace social effectiveness and whether that relationship was mediated by the ability to connect with others. Results from a structural equation model analysis suggest that both a communal and positive social approach predict workplace social effectiveness. The ability to connect with others partially mediated relationships between both communal and positive approaches and workplace social effectiveness. Although the cross-sectional and self-report nature of this study limits the conclusions that can be drawn, the findings lay a groundwork for further model testing and clinical interventions in rehabilitation counseling services. The results offer an alternative socioemotional approach for identifying and intervening on workplace social effectiveness that can be applied to adults with disabilities.

Resilience From a Virtue Perspective

Resilience refers to one’s ability to adapt and navigate through challenges in the face of a chronic illness and disability (CID). Originally reported in posttraumatic stress literature, resilience has been studied in various contexts; however, very few studies have been conducted from a virtue perspective. Virtue, in psychological terms, is consistent, everyday action toward a worthwhile pursuit, based on one’s values. From a virtue perspective, resilience is defined as a positive by-product of having endured adversities while transforming them into insightful opportunities for renewal. This article introduces the virtue-based psychosocial adaptation model (V-PAM) and its applicability to the study of resilience. College students with CID ( N = 256) were recruited, and their resilience was empirically examined based on the proposed model.

Psychosocial Adaptation to Disability Within the Context of Positive Psychology: Findings from the Literature

PURPOSE

This purpose of this article is to review of the trends of research that examined positive psychology constructs in the context of adapting to chronic illness and disability (CID). This article examines the empirical findings on the relationships between six selected positive psychology-associated constructs (optimism, hope, resilience, benefit-finding, meaning-making, and post-traumatic growth) and adaptation to disability.

METHODS

Six positive psychology constructs were selected to represent the trends found in recent literature published on CID. The process of choosing these six variables included reviewing chapters on positive psychology and CID, reviewing the top rehabilitation journals that typically publish articles on psychosocial adaptation to CID, using search engines to find relevant journal articles published since the year 2000, and selecting the most important constructs based on the authors’ professional judgment.

CONCLUSION

The available evidence supports the unique benefits of these six positive psychology constructs in predicting successful adaptation to a range of disabling conditions. Based on the available findings, the authors offer four suggestions for occupational rehabilitation researchers.