Personal and environmental contextual factors as mediators between functional disability and quality of life in adults with serious mental illness: a cross-sectional analysis

Accommodation requests among older workers: The role of disability acceptance and other psychosocial factors

BackgroundWith an aging workforce becoming increasingly prevalent in the United States, the intersection of older age and disability presents significant challenges for employment, particularly in the context of workplace accommodations.ObjectiveThis study aimed to elucidate the psychosocial factors influencing older workers' requests and receipts of job accommodations, focusing on the pivotal role of disability acceptance.MethodsEmploying a quantitative approach, we included 217 older workers (50 years and older) across various employment sectors, analyzing their experiences with accommodation requests, workplace support, knowledge of the Americans with Disabilities Act (ADA), and levels of disability acceptance.ResultsLogistic regression models revealed that perceived workplace support significantly predicted the likelihood of requesting and receiving accommodations, whereas disability acceptance, despite its hypothesized importance, did not emerge as a significant predictor in our models. Results highlight the critical role of workplace support in facilitating accommodation processes for older workers and suggest that interventions to increase ADA awareness and foster supportive work environments may enhance accommodation outcomes.ConclusionThis study contributes to a nuanced understanding of the dynamics surrounding accommodation requests among the aging workforce, emphasizing the need for inclusive workplace practices and policies.

Relationships Between Family Resilience, Individual Resilience, and Quality of Life in Patients with Head and Neck Cancer: A Cross-Sectional Study

BACKGROUND

Patients with head and neck cancer (HNC) have to cope with a multitude of treatment-related adverse effects that impact their quality of life (QoL) post-treatment completion. The presence of family resilience could potentially foster individual resilience and might contribute to patients' QoL. However, this interconnection has not been confirmed.

OBJECTIVE

To explore the relationships between family resilience, individual resilience, and QoL in patients with HNC and to determine whether individual resilience in HNC patients functions as a mediator between family resilience and QoL.

METHODS

From September 2022 to June 2023, a cross-sectional survey was conducted among 185 patients with HNC recruited through convenience sampling from a tertiary care hospital in Jiangsu Province, China. Self-report measures of family resilience, individual resilience, and QoL were assessed. Relationships were examined by Pearson's correlations. Structural equation models were used to assess whether individual resilience played a mediating role between family resilience and QoL.

RESULTS

There were significant positive correlations between QoL and both family resilience (r = 0.43, P < .01) and individual resilience (r = 0.59, P < .01). Moreover, family resilience had an indirect influence on QoL through its effect on individual resilience (β = 0.319, 95% CI: 0.336-0.815).

CONCLUSION

Family resilience emerges as a significant positive factor capable of enhancing QoL for patients with HNC by bolstering their resilience. To mitigate the detrimental effects of inadequate individual resilience on QoL of patients with HNC, it is advised to implement interventions focused on enhancing family resilience.

CHINA CLINICAL TRIALS REGISTRY NUMBER

ChiCTR2300067612.

Academic motivation and contextual influences in well-being for students with disabilities in higher education

Objective: The purpose of this study was to utilize self-determination theory (SDT) incorporating the person-environment contextual factors as a framework to examine how the SDT factors may interact with functional disability and contextual factors to influence well-being for students with disabilities in higher education. Methods and participants: A quantitative descriptive design utilizing a convenience sample of 210 students with disabilities in higher education was used. Results: The final regression model accounted for 64% of the variance in well-being. When controlling for all other predictor variables in the model, functional disability, autonomy, learning competence, and relatedness were found to be predictive of well-being, with autonomy being the strongest predictor of well-being, followed by relatedness, learning competence, and functional disability. Conclusion: This study offers critical insights for higher education institutions, emphasizing the need for fostering environments that prioritize autonomy, competence, and relatedness to promote the well-being of students with disabilities.

A Contemporary Review of the Clubhouse Model of Psychosocial Rehabilitation: Past, Present, and Emerging Directions

Since the 1940s, the Clubhouse model of psychosocial rehabilitation has evolved towards a comprehensive practice of social theory and intervention. Despite the model's cost effectiveness and observational evidence of its efficacy, empirical research remains lacking. The current narrative review examines studies from recent years (2015-2021), not to assess study rigor, but to identify trends in research aims, findings, and methodology, as well as specify future research directions. A narrative review was conducted using PRISMA guidelines. Using the search term "Clubhouse," 194 articles were identified in online databases. 38 met criteria for inclusion. Most studies were qualitative (60.5%) and few utilized experimental or quasi-experimental designs (7.9%). Narrative synthesis revealed research aims and outcome variables falling into six key areas: social integration and connectedness, quality of life (QOL), recovery outcomes, relational dynamics, policy, and virtual adaptations of the model. Findings indicate that recent Clubhouse-related research trends have primarily involved studies of social connectedness, QOL, recovery, relationships, and policy, as well as studies examining the value of the virtual Clubhouse in maintaining well-being. However, heterogeneity of methodologies and measures present a critical limitation to assessing results across studies. Options for increasing experimental methodologies in this area are reviewed. Recommended future directions involve moving towards a biopsychosocial approach to clarifying the mechanisms through which the model promotes recovery-aims that may yield implications beyond the realm of serious mental illness.

The Relationship Between Acceptance, Biopsychosocial Factors, and Quality of Life: A Structural Equation Model

Disability acceptance is one of the most significant constructs in the psychosocial adaptation process. Although prior research has examined the relationship among different biopsychosocial factors, disability acceptance, and quality of life (QoL), limited study focused on entering a series of biopsychosocial factors simultaneously into analysis to reflect live experience of individuals with disabilities. This study aimed to examine the role of acceptance regarding the relationship between a series of biopsychosocial factors (i.e., general health, physical functioning, pain, anxiety, depression, stress, loneliness, stigma, sense of community, and neighborhood problems) and QoL based on Livneh’s psychosocial adaptation model to inform psychosocial interventions. A total of 430 participants with disabilities completed an online survey consisting of instruments measuring target variables. Exploratory and confirmatory factor analyses indicated a three-factor structure for selected biopsychosocial factors (i.e., psychological difficulties, physical status, and community issues). Structural equation modeling results showed that the proposed model indicated a fair model fit after respecification. Effect analyses showed that disability acceptance directly affected QoL and partially mediated the relationship between physical status and QoL and psychological difficulties and QoL. In addition, loneliness has been found to significantly and directly predict QoL in the respecified model. The model demonstrated that disability acceptance and loneliness have a significant impact on QoL.

Incidence and persistence of psychological distress during the COVID-19 pandemic among individuals with and without disability

OBJECTIVES

We investigated the incidence (becoming distressed at the follow-up) and persistence (distressed at the baseline and the follow-up) of psychological distress among individuals with and without disability in the period from early 2017 (before the COVID-19 pandemic) to late 2020 (the second wave of the pandemic).

METHODS

We analyzed the population-based FinHealth 2017 survey and its follow-up conducted in 2020 (number of individuals who participated in both surveys: n = 4881; age = 18+). Logistic regressions were applied to investigate differences in the incidence and persistence of psychological distress between people with and without disability. We also investigated whether age, quality of life at the baseline, and perceived increase in loneliness during the COVID-19 pandemic moderated the association between disability and the incidence of distress.

RESULTS

The incidence of psychological distress was higher (OR = 3.01, 95% CI:2.09-4.35) for people with disability (18.9%) than among those without (7.4%), being highest (31.5%) among the youngest participants with disability, aged 18 to 39. People with disability who had a poor quality of life at the baseline were particularly prone to become distressed during the follow-up. People who reported perceived increase in loneliness during the pandemic were prone to become distressed at the follow-up regardless of their disability status. The persistence of distress was more common (OR = 6.00, 95% CI:3.53-10.12) among people with disability (65.7%) than among those without (24.9%).

CONCLUSION

The COVID-19 pandemic had more negative mental health effects on people with disability, especially adults with disability who were young and had a low quality of life before the pandemic.

Service-Connected Disability and Happiness in Student Veterans: A Parallel Mediation Study of PERMA

The student veteran population has been growing in higher education, along with the attention to their happiness and well-being. Seligman developed the positive emotion, engagement, relationships, meaning, and accomplishment (PERMA) model to help understand an individual’s happiness, including five pillars: Positive emotion, Engagement, Relationship, Meaning, and Accomplishment. In this study, we aim at evaluating the role of the PERMA model’s five pillars in explaining the relationship between service-connected disability and happiness. Data were collected from 205 student veterans. The result demonstrated that positive emotion and accomplishment mediated the relationship between service-connected disability and happiness. The findings of this study suggest utilizing positive psychology to help student veterans improve happiness, as well as engage in more activities that could potentially increase an individual’s positive emotion and accomplishment, and eventually increase the level of happiness.

Current Status of Acceptance of Disability and the Correlation With the Life Quality in Parkinson's Disease in Southwest China

Background

Acceptance of disability (AOD) is a process that a patient must undergo to cope with altered abilities, but its effect in Parkinson's disease (PD) remains unclear. The present study aimed to determine the level of AOD, examine the influence of sociodemographic variables and disease characteristics on the AOD level, and evaluate the relation between AOD level and quality of life in a cohort of PD patients from Southwest of China.

Methods

A total of 336 PD patients were consecutively recruited from November 2018 to October 2020. At enrollment, demographic and clinical data were obtained using a questionnaire, and the Acceptance of Disability Scale-Revised (AODS-R) scale was used to measure the AOD level.

Results

The mean total score of AOD is 87.28, indicating a moderate level of disability acceptance in PD patients. Statistical analysis showed that understanding of PD, family support, and UPDRS-II score were major factors affecting AOD level, and patients with low AOD levels were more likely to have poorer quality of life.

Conclusion

AOD is a serious problem in PD patients in Southwest China, especially among individuals with insufficient family support and a lack of recognition of the disease. AOD was also associated with motor function and daily living ability, thus suggesting that evaluation of the AOD and promotion of the awareness may be helpful to improve the quality of life in patients with PD.

Character Strengths Across Disabilities: An International Exploratory Study and Implications for Positive Psychiatry and Psychology

The purpose of this study was to examine the differences in character strengths for people with disabilities by using an international dataset by the VIA Institiute on Character. Specifically, we aimed to explore (a) the top and bottom five character strengths reported by different disability groups and all people with disabilities more broadly, and (b) group differences in each character strength and total character strengths. The investigator contacted the VIA Institute on Character (http://www.viacharacter.org/) for obtaining the dataset for the current study. After data cleaning, our sample size resulted in 11,699 people with disabilities. Among most people with disabilities, the top five character strengths scores were love of learning, honesty, appreciation of beauty and excellence, kindness, and fairness. The bottom five character strengths scores were self-regulation, perseverance, zest, spirituality, and prudence. Knowing that there is heterogeneity in character strengths across groups gives us a better understanding of the areas that people with different disabilities and conditions might thrive and provides clinicians and practitioners with a more nuanced understanding for how to possibly intervene with their clients. Positive psychiatry and psychology implications are discussed.

The Differential Impact of Lockdown Measures Upon Migrant and Female Psychiatric Patients - A Cross-Sectional Survey in a Psychiatric Hospital in Berlin, Germany

The COVID-19 pandemic could have major effects on already vulnerable individuals with psychiatric disorders. It is important to assess how different patient groups respond to stress related to the pandemic, and what additional factors influence it, including family-related stress, migration background, and sex. We conducted a survey in a sample of 294 psychiatric patients in a large outpatient clinic in Berlin, measuring level of distress in relation to COVID-19 lockdown as well as family-related distress. We also measured potential influencing factors such as media consumption and medical support. In the migration background group, we found that women had more lockdown related psychological distress than men. This was not apparent in those patients with a German background. We found that females were more strongly affected by family-related distress, particularly those with a migration background. People with PTSD were most strongly affected by family-related distress, whereas people with psychotic disorders and addiction reported the least distress. There were no effects of media consumption. There were no differences in ability to abide by the lockdown related restrictions across diagnoses. Our results support earlier findings on differential vulnerability of diagnostic groups to these stressors. Thus, clinicians can optimize treatment by taking family-related stressors into account particularly for females and people with a migrant background.

Psychological factors involved in psychopharmacological medication adherence in mental health patients: A systematic review

BACKGROUND

Psychopharmacological medication adherence is essential for psychiatric patients' treatment and well-being.

OBJECTIVE

This review aimed to identify psychological factors related to health control that have been linked to psychopharmacological medication adherence in psychiatric patients.

METHODS

A literature search was performed through the databases Medline, PubMed, PsycINFO, and Google Scholar to identify relevant studies published before October 15th, 2019. Articles published in peer-reviewed journals that analyzed the psychological factors of health belief and health control involved in psychopharmacological medication adherence in a psychiatric population were included.

RESULTS

The search identified 124 potentially relevant papers, 29 of which met the eligibility criteria. The final sample was 222 adolescents, most with a diagnosis of attention deficit/hyperactivity disorder (ADHD), and 6139 adults diagnosed especially with schizophrenia spectrum disorder, bipolar disorder, or depressive disorder. Results suggested that medication adherence is associated with health beliefs and psychological variables, such as self-efficacy and locus of control. Family support was also positively related to medication adherence.

CONCLUSION

Psychopharmacological medication adherence requires a consideration of multicausality, which depends on sociodemographic, clinical, and psychological factors.

PRACTICE IMPLICATIONS

These findings should be considered in the development and implementation of psychological interventions focused on self-control and family support.

Psychiatric Symptoms, Psychosocial Factors, and Life Satisfaction Among Persons With Serious Mental Illness: A Path Analysis

This study explores the effects of biopsychosocial factors on life satisfaction among persons with serious mental illness. Participants in this study included a convenience sample of 194 adults recruited from Texas and Wisconsin. A path analysis was conducted with psychiatric symptoms as an exogenous variable, and illness insight, social self-efficacy, social support, community integration, and life satisfaction as endogenous variables. Beginning with a hypothesized model, a best model was obtained after removing the paths that were not significant and adding recommended paths supported by theory. In the final model, psychiatric symptoms, social self-efficacy, social support, and community integration were directly associated with life satisfaction. Illness insight did not directly affect life satisfaction but had indirect effects. Psychiatric symptoms may be the most important and direct predictor of life satisfaction; illness insight, social self-efficacy, social support, and community integration buffer the direct of effect of psychiatric symptoms on life satisfaction.

Family support and adaptation mechanisms of adults outpatients with schizophrenia

Background: The presence of psychotic symptoms in adults’ with schizophrenia need an increase in family control and support to prevent the risk of aggressive behavior. However, the issue of whether psychotic symptoms hold any clinical relevance in relatively stable outpatient samples has not been established. The purpose of this study, therefore, was to identify the relationship between family supports and adaptation mechanisms of adults’ outpatients with schizophrenia.

Design and methods: The study design involves quantitative research and descriptive correlation, attained through purposive sampling approach. 101 samples were obtained from the population of schizophrenia outpatients. The questionnaires of House & Kahn were used as an instrument to evaluate family support, while Nursalam questionnaires were used to access adaptation skills.

Results: Findings from Spearman’s rho test showed P<0.005, indicating the provision of high family support, while patients were highly adaptive to the symptoms of schizophrenia.

Conclusions: This study indicates the positive influence of family support on the adaptability of schizophrenia outpatients, hence there is need for relatives to provide good level of support, in order to facilitate adaptability.

The role of social engagement in the association of self-reported hearing loss and health-related quality of life

BACKGROUND

Hearing loss is highly prevalent and associated with reduced well-being in older adults. But little is known about the role of social factors in the association of hearing difficulty and its health consequences. This study aims to examine the association between self-reported hearing loss and health-related quality of life (HRQoL, consisted of physical and mental component summary, PCS and MCS), and to investigate whether social engagement mediates this association.

METHOD

Data on 4035 older adults aged 60 years or above from a cross-sectional nationally representative database in China were obtained to address this study. HRQoL was measured by the Short Form 12 Health Survey (SF-12). Hearing loss was defined by a dichotomized measure of self-reported hearing difficulty, which has been proved to be sensitive and displayed moderate associations with audiometric assessment in elderly population. Social engagement was measured by the Index of Social Engagement Scale. Bootstrap test was applied to test for the significance of the mediating role of social engagement.

RESULTS

Self-reported hearing loss was found negatively associated with HRQoL in older adults, and hearing loss was much more related to reduced mental well-being. Social engagement played a partial mediating role in the association of hearing loss and HRQoL. Social engagement account for 4.14% of the variance in the change of PCS scores and 13.72% for MCS, respectively.

CONCLUSION

The study lends support to the hypothesis that hearing loss is associated with aging well beings, and the use of hearing aid or proper social engagement intervention may improve the quality of life among the elderly.