1
|
Soendergaard PL, Arango-Lasprilla JC, Wolffbrandt MM, Dornonville de la Cour FL, Biering-Sørensen F, Norup A. Investigating the Effectiveness of a Family Intervention after Acquired Brain or Spinal Cord Injury: A Randomized Controlled Trial. J Clin Med 2023; 12:jcm12093214. [PMID: 37176654 PMCID: PMC10179666 DOI: 10.3390/jcm12093214] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
(1) Background: Acquired brain injury (ABI) or spinal cord injury (SCI) constitutes a severe life change for the entire family, often resulting in decreased quality of life (QoL) and increased caregiver burden. The objective of this study was to investigate the effectiveness of a family intervention in individuals with ABI or SCI and in their family members. (2) Methods: An RCT of a family intervention group (FIG) vs. a psychoeducational group (PEG) (ratio 1:1) was performed. The FIG received an eight-week manual-based family intervention, and the PEG received one psychoeducational session. Self-reported questionnaires on QoL with the Mental Component Summary (MCS) and on caregiver burden with the Caregiver Burden Scale (CBS) were the primary outcomes. The data analysis involved linear mixed-effects regression models. (3) Results: In total, 74 participants were allocated randomly to the FIG and 84 were allocated randomly to the PEG. The FIG had significantly larger improvements on the MCS and significantly larger reductions on the CBS at the two-month follow-up than participants in the PEG (mean differences of 5.64 points on the MCS and -0.26 points on the CBS). At the eight-month follow-up, the between-group difference remained significant (mean difference of 4.59 points) on the MCS, whereas that on the CBS was borderline significant (mean change of -0.14 points). (4) Conclusions: Family intervention was superior to psychoeducation, with larger improvements in QoL and larger reductions in caregiver burden.
Collapse
Affiliation(s)
- Pernille Langer Soendergaard
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, 2600 Glostrup, Denmark
- Department of Psychology, University of Southern Denmark, 5230 Odense, Denmark
- Neurorehabilitation-CPH, City of Copenhagen, 2900 Hellerup, Denmark
| | | | - Mia Moth Wolffbrandt
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, 2600 Glostrup, Denmark
- Department of Psychology, University of Southern Denmark, 5230 Odense, Denmark
| | - Frederik Lehman Dornonville de la Cour
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, 2600 Glostrup, Denmark
- Department of Neuroscience, University of Copenhagen, 2200 Copenhagen, Denmark
- The Elsass Foundation, 2920 Charlottenlund, Denmark
| | - Fin Biering-Sørensen
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Brain and Spinal Cord Injuries, Rigshospitalet, Copenhagen University Hospital, 2600 Glostrup, Denmark
| | - Anne Norup
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, 2600 Glostrup, Denmark
- Department of Psychology, University of Southern Denmark, 5230 Odense, Denmark
| |
Collapse
|
2
|
Brady J, Mouneimne M, Milaney K. Environmental and systems experiences of persons with spinal cord injury and their caregivers when transitioning from acute care to community living during the COVID-19 pandemic: a comparative case study. Spinal Cord Ser Cases 2023; 9:8. [PMID: 36906673 PMCID: PMC10006547 DOI: 10.1038/s41394-023-00561-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 03/13/2023] Open
Abstract
STUDY DESIGN Comparative case study OBJECTIVES: To elevate the voices of and capture the lived environmental and systems experiences of persons with spinal cord injury (PWSCI) and their caregivers, in transitions from inpatient rehabilitation to the community. Also, to examine the perceived and actual availability and accessibility of services and programs for this group. SETTING Inpatient rehabilitation unit and community in Calgary, Alberta, Canada METHODS: As a comparative case study, this research included multiple sources of data including brief demographic surveys, pre- and post-discharge semi-structured interviews, and conceptual mapping of services and programs for PWSCI and caregivers in Calgary, Canada (dyads). Three dyads (six participants) were recruited from an inpatient rehabilitation unit at an acute care facility, from October 2020 to January 2021. Interviews were analyzed using the Interpretative Phenomenological Analysis approach. RESULTS Dyads described transition experiences from inpatient rehabilitation to community as uncertain and unsupported. Breakdowns in communication, COVID-19 restrictions, and challenges in navigating physical spaces and community services were identified by participants as concerns. Concept mapping of programs and services showed a gap in identification of available resources and a lack of services designed for both PWSCI and their caregivers together. CONCLUSIONS Areas for innovation were identified that may improve discharge planning and community reintegration for dyads. There is an intensified need for PWSCI and caregiver engagement in decision-making, discharge planning and patient-centered care during the pandemic. Novel methods used may provide a framework for future SCI research in comparable settings.
Collapse
Affiliation(s)
- Jocelyn Brady
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | | | - Katrina Milaney
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
3
|
Rhudy LM, Hines EA, Farr EM, Esterov D, Chesak SS. Feasibility and acceptability of the Resilient Living program among persons with stroke or brain tumor and their family caregivers. NeuroRehabilitation 2023; 52:123-135. [PMID: 36617758 DOI: 10.3233/nre-220127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Practice guidelines and research results emphasize the need for dyadic interventions targeting psychosocial outcomes such as depression, anxiety, social function, physical function, and health-related quality of life. Resilience interventions have been proposed as one strategy to influence these outcomes. OBJECTIVE The objective of this observational pilot study was to determine the feasibility and acceptability of the Resilient Living program among persons with stroke or brain tumor (BT) admitted for comprehensive acute inpatient rehabilitation and/or their family caregivers. A secondary aim was to gather preliminary data to assess the effects of the program on quality of life, stress, anxiety, physical function, sleep disturbance, fatigue, resilience, dyadic coping, and caregiver role overload. METHODS The Resilient Living program is a psychosocial intervention with a focus on building resilience skills. Feasibility and acceptability outcomes were assessed at the end of the study. Quantitative outcome measures were collected at baseline, 12 weeks, and 6 months post the intervention. RESULTS Eight patients and eight caregivers completed the study. The intervention was feasible with this population. Participants found the intervention useful and appreciated the flexibility of an online program; however, finding time to engage in it was challenging. Recruitment of eligible patients with acquired brain disorders and their caregivers as a dyad was challenging. CONCLUSION The study confirms prior research suggesting that interventions targeting resilience are feasible, but larger studies with more rigorous methods are needed to appreciate the influence of resilience interventions in persons with brain disorders and their caregivers. Further research is needed to identify the characteristics of those most likely to benefit from resilience interventions and the optimal timing of such interventions.
Collapse
Affiliation(s)
- Lori M Rhudy
- Department of Graduate Nursing, Winona State University, Rochester, Minnesota, USA
| | - Emily A Hines
- Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Ellen M Farr
- Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Dmitry Esterov
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - Sherry S Chesak
- Department of Nursing, Division of Nursing Research, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
4
|
Mohammadi F, Oshvandi K, Bijani M, Borzou SR, Khodaveisi M, Masoumi SZ. Perception of facing life's challenges in patients with spinal cord injury in Iran: a qualitative study. BMC Psychol 2022; 10:202. [PMID: 35971169 PMCID: PMC9376906 DOI: 10.1186/s40359-022-00909-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Spinal cord injury (SCI) is one of the most serious types of physical trauma and has become a major life-threatening condition in the recent decade. It is essential that the life perception and experiences of patients with SCI be studied and evaluated in different cultural contexts so that their needs and the challenges they face can be properly determined. The present study aims to explore the how patients with SCI in the south of Iran perceive facing life's challenges. METHODS The present study is a qualitative research with a descriptive phenomenological design. Participants were identified through purposive sampling of patients with spinal cord injury admitted to two state hospitals affiliated with a university of medical sciences in western Iran. The researchers collected data using semi-structured, in-depth interviews with 25 SCI patients conducted between August and October 2021. Data was analyzed according to Colaizzi's method using MAXQDA v. 2007. RESULTS Analysis of the data led to the emergence of three themes and nine sub-themes. The three main themes were emotional shock (crisis making and mental rumination, persistent depressive disorder, pitying behaviors, fear of the future), loss of dignity (poor self- care, sexual dysfunction, loss of job and educational status), and lack of effective support (lack of financial institutions and sponsors, lack of social support). CONCLUSION Patients with spinal cord injuries face various issues in their care and social lives. Attention to their psycho-emotional needs along with comprehensive health support play key roles in generating a sense of self efficacy and promoting the mental well-being and dignity of patients with spinal cord injuries. Accordingly, healthcare administrators and caregivers are recommended to provide more comprehensive health support to SCI patients to meet their needs more effectively.
Collapse
Affiliation(s)
- Fateme Mohammadi
- Chronic Diseases (Home Care) Research Center and Autism Spectrum Disorders Research Center, Department of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Khodayar Oshvandi
- Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa, Iran.
| | - Seyed Reza Borzou
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Masoud Khodaveisi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Community Health Nursing, School of Nursing and Midwifery, Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyedeh Zahra Masoumi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Midwifery, School of Nursing and Midwifery, Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
5
|
Mei X, Wang H, Wang X, Wu X, Wu J, Ye Z. Associations among neuroticism, self-efficacy, resilience and psychological distress in freshman nursing students: a cross-sectional study in China. BMJ Open 2022; 12:e059704. [PMID: 35697443 PMCID: PMC9196198 DOI: 10.1136/bmjopen-2021-059704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The current study examines the mediating roles of resilience and self-efficacy and the moderating role of gender in the association between neuroticism and psychological distress in Chinese freshman nursing students (FNSs). METHODS A total of 1220 FNSs were enrolled from the Be Resilient to Nursing Career (ChiCTR2000038693) Programme and the following instruments were administered to them: NEO Five-Factor Inventory, General Self-Efficacy Scale, Connor-Davidson Resilience Scale and Kessler Psychological Distress Scale. A moderated mediation analysis and a generalised additive model analysis were performed. RESULTS The direct and indirect effects of neuroticism on psychological distress were significantly mediated by self-efficacy (B = 0.200, 95% CI 0.001 to 0.039), resilience (B = 0.021, 95% CI 0.007 to 0.038) and the interaction between self-efficacy and resilience (B = 0.016, 95% CI 0.005 to 0.028). The interactions between neuroticism and gender (β = 0.102, 95% CI 0.001 to 0.203, p<0.05) and between resilience and gender were significant (β = 0.160, 95% CI 0.045 to 0.275, p<0.01). A non-linear and positive association was confirmed between neuroticism and psychological distress. CONCLUSIONS Self-efficacy and resilience significantly mediate the relationship between neuroticism and psychological distress. Gender moderates the relationships between neuroticism and resilience and between resilience and psychological distress.
Collapse
Affiliation(s)
- Xiaoxiao Mei
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Huiyuan Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xinqin Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiaona Wu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jieyi Wu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zengjie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| |
Collapse
|
6
|
Eroğlu S, Solak S, Dündar Ü. The association of Type D personality with functional outcomes, quality of life and neuropathic pain in persons with spinal cord injury. Spinal Cord 2022; 60:567-573. [PMID: 35124701 DOI: 10.1038/s41393-022-00760-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES This study aimed to investigate the association of Type D personality (TDP) with functional outcomes, health-related quality of life (HRQoL) and neuropathic pain in persons with spinal cord injury (SCI), using dichotomous and continuous analysis methods. SETTING Tertiary rehabilitation center. METHODS This study included 105 persons with SCI. Independence level was determined using the Functional Independence Measure (FIM)-motor subscale. The Short Form-36 questionnaire (SF-36) was used to assess HRQoL. TDP (combined existence of negative affectivity and social inhibition) was assessed using Type D Scale-14 (DS-14). Presence of chronic pain was questioned and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Pain Scale was used to distinguish neuropathic pain from others. RESULTS In dichotomous method, the FIM-motor score was significantly lower in persons with TDP (41 persons, 39%) (p = 0.025). Persons with TDP had significantly lower scores in vitality, emotional role and mental health. There was no significant difference between the groups, regarding neuropathic pain and LANSS scores (p > 0.05 for all). Negative affectivity and total DS-14 scores had negative correlation with mental health and vitality. In continuous interaction method, TDP predicted mainly the mental health components of SF-36 (particularly, vitality and mental health). Negative affectivity was the driving factor. TDP was not associated with FIM-motor, VAS pain or LANSS scores. CONCLUSIONS Mental component of HRQoL is associated with Type D in persons with SCI in both analyses. Assessment of potential differences related with TDP may be beneficial to develop and apply person-specific goals in SCI rehabilitation.
Collapse
Affiliation(s)
- Selma Eroğlu
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
| | - Samed Solak
- Department of Physical Medicine and Rehabilitation, Kahta State Hospital, Adıyaman, Turkey
| | - Ümit Dündar
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| |
Collapse
|
7
|
Welten JJE, Cox VCM, Kruithof WJ, Visser-Meily JMA, Post MWM, van Heugten CM, Schepers VPM. Intra- and interpersonal effects of coping style and self-efficacy on anxiety, depression and life satisfaction in patient-partner couples after stroke. Neuropsychol Rehabil 2022; 33:849-870. [PMID: 35297736 DOI: 10.1080/09602011.2022.2051564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Many stroke patients and partners suffer from anxiety, depression, and low life satisfaction. Psychological factors such as coping style and self-efficacy can be protective factors within individuals. The close relationship between stroke patients and partners suggests that there may be interdependence in psychological functioning. The aim of this study was to examine intra- and interpersonal effects of coping style and self-efficacy on anxiety, depression, and life satisfaction in patient-partners couples. In this prospective cohort study, pro-active coping (UPCC), general self-efficacy (GSES), anxiety (HADS-A), depression (HADS-D), and life satisfaction (1-6 scale) were assessed in 215 couples at 2 and 12 months post-stroke. Effects within couples were assessed using structural equation modelling. Several intra- and interpersonal effects of coping style and self-efficacy at 2 months post-stroke were related to emotional health at 12 months post-stroke. Most effects were intrapersonal effects. The interpersonal effects were small but showed that pro-active coping by the patient was associated with lower anxiety of the partner. Higher self-efficacy of the partner was associated with lower depression scores and higher life satisfaction of the patient. This study underscores the importance of a dyadic approach to post-stroke functioning. It supports a family-based approach for treating post-stroke emotional problems.
Collapse
Affiliation(s)
- J J E Welten
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - V C M Cox
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - W J Kruithof
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - C M van Heugten
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - V P M Schepers
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
8
|
Soendergaard PL, Norup A, Kruse M, Biering-Sørensen F. Socioeconomic consequences of traumatic and non-traumatic spinal cord injuries: a Danish nationwide register-based study. Spinal Cord 2022; 60:647-654. [PMID: 34999725 DOI: 10.1038/s41393-021-00724-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN A nationwide population-based register study. OBJECTIVES To investigate the socioeconomic consequences of traumatic (tSCI) and non-traumatic (ntSCI) spinal cord injuries (SCI) in relation to health care costs, risk of job loss, and divorce. SETTING Denmark. METHODS All survivors admitted for specialized SCI rehabilitation from 2008 to 2018 were included (n = 1751), together with their relatives (n = 3084). Control groups for the SCI group (n = 8139) and their relatives (n = 15,921) were identified. Data on socioeconomics up to 2 years before and up to 4 years after the injury year were included. RESULTS Survivors of tSCI and ntSCI had significantly increased health care costs 2 years before injury compared to their controls, and increased health care cost was maintained 4 years after the injury (all p values < 0.0001). The SCI group had significantly increased risk of job loss (OR = 9.26; 95% CI: 7.70-11.15) and higher risk of divorce (OR = 1.44; 95% CI: 1.08-1.87) the 3 following years after injury compared to controls, but risk of divorce was only significant for the ntSCI group (OR = 1.58; 95% CI: 1.09-2.29). No significant differences on health care cost and job loss between the group of relatives of SCI survivors and their controls were found, except for the relatives (n = 1604) of SCI survivors <18 years old, where a higher risk of job loss was found (OR = 1.43, 95% CI 0.97-2.1). CONCLUSION These results emphasize that socioeconomic consequences for survivors of both tSCI and ntSCI are pervasive and long-lasting.
Collapse
Affiliation(s)
- Pernille Langer Soendergaard
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Glostrup, Denmark. .,Department of Psychology, University of Southern Denmark, Odense, Denmark. .,Department of Brain and Spinal Cord Injuries, Rigshospitalet, Copenhagen University Hospital, Glostrup, Denmark.
| | - Anne Norup
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Glostrup, Denmark.,Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Marie Kruse
- DaCHE - Danish Centre for Health Economics, University of Southern Denmark, Odense, Denmark
| | - Fin Biering-Sørensen
- Department of Brain and Spinal Cord Injuries, Rigshospitalet, Copenhagen University Hospital, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
9
|
McKenna O, Fakolade A, Cardwell K, Langlois N, Jiang K, Pilutti LA. Towards conceptual convergence: A systematic review of psychological resilience in family caregivers of persons living with chronic neurological conditions. Health Expect 2021; 25:4-37. [PMID: 34676951 PMCID: PMC8849377 DOI: 10.1111/hex.13374] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/31/2021] [Accepted: 09/17/2021] [Indexed: 01/28/2023] Open
Abstract
Background The demand for family caregiving in persons with chronic neurological conditions (CNCs) is increasing. Psychological resilience may empower and protect caregivers in their role. Thus, a synthesis of resilience evidence within this specific population is warranted. Aim In this systematic review we aimed to: (1) examine the origins and conceptualizations of resilience; (2) summarize current resilience measurement tools; and (3) synthesize correlates, predictors and outcomes of resilience in family caregivers of persons with CNCs. Design We sourced English articles published up to July 2020 across five databases using search terms involving CNCs, family caregivers and resilience. Results A total of 50 studies were retained. Nearly half (44%) of the studies used trait‐based resilience definitions, while about one third (36%) used process‐based definitions. Twelve different resilience scales were used, revealing mostly moderate to high‐resilience levels. Findings confirmed that resilience is related to multiple indicators of healthy functioning (e.g., quality of life, social support, positive coping), as it buffers against negative outcomes of burden and distress. Discordance relating to the interaction between resilience and demographic, sociocultural and environmental factors was apparent. Conclusions Incongruity remains with respect to how resilience is defined and assessed, despite consistent definitional concepts of healthy adaptation and equilibrium. The array of implications of resilience for well‐being confirms the potential for resilience to be leveraged within caregiver health promotion initiatives via policy and practice. Patient or Public Contribution The findings may inform future recommendations for researchers and practitioners to develop high‐quality resilience‐building interventions and programmes to better mobilize and support this vulnerable group.
Collapse
Affiliation(s)
- Odessa McKenna
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | | | - Katherine Cardwell
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Nigèle Langlois
- Health Sciences Library, University of Ottawa, Ottawa, Canada
| | - Karen Jiang
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Lara A Pilutti
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.,Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| |
Collapse
|
10
|
Finlay KA, Hearn JH, Chater A. The impact of neurological disability and sensory loss on mindfulness practice. Disabil Rehabil 2021; 44:3825-3833. [PMID: 33621135 DOI: 10.1080/09638288.2021.1887946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Mindfulness-based approaches are increasingly recommended in the management of medical conditions associated with sensory loss and absence, such as Spinal Cord Injury (SCI), Multiple Sclerosis (MS) and Functional Neurological Disorder (FND). Yet the implications of undertaking practices such as body scanning when living with sensory loss have not been considered. This study aimed to explore the impact of sensory loss on the practice and experience of mindfulness in qualified mindfulness teachers with SCI/FND/MS. METHODS Eight mindfulness teachers (5 females, 3 males) with SCI/FND/MS, sensory loss and wheelchair use were recruited from mindfulness teacher databases. In-depth, semi-structured interviews were undertaken, lasting between 50 and 93 min. Interviews were transcribed verbatim and analysed using Interpretative Phenomenological Analysis. Idiographic analyses for descriptive, linguistic and conceptual themes were completed before cross-case analyses. RESULTS Analyses resulted in two superordinate themes: (1) Adopting your Body; and (2) Sensation without Loss. These themes reflected the challenge of overcoming initial resistance to areas of the body with sensory disruption, building a relationship with the whole body, such that sensory awareness could be visualised and experienced without proprioception. CONCLUSIONS Mindfulness offers a unique approach to accepting and working with the body after paralysis or sensory loss. Fundamental to the use of mindfulness with such populations, is the prioritisation of inclusive sensory language and exploring sensory absence as well as sensory presence. The cognitive and emotional outcomes of body scanning may be uniquely elevated in populations with neurophysiological disorders, highlighting the benefits of mindfulness for adaptive and protective self-management.IMPLICATIONS FOR REHABILITATIONMindfulness-based practices which focus on the body and sensation are accessible to people with neurological limitations.Mindfulness techniques can be extended through the use of visualisation strategies to encourage (non-proprioceptive) awareness of paralysed limbs or areas of the body with sensory loss.The language used in mindfulness-based interventions may need adapted by practitioners so that it remains inclusive for people with sensory loss as well as sensory presence.Additional care needs to be taken when using body scans during mindfulness as they have the potential to exacerbate psychological distress in people with reduced sensory awareness.
Collapse
Affiliation(s)
- K A Finlay
- School of Psychology Clinical Language Sciences, University of Reading, Reading, UK
| | - J H Hearn
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - A Chater
- School of Sport Science and Physical Activity, University of Bedfordshire, Luton, UK
| |
Collapse
|