Contextual factors of financial capability and financial well-being for adults living with brain injury: a qualitative photovoice study

OBJECTIVE

To identify the contextual factors related to financial capability and financial well-being for adults living with acquired brain injury (ABI).

DESIGN & METHOD

We conducted a qualitative descriptive study using photovoice and included 17 adults who live with ABI in Manitoba, Canada. Over 3-to-5 weeks, participants took photos of their financial capability (i.e. knowledge, skills, and behaviors related to managing finances) or their financial well-being (i.e. subjective and objective financial outcomes). Participants were interviewed about their photos. Five researchers iteratively and thematically analyzed interview transcripts.

MAIN OUTCOMES/RESULTS

Analysis identified the importance of the economic, social, technology, and physical or sensory context. Subthemes related to: (i) hard times finding financial resources; (ii) processes not making sense; (iii) getting help from the right person; and (iv) invisible disability bias and stigma.

CONCLUSIONS

There is decreased literature about financial capability or financial well-being after ABI. The results of this study highlight the salience of finance to living with ABI and the importance of the context to addressing financial-related life participation for people living with ABI. Information about contextual factors related to finance can improve rehabilitation assessment and intervention practice as well as emphasize needed accessibility changes to financial environments.

Financial Capability Interventions Used for Specific Diagnoses Related to Functional Impairment: A Scoping Review

IMPORTANCE

Occupational therapists often address financial occupations of clients with acquired functional impairments who experience challenges with financial capability (FC).

OBJECTIVE

To explore the intervention literature aimed at improving FC in five diagnostic adult populations.

DATA SOURCES

MEDLINE, CINAHL, PsycInfo, EconLit, and EMBASE; researchers also completed backward and forward citation searching and contacted expert authors.

STUDY SELECTION AND DATA COLLECTION

Two independent reviewers completed article screening, selection, and extraction using a scoping review approach; a priori inclusion criteria were peer-reviewed articles, written in English, involving adults with one of five diagnostic conditions, describing any intervention to improve FC.

FINDINGS

Twenty-four articles met the inclusion criteria. Most articles were aimed at substance use or mental health populations (n = 20); fewer focused on brain injury (n = 2), multiple sclerosis (n = 1), or mixed-diagnosis (n = 1) populations. Only 4 were randomized controlled trials (RCTs). Interventions were heterogeneous and complex, including components of skills training (n = 21), individualized budgeting (n = 18), representative payeeship (n = 11), education (n = 10), structured goal setting (n = 7), savings building (n = 5), metacognitive strategies (n = 2), and assistive technology (n = 1).

CONCLUSIONS AND RELEVANCE

Despite growth in the area, the literature regarding FC intervention is limited, with few RCTs and many populations unrepresented. The literature for a systematic review of FC intervention efficacy for these populations is insufficient, particularly because included studies used varied components, limiting comparison. Further research is imperative to guide evidence-based practice. Plain-Language Summary: This study is an overview of literature about interventions to address the financial occupations of clients with acquired functional impairments. The findings give occupational therapy researchers and clinicians the information they need to begin analyzing, using, and building the evidence to support the use of interventions to improve clients' financial capability and well-being.

Review and Consultations of Canadian Financial Education Programs for Individuals with Disabilities

Background. Individuals or persons who live with a disability (PWD) can experience unique financial occupation challenges. Financial education programs can address some challenges. Purpose. The aim of this study was to describe and critically appraise current financial education programs for PWD in Canada. Method. This environmental scan framed by scoping review methods included a critical appraisal of Canadian programs' online content and provider consultations. Researchers used four search methods to identify programs, interviewed service providers from four Canadian programs, and thematically analyzed interview transcripts. Findings. Researchers identified 134 programs; 50 (37.3%) included services. The online content of only 26 (19%) programs explicitly addressed accessibility; 106 (79%) programs' content was at least college reading level. The qualitative results include three themes: (a) individualized approach, (b) "getting the word out", and (c) service growth. Implications. There are financial education programs specific to PWD in Canada. Accessibility, individualization, advocacy, and development are needed.

Cognitive impairment in systemic lupus erythematosus is negatively related to social role participation and quality of life: A systematic review

Introduction

At least 38% of patients with Systemic Lupus Erythematosus (SLE) experience cognitive impairment (CI). Patients report CI impacts their health-related quality of life (HRQoL) and social role participation.

Objectives

To synthesize and critically appraise the quantitative literature on the relationship of CI to HRQoL and social role participation in individuals with SLE.

Methods

Six electronic databases were searched in December 2018 and June 2020 by an information specialist. Two reviewers independently completed all screening phases and data extraction; a third reviewer resolved disagreements. The Mixed Methods Appraisal Tool was used to critically appraise the quality of included studies. Data has been synthesized and analyzed descriptively to present evidence on the relationship of CI to HRQoL and social role participation.

Results

A total of 7182 references were identified and screened, with 14 articles included. Four of the included articles investigated the relationship between CI and HRQoL and all identified a negative relationship. Ten of the 14 studies investigated CI and social role participation, eight identified a negative relationship. There was heterogeneity of measures used between studies to examine CI, HRQoL, and social role participation. As such, results were interpreted descriptively and could not be pooled for meta-analysis.

Conclusion

The presence of CI is negatively related to HRQoL and social role participation in patients with SLE. Healthcare professionals should be aware of this relationship so that it can be addressed in clinical practice. Further research, using consistent methods of quantifying CI, HRQoL and social role participation, is needed to enable data pooling.