The Burden of Hate: How Nonwork Discrimination Experienced During the COVID-19 Pandemic Impacts Asian American Employees

The COVID-19 pandemic has been accompanied by a sharp increase in prejudice and discrimination targeting Asian Americans in the USA. Thus, in addition to the public health risks associated with the virus, exposure to discrimination poses a unique threat to the health and well-being of Asian Americans. Indeed, empirical evidence has documented the linkage between experiencing anti-Asian discrimination during the pandemic and health decrements among Asian Americans. The goal of this study was to expand that research to also consider the ways experiencing discrimination in a nonwork context may spill over to affect the general and job-related well-being of Asian American employees as well as the potential mitigating role of coworker compassion. Results from a sample of 311 Asian American employees demonstrated that experiencing nonwork discrimination was associated with decrements in physical health and increased depression and job-related exhaustion. Further, there were significant interactions between nonwork discrimination and coworker compassion for engagement, emotional exhaustion, and depressive symptoms such that nonwork discrimination was more strongly related to each outcome when coworker compassion was low. The findings from the current study suggest that experiences of racial derogation, even those that occur outside the workplace environment, are detrimental to the well-being of employees and that coworker compassion is a positive resource that may foster healthier and more inclusive work environments.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10869-022-09848-6.

Thriving after pediatric spinal cord injury: two life stories

INTRODUCTION

The primary objective of this qualitative study was to explore the lived experience of spinal cord injury (SCI) as described by life story interviews with two adults who sustained SCI as children.

CASE PRESENTATION

Data were collected by conducting 15 life story interviews with two individuals with SCI. Atkinson's Life Story Interview approach along with open-ended questions was utilized to capture the narrative data. Polkinghorne's narrative analysis of eventful data approach was used to configure the data elements into a story with the purpose of understanding the lived experience of SCI of these two individuals. Four themes relevant to the experience of living with a chronic condition emerged: adjustment to life with SCI, hardiness, interdependence, and post-traumatic growth.

DISCUSSION

This study illustrated how the two participants' personal development and life trajectories were deeply shaped by pediatric-onset SCI. The life story interview process proved to be an effective approach to understanding the lived experience of SCI as told by two adults with pediatric-onset SCI. While the two participants represented unique contexts, their stories conveyed several cohesive, transcendent themes relevant to the experience of living with a chronic condition. Future narrative inquiry research in individuals with pediatric-onset SCI is necessary to build a representation of this population's lived experiences.

Determinants of participating in life after spinal cord injury - advice for health professionals arising from an examination of shared narratives

PURPOSE

To explore the perceived determinants of participation in life after spinal cord injury and incorporate these into a framework for the promotion of participation suitable for use by rehabilitation professionals.

METHOD

Four people with spinal cord injury and one health service researcher engaged in a process of sharing narratives of life after spinal cord injury over a period of one year. The narratives were distilled using thematic analysis.

RESULTS

The relevant subset of data from the narratives categorized as This is what we think determines our participation in life was analyzed in depth to reveal nine themes (1) The world can be my friend or foe; (2) I am who I am; (3) It is a personal journey; (4) Some like to talk, others like to do; (5) We have the technology; (6) A support network is vital and it can be built; (7) Life involves tradeoffs; (8) Push; and (9) Be flexible. These themes were combined into a framework for the promotion of participation to be used by rehabilitation professionals. The collaboratively developed framework has three aspects - Help me, Encourage me and Accept.

CONCLUSION

The proposed participation promotion framework is grounded in the narratives of the research group but needs to be tested before it can be endorsed for practice. Implications for Rehabilitation In order to promote participation in life after spinal cord injury rehabilitation professionals can help people with spinal cord injury to negotiate the world, build and maintain a support crew and access equipment and technology. Spinal cord injury rehabilitation professionals can encourage people with spinal cord injury to push themselves, be assertive and be flexible, as these attributes can assist participation in life after spinal cord injury. In the pursuit of participation goals, rehabilitation professionals must accept the individuality of each person with spinal cord injury, respect that they may or may not be willing to make tradeoffs to achieve participation goals and that they are on an ever changing life journey.

Factors associated with participation frequency and satisfaction among people applying for a housing adaptation grant

BACKGROUND

People applying for a housing adaptation (HA) grant are at great risk of participation restrictions due to declining capacity and environmental barriers.

AIM

To investigate the association of person-, environment-, and activity-related factors with participation frequency and satisfaction among people applying for a housing adaptation grant.

MATERIAL AND METHODS

Baseline cross-sectional data were collected during home visits (n = 128). The association between person-, environment-, and activity-related factors and participation frequency and satisfaction was analysed using logistic regressions.

RESULTS

The main result is that frequency of participation outside the home is strongly associated with dependence in activities of daily living (ADL) and cognitive impairments, while satisfaction with participation outside the home is strongly associated with self-reported health. Moreover, aspects of usability in the home were associated with frequency of participation outside the home and satisfaction with participation in the home and outside the home alone.

CONCLUSION

Dependence in ADL, cognitive impairments, self-rated health, and aspects of usability are important factors contributing to participation frequency and satisfaction among people applying for a housing adaptation grant, particularly outside the home.

SIGNIFICANCE

Our findings indicate that more attention should be directed towards activity-related factors to facilitate participation among HA applicants, inside and outside the home.

Heterogeneity of Characteristics among Housing Adaptation Clients in Sweden--Relationship to Participation and Self-Rated Health

The aim of the paper was to explore the heterogeneity among housing adaptation clients. Cluster analysis was performed using baseline data from applicants in three Swedish municipalities. The analysis identified six main groups: “adults at risk of disability”, “young old with disabilities”, “well-functioning older adults”, “frail older adults”, “frail older with moderate cognitive impairments” and “resilient oldest old”. The clusters differed significantly in terms of participation frequency and satisfaction in and outside the home as well as in terms of self-rated health. The identification of clusters in a heterogeneous sample served the purpose of finding groups with different characteristics, including participation and self-rated health which could be used to facilitate targeted home-based interventions. The findings indicate that housing adaptions should take person/environment/activity specific characteristics into consideration so that they may fully serve the purpose of facilitating independent living, as well as enhancing participation and health.

Social and community participation following spinal cord injury: a critical review

Evaluation of rehabilitation outcomes following acquired disability should include participation in social and community life. Evidence is needed to guide clinical practice to ensure that it is client-centered; therefore, findings from studies that report on social and community participation following spinal cord injury (SCI) need to be reviewed and synthesized. The objectives of this critical literature review are to examine the available evidence on social and community participation following SCI and to examine the factors that influence that participation. The barriers and facilitators will be identified and described in terms of the contextual factors - personal or environmental, as outlined by the International Classification of Functioning, Disability and Health. An additional objective is to appraise the quality of the evidence examined. A systematic literature search was completed in the databases OVID MEDLINE, AMED, CINAHL PLUS, PSYCHINFO, and hand searches were carried out. Quantitative, qualitative, and mixed methods studies were included. Twenty-three studies fulfilled the inclusion criteria: 17 quantitative, five qualitative, and one mixed methods. In general, studies were of low methodological quality, and no intervention studies were identified. The terms participation, social participation, and community participation were used interchangeably often without clarification of meaning. Adequate personal care assistance, appropriate social support, having adequate specialized equipment, and appropriate occupational therapy input were found to facilitate social and community participation, whereas problems with transport, inaccessibility of the natural and built environment, issues with healthcare services and rehabilitation providers, and pain were identified as barriers. In-depth investigation into what aspects of social and community participation are important to those living with SCI is needed so that client-focused solutions and interventions can be identified and developed, aimed at creating and promoting opportunities for social and community participation.

The influence of social support on the rehabilitation of women with spinal cord injury: experiences recounted by occupational therapists

OBJECTIVE

Women with a spinal cord injury (SCI) often require support from others to perform their everyday activities. The aim was to describe OTs' experiences of how social support from the network influences or could influence the rehabilitation of women with SCIs.

METHODS

Four occupational therapists, specialized in rehabilitation of persons with SCIs, narrated 11 separate stories relating to women with an SCI. Five themes were identified: "Assisting the women to identify new ways to perform activities", "Giving support to the women by re-establishing relationships on their behalf", "Enabling the women to find solutions to problems that have an impact on everyday activities", "Enabling the women to learn what it is like to live with an SCI from first-hand accounts", and "Assisting the women to set goals in anticipation of life outside the clinic".

RESULTS AND CONCLUSIONS

The results indicate that professionals within rehabilitation need to be aware of and actively create and strengthen natural social networks during the complex and demanding rehabilitation process. Furthermore, they ought to use their capacity as professionals to ensure that support is provided and to reduce negative interactions within the injured person's network, given that social support, social integration, and negative interactions have the potential to influence health and well-being.

Using peer mentoring for people with spinal cord injury to enhance self-efficacy beliefs and prevent medical complications

AIMS AND OBJECTIVES

Individuals with spinal cord injury/disease are faced with a myriad of psychosocial adjustment challenges. This article describes the implementation of a peer-mentoring programme designed to support this adjustment process for people with SCI/disease and the programme's believed impact on self-efficacy and prevention of medical complications.

BACKGROUND

With shorter length of stay in acute inpatient rehabilitation after spinal cord injury/disease, peer mentor programmes are becoming an important component to assist with education and community re-integration.

DESIGN

Quasi-experimental non-controlled pretest/post-test.

METHOD

Patients with newly acquired spinal cord injury/disease participated in a one-year spinal cord injury peer-mentoring programme. Peer mentors met with their assigned participants regularly during inpatient care and on discharge to track medical complications and assist with adjusting to life after spinal cord injury/disease.

RESULTS

In all, of 37 mentees enrolled, 24 successfully completed the programme. Sixty-seven per cent showed improved self-efficacy score between the two time points. Medical complications and doctor visits all decreased significantly between 0-6 months and 7-12 months. Our findings indicate that the older an individual is, the lower the likelihood of having a urinary tract infection (p = 0.006). The programme was well received by all mentees who felt they could connect well with their peer mentor.

CONCLUSION

Peer mentoring in a rehabilitation setting enhances the understanding of challenges that patients and medical staff deal with on a day-to-day basis. Our findings suggest it is important to monitor and educate individuals with spinal cord injury/disease at the acute stage to improve medical outcomes. Caution is advised in the interpretation of these results as they were obtained in a small non-random sample using self-report data.

RELEVANCE TO CLINICAL PRACTICE

Peer mentors play an increasingly important role in nurse-delivered education in the spinal cord injury/disease population.