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Publisher: Elsevier BV
Date: 03-2023
Publisher: Springer Science and Business Media LLC
Date: 11-12-2020
DOI: 10.1038/S41393-019-0394-X
Abstract: Qualitative study using semi-structured interviews. To describe and compare models of service delivery intended to support community integration in the immediate period following inpatient rehabilitation for SCI, and describe the characteristics of these models or approaches. Spinal services from multiple international countries METHODS: Semi-structured interviews were completed with 12 participants from a convenience s le of ten spinal services from developed economies. Interviews were audio-recorded, transcribed verbatim and thematically analysed. Three themes were identified, and are described with supporting quotations. These are: Theme One-Models of service delivery (sub-themes: staffing, peer mentors, facilitating community integration during inpatient rehabilitation Theme Two-Services provided (sub-themes: telehealth, vocational services, groups) Theme Three-Facilitating self-efficacy and self-management. A variety of models aimed at supporting community integration in the immediate period following inpatient rehabilitation for SCI were found. Multi-disciplinary staffing and involvement of peer mentors was common to all services. The importance of vocational rehabilitation was acknowledged by all participants, although the approaches taken to this varied. Telehealth has the potential to assist in self-management, particularly for patients who live a long distance from the spinal unit or are confined to the home for health reasons, and could be further developed. Although service models are greatly influenced by the funding context, the findings from this study can be used to inform service planning in this area.
Publisher: Informa UK Limited
Date: 10-04-2017
DOI: 10.3109/09638288.2016.1161847
Abstract: Media-based rehabilitation provides a powerful opportunity to examine vocational behaviors in the disability sector. However, this research is preliminary at best. This paper reports pilot data. Eighteen adults with multiple sclerosis (MS) accessed an email-delivered, resource-based package, Work and MS. Pre- and post-access vocational self-efficacy and identity (Job-Procurement Self Efficacy Scale, My Vocational Situation Scale- primary outcomes), life orientation and depressed mood (Life Orientation Test - revised and Patient Health Questionnaire-9 - secondary outcomes) were assessed. Pre- and post-change scores were examined with Wilcoxon signed ranks tests and Hedges g effect sizes with associated 95% confidence intervals. Reliable change analyses were additionally calculated to determine the clinical significance of in idual change scores. Significant and positive effects were reported for vocational self-efficacy, identity, and optimism. Reliable change scores in one or more of these key outcomes were reported by 30% of the s le. Satisfaction with the content and delivery of the email-based intervention was also noted. Preliminary evidence suggests that Work and MS can help to promote vocational goals, interests and strengths among job seekers with a disability by providing a set of tools, information and linkages relating to vocational pursuits and career development. Replication with a randomized control design is indicated. Implications for Rehabilitation Research indicates a high unemployment rate among working-age adults with MS. A combination of disease-specific, psychological, programmatic and societal variables contribute to employment instability in this group. This pilot study demonstrates that an e-mail-based resource package, Work and MS, provides an innovative and feasible option for promoting consumer engagement with vocational services and, potentially, improving vocational outcomes. Work and MS has potential applicability to other disability groups.
Publisher: Informa UK Limited
Date: 05-2021
DOI: 10.1080/09638288.2020.1749889
Abstract: The focus of this scoping review was to identify the extent, range, and nature of studies that have been published regarding community integration programs and interventions that support people during the transition home from hospital following spinal cord injury. Four electronic databases and one search engine were searched for articles published between 2010 and 2020. Grey literature and manual searches were also done. Of the 16 articles included, 8 were published in peer-reviewed journals. Two of these did not include an evaluation. Study designs included but were not limited to pilot studies ( The majority of interventions focused on addressing health-related educational needs, followed by community mobility. Goal setting and promoting self-efficacy were identified as important components, and the importance of involvement of people with lived experience was also highlighted. There was a lack of focus on management of relationships, including addressing sexuality needs. This review highlights the need for further empirical evaluation of implemented programs and interventions in this area, particularly in countries other than the USA, to inform service development.IMPLICATIONS FOR REHABILITATIONSuccessful community integration is an important outcome of spinal cord injuries rehabilitation.The majority of published programs focus on health-related educational needs, followed by community mobility.It is recommended that goal setting and promoting self-efficacy are included in programs.It is recommended that people with lived experience of spinal cord injuries are involved in interventions.It is recommended that programs include a focus on management of relationships, including addressing sexuality needs.
Publisher: Wiley
Date: 22-08-2018
DOI: 10.1111/NEP.13251
Abstract: The role of autophagy in the kidney and many nephrological diseases has gained prominence in recent years. Much of this research has been focused on markers of autophagy that are static and reveal little about the state of this dynamic pathway. Other mechanistic investigations are limited to in vitro studies, that often provide circumstantial evidence of autophagic flux. Here we describe a method for measuring autophagic flux ex vivo that allows more direct observations to be made in situ regarding the state of autophagic flux within the renal cortex of a single animal.
Publisher: Springer Science and Business Media LLC
Date: 10-08-2011
DOI: 10.1038/SC.2010.102
Abstract: The study design used is cross-sectional descriptive survey. The aim of this study is to describe the subjective and objective quality of life (QoL) of adults with chronic non-traumatic spinal cord injury (NT-SCI) and to compare the objective and subjective QoL of adults with chronic NT-SCI with adults who have a chronic traumatic spinal cord injury (T-SCI) and the general population. Living in the general community (non-residential care), Australia. The study included 443 adults with SCI (T-SCI, n=381) (NT-SCI, n=62), all SCI ≥6 months duration. Not applicable. Objective and subjective QoL domains--Comprehensive QoL Scale for Adults, version 5 (COMQoL-A5) acceptance subscale--the Spinal Cord Lesion Coping Strategies Questionnaire, version 1 Australia (SCL CSQ v1.0 Australia). Despite demographic differences, only the objective QoL domain material (higher in NT-SCI) and the subjective QoL domain health (lower in NT-SCI) were significantly different between the SCI subgroups. In contrast, five of the seven objective domains and four of the seven subjective domains were significantly lower in the SCI s le as a whole, compared with the general population. Post hoc analyses suggested that aetiology of the SCI was not responsible for QoL differences within the cohort with SCI. On the whole, aetiology makes little difference to QoL outcomes after SCI. The QoL of adults with chronic T-SCI and NT-SCI fall significantly below that of the general population in most domains.
Publisher: Springer Science and Business Media LLC
Date: 27-09-2018
DOI: 10.1038/S41393-018-0200-1
Abstract: A prospective, parallel randomized controlled trial (RCT). To test the preliminary effects of an online resource targeted to job-seekers with spinal cord injury or disorder (SCI/D), and to determine the feasibility of proceeding to a full-scale RCT. A community cohort in Australia. Forty-eight adults (M = 42 years, SD = 10.95, 27 males) were randomized to receive 4-weeks access to the Work and SCI resource (n = 25) or to a wait-list control group (n = 23). The Work and SCI intervention involved six stand-alone learning modules which provided job-searching and career-planning information through text, videos, and interactive activities. Self-report measures were administered at baseline and after 4 weeks: Job Procurement Self-Efficacy Scale (JSES), Life Orientation Test-Revised (LOT-R), and Patient Health Questionnaire-9 (PHQ-9). Online usage data identified high uptake of the Work and SCI resource, although study attrition was problematic. Intention-to-treat analyses failed to reach statistical significance, whereas complete data revealed a significant interaction effect for optimism (LOT-R). Further research to develop and enhance Work and SCI is indicated. Remediable strategies to optimize recruitment and statistical power in a future definitive RCT are discussed. This project was funded by the auDA Foundation (project 16019).
Publisher: Springer Science and Business Media LLC
Date: 28-04-2009
DOI: 10.1038/SC.2009.43
Abstract: Community cross-sectional self-report survey of adults with spinal cord injury (SCI). The aim of this study was to examine the likelihood of depression, anxiety and stress in adults with non-traumatic SCI (NT-SCI) compared with adults with traumatic SCI (T-SCI). Victoria, Australia. Adults (N=443 NT-SCI n=62) living in the community and attending specialist SCI rehabilitation clinics. Participants completed a self-report survey by internet, telephone or hard copy. Items included demographic and injury-related characteristics and the short form Depression, Anxiety and Stress Scale (DASS-21). Persons with NT-SCI were significantly more likely to be female (P<0.05), older (P<0.001) and have lower-level incomplete injuries (P 0.05). Overall, the prevalence of adverse mental health problems defined by scoring above DASS-21 cutoffs, were depression 37%, anxiety 30%, and clinically significant stress 25%. This study examined multiple mental health outcomes after NT-SCI in Australia. This study provides some evidence that the results of studies of depression, anxiety or stress in persons with T-SCI can be generalised to those with NT-SCI in the post-acute phase. NT-SCI patients are also at substantial risk of poor mental health outcomes. General demographic and injury-related characteristics do not seem to be important factors associated with the mental health of adults with SCI whether the SCI is traumatic or non-traumatic in origin.
Publisher: Springer Science and Business Media LLC
Date: 22-12-2016
DOI: 10.1038/SC.2015.221
Abstract: Prospective parallel waitlist randomised controlled trial. Evaluate the feasibility and effectiveness of an Internet-based psychological intervention treating comorbid mood disorder in adults with spinal cord injury (SCI). Improved mood and satisfaction with life were primary outcomes. Victoria, Australia. Electronic Personal Administration of Cognitive Therapy (ePACT). Depression, Anxiety and Stress Scale-Short Form (DASS21), Personal Well-being Index, Helplessness subscale of the Spinal Cord Lesion Emotional Well-being Scale v1 Australia, at each time point.Participant qualifying criteria:Adults (18-70 years), chronic SCI, attend SCI review clinic at Austin or Caulfield Hospital and score above normative threshold of the Depression, Anxiety and Stress Scale-Short Form (DASS21). Forty-eight participants completed Time 2 post intervention (n=23) or time equivalent for waitlist control group (n=25) telephone interviews. The measures were repeated a third time (Time 3) for a small subgroup (n=12) at 6 months post intervention within the study implementation time frame. Univariate within group analyses revealed significant improvement in mood in the intervention group at Time 2: (lower depression (effect size (ES)=0.4), anxiety (ES=0.4) and stress (ES=0.3)) and higher satisfaction with life (ES=0.2). Waitlist control group improved in depression only (ES=0.3) by Time 2. Multilevel variance components analyses, although not as positive, were still encouraging. Improvement in mood symptoms was maintained in the small group reinterviewed at Time 3. Although Internet-based interventions for mental health issues in SCI not a solution for all, our results indicate that they are a potentially valuable addition to the currently available options.
Publisher: Informa UK Limited
Date: 11-2013
Publisher: Wiley
Date: 13-04-2016
Abstract: Consideration of the relationship between meaningful participation, health and wellbeing underpins occupational therapy intervention, and drives measurement of community integration following acquired brain injury (ABI). However, utility of community integration measures has been limited to date by lack of normative data against which to compare outcomes, and none examine the growing use of electronic social networking (ESN) for social participation. This research had four aims: (i) develop and pilot items assessing ESN to add to the Community Integration Questionnaire, producing the Community Integration Questionnaire-Revised (CIQ-R) (ii) examine factor structure of the CIQ-R (iii) collect Australian CIQ-R normative data and (iv) assess test-retest reliability of the revised measure. Australia. A convenience s le of adults without ABI (N = 124) was used to develop and pilot ESN items. A representative general population s le of adults without ABI aged 18-64 years (N = 1973) was recruited to gather normative CIQ-R data. Cross-sectional survey. Demographic items and the CIQ-R. The CIQ-R demonstrated acceptable psychometric properties, with minor modification to the original scoring based on the factor analyses provided. Large representative general population CIQ-R normative data have been established, detailing contribution of a range of independent demographic variables to community integration. The addition of electronic social networking items to the CIQ-R offers a contemporary method of assessing community integration following ABI. Normative CIQ-R data enhance the understanding of community integration in the general population, allowing occupational therapists and other clinicians to make more meaningful comparisons between groups.
Publisher: Informa UK Limited
Date: 04-12-2019
DOI: 10.1080/02699052.2018.1553307
Abstract: The Family Outcome Measure (FOM-40) captures multidimensional data about well-being and capacity of family member as well as the relative with brain injury. This study aimed to produce a profile (positive and negative) of families supporting relatives with traumatic brain injury (TBI) and high support needs. Thirty-eight dyads (family member plus relative with TBI and high daily support needs) participated in this cross-sectional survey-based pilot study. The survey comprised several published scales, as well as a range of demographic and clinical characteristics of the relative. Non-parametric bivariate analyses were conducted. Independence of the FOM-40 domains was confirmed. Place of residence (shared supported accommodation (SSA)/family home) was an important predictor variable. SSA was strongly associated with lower levels of burden in families. Family home was strongly associated with better adjustment of the relative. Family resilience was positively associated with sustainability of support and comorbidity in the relative. Family outcomes were associated with a variety of demographic and clinical characteristics of the relative with TBI including residence, behaviour and mental health symptoms. The results provide meaningful evidence for service providers given the increasing investment in independent living in people with disabilities, and the ongoing reliance on families to supplement paid support.
Publisher: Informa UK Limited
Date: 17-06-2016
DOI: 10.1080/02699052.2016.1175666
Abstract: To determine level of community integration in adults with traumatic brain injury and high support needs (TBI-HSN) compared with multiple matched controls. Community setting, Victoria, Australia. Adults with TBI-HSN living in the community (n = 61). Australian normative data (n = 1973) was used for matching purposes (1:4). Matched analysis from people with and without TBI. Matching aimed to reduce variability expected from age, gender, metropolitan/rural residence and co-resident status. Community Integration Questionnaire (CIQ): total and sub-scales of Home Integration, Social Integration and Productivity. Matched analysis showed large effects favouring the general population, e.g. CIQ total scores were significantly different, F(1, 304) = 5.8, p < 0.0001. Conditional relative risk showed community-dwelling participants with TBI were 540-times more likely to report a poor CIQ total score compared to the general population. Normative CIQ data has enabled meaningful comparisons of the community integration of adults with chronic TBI to the general population in Australia. Evidence makes clear with numeric precision that in iduals with TBI and high support needs are much less integrated than their non-TBI counterparts despite living in the community for many years.
Publisher: Frontiers Media SA
Date: 20-01-2023
DOI: 10.3389/FPSYT.2022.947987
Abstract: The consequences and impact of violent behavior in schizophrenia are often serious, and identification of risk factors is of great importance to achieve early identification and effective management. This follow-up study s led adult patients with schizophrenia in primary mental health care in a rural area of southern China, in which 491 participants completed a comprehensive questionnaire at baseline and the 2-year follow-up. Sociodemographic, clinical and psychological assessment data were collected from all participants. Paired s le T- Tests and the McNemar Test were performed to examine changes over the follow-up period. Generalized Estimating Equations (GEE) were used to analyze the risk factors for violent behavior. The results showed that about two in five community-dwelling patients with schizophrenia reported violent behavior in the past year. At follow-up, participants were significantly less employed, had more times of hospitalization, more psychotropic medication, and severer depressive symptoms, but had better health-related quality of life than at baseline. Use of clozapine and better insight into medication decreased the possibility of violent behavior, while more severe positive symptoms, insomnia, as well as use of second-generation antipsychotics other than clozapine, antidepressants and mood stabilizers increased the possibility of violent behavior. Risk evaluation, prevention and management of violence in patients with schizophrenia are demanded in primary mental health care.
Publisher: Frontiers Media SA
Date: 09-09-2022
DOI: 10.3389/FPSYT.2022.1013919
Abstract: Person-centered care is a collaborative approach to health care. To provide effective, person-centered care to people living with severe mental illness, it is necessary to understand how people view their own needs. The Perceived Need for Care Questionnaire (PNCQ) was used in the Australian National Survey of High Impact Psychosis (SHIP) to deepen understanding and evaluate, at a population level, the needs of Australian adults living with psychotic illness. SHIP participants were 1,825 adults, aged 18–65 years, living with psychotic illness and in contact with public specialized mental health services across Australia in 2010. The survey package included demographic and clinical items, and various scales including the PNCQ appraising a comprehensive range of life domains. Logistic regressions measured the impact that various demographic, clinical and psychosocial independent variables (e.g., loneliness, health-related quality of life, disability, accommodation type) had on the likelihood of inadequately met PNCQ domain-related need. Over two-thirds of people living with psychosis reported at least two areas of unmet need for care despite most being in contact with mental health services. Work or using one's time and socializing, counseling, and self-care domains had the largest proportion of inadequately met needs (range between 49 and 57%). Feelings of loneliness and/or social isolation were significantly associated with unmet needs across all PNCQ domains, except for financial needs. Health-related quality of life was significantly associated with unmet needs across all domains, except for housing needs. Disability was significantly associated with unmet social, occupation (work or time use), housing and medication-related needs. Consumers view their needs for care as unmet across many life areas despite being in contact with mental health services. Loneliness, unmet psychosocial needs, and health-related quality of life appear strongly interconnected and warrant greater attention in the delivery of person-centered care for people living with psychosis. Support to address social, work or time use and housing related needs among people living with psychosis appears less well targeted toward those with disability. Results underscore the link between quality of life, recovery and needs. These inter-relationships should be considered in mental health services research and evaluation.
Publisher: Springer Science and Business Media LLC
Date: 14-12-2022
DOI: 10.1186/S12909-022-03936-0
Abstract: Investment in a clinical research culture appears to be associated with benefits for consumers, staff, and overall organisational performance. The validated 55-item Research Capacity and Culture (RCC) tool was developed specifically to gauge the research capacity and culture of health professionals and workplace settings within which they work. Results of some in idual studies suggest that professional discipline and workplace setting may impact RCC results however it has never been used in a dedicated public mental health setting. Therefore, this study will explore the research capacity and culture of allied mental health clinicians (Part 1). Another aim is to explore potential connections between workplace settings, locations and disciplines based on published RCC-based data to help signpost potential impediments to service improvements (Part 2). Part 1: An RCC-based online survey canvased Australian Social Workers and Occupational Therapists ( n = 59) based in a metropolitan public mental health service. Non-parametric analyses explored links between research-related experience and participant characteristics. Part 2: Comparative analyses explored the potential influence of workplace settings and professional disciplines on published RCC results. Part 1: Overall, the research capacity and experiences of mental health Social Workers and Occupational Therapists seemed modest. Discipline was statistically associated with level of research-activity experience, weighted towards occupational therapy demographic characteristics were not. Only two items in the RCC were rated high many more items were rated low. Part 2: Published studies exploration found no link between RCC ratings and workplace location, setting, or professional discipline. S ling biases and use of modified, non-validated RCC versions likely impacted the results. Allied mental health clinicians may not be sufficiently experienced, knowledgeable, or confident with a range of research-related activities given the emphasis on workforce research capability in policy and practice nowadays. This may be commonplace across health-based organisations. We recommend the systematic implementation of research training programs in (mental) health services, and a ‘whole-of-service levels’ approach be used i.e., transform policy, culture and leadership as well as provide practical resources with in idual training. Potential benefits include a positive impact on organisation functioning, clinicians’ confidence and practice, and improved consumer outcomes.
Publisher: Frontiers Media SA
Date: 07-09-2022
DOI: 10.3389/FPUBH.2022.983733
Abstract: Quality of life (QoL) has been always an important way to evaluate the outcomes of schizophrenia, but there have been few previous longitudinal studies and few in middle-income countries. This study aimed to explore the QoL in Chinese patients with schizophrenia treated in primary mental health care and the risk factors of QoL over time. Patients with schizophrenia treated in primary mental health care in rural/regional areas in Luoding, Guangdong, PR China, were evaluated with an extended questionnaire including the Chinese version of the World Health Organization Quality of Life (WHOQOL-BREF) at baseline and 2-year follow-up. Bivariate and multivariate analyses were conducted including Generalized Estimated Equation analyses (GEE). Four hundred and ninety-one patients with schizophrenia in primary care completed the 2-year follow up evaluation. The QoL physical, environmental, and social relationships domains showed improvement after the 2-year period, but the psychological domain did not. GEE results showed that earlier age of onset, older age, being employed, being unmarried, the thicker waist circumference, less use of clozapine or other SGAs, fewer hospitalizations, more frequent insomnia, more severe depressive and negative symptoms as well as worse treatment insight were independently associated with poor QoL in patients with schizophrenia. According to our results, to improve the quality of life of patients with schizophrenia in primary care, we should pay more attention to the treatment of depression, negative and insomnia symptoms of schizophrenia, the choice and dosage of antipsychotic medication and improvement in the treatment compliance. The combined use of educational and behavioral strategies may improve treatment adherence.
Publisher: Informa UK Limited
Date: 03-05-2017
Publisher: SAGE Publications
Date: 17-01-2023
DOI: 10.1177/10497323221147130
Abstract: Little has been documented of the journey that family and friends (F& F) undertake when supporting a young person aged 12–25 years struggling with mental illness. The experiences of family and friends were explored using an online qualitative survey ( N = 58) and semi-structured interviews ( n = 15). Recruitment was through a national youth mental health service Facebook page and website. An experiential thematic analysis was conducted focusing on participants’ experiences and sense of their world. Strong feelings and challenging life circumstances made the context of help-seeking complicated. Despite following usual avenues for advice or support, F& F still came across professionals and a health/mental health system that compounded their distress. It was the simpler things that some professionals did that made their journey more bearable. Useful insights derived from the narratives allow service improvement recommendations such as reminding professionals of the multiplicity of stressors commonplace to families and the value of validation and acknowledgement.
Publisher: SAGE Publications
Date: 2008
DOI: 10.1080/00048670801886080
Abstract: Objectives: The aim of the study was to examine the mental health of adults with spinal cord injury living in the community Methods: The study was a representative community cross-sectional cohort self-report survey, carried out in adults with traumatic spinal cord injury registered on the Victorian Spinal Cord Injury Register and adults with non-traumatic spinal cord injury attending a specialist non-traumatic spinal cord injury rehabilitation clinic. Participants (n=443) completed a self-report survey by internet, telephone or hard copy, which used reliable and valid measures of depression, anxiety and stress (Depression, Anxiety and Stress Scale) and post-traumatic stress disorder (Impact of Events Scale–Revised). Results: Nearly half (48.5%) of the population with spinal cord injury suffered mental health problems of depression (37%), anxiety (30%), clinical-level stress (25%) or post-traumatic stress disorder (8.4%). Overall, there was a twofold or more increase in the probability of emotional disorders compared to the general population. Of those with one mental health disorder, 60% also had at least one other emotional disorder, representing a substantial 56% increase over the general population in the probability of comorbidity of psychopathology. Better health and time since injury were associated with decreasing the risk of psychopathology. Conclusion: The results of the present study underscore the vulnerability of the population with spinal cord injury to emotional disorders. This study highlights the complexity of mental health problems experienced by many in iduals with spinal cord injury living in the community. The delivery of mental health services to this vulnerable population requires recognition of comorbidity and problems of mobility, access and stigma.
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.APMR.2017.08.475
Abstract: To provide a preliminary evaluation of the effectiveness of an online resource for job seekers with multiple sclerosis (MS). Randomized controlled design. Community-dwelling cohort. Adults (N = 95) with relapsing-remitting or progressive MS were randomly assigned to one of two groups. Forty-five accessed an email delivered, 7 module resource, Work and MS, over a 4 week period. Waitlist control participants (n=50) were offered the opportunity to access Work and MS 4 weeks postenrollment. Primary outcomes focused on vocational interests (My Vocational Situation Scale) and self-efficacy in job-seeking activities (Job-Procurement Self Efficacy Scale). Secondary outcomes focused on perceived workplace difficulties (Multiple Sclerosis Work Difficulties Questionnaire [MSWDQ]), optimism (Life Orientation Test - Revised), and mood (Patient Health Questionnaire-9). Intention-to-treat analyses revealed pre-post gains: participants who accessed Work and MS reported improved confidence in their career goals (My Vocational Situation Scale g=.55 95% confidence interval [CI], .14-.96 P=.008) and positively reappraised potential workplace difficulties (MSWDQ g range, .42-.47 P range, .023-.042). The effect on job self-efficacy was not significant, but changed in the expected direction (g=.17 95% CI, -.23 to .57 P=.409). Completer data revealed larger, significant effect estimates (g range, .52-.64 P range, .009-.035). Findings provide preliminary support for the utility of a job information resource, Work and MS, to augment existing employment services. The results also suggest the need to test employment-ready interventions in a larger study population. This might include the addition of online peer support to increase intervention compliance.
Publisher: Medical Journals Sweden AB
Date: 2009
Abstract: The aim of this study was to examine factors associated with the subjective well-being of in iduals with spinal cord injuries, while acknowledging theories that describe the subjective well-being tendency to homeostasis. A representative community cross-sectional cohort of 443 adults with traumatic and non-traumatic spinal cord injury completed a self-report survey (by internet, telephone or hard copy) that included reliable and valid measures of quality of life, depression, anxiety and stress, post-traumatic stress disorder, coping strategies, and emotional consequences. The subjective well-being of half of the population with spinal cord injury lay above the normative subjective well-being set-point threshold. Despite the inclusion of many biopsychosocial factors, only Intimacy, Safety, Acceptance, and Helplessness were significantly associated with normative subjective well-being. Comparatively few factors were significantly associated with normative subjective well-being, but the results help to explain observed contradictions noted in previous research into subjective well-being after spinal cord injuries. The results highlight the resilience of in iduals in general and are in keeping with the disability paradox. However, many in iduals with spinal cord injuries do not live satisfactory lives. It is for them that further psychological care and rehabilitation is necessary to create a good life after spinal cord injury.
Publisher: Wiley
Date: 02-11-2022
DOI: 10.1111/EIP.13230
Abstract: Family and friends are often the first and/or only support options used by young people (12–25 years) struggling with mental health issues. The overarching aim of this literature review is to map current practice in online interventions specifically targeting family and friends of young people with mental health issues, especially relevant in light of the current worldwide COVID‐19 pandemic. A rapid scoping literature review was conducted searching health and psychology databases for online interventions targeting family and friends supporting a young person (12–25 years) struggling with a mental health issue. The search strategy was comprehensive and expert librarian endorsed. The final synthesis comprised 13 articles. Identified articles were few, reporting a disparate range of research aims, intervention content and delivery modes. Studies addressing caregivers of adolescents with a mental health diagnosis were small‐scale, although suggested virtual modalities are positively received and viable alternatives to other delivery methods with potential for equivalent outcomes. Five randomized control trials involving caregivers of ‘at‐risk’ adolescents reported improved parental knowledge, but mixed effects on family functioning. Preliminary evidence suggests flexible online options including professional and peer support, to respond to carers' busy lives are needed to maximize benefits. Content that is sufficiently in idualized and targeted to address the erse needs of parents, as well as other caregivers, is also required. Well‐being and self‐care, in addition to parenting skills should be given more consideration in online interventions. Examination of the value of support from peers is also warranted.
Publisher: Springer Science and Business Media LLC
Date: 11-03-2008
DOI: 10.1038/SC.2008.22
Abstract: Representative community cross-sectional self-report survey of adults with spinal cord injury (SCI). To establish semantic translation and validation of the Swedish scales--the Spinal Cord Lesion Coping Strategies Questionnaire and the Spinal Cord Lesion Emotional Wellbeing Questionnaire. Adults on the Victorian traumatic SCI register and attendees of the nontraumatic outpatient clinic were invited to participate. Instruments were forward and backward translated to establish semantic equivalence. Principle components analyses were undertaken. Correlation and logistic regression analyses were conducted to demonstrate validity of the instruments using both positive (high quality of life) and negative (depression and anxiety) psychological outcomes. The final s le consisted of 443 adults with SCI living in the community. Both instruments demonstrated acceptable psychometric properties. Univariate correlation analyses showed most of the new scale components displayed medium to large relationships in the expected direction with the psychological outcomes and the other subscales. Health status and helplessness were significant predictors of both the positive and negative psychological outcomes in the logistic regression analyses. Acceptance was significantly related to the positive outcome only. Female and incomplete tetraplegia categories were significantly and positively related to depression only. Notwithstanding a few issues with some of the subscales, the results support the usefulness of these easy to use instruments and point to ways for further development of the scales.
Publisher: Cambridge University Press (CUP)
Date: 05-2011
DOI: 10.1375/BECH.28.1.45
Abstract: Accessibility, stigma and adverse effects of self-reliance can hinder the receipt of psychological treatments, especially in people living with chronic illness or disability. The aim of this study was to develop and pilot a flexible online psychological treatment using CBT and positive-psychology based techniques, for in iduals with spinal cord injury (SCI) who also lived with depression or both depression and anxiety. A multiple case study approach provided in-principle evidence of the acceptability of the Electronic Personal Administration of Cognitive Therapy: e PACT. Three adults living with SCI completed pre- and post-intervention interviews and multiple modules of e PACT. The interviews used the Structural Clinical Interview for DSM Disorders (SCID/-N/P) for diagnosis and the standardised survey instruments: Depression Anxiety and Stress Scale — short version (DASS-21), Personal Wellbeing Index 4th edition (PWI) and the Spinal Cord Lesion Emotional Wellbeing Questionnaire (SCL EWQ v1 Australia). The results indicated that the online program was acceptable, and they all showed some improvement in symptoms. All participants indicated that they would not have sought face-to-face therapy for reasons of access and stigma. They all had a strong sense of independence and felt this would have been questioned if they sought therapy.
Publisher: Wiley
Date: 27-12-2016
Abstract: Australia's National Disability Insurance Scheme (NDIS) is designed to influence home, social and economic participation for Scheme participants. Given the major disability reform underway, this pilot study aimed to: (i) examine community integration outcomes of people with spinal cord injury (SCI) (ii) compare findings with multiple matched controls and (iii) consider findings within the context of Australia's NDIS. Setting: Victoria, Australia. Matched analysis (people with and without SCI). Community Integration Questionnaire (CIQ). n = 40 adults with SCI (M age = 52.8 years 61% male 77% traumatic SCI). Matched analyses from each SCI subject aged <70 years (n = 31) with four CIQ normative data subjects (from n = 1927) was undertaken, with key demographic variables matched (age range, gender, living location and living situation). Risk of low CIQ score as a function of SCI was also examined using conditional Poisson regression. With key demographic variables held constant, small to medium effect sizes were found in favour of the normative s le, with statistically significant differences in home (ρ = 0.003) and productivity integration (ρ = 0.02). Relative risk of low home integration was significant in the SCI cohort (conditional RR (95% CI) = 3.1 (1.5-6.3), ρ = 0.001). Relative risk of low CIQ total, social integration and productivity scores did not reach significance. This cohort of SCI participants was less integrated into home and productive occupations than matched norms, holding implications for planning and allocation of supports to influence outcomes within an NDIS. Further research is necessary to understand community integration outcomes in larger matched s les.
Publisher: Wiley
Date: 10-2015
DOI: 10.1111/IMJ.12825
Abstract: There is little understanding of the prevalence of mental health issues in people with spinal cord injury (SCI) after they leave rehabilitation or how mental health issues can alter over time. The aims were to (i) determine the prevalence of mood disturbance in adults with chronic SCI living in the community, (ii) ascertain whether the prevalence of mood disturbance had changed since a previous study in 2004-2005 and (iii) establish whether people with chronic SCI remain vulnerable to mood disturbance, irrespective of time since injury. Prospective, open-cohort case series. Participants were 573 community-based adults with a chronic SCI. The depression, anxiety and stress scale - short version was used. Analyses included simple descriptors, Chi-squared and repeated measures t-tests. Nearly half of participants (n = 263/573 46%) reported symptoms indicating mood disturbance, which was similar to the level found in the previous study. While the presence of mood disturbance persisted in 23% of adults (n = 26) and 46 (41%) were in the 'below threshold' category, just over a third of the adults who participated in both studies (n = 111) experienced a change (n = 21, 19% mood disturbance resolved and n = 18, 16% mood disturbance developed). Both resilience and change are common. At no time after SCI is the risk of mental health problems considered reduced or even stable. These results highlight the importance of regular mental health reviews even in those who have previously displayed good resilience.
No related grants have been discovered for Christine Migliorini.