The Lived Experience of Healthy Behaviors in People With Debilitating Illness

Examine the Role of Psychological Resilience in Predicting Social and Professional Performance in Patients with Diabetes, Multiple Sclerosis, and Rheumatism

Psychological resilience is one of the most important factors that help a person adapt to the difficulties of life. The present study aimed to examine the role of psychological resilience in the social and professional functioning of patients with multiple sclerosis (MS), diabetes mellitus, and rheumatoid arthritis (RA). A total of 301 individuals (58.8% female) participated in the study. Approximately 44% of participants were diagnosed with diabetes, 28% with rheumatoid arthritis, and around 25% with multiple sclerosis. Two psychometric measures were used to achieve the objectives of the present study: the Psychological Resilience Scale and the Performance of Social and Occupational Functions Scale. Regression analyses were used to examine the amount of variance predicted by psychological resilience in terms of the following variables of social and professional functions: relationships, communication, social activities, entertainment activities, life skills, employment-based job functions, and unemployment-based job functions. Results revealed that psychological resilience positively predicted social and occupational functions among all illnesses. Resilience best predicted social and professional functions among MS patients, followed by diabetes patients and RA patients. These findings highlight the role of psychological resilience in improving the social and occupational performance of patients with chronic illnesses and the positive relationship between employment and resilience.

Spirituality and quality of life in limb amputees

Limb amputation is a life-changing event that signifies long-term physical, social, psychological, and environmental change. Spiritual well-being in patients plays a significant role in coping and may affect outcomes of patients with limb loss. The objective of this study was to describe the role of spirituality in individuals with limb amputation and to determine whether spirituality is related to the quality of life (QOL) in this sample. Study participants were recruited through prosthetists, physicians, amputee support groups, the Amputee Coalition of America, and amputee listserv discussion groups in the United States and Canada. Participants completed questionnaires containing measures of satisfaction with life, general health, mobility, and social integration. A quantitative descriptive research design was used to examine the relationships between existential spirituality (belief that one's life is meaningful or has purpose) and religious spirituality and QOL among individuals with limb amputation. A prospective study of 108 patients with a history of limb amputation was performed. The study population consisted of 66.3% males and 33.7% females. Most patients were Caucasian (96.2%). Of the 108 participants, 86 (79.6%) were 41 years of age or older with a mean of 18 years since amputation. The most frequent cause of amputation was trauma (55.6%) and the most common location of amputation was below-the-knee (49.1%). Existential spirituality, female gender, and age above 50 years related to higher QOL in patients with a history of limb amputation. The findings of this research confirmed that amputees use spirituality to cope with limb amputation. Existential spirituality was a significant predictor of satisfaction with life, general health, and social integration.

A systematic review of resilience in the physically ill

BACKGROUND

Resilience is the capacity of individuals to maintain, or regain, their mental health in the face of significant adversity, including physical illness.

OBJECTIVE

We conducted a systematic review of resilience and related concepts in the physically ill to determine factors associated with predicting or promoting resilience.

METHODS

An electronic search of PsychInfo, Medline, and CINAHL databases between 1950 and May 2009 was performed using the terms resilience, and various types of physical illnesses. Inclusion criteria were broad and exclusion criteria were not published in English or not focused on resilience in physical illness.

RESULTS

A total of 475 articles were retrieved and 52 articles met inclusion/exclusion criteria. Psychological factors associated with resilience were self-efficacy, self-esteem, internal locus of control, optimism, mastery, hardiness, hope, self-empowerment, acceptance of illness, and determination. Social support was highly predictive of, and associated with, resilience. Coping strategies such as positive cognitive appraisal, spirituality, active coping, and mastery were also associated with resilience. Resilience factors directly salient to physical illness such as self-care, adherence to treatment, health related quality of life, illness perception, pain perception, exercise adherence, and physical outcomes were also found.

DISCUSSION

These findings need to be considered and when appropriate incorporated into the psychological and psychiatric care of physically ill individuals.

Spirituality and quality of life in low-income men with metastatic prostate cancer

OBJECTIVE

To determine how spirituality is associated with health-related quality of life (HRQOL) in an ethnically diverse cohort of low-income men with metastatic prostate cancer.

METHODS

Eighty-six participants in a state-funded program that provides free prostate cancer treatment to uninsured, low-income men completed written surveys and telephone interviews containing validated measures of spirituality, and general and disease-specific HRQOL. Assessments were made following diagnosis of metastatic disease. We used multivariate analyses to assess the effect of spirituality and its two subscales, faith and meaning/peace, on HRQOL.

RESULTS

African American and Latino men, and men with less than a high-school education had the highest spirituality scores. Spirituality was significantly associated with general and disease-specific HRQOL. We also found a significant interaction between faith and meaning/peace in the physical and pain domains.

CONCLUSION

Greater spirituality was associated with better HRQOL and psychosocial function. Meaning/peace closely tracks with HRQOL. Higher faith scores, in the absence of high meaning/peace scores, are negatively associated with HRQOL.