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Sherman DS, Burnett HJ, Lindstrom D. Engagement in Meaningful Activity Mediates the Relationship Between Stressful Life Events and Functional Resilience. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024:15394492241237746. [PMID: 38520308 DOI: 10.1177/15394492241237746] [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: 03/25/2024]
Abstract
Resilience during stressful life events is a priority for administering the most client-centered care as possible. Occupational therapy practitioners have the unique opportunity to support resilience through promoting meaningful participation. The current study aims to understand the associations between meaningful activity engagement, resilience, and stressful life events. We specifically focused on answering if meaningful participation mediates the relationship between stressful life events and resilience. 492 participants from a non-clinical convenience sample of Amazon's MTurk completed the study. Participants completed an online survey and reported their experiences of stressful life events, resilience, well-being, and meaningful participation. We used SPSS and PROCESS to analyze our data. Stressful event severity and resilience were inversely related. When accounting for the effect of meaningful participation, the relationship became non-significant, indicating evidence of mediation. Implications: Focusing on measuring meaningful participation may be worth studying in further research.
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Bislick L, Dietz A, Duncan ES, Cornelius K. The Feasibility and Benefits of a Virtual Yoga Practice for Stroke Survivors With Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023:1-10. [PMID: 37130156 DOI: 10.1044/2023_ajslp-22-00269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE The purpose of this study was to (a) examine the feasibility of a virtual, adapted, aphasia-friendly yoga program for people with aphasia; (b) evaluate evidence of improvement in patient-reported outcomes and word retrieval; (c) explore the immediate impact of a yoga session on participant subjective emotional state; and (d) assess participant motivation and perceived benefits of participating in a yoga program. METHOD This feasibility study employed a mixed-method design to document the feasibility of a virtual, 8-week adapted yoga program. A pre-/posttreatment design was used to assess patient-reported outcome measures for resilience, stress, sleep, and pain, as well as word-finding abilities. Semistructured interviews with participants were thematically analyzed to provide insight into participants' motivation and perceptions regarding their experience. RESULTS Comparisons of pre- and postprogram group means suggest that participation in an 8-week adapted yoga program may positively impact perceptions of resilience (large effect), stress (medium effect), sleep disturbance (medium effect), and pain (small effect) for people with aphasia. Findings from within-session reports and brief, semistructured interviews with participants indicated positive outcomes and subjective experiences and suggest that people with aphasia are motivated to participate in yoga for a variety of reasons. CONCLUSIONS This study is an important first step in confirming the feasibility of an adapted, aphasia-friendly yoga program offered via a remote platform for people with aphasia. The findings support recent work suggesting that yoga may be a potent adjunct to traditional rehabilitation efforts to improve resilience and psychosocial aspects in persons with aphasia. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.22688125.
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Affiliation(s)
- Lauren Bislick
- School of Communication Sciences and Disorders, University of Central Florida, Orlando
| | - Aimee Dietz
- Department of Communication Sciences and Disorders, Georgia State University, Atlanta
| | - E Susan Duncan
- Department of Communication Sciences & Disorders, Louisiana State University, Baton Rouge
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Yang SL, Tan CX, Li J, Zhang J, Chen YP, Li YF, Tao YX, Ye BY, Chen SH, Li HY, Zhang JP. Negative life events and aggression among Chinese rural left-behind adolescents: do self-esteem and resilience mediate the relationship? BMC Psychiatry 2023; 23:167. [PMID: 36922776 PMCID: PMC10015683 DOI: 10.1186/s12888-023-04587-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/03/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Left-behind adolescents (LBAs) are adolescents aged 11-18 years who are separated from their parents and left behind in local cities by one or both parents for a period of more than 6 months. LBAs in rural areas are likely to engage in aggressive behavior, which can affect interpersonal relationships, reduce academic performance, and even lead to anxiety and depression. To our knowledge, no studies have examined the mediating effect of resilience and self-esteem on the relationship between negative life events and aggression among Chinese rural LBAs. Therefore, this study aimed to explore the relationship between negative life events and aggression among Chinese rural LBAs and how self-esteem and resilience mediate the association. METHODS Using a stratified random sampling method, 1344 LBAs in Hunan Province of China were investigated. Information was collected by a self-designed sociodemographic questionnaire, Adolescent Self-Rating Life Events Checklist, Resilience Scale Chinese Adolescent, Rosenberg Self-Esteem Scale and Aggression Scales to assess the psychology of LBAs. Data analysis was conducted using descriptive statistics, Pearson correlation, and regression analysis to estimate direct and indirect effects using bootstrap analysis. RESULTS Negative life events were significantly related to self-esteem (r = - 0.338), resilience (r = - 0.359), and aggression (r = 0.441). Aggression was directly affected by self-esteem (β = - 0.44) and resilience (β = - 0.34). Negative life events were not only directly related to aggression (β = 0.34, 95% CI: 0.275 ~ 0.398) but also showed an indirect effect on aggression through self-esteem and resilience. The direct effect, total effect and indirect effect of negative life events on aggression through self-esteem and resilience were 0.3364, 0.4344 and 0.0980, respectively. The mediating effect of self-esteem and resilience accounted for 22.56% of the relationship between negative life events and aggression. CONCLUSIONS We found that self-esteem and resilience mediated most negative life events on aggression. It is imperative for educators and families to improve LBAs' self-esteem and resilience to reduce the occurrence of aggression. Future intervention studies should be designed to strengthen self-esteem and resilience.
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Affiliation(s)
- Si Lan Yang
- grid.411870.b0000 0001 0063 8301The First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University, Zhejiang, China
| | - Chu Xia Tan
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Juan Li
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Jie Zhang
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Yi Ping Chen
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Yi Fei Li
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Ying Xiang Tao
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Bi Yun Ye
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Shi Hao Chen
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
| | - Hui Yuan Li
- grid.10784.3a0000 0004 1937 0482The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Jing Ping Zhang
- grid.216417.70000 0001 0379 7164Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000 Hunan China
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Seneviratne H, Mann G, Troeung L, Martini A. The association between functional independence and quality of life for individuals with acquired brain injury undergoing community-based rehabilitation and disability support. NeuroRehabilitation 2022; 51:291-302. [DOI: 10.3233/nre-220062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Following acquired brain injury (ABI), cognitive and physical barriers can prevent access to a previously enjoyed lifestyle, reducing quality of life. OBJECTIVE: This study aimed to examine predictors of health-related quality of life (HRQoL) in adults with ABI receiving post-acute community-based rehabilitation and disability support services, using tools developed for this population. METHODS: Retrospective cross-sectional design. Main outcome measures were the Quality of Life after Brain Injury Inventory (QOLIBRI) and Functional Independence and Assessment Measure (FIM + FAM) for adults with ABI (n = 67) undergoing post-acute rehabilitation in Western Australia, 2015–2021. RESULTS: Mean QOLIBRI total score (±standard deviation) was 57.2±17.4, indicating impaired HRQoL, with mood disorders likely prevalent. Regression analysis demonstrated no differences in HRQoL between different age groups, sexes or brain injury types. Shorter time since injury and lower total FIM + FAM score significantly predicted poorer HRQoL in the model. CONCLUSION: This population appears vulnerable to psychological illness, although HRQoL is addressed for a minority of clients during routine post-acute care (19%). As improvement in quality of life is a fundamental goal of rehabilitation post-ABI, understanding the relationship between potentially modifiable factors such as functional independence and HRQoL is critical to improve outcomes and provide the best chance at a satisfying life.
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Affiliation(s)
- Harshana Seneviratne
- Brightwater Research Centre, Brightwater Care Group, Osborne Park, WA, Australia
- The University of Western Australia, Crawley, WA, Australia
| | - Georgina Mann
- Brightwater Research Centre, Brightwater Care Group, Osborne Park, WA, Australia
| | - Lakkhina Troeung
- Brightwater Research Centre, Brightwater Care Group, Osborne Park, WA, Australia
| | - Angelita Martini
- Brightwater Research Centre, Brightwater Care Group, Osborne Park, WA, Australia
- The University of Western Australia, Crawley, WA, Australia
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Paasila JM, Smith E, Daher M, Simpson GK. Reasons for living, positive psychological constructs and their relationship with suicide ideation in people with moderate to severe traumatic brain injury: A cross-sectional study. Neuropsychol Rehabil 2022; 32:2125-2146. [PMID: 35862622 DOI: 10.1080/09602011.2022.2100795] [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: 10/17/2022]
Abstract
Positive psychological constructs such as reasons for living, self-esteem and resilience have previously been shown to act as protective psychological barriers against negative psychological outcomes, including suicide ideation in both clinical populations and the general population. This study aims to explore the positive psychological constructs of reasons for living, self-esteem, resilience and their relationship with suicide ideation and predictors of suicide ideation (depression, hopelessness) for N = 50 people who have a severe TBI and are currently receiving community rehabilitation at Liverpool Brain Injury Rehabilitation Unit (LBIRU), NSW. Results indicated good reliability for the use of the RFLI with people who have TBI, with the most frequently endorsed subscale (range 0-5) being "survival and coping beliefs" (4.7 ± 1.0) and the least frequently being "fear of suicide" (2.2 ± 1.1). The shortened version of the RFLI (BRFLI) also displayed good reliability. Positive psychological constructs (reasons for living, resilience, self-esteem) were all significantly inversely associated with suicide and suicide predictors (depression, hopelessness). This study suggests that positive psychological constructs can act as a buffer against suicide ideation after moderate to severe TBI.
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Affiliation(s)
- Josephine M Paasila
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia.,School of Psychology, Western Sydney University, Sydney, Australia.,Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Evelyn Smith
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Maysaa Daher
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Grahame K Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia.,John Walsh Centre of Rehabilitation Research, Kolling Institute, Sydney, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Gibbs K, Wilkie L, Jarman J, Barker-Smith A, Kemp AH, Fisher Z. Riding the wave into wellbeing: A qualitative evaluation of surf therapy for individuals living with acquired brain injury. PLoS One 2022; 17:e0266388. [PMID: 35390052 PMCID: PMC8989185 DOI: 10.1371/journal.pone.0266388] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 03/19/2022] [Indexed: 12/02/2022] Open
Abstract
Nature has long demonstrated the capacity to facilitate wellbeing. Interventions involving the natural environment such as surf therapy, are increasingly being used to facilitate aspects of wellbeing in clinical populations. However, explorations of how nature-based interventions such as surf therapy may be used to promote wellbeing in the context of neurorehabilitation are missing from the peer-reviewed literature. Here we characterize the experience of a five-week surfing intervention involving fifteen adults living with the psycho-social and cognitive sequelae of acquired brain injury. Insights were analysed using reflexive thematic analysis, which highlighted the importance of seven overarching themes, including: 1) Connection to Nature, 2) Facilitating Trust and Safety, 3) Managing and Accepting Difficult Emotions, 4) Facilitating Positive Emotion, Meaning and Purpose, 5) Building Community through Social Connection, and 6) Positive Change. Barriers and opportunities (theme 7) were also identified as components on which clinical services may be improved. We present a theoretical model for the benefits of surf therapy in people living with acquired brain injury (ABI) based on these themes and reflections on findings from the wider literature. Findings emphasise the importance of leveraging community partnerships to augment the holistic model of neurorehabilitation and potential implications for service redesign are discussed, focusing on recent developments in wellbeing science.
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Affiliation(s)
- Katie Gibbs
- School of Psychology, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, United Kingdom
- Regional Neuropsychology and Community Brain Injury Service, Morriston Hospital, Swansea, United Kingdom
| | - Lowri Wilkie
- School of Psychology, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, United Kingdom
- Regional Neuropsychology and Community Brain Injury Service, Morriston Hospital, Swansea, United Kingdom
| | - Jack Jarman
- Regional Neuropsychology and Community Brain Injury Service, Morriston Hospital, Swansea, United Kingdom
| | - Abigail Barker-Smith
- Regional Neuropsychology and Community Brain Injury Service, Morriston Hospital, Swansea, United Kingdom
| | - Andrew H. Kemp
- School of Psychology, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, United Kingdom
- Regional Neuropsychology and Community Brain Injury Service, Morriston Hospital, Swansea, United Kingdom
| | - Zoe Fisher
- Regional Neuropsychology and Community Brain Injury Service, Morriston Hospital, Swansea, United Kingdom
- Health and Wellbeing Academy, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, United Kingdom
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Merritt VC, Brickell TA, Bailie JM, Hungerford L, Lippa SM, French LM, Lange RT. Low resilience following traumatic brain injury is strongly associated with poor neurobehavioral functioning in U.S. military service members and veterans. Brain Inj 2022; 36:339-352. [PMID: 35171749 DOI: 10.1080/02699052.2022.2034183] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the relationship between resilience and self-reported neurobehavioral functioning following traumatic brain injury (TBI) in U.S. military service members and veterans (SMVs). A secondary objective was to examine the interaction between resilience and posttraumatic stress disorder (PTSD) on neurobehavioral functioning. METHOD Participants included 795 SMVs classified into four groups: Uncomplicated Mild TBI (MTBI; n=300); Complicated Mild, Moderate, Severe, or Penetrating TBI (STBI, n 162); Injured Controls (IC, n=185); and Non-injured Controls (NIC, n=148). Two independent cohorts were evaluated - those assessed within 1-year of injury and those assessed 10-years post-injury. SMVs completed self-report measures including the PTSD Checklist-Civilian version, Neurobehavioral Symptom Inventory, and TBI-Quality of Life. RESULTS Results showed that (1) lower resilience was strongly associated with poorer neurobehavioral functioning across all groups at 1-year and 10-years post-injury, and (2) PTSD and resilience had a robust influence on neurobehavioral functioning at both time periods post-injury, such that SMVs with PTSD and low resilience displayed the poorest neurobehavioral functioning. CONCLUSION Results suggest that regardless of injury group and time since injury, resilience and PTSD strongly influence neurobehavioral functioning following TBI among SMVs. Future research evaluating interventions designed to enhance resilience in this population is indicated.
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Affiliation(s)
- Victoria C Merritt
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Tracey A Brickell
- Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA.,Walter Reed National Military Medical Center, Bethesda, MD, USA.,National Intrepid Center of Excellence, Bethesda, MD, USA.,Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Contractor, General Dynamics Information Technology, Falls Church, VA, USA
| | - Jason M Bailie
- Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA.,Contractor, General Dynamics Information Technology, Falls Church, VA, USA.,Naval Hospital Camp Pendleton, Oceanside, CA, Oceanside, CA, USA
| | - Lars Hungerford
- Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA.,Contractor, General Dynamics Information Technology, Falls Church, VA, USA.,Naval Medical Center San Diego, San Diego, CA, USA
| | - Sara M Lippa
- Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA.,Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Louis M French
- Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA.,Walter Reed National Military Medical Center, Bethesda, MD, USA.,National Intrepid Center of Excellence, Bethesda, MD, USA.,Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Rael T Lange
- Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA.,Walter Reed National Military Medical Center, Bethesda, MD, USA.,National Intrepid Center of Excellence, Bethesda, MD, USA.,Contractor, General Dynamics Information Technology, Falls Church, VA, USA.,University of British Columbia, Vancouver, BCCanada
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8
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Assonov D. Two-Step Resilience-Oriented Intervention for Veterans with Traumatic Brain Injury: A Pilot Randomized Controlled Trial. CLINICAL NEUROPSYCHIATRY 2021; 18:247-259. [PMID: 34984068 PMCID: PMC8696289 DOI: 10.36131/cnfioritieditore20210503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The present randomized parallel two-arm pilot study aimed to compare the efficacy of two-step resilience-oriented intervention with treatment as usual in veterans with mild to moderate traumatic brain injury. METHOD Two-step Resilience-Oriented Intervention (TROI) is a brief psychological intervention that targets cognitive (step 1) and emotional (step 2) factors of resilience and consists of six 1-hour sessions. Overall, 70 Ukrainian veterans serviced in Anti-Terrorist Operation / Joint Forces Operation were randomly assigned to an intervention group (TROI group) or a control group that underwent treatment as usual (TAU group). For pre- (T1) and post-treatment (T2) assessment the Connor-Davidson Resilience Scale (CD-RISC), Hospital Anxiety and Depression Scale (HADS), Montreal Cognitive Assessment Scale (MoCA), Neurobehavioral Symptom Inventory (NSI), Posttraumatic Stress Disorder Checklist 5 (PCL-5), Chaban Quality of Life Scale (CQLS), Positive and Negative Affect Scale (PANAS) were used. RESULTS Multivariable linear regression with the treatment group, gender, baseline cognitive performance level and TBI severity as the independent variables revealed statistically significant improvements in the TROI group in resilience (CD-RISC), cognitive performance (MoCA), postconcussive symptoms (NSI), posttraumatic symptoms (PCL-5), positive affect (PANAS) and quality of life (CQLS) comparing to such in TAU group. We found no statistically significant differences between groups in depression, anxiety (HADS) and negative affect (PANAS) outcomes. Additionally, Wilcoxon signed-rank test revealed that participants who completed two-step resilience-oriented intervention had significantly improved scores for all outcomes compared to the baseline (p < 0.05). CONCLUSIONS In summary, we can tentatively conclude that adding TROI to the standard treatment measures may improve the resilience and sustainable symptoms in veterans with TBI when compared with standard treatment. Targeting cognitive and emotional factors like problem-solving, decision-making, positive thinking can promote resilience in veterans with TBI and be useful in facilitating recovery from injury. Results of this pilot study are promising, but the intervention needs to be studied in a larger trial.
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Affiliation(s)
- Dmytro Assonov
- Department of Medical Psychology, Psychosomatic Medicine and Psychotherapy, Bogomolets National Medical University, Kyiv, Ukraine,Corresponding author Dmytro Assonov, E-mail:
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Dong M, Nie A, Liu C, Zheng J. Psychological resilience of patients with bladder cancer after radical cystectomy and urinary diversion: A cross-sectional study. Psychooncology 2021; 31:21-29. [PMID: 34344061 DOI: 10.1002/pon.5770] [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: 12/02/2020] [Revised: 07/10/2021] [Accepted: 07/13/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aims of this study were to investigate the current state of psychological resilience and identify its associated factors in bladder cancer (BC) patients undergoing radical cystectomy (RC). METHODS A cross-sectional study, using convenience sampling was conducted among 248 patients recruited from urology department of a tertiary hospital in Shenyang, China. According to the resilience in illness model, participants were invited to finish a questionnaire included demographic and disease-related information, Connor-Davidson Resilience Scale, Mishel Uncertainty in Illness Scale, Medical Coping Modes Questionnaire, Social Support Rating Scale, Family adaptation, partnership, growth, affection, and resolve Index and Herth Hope Index. Multiple regression analysis was conducted to explore the predictors of resilience. RESULTS The average resilience score of 53.45 ± 6.22 among BC patients undergoing RC. Multiple regression showed that the associated factors of resilience of postoperative BC patients were gender (β = -0.142, p = 0.002), living in town (β = -0.103, p = 0.052), living alone (β = 0.118, p = 0.026), almost need to be taken care of (β = 0.094, p = 0.064), illness uncertainty (β = -0.249, p < 0.001), confrontation (β = 0.091, p = 0.077), acceptance-resignation (β = -0.205, p < 0.001), social support (β = 0.122, p = 0.029) and hope (β = 0.350, p < 0.001). These predictors accounted for 56.9% of the total variance in resilience (F = 14.964, p < 0.001). CONCLUSIONS Resilience among BC patients undergoing RC needs to be further improved. Hope was the most important variable influencing resilience in BC patients undergoing RC. In the future, we need to pay more attention to the psychological status of patients and encourage them to face the disease with positive emotion and positive coping style to enhance the hope and resilience of patients, so as to improve the quality of life of patients with BC undergoing RC.
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Affiliation(s)
- Mengyuan Dong
- Department of Urinary Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Anliu Nie
- Department of Emergency, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chunxiang Liu
- Department of Urinary Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jin Zheng
- Department of Urinary Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
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Schneider JC, Hendrix-Bennett F, Beydoun HA, Johnstone B. A Retrospective Study of Demographic, Medical, and Psychological Predictors of Readiness in Service Members With Mild Traumatic Brain Injury. Mil Med 2021; 186:e401-e409. [PMID: 33175963 DOI: 10.1093/milmed/usaa274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/17/2020] [Accepted: 08/09/2020] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Given the significant number of service members who have incurred mild traumatic brain injury (TBI) over the past two decades, this study was completed to determine the relative contribution of demographic, TBI-related, and psychological factors that predict the readiness of service members with primarily mild TBI. METHODS AND MATERIALS This retrospective study included 141 service members who were evaluated at an outpatient military TBI rehabilitation clinic. Information regarding demographics, TBI-related variables, and psychological factors was collected and entered into hierarchical multinomial logistic regressions to predict military work status. Demographic predictor variables included age, race, gender, rank, service branch; TBI-specific variables including time since injury and neuropsychological variables (i.e., Wechsler Adult Intelligence Scale-IV (WAIS-IV) Full Scale Intelligence Quotient (FSIQ) and Processing Speed Indices; California Verbal Learning Test-IV total recall t-score); and psychiatric variables including concomitant psychiatric diagnoses and Personality Assessment Inventory indices. The outcome variable was the service member's military work status (i.e., return to duty (RTD); Medical Evaluation Board-disabled (MEB); retired) at time of discharge from the TBI clinic. RESULTS Statistical analyses indicated that the total model predicted 31% of the variance in work status, with demographics predicting 16% of the variance, concomitant psychiatric diagnoses and WAIS-IV FSIQ predicting an additional 12%, and subjective somatic/psychological distress (Personality Assessment Inventory indices) predicting an additional 3%. Regarding the primary groups of interest (i.e., RTD vs. MEB), stepwise regressions indicated that those who RTD have higher intelligence and report less physical/psychological distress than the disabled group. CONCLUSIONS In general, those service members who were able to RTD versus those who were classified as disabled (MEB) were of higher IQ and reported less somatic/psychological distress. Of note, traditional indices of TBI severity did not predict the ability of the sample to RTD. The results suggest the importance of treating psychological conditions and identifying possible indicators of resilience (e.g., higher intelligence) to increase the readiness of service members with mild TBI.
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Affiliation(s)
| | - Felicia Hendrix-Bennett
- Fort Belvoir Intrepid Spirit Center, Fort Belvoir, VA 22060, USA.,Defense and Veterans Brain Injury Center, Fort Belvoir Intrepid Spirit Center, Fort Belvoir, VA 22060, USA.,General Dynamics Information Technology, Falls Church, VA 22042, USA
| | - Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA 22060, USA
| | - Brick Johnstone
- Fort Belvoir Intrepid Spirit Center, Fort Belvoir, VA 22060, USA.,Defense and Veterans Brain Injury Center, Fort Belvoir Intrepid Spirit Center, Fort Belvoir, VA 22060, USA.,Virginia Crawford Research Institute, Shepherd Center, Atlanta, GA 30309, USA
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11
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Lesniak E, Ramsey KG, Brady C, Beydoun HA, Johnstone B. Predicting military readiness using objective and subjective indices of neuropsychological impairment in service members with mild traumatic brain injury. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:1152-1159. [PMID: 33356571 DOI: 10.1080/23279095.2020.1855588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The military is interested in identifying factors to improve the readiness of service members with traumatic brain injury (TBI). TBI outcome studies have primarily used objective neuropsychological data interpreted using the absolute level of functioning (i.e., high average, average, low average), though research suggests it is also important to consider other objective indices of the relative degree of decline (e.g., mild, moderate, severe) and subjective complaints. The current study determined the predictive ability of objective indices of neuropsychological functioning (i.e., absolute level and the relative degree of decline) and subjective complaints (i.e., Neurobehavioral Symptom Inventory) in terms of military work status (i.e., return to duty, medically disabled, retired) for 113 service members with mild TBI. ANOVAs and post-hoc tests indicated individuals who were able to return to duty had higher absolute indices and lower relative decline scores in working memory and overall intelligence, as well as lower subjective neuropsychological complaints when compared to those who were disabled or retired. Multinomial logistic regression models generally supported these findings, except relative decline scores were not predictive of military work status likely due to issues of collinearity (i.e., relative decline scores are calculated using absolute scores). In conclusion, indices of absolute functioning and subjective neuropsychological impairments appear to be predictors of the ability to return to duty post-TBI in military populations, emphasizing the need to focus on cognitive reserve and emotional resilience as potential interventions.
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Affiliation(s)
- Elizabeth Lesniak
- Adult Behavioral Health Department, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA
| | - Kathryn G Ramsey
- Fort Belvoir Intrepid Spirit Center, Fort Belvoir, VA, USA.,Defense and Veterans Brain Injury Center, Fort Belvoir Intrepid Spirit Center, Fort Belvoir, VA, USA
| | | | - Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA
| | - Brick Johnstone
- Fort Belvoir Intrepid Spirit Center, Fort Belvoir, VA, USA.,Defense and Veterans Brain Injury Center, Fort Belvoir Intrepid Spirit Center, Fort Belvoir, VA, USA.,Shepherd Center, Atlanta, GA, USA
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12
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Popovitz J, Mysore SP, Adwanikar H. Neural Markers of Vulnerability to Anxiety Outcomes after Traumatic Brain Injury. J Neurotrauma 2020; 38:1006-1022. [PMID: 33050836 DOI: 10.1089/neu.2020.7320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Anxiety outcomes after traumatic brain injury (TBI) are complex, and the underlying neural mechanisms are poorly understood. Here, we developed a multi-dimensional behavioral profiling approach to investigate anxiety-like outcomes in mice that takes into account individual variability. Departing from the tradition of comparing outcomes in TBI versus sham groups, we identified a subgroup within the TBI group that is vulnerable to anxiety dysfunction, and present increased exploration of the anxiogenic zone compared to sham controls or resilient injured animals, by applying dimensionality reduction, clustering, and post hoc validation to behavioral data obtained from multiple assays for anxiety at several post-injury time points. These vulnerable animals expressed distinct molecular profiles in the corticolimbic network, with downregulation in gamma-aminobutyric acid and glutamate and upregulation in neuropeptide Y markers. Indeed, among vulnerable animals, not resilient or sham controls, severity of anxiety-related outcomes correlated strongly with expression of molecular markers. Our results establish a foundational approach, with predictive power, for reliably identifying maladaptive anxiety outcomes after TBI and uncovering neural signatures of vulnerability to anxiety.
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Affiliation(s)
- Juliana Popovitz
- Department of Psychological and Brain Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Shreesh P Mysore
- Department of Psychological and Brain Sciences, Johns Hopkins University, Baltimore, Maryland, USA.,Department of Neuroscience, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hita Adwanikar
- Department of Psychological and Brain Sciences, Johns Hopkins University, Baltimore, Maryland, USA
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13
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Mental Health and Family Functioning in Patients and Their Family Members after Traumatic Brain Injury: A Cross-Sectional Study. Brain Sci 2020; 10:brainsci10100670. [PMID: 32992808 PMCID: PMC7600942 DOI: 10.3390/brainsci10100670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 11/17/2022] Open
Abstract
Traumatic brain injury (TBI) affects the family as a whole. This study aimed to describe and compare mental health and family functioning in TBI patients and their family members, and to identify individual and family-related factors that were associated with mental health. It was conducted at an urban, specialized, TBI outpatient clinic and included 61 patients with mild to severe TBI and 63 family members. Baseline demographics and injury-related data were collected, and the participants answered standardized, self-reported questionnaires 6-18 months post-injury that assessed mental health; general health; family functioning, communication, and satisfaction; depression and anxiety; self-efficacy; resilience; and condition-specific quality of life. The patients reported significantly worse mental health, depression, resilience, self-efficacy, and general health compared with the family members. Patients and family members had similar perceptions, showing balanced family functioning, high family communication levels, and moderate family satisfaction. Factors significantly associated with mental health in patients and family members were depression, anxiety, and resilience, explaining 56% of the variance (p < 0.001). Family-related factors were not associated with mental health. The disease burden was mainly on the patients; however, the family members also reported emotional distress. Family-targeted interventions across the TBI continuum should be considered.
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14
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Using Decision Tree Methodology to Predict Employment After Moderate to Severe Traumatic Brain Injury. J Head Trauma Rehabil 2020; 34:E64-E74. [PMID: 30234849 PMCID: PMC6553979 DOI: 10.1097/htr.0000000000000438] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objective: To build decision tree prediction models for long-term employment outcomes of individuals after moderate to severe closed traumatic brain injury (TBI) and assess model accuracy in an independent sample. Setting: TBI Model Systems Centers. Participants: TBI Model Systems National Database participants injured between January 1997 and January 2017 with moderate to severe closed TBI. Sample sizes were 7867 (year 1 postinjury), 6783 (year 2 postinjury), and 4927 (year 5 postinjury). Design: Cross-sectional analyses using flexible classification tree methodology and validation using an independent subset of TBI Model Systems National Database participants. Main Measures: Competitive employment at 1, 2, and 5 years postinjury. Results: In the final employment prediction models, posttraumatic amnesia duration was the most important predictor of employment in each outcome year. Additional variables consistently contributing were age, preinjury education, productivity, and occupational category. Generally, individuals spending fewer days in posttraumatic amnesia, who were competitively employed preinjury, and more highly educated had better outcomes. Predictability in test data sets ranged from a C-statistic of 0.72 (year 5; confidence interval: 0.68-0.76) to 0.77 (year 1; confidence interval: 0.74-0.80). Conclusion: An easy-to-use decision tree tool was created to provide prognostic information on long-term competitive employment outcomes in individuals with moderate to severe closed TBI. Length of posttraumatic amnesia, a clinical marker of injury severity, and preinjury education and employment status were the most important predictors.
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15
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Johnstone B, Ramsey KG, Beydoun HA. Comparing indices of objective and subjective neuropsychological impairments in service members with mild traumatic brain injury. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:397-404. [PMID: 32476468 DOI: 10.1080/23279095.2020.1763999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Neuropsychological impairments are evaluated using subjective measures and objective tests, although their relationship remains unclear. This is likely because objective data is interpreted in terms of absolute level of functioning (e.g., high average, average, low average) while subjective complaints are interpreted in terms of relative decline from premorbid levels (e.g., mild, moderate, severe). The current study calculated objective indices of estimated degree of relative decline (i.e., difference between current cognitive ability and estimated premorbid level) to compare objective and subjective indices of relative decline for military service members with mild traumatic brain injury (mTBI). Contrary to hypotheses, more indices of absolute level of functioning were significantly correlated with subjective neuropsychological (i.e., Neurobehavioral Symptom Inventory) and psychological complaints (e.g., Personality Assessment Inventory) than relative decline scores. The results suggest stronger cognitive abilities may be associated with greater cognitive reserve or emotional resilience and, thereby, less subjective complaints for individuals with TBI, regardless of the extent of neuropsychological decline experienced.
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Affiliation(s)
- Brick Johnstone
- Defense and Veterans Brain Injury Center, Fort Belvoir, VA, USA
| | - Kathryn G Ramsey
- Defense and Veterans Brain Injury Center, Fort Belvoir Intrepid Spirit Center, Fort Belvoir, VA, USA
| | - Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA
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16
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Gyawali P, Chow WZ, Hinwood M, Kluge M, English C, Ong LK, Nilsson M, Walker FR. Opposing Associations of Stress and Resilience With Functional Outcomes in Stroke Survivors in the Chronic Phase of Stroke: A Cross-Sectional Study. Front Neurol 2020; 11:230. [PMID: 32390923 PMCID: PMC7188983 DOI: 10.3389/fneur.2020.00230] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/10/2020] [Indexed: 12/21/2022] Open
Abstract
Stroke survivors report significant levels of psychological distress post stroke. To date, most studies conducted have focused on the relationship between psychological stress and functional outcomes in the acute phase of stroke. However, no studies had considered the role of stress over the chronic phase, where stress may continue to exert negative effects on cognitive and psychological processes. Further, the role of potentially modulatory variables, such as psychological resilience, on stroke outcomes has been understudied. The purpose of this study was to consider the relationships between stress and resilience with functional outcomes in long-term survivors of stroke. People (N = 70) who had experienced a stroke between 5 months and 28 years ago were included in the cross-sectional study, along with age-matched controls (N = 70). We measured stress using both the Perceived Stress Scale and biological markers, and resilience using both the Brief Resilience Scale and the Connor-Davidson Resilience Scale. Stroke outcomes were assessed using the Stroke Impact Scale. We found that, compared with age-matched controls, stroke survivors reported greater levels of perceived stress, and lower levels of resilience. In stroke survivors, both perceived stress and resilience were independently associated with stroke outcomes in linear regression models. In particular, these relationships were observed for cognitive outcomes including mood, memory, and communication. The association between stress and stroke outcome did not differ across time post stroke. Given that resilience is a modifiable psychological construct, future research may consider whether strategies directed at enhancing resilience may improve recovery from stroke. Australia and New Zealand Clinical Trials Registry: ACTRN12617000736347.
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Affiliation(s)
- Prajwal Gyawali
- School of Biomedical Sciences and Pharmacy and Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia
| | - Wei Zhen Chow
- School of Biomedical Sciences and Pharmacy and Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia
| | - Madeleine Hinwood
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Murielle Kluge
- School of Biomedical Sciences and Pharmacy and Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Coralie English
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia.,Centre for Rehab Innovations, The University of Newcastle, Callaghan, NSW, Australia.,School of Health Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Lin Kooi Ong
- School of Biomedical Sciences and Pharmacy and Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia.,School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Michael Nilsson
- School of Biomedical Sciences and Pharmacy and Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia.,Centre for Rehab Innovations, The University of Newcastle, Callaghan, NSW, Australia
| | - Frederick Rohan Walker
- School of Biomedical Sciences and Pharmacy and Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia.,Centre for Rehab Innovations, The University of Newcastle, Callaghan, NSW, Australia
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17
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Li J, Chen YP, Zhang J, Lv MM, Välimäki M, Li YF, Yang SL, Tao YX, Ye BY, Tan CX, Zhang JP. The Mediating Role of Resilience and Self-Esteem Between Life Events and Coping Styles Among Rural Left-Behind Adolescents in China: A Cross-Sectional Study. Front Psychiatry 2020; 11:560556. [PMID: 33329099 PMCID: PMC7714763 DOI: 10.3389/fpsyt.2020.560556] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/12/2020] [Indexed: 02/04/2023] Open
Abstract
Objective: This study aims to explore the association between life events and coping styles, and how resilience and self-esteem mediate the association. Methods: A cross-sectional study was conducted among 981 left-behind adolescents (LBAs) in five junior high schools in Hunan Province, China, from April 13 to April 20, 2020. We utilized self-designed sociodemographic questionnaire, Adolescent Self-Rating Life Events Checklist, Resilience Scale Chinese Adolescent, Rosenberg Self-Esteem Scale, and Simplified Coping Style Questionnaire to assess the mental health of LBAs. Statistic description, Pearson correlation analysis, and structural equation model were adopted to analyze the data. Results: Results revealed that life events could negatively predict resilience (β = -0.29, P < 0.001) and self-esteem (β = -0.39, P < 0.001) and positively predict LBAs' positive coping style (β = 0.28, P < 0.001) and negative coping style (β = 0.21, P < 0.001). Self-esteem could also positively predict the resilience of LBAs (β = 0.62, P < 0.001); resilience could negatively predict the negative coping style (β = -0.21, P < 0.001) and positively predict the positive coping style (β = 0.79, P < 0.001). Life events not only have direct effects on negative coping style (β = 0.21) and positive coping style (β = 0.28) but also have indirect effects on coping styles by affecting resilience (β = -0.29) and self-esteem (β = -0.39). The total effect of life events on coping styles was 0.32, where 34.37% was mediated by resilience and self-esteem. Conclusion: We proved that resilience and self-esteem mediated most of the effects of life events on coping styles. The findings had important implications for interventions to promote mental health of LBAs, particularly the enhancement of resilience and self-esteem.
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Affiliation(s)
- Juan Li
- Xiangya Nursing School of Central South University, Changsha, China
| | - Yi-Ping Chen
- Xiangya Nursing School of Central South University, Changsha, China
| | - Jie Zhang
- Xiangya Nursing School of Central South University, Changsha, China
| | - Meng-Meng Lv
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Yi-Fei Li
- Xiangya Nursing School of Central South University, Changsha, China
| | - Si-Lan Yang
- Xiangya Nursing School of Central South University, Changsha, China
| | - Ying-Xiang Tao
- Xiangya Nursing School of Central South University, Changsha, China
| | - Bi-Yun Ye
- Xiangya Nursing School of Central South University, Changsha, China
| | - Chu-Xia Tan
- Xiangya Nursing School of Central South University, Changsha, China
| | - Jing-Ping Zhang
- Xiangya Nursing School of Central South University, Changsha, China
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18
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Algethamy H. Baseline Predictors of Survival, Neurological Recovery, Cognitive Function, Neuropsychiatric Outcomes, and Return to Work in Patients after a Severe Traumatic Brain Injury: an Updated Review. Mater Sociomed 2020; 32:148-157. [PMID: 32843865 PMCID: PMC7428895 DOI: 10.5455/msm.2020.32.148-157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Introduction Severe traumatic brain injury (sTBI) is a common cause of death and disability worldwide, with long-term squeal among survivors that include cognitive deficits, psychosocial and neuropsychiatric dysfunction, failure to return to pre-injury levels of work, school and inter-personal relationships, and overall reduced quality of and satisfaction with life. Aim The aim of this work is to review the current literature on baseline predictors of outcomes in adults post sTBI. Method Most of available literature on baseline predictors of outcomes in adults post sTBI were reviewed and summarized in this work. Results Currently, a sizeable number of composite predictors of mortality and overall function exists; however, these instruments tend to over-estimate poor outcomes and fail to address issues like cognition, psychosocial/ neuropsychiatric dysfunction, and return to work or school. Conclusion This article reviews currently-identified predictors of all these outcomes.
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Affiliation(s)
- Haifa Algethamy
- Department of Anaesthesia and Critical Care, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
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19
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Donnelly KZ, Baker K, Pierce R, St Ivany AR, Barr PJ, Bruce ML. A retrospective study on the acceptability, feasibility, and effectiveness of LoveYourBrain Yoga for people with traumatic brain injury and caregivers. Disabil Rehabil 2019; 43:1764-1775. [PMID: 31577456 DOI: 10.1080/09638288.2019.1672109] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE To conduct a mixed methods, pre-post, retrospective study on the feasibility, acceptability, and effectiveness of the LoveYourBrain Yoga program. MATERIALS AND METHODS People were eligible if they were a traumatic brain injury survivor or caregiver, age 15-70, ambulatory, and capable of gentle exercise and group discussion. We analyzed attendance, satisfaction, and mean differences in scores on Quality of Life After Brain Injury Overall scale (QOLIBRI-OS) and four TBI-QOL/Neuro-QOL scales. Content analysis explored perceptions of benefits and areas of improvement. RESULTS 1563 people (82.0%) participated ≥1 class in 156 programs across 18 states and 3 Canadian provinces. Mean satisfaction was 9.3 out of 10 (SD 1.0). Mixed effects linear regression found significant improvements in QOLIBRI-OS (B 9.70, 95% CI: 8.51, 10.90), Resilience (B 1.30, 95% CI: 0.60, 2.06), Positive Affect and Well-being (B 1.49, 95% CI: 1.14, 1.84), and Cognition (B 1.48, 95% CI: 0.78, 2.18) among traumatic brain injury survivors (n = 705). No improvement was found in Emotional and Behavioral Dysregulation, however, content analysis revealed better ability to regulate anxiety, anger, stress, and impulsivity. Caregivers perceived improvements in physical and psychological health. CONCLUSIONS LoveYourBrain Yoga is feasible and acceptable and may be an effective mode of community-based rehabilitation.IMPLICATIONS FOR REHABILITATIONPeople with traumatic brain injury and their caregivers often experience poor quality of life and difficulty accessing community-based rehabilitation services.Yoga is a holistic, mind-body therapy with many benefits to quality of life, yet is largely inaccessible to people affected by traumatic brain injury in community settings.Participants in LoveYourBrain Yoga, a six-session, community-based yoga with psychoeducation program in 18 states and 3 Canadian provinces, experienced significant improvements in quality of life, resilience, cognition, and positive affect.LoveYourBrain Yoga is feasible and acceptable when implemented on a large scale and may be an effective mode of, or adjunct to, community-based rehabilitation.
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Affiliation(s)
- Kyla Z Donnelly
- Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA.,The LoveYourBrain Foundation, Windsor, VT, USA
| | - Kim Baker
- The LoveYourBrain Foundation, Windsor, VT, USA
| | | | - Amanda R St Ivany
- Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
| | - Paul J Barr
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
| | - Martha L Bruce
- Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
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20
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Vos L, Poritz JMP, Ngan E, Leon-Novelo L, Sherer M. The relationship between resilience, emotional distress, and community participation outcomes following traumatic brain injury. Brain Inj 2019; 33:1615-1623. [PMID: 31456432 DOI: 10.1080/02699052.2019.1658132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Purpose/Objective: To determine how resilience is associated with social participation outcomes in persons with traumatic brain injury (TBI), in the context of emotional distress, demographics, and injury-related factors.Setting: Individuals with a history of TBI recruited the following stay at three rehabilitation facilities in the USA.Participants: 201 community-dwelling persons with medically documented TBI ranging in severity from mild to severe.Design: Prospective cohort observational study. Data were collected at two time points, approximately 6 months apart.Main Measures: TBI-QOL; PART-OResults: Resilience at baseline was moderately to strongly correlated with baseline psychological distress variables (rs= -.66) and social participation variables (rs =.33 to.57). In regression analyses, resilience was directly associated with social participation outcomes and formed a significant interaction with emotional distress in some models. Resilience failed to show a relationship with social participation at 6-month follow-up, when controlling for baseline social participation.Conclusions: Though related to emotional distress, self-reported resilience makes a unique contribution to predicting outcomes over time following brain injury, and may impact the relationship between stress and negative participation outcomes. As such, it is possible interventions that promote resilience may mitigate distress and promote community integration.
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Affiliation(s)
- Leia Vos
- TIRR Memorial Hermann, Brain Injury Research Center.,Neuropsychology, Zablocki VA Medical Center, Milwaukee, WI, USA.,Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, USA
| | | | - Esther Ngan
- School of Public Health, Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston
| | - Luis Leon-Novelo
- School of Public Health, Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston
| | - Mark Sherer
- TIRR Memorial Hermann, Brain Injury Research Center.,Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, USA
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21
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Gao F, Yao Y, Yao C, Xiong Y, Ma H, Liu H. The mediating role of resilience and self-esteem between negative life events and positive social adjustment among left-behind adolescents in China: a cross-sectional study. BMC Psychiatry 2019; 19:239. [PMID: 31370895 PMCID: PMC6676624 DOI: 10.1186/s12888-019-2219-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 07/24/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In China, adolescents are frequently left behind by their parents. A great deal of scientific evidence demonstrates considerable psychological and social impacts that negative life events may have on adolescents who are left behind. While a direct relationship between negative life events and psychological and social effects has been observed, indirect effects have yet to be examined. Therefore, the objective of this study was to determine the association between negative life events and positive social adjustment and how resilience and self-esteem mediate this association. METHODS A cross-sectional study was carried out in the provinces of Shandong, Henan, and Sichuan in China. A questionnaire was distributed to 4716 left-behind adolescents in ten middle/high schools. We performed Bayesian estimations in structural equation modeling using the Markov Chain Monte Carlo algorithm to test our hypotheses. RESULTS Negative life events were significantly related to resilience (rs = - 0.402), self-esteem (rs = - 0.292), and positive social adjustment (rs = - 0.239). Positive social adjustment was directly affected by resilience (β = 0.639) and self-esteem (β = 0.448). Negative life events were not only directly related to positive social adjustment (β = - 0.187, 95% credible interval: - 0.233 ~ - 0.139), but also showed an indirect effect on positive social adjustment (β = - 0.541, 95% credible interval: - 0.583 ~ - 0.501) through resilience (β = - 0.370) and self-esteem (β = - 0.171). The total effect of negative life events on positive social adjustment was - 0.728, where 74.31% was mediated by resilience and self-esteem. The indirect effect of negative life events on positive social adjustment through resilience and self-esteem was 2.893 times more than the direct effect. CONCLUSIONS Resilience and self-esteem mediated most of the effect of negative life events on positive social adjustment. Interventions should be developed to improve the social adjustment of adolescents who are left behind, particularly the enhancement of resilience and self-esteem.
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Affiliation(s)
- Feifei Gao
- Department of Health Statistics, School of Public Health, Jinzhou Medical University, Jinzhou, 121000, Liaoning Province, People's Republic of China. .,Department of Health Statistics, School of Public Health, China Medical University, Shenyang, 110122, Liaoning Province, People's Republic of China.
| | - Yuan Yao
- 0000 0001 0455 0905grid.410645.2Medical College, Qingdao University, Qingdao, 266021 Shandong Province People’s Republic of China
| | - Chengwen Yao
- Middle School of Ying-Li Town, Heze, 274927 Shandong Province People’s Republic of China
| | - Yan Xiong
- Hospital of Xi-He Town, Longquanyi district, Chengdu, 610107 Sichuan Province People’s Republic of China
| | - Honglin Ma
- 0000 0000 9860 0426grid.454145.5Department of Health Statistics, School of Public Health, Jinzhou Medical University, Jinzhou, 121000 Liaoning Province People’s Republic of China
| | - Hongbo Liu
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, 110122, Liaoning Province, People's Republic of China.
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22
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Drayer NJ, Wallace CS, Yu HH, Mansfield TD, Cummings DL, Hood DK, Arrington ED, Kang DG. High Resiliency Linked to Short-Term Patient Reported Outcomes and Return to Duty Following Arthroscopic Knee Surgery. Mil Med 2019; 185:112-116. [DOI: 10.1093/milmed/usz180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/02/2019] [Accepted: 06/27/2019] [Indexed: 12/11/2022] Open
Abstract
Abstract
Introduction
Resilience is a psychometric construct of a patient’s ability to recover from adversity and has been used to predict outcomes but its use in orthopedics has been limited. The purpose of this study was to examine the association between resilience and outcomes.
Materials and Methods
We performed a retrospective analysis of prospectively collected data of patient who underwent sports knee surgery at a single institution performed by 6 orthopedic surgeons from January 2017 to December 2017. We included active-duty patients with complete preoperative outcomes and a minimum of 6 month follow-up. All patients completed the Brief Resilience Scale (BRS), Veteran’s Rand-12 (VR-12), Patient-Reported Outcomes Measurement Information System 43 (PROMIS-43), International Knee Documentation Committee function score (IKDC), and Knee Injury and Osteoarthritis Outcome Score (KOOS). Patients were divided into low resilience (LR) and high resilience (HR) groups based on a score of less than 24 for low and greater than or equal to 24 according to BRS. Outcomes were then compared.
Results
We identified 50 active-duty patients who had complete preoperative and postoperative outcomes at a minimum of 6 months. Mean preoperative and postoperative BRS were significantly different (25.8 HR v 18.6 LR, p < 0.001). We found a difference in postop KOOS in pain, sports, and short form (pain 70.9 HR v 55.7 LR, p = 0.03; sports 50.3 HR v 32.2 LR, p = 0.03; short form (72.1 HR v 62.5 LR, p = 0.04). Similarly, there was a significant difference in postoperative IKDC score (58.0 HR v 44.0 LR, p = 0.03). Similarly we found significant differences in postoperative PROMIS-43 (anxiety 44.4 HR v 60.3 LR, p = 0.004; depression 41.6 HR v 58.1 LR, p = 0.004; fatigue 45.1 HR v 58.6 LR, p = 0.001; sleep 52.6 HR v 62.5 LR, p = 0.02; social participation 36.2 HR v 47.6 LR, p < 0.001). Postoperative VR-12 mental was also statistically different between the two groups (53.5 HR v 41.6 LR; p = 0.01). In addition, 2.3% of the HR group changed MOS as a result of their sports knee surgery compared to 22.2% of the LR group.
Conclusions
Active-military patients with high preoperative resilience appear to have significantly better early postoperative outcomes following sports knee surgery in terms of PROMIS-43, KOOS, and IKDC. There was also a lower rate of changing MOS secondary to sports knee surgery in patients with high resilience.
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Affiliation(s)
- Nicholas J Drayer
- Madigan Army Medical Center, Department of Orthopedic Surgery, 9040 Jackson Ave, Tacoma, WA
| | - Christopher S Wallace
- Madigan Army Medical Center, Department of Orthopedic Surgery, 9040 Jackson Ave, Tacoma, WA
| | - Henry H Yu
- Madigan Army Medical Center, Department of Orthopedic Surgery, 9040 Jackson Ave, Tacoma, WA
| | - Taylor D Mansfield
- Madigan Army Medical Center, Department of Orthopedic Surgery, 9040 Jackson Ave, Tacoma, WA
| | - Danielle L Cummings
- Madigan Army Medical Center, Department of Orthopedic Surgery, 9040 Jackson Ave, Tacoma, WA
| | - Debra K Hood
- Madigan Army Medical Center, Department of Orthopedic Surgery, 9040 Jackson Ave, Tacoma, WA
| | - Edward D Arrington
- Madigan Army Medical Center, Department of Orthopedic Surgery, 9040 Jackson Ave, Tacoma, WA
| | - Daniel G Kang
- Madigan Army Medical Center, Department of Orthopedic Surgery, 9040 Jackson Ave, Tacoma, WA
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23
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Abstract
Purpose: This study examined the extent to which resilience is associated with well-being outcomes after traumatic brain injury, and whether those relationships are independent of global personality traits, such as affectivity.Materials and methods: Sixty-seven adults with complicated-mild to severe traumatic brain injury participated. Measures included the Connor-Davidson Resilience Scale, Modified Cumulative Illness Rating Scale, Disability Rating Scale, SF-12 Health Survey, Satisfaction with Life Scale, and Community Integration Measure.Results: Objective physical health and disability showed modest relation to resilience, indicating that adverse health conditions and disability decreased with increasing resilience. The three measures of subjective well-being showed modest-to-strong positive relation to resilience. These correlations between resilience and well-being generally remained significant after accounting for negative and positive affectivity. Results also suggest that the influence of resilience on well-being has a threshold effect: a greater influence on outcome among people with low or inadequate resilience than among people with average or high resilience.Conclusion: The experience of brain injury does not diminish the positive influence resilience may have on long-term well-being. Resilience may function as a buffer to trauma even in the challenging context of cognitive insult. Routine assessment of resilience might be beneficial to the rehabilitation team.Implications for rehabilitationResilience is positively associated with subjective and objective well-being among adults with moderate-to-severe traumatic brain injury, and it appears to function among adults with traumatic brain injury similarly to adults without cognitive disabilities.Resilience overlaps with overarching trait personality constructs such as affectivity; yet, it has unique characteristics and unique value in understanding well-being.The adverse effects of low resilience show stronger influence on well-being than do the positive effects of high resilience.Routine assessment of resilience might be beneficial to the rehabilitation team in understanding patients and their families, especially in discharge planning, where beliefs about personal capabilities to rebound from adversity shape likely future behavior.
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Affiliation(s)
- Lisa J Rapport
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Christina G Wong
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Robin A Hanks
- Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, Michigan, USA
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Brunner M, Palmer S, Togher L, Hemsley B. 'I kind of figured it out': the views and experiences of people with traumatic brain injury (TBI) in using social media-self-determination for participation and inclusion online. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2019; 54:221-233. [PMID: 29873159 PMCID: PMC6585763 DOI: 10.1111/1460-6984.12405] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/11/2018] [Accepted: 05/22/2018] [Indexed: 05/11/2023]
Abstract
BACKGROUND Social media can support people with communication disability to access information, social participation and support. However, little is known about the experiences of people with traumatic brain injury (TBI) who use social media to determine their needs in relation to social media use. AIMS To determine the views and experiences of adults with TBI and cognitive-communication disability on using social media, specifically: (1) the nature of their social media experience; (2) barriers and facilitators to successful use; and (3) strategies that enabled their use of social media. METHODS & PROCEDURES Thirteen adults (seven men, six women) with TBI and cognitive-communication disability were interviewed about their social media experiences, and a content thematic analysis was conducted. OUTCOMES & RESULTS Participants used several social media platforms including Facebook, Twitter, Instagram and virtual gaming worlds. All but one participant used social media several times each day and all used social media for social connection. Five major themes emerged from the data: (1) getting started in social media for participation and inclusion; (2) drivers to continued use of social media; (3) manner of using social media; (4) navigating social media; and (5) an evolving sense of social media mastery. In using platforms in a variety of ways, some participants developed an evolving sense of social media mastery. Participants applied caution in using social media, tended to learn through a process of trial and error, and lacked structured supports from family, friends or health professionals. They also reported several challenges that influenced their ability to use social media, but found support from peers in using the social media platforms. This information could be used to inform interventions supporting the use of social media for people with TBI and directions for future research. CONCLUSIONS & IMPLICATIONS Social media offers adults with TBI several opportunities to communicate and for some to develop and strengthen social relationships. However, some adults with TBI also reported the need for more information about how to use social media. Their stories suggested a need to develop a sense of purpose in relation to using social media, and ultimately more routine and purposeful use to develop a sense of social media mastery. Further research is needed to examine the social media data and networks of people with TBI, to verify and expand upon the reported findings, and to inform roles that family, friends and health professionals may play in supporting rehabilitation goals for people with TBI.
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Affiliation(s)
- Melissa Brunner
- Speech Pathology, Graduate School of HealthUTSUltimoNSWAustralia
| | - Stuart Palmer
- School of EngineeringDeakin UniversityGeelongVICAustralia
| | - Leanne Togher
- Speech Pathology, Faculty of Health SciencesUniversity of SydneySydneyNSWAustralia
- NHMRC Centre of Research Excellence in Brain RecoveryUNSWSydneyNSWAustralia
| | - Bronwyn Hemsley
- Speech Pathology, Graduate School of HealthUTSUltimoNSWAustralia
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Braaf S, Ameratunga S, Ponsford J, Cameron P, Collie A, Harrison J, Ekegren C, Christie N, Nunn A, Gabbe B. Traumatic injury survivors’ perceptions of their future: a longitudinal qualitative study. Disabil Rehabil 2019; 42:2707-2717. [DOI: 10.1080/09638288.2019.1571116] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Sandy Braaf
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shanthi Ameratunga
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Peter Cameron
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alex Collie
- Insurance Work and Health Group, Monash University, Melbourne, Victoria, Australia
| | - James Harrison
- Research Centre for Injury Studies, Flinders University, Adelaide, South Australia, Australia
| | - Christina Ekegren
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Nicola Christie
- Department of Civil, Environmental and Geomatic Engineering, University College of London, London, UK
| | - Andrew Nunn
- Victorian Spinal Cord Service, Austin Hospital, Heidelberg, Victoria, Australia
| | - Belinda Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Holloway M, Orr D, Clark-Wilson J. Experiences of challenges and support among family members of people with acquired brain injury: a qualitative study in the UK. Brain Inj 2019; 33:401-411. [PMID: 30663417 DOI: 10.1080/02699052.2019.1566967] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PRIMARY OBJECTIVE Family members (FM) are affected by the impact of an Acquired Brain Injury (ABI) upon their relatives and play an important role in rehabilitation and long-term support. This study explores how families are affected and integrates their views on the formal/informal support received as a consequence of ABI. RESEARCH DESIGN A qualitative research design was employed to capture the lived experience of FM of people with ABI. METHOD Semi-structured interviews were conducted with 16 FM of people with severe ABI. Participants were chosen from respondents to a UK national online survey of affected individuals. Interview data were analysed using inductive thematic analysis. RESULTS Family members' experiences are complex, enduring and are affected by the context in which the ABI occurs as well as by formal/informal support. The grief experienced by FM is ambiguous, develops over time and FM perceive little option but to remain involved. Experience of formal and informal support is noted to vary significantly in availability and quality, poor support exacerbates difficulties and isolates family members. CONCLUSION Greater understanding of the lived experience of FM is needed to support more effective responses to both them and the individual with ABI, integrating services and families to improve quality-of-life.
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Affiliation(s)
| | - David Orr
- b University of Sussex , Brighton , UK
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27
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Castor N, El Massioui F. Resilience after a neurological pathology: What impact on the cognitive abilities of patients with brain damage? Neuropsychol Rehabil 2018; 30:853-871. [PMID: 30136623 DOI: 10.1080/09602011.2018.1512873] [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: 10/28/2022]
Abstract
The aim of this study is to examine resilience in patients with traumatic brain injury and patients who suffered from stroke. As traumatic brain injury and stroke both have a recovery potential, we investigate cognitive recovery in this context. Given the involvement of resilience in physiological recovery and positive emotions in enhancing cognitive capacities, we hypothesised that resilience could be related to cognitive abilities and recovery following traumatic brain injury and stroke. Our results show the same degree of resilience and cognitive capacities in our participants in two separate assessments. An improvement in cognitive abilities was observed, as was a correlation between these abilities and resilience. In other words, the greater the resilience, the higher the patient's cognitive performances. Resilience appears to influence cognitive abilities in participants with brain damage and also be involved in recovery.
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Affiliation(s)
- Naomie Castor
- Département de Psychologie, Université Paris 8, Paris, France
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Wardlaw C, Hicks AJ, Sherer M, Ponsford JL. Psychological Resilience Is Associated With Participation Outcomes Following Mild to Severe Traumatic Brain Injury. Front Neurol 2018; 9:563. [PMID: 30061858 PMCID: PMC6054998 DOI: 10.3389/fneur.2018.00563] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/22/2018] [Indexed: 11/13/2022] Open
Abstract
Traumatic brain injury (TBI) causes physical and cognitive-behavioral impairments that reduce participation in employment, leisure, and social relationships. Demographic and injury-related factors account for a small proportion of variance in participation post-injury. Personal factors such as resilience may also impact outcomes. This study aimed to examine the association of resilience alongside demographic, injury-related, cognitive, emotional, and family factors with participation following TBI. It was hypothesized that resilience would make an independent contribution to participation outcomes after TBI. Participants included 245 individuals with mild-severe TBI [Mage = 44.41, SDage = 16.09; post traumatic amnesia (PTA) duration M 24.95 days, SD 45.99] who completed the Participation Assessment with Recombined Tools-Objective (PART-O), TBI Quality of Life Resilience scale, Family Assessment Device General Functioning Scale, Rey Auditory Verbal Learning Test, National Adult Reading Test, and Hospital Anxiety and Depression Scale an average 4.63 years post-injury (SD 3.02, R 0.5-13). Multiple regression analyses were used to examine predictors of PART-O scores as the participation measure. Variables in the model accounted for a significant 38% of the variability in participation outcomes, F(13, 211) = 9.93, p < 0.05, R2 = 0.38, adjusted R2 = 0.34. Resilience was a significant predictor of higher participation, along with shorter PTA duration, more years since injury, higher education and IQ, and younger age. Mediation analyses revealed depression mediated the relationship between resilience and participation. As greater resilience may protect against depression and enhance participation this may be a focus of intervention.
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Affiliation(s)
- Carla Wardlaw
- Monash-Epworth Rehabilitation Research Centre, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, VIC, Australia
| | - Amelia J. Hicks
- Monash-Epworth Rehabilitation Research Centre, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, VIC, Australia
| | - Mark Sherer
- TIRR Memorial Hermann, Houston, TX, United States
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, United States
| | - Jennie L. Ponsford
- Monash-Epworth Rehabilitation Research Centre, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, VIC, Australia
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29
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Nalder E, Hartman L, Hunt A, King G. Traumatic brain injury resiliency model: a conceptual model to guide rehabilitation research and practice. Disabil Rehabil 2018; 41:2708-2717. [DOI: 10.1080/09638288.2018.1474495] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Emily Nalder
- Department of Occupational Science and Occupational Therapy, and Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- March of Dimes Canada, Toronto, Ontario, Canada
| | - Laura Hartman
- Department of Occupational Science and Occupational Therapy, and Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Anne Hunt
- Department of Occupational Science and Occupational Therapy, and Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Gillian King
- Department of Occupational Science and Occupational Therapy, and Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
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30
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Kreutzer JS, Marwitz JH, Sima AP, Mills A, Hsu NH, Lukow HR. Efficacy of the resilience and adjustment intervention after traumatic brain injury: a randomized controlled trial. Brain Inj 2018; 32:963-971. [DOI: 10.1080/02699052.2018.1468577] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Jeffrey S. Kreutzer
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
| | - Jennifer H. Marwitz
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
| | - Adam P. Sima
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA
| | - Ana Mills
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
| | - Nancy H. Hsu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
| | - Herman R. Lukow
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
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31
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Rabinowitz AR, Arnett PA. Positive psychology perspective on traumatic brain injury recovery and rehabilitation. APPLIED NEUROPSYCHOLOGY-ADULT 2018; 25:295-303. [DOI: 10.1080/23279095.2018.1458514] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Amanda R. Rabinowitz
- Moss Rehabilitation Research Institute, MossRehab, Elkins Park, Pennsylvania, USA
| | - Peter A. Arnett
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
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32
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Iverson GL, Terry DP, Karr JE, Panenka WJ, Silverberg ND. Perceived Injustice and Its Correlates after Mild Traumatic Brain Injury. J Neurotrauma 2018; 35:1156-1166. [DOI: 10.1089/neu.2017.5402] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Grant L. Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
- Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts
| | - Douglas P. Terry
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
- Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts
| | - Justin E. Karr
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - William J. Panenka
- British Columbia Neuropsychiatry Program, Vancouver, British Columbia, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Noah D. Silverberg
- Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada
- Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, Canada
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33
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Knowledge, Attitudes and Concussion Information Sources Among First Nations in Ontario. Can J Neurol Sci 2018; 45:283-289. [PMID: 29552994 DOI: 10.1017/cjn.2017.299] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Hockey is a popular sport played by many First Nation youth. Concussion frequently goes unrecognized and unreported in youth hockey. Unintentional injuries among Indigenous youth occur at rates three to four times the national Canadian average. The study sought to examine knowledge, attitudes and sources of concussion information among First Nations people attending a provincial hockey tournament. METHODS A cross-sectional survey was undertaken. The survey by Mzazik et al. were modified to use in this study. Participants included youth (6-18 years) hockey players (n=75), parents (n=248) and coaches (n=68). The main outcome measure was total knowledge index (TKI) which consisted of the sum of correct responses to 15 multiple choice questions. Additional data gathered included demographics, concussion history, attitudes toward concussion and sources of information. Descriptive statistics included proportion comparisons. Variables were tested using χ 2 and analysis of variance. RESULTS Overall TKI scores (out of a total of 15) were low; players (5.9±2.8), parents (7.5±2.6) and coaches (7.9±2.6). Participants with higher knowledge scores reported more appreciation of the seriousness of concussion. Sources of information about concussion differed by study group, suggesting the need for multiple knowledge translation strategies to reach youth, parents and coaches. CONCLUSIONS Future initiatives are urgently needed to improve education and prevention of concussion in First Nations youth hockey. Collaborating and engaging with communities can help to ensure an Indigenous lens for culturally safe interventions.
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Living Life After Traumatic Brain Injury: Phase 1 of a Longitudinal Qualitative Study. J Head Trauma Rehabil 2018; 33:E44-E52. [DOI: 10.1097/htr.0000000000000321] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Brunner M, Hemsley B, Dann S, Togher L, Palmer S. Hashtag #TBI: A content and network data analysis of tweets about Traumatic Brain Injury. Brain Inj 2017; 32:49-63. [DOI: 10.1080/02699052.2017.1403047] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Melissa Brunner
- Speech Pathology, Faculty of Education and Arts, University of Newcastle, Newcastle, Australia
| | - Bronwyn Hemsley
- Speech Pathology, Faculty of Education and Arts, University of Newcastle, Newcastle, Australia
| | - Stephen Dann
- College of Business and Economics, Australian National University, Canberra, Australia
| | - Leanne Togher
- Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, Australia
- University of New South Wales, NHMRC Centre of Research Excellence in Brain Recovery, Sydney, Australia
| | - Stuart Palmer
- Dean’s Office, Faculty of Science, Engineering & Built Environment, Deakin University, Geelong, Australia
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36
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Marwitz JH, Sima AP, Kreutzer JS, Dreer LE, Bergquist TF, Zafonte R, Johnson-Greene D, Felix ER. Longitudinal Examination of Resilience After Traumatic Brain Injury: A Traumatic Brain Injury Model Systems Study. Arch Phys Med Rehabil 2017; 99:264-271. [PMID: 28734937 DOI: 10.1016/j.apmr.2017.06.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 05/23/2017] [Accepted: 06/11/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To evaluate (1) the trajectory of resilience during the first year after a moderate-severe traumatic brain injury (TBI); (2) factors associated with resilience at 3, 6, and 12 months postinjury; and (3) changing relationships over time between resilience and other factors. DESIGN Longitudinal analysis of an observational cohort. SETTING Five inpatient rehabilitation centers. PARTICIPANTS Patients with TBI (N=195) enrolled in the resilience module of the TBI Model Systems study with data collected at 3-, 6-, and 12-month follow-up. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Connor-Davidson Resilience Scale. RESULTS Initially, resilience levels appeared to be stable during the first year postinjury. Individual growth curve models were used to examine resilience over time in relation to demographic, psychosocial, and injury characteristics. After adjusting for these characteristics, resilience actually declined over time. Higher levels of resilience were related to nonminority status, absence of preinjury substance abuse, lower anxiety and disability level, and greater life satisfaction. CONCLUSIONS Resilience is a construct that is relevant to understanding brain injury outcomes and has potential value in planning clinical interventions.
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Affiliation(s)
- Jennifer H Marwitz
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA.
| | - Adam P Sima
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA
| | - Jeffrey S Kreutzer
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA; Department of Neurological Surgery, Virginia Commonwealth University, Richmond, VA; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA
| | - Laura E Dreer
- Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, AL; Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL
| | - Thomas F Bergquist
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN; Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, MN
| | - Ross Zafonte
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Douglas Johnson-Greene
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL
| | - Elizabeth R Felix
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL
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Yeates KO, Beauchamp M, Craig W, Doan Q, Zemek R, Bjornson BH, Gravel J, Mikrogianakis A, Goodyear B, Abdeen N, Beaulieu C, Dehaes M, Deschenes S, Harris A, Lebel C, Lamont R, Williamson T, Barlow KM, Bernier F, Brooks BL, Emery C, Freedman SB, Kowalski K, Mrklas K, Tomfohr-Madsen L, Schneider KJ. Advancing Concussion Assessment in Pediatrics (A-CAP): a prospective, concurrent cohort, longitudinal study of mild traumatic brain injury in children: protocol study. BMJ Open 2017; 7:e017012. [PMID: 28710227 PMCID: PMC5724225 DOI: 10.1136/bmjopen-2017-017012] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Paediatric mild traumatic brain injury (mTBI) is a public health burden. Clinicians urgently need evidence-based guidance to manage mTBI, but gold standards for diagnosing and predicting the outcomes of mTBI are lacking. The objective of the Advancing Concussion Assessment in Pediatrics (A-CAP) study is to assess a broad pool of neurobiological and psychosocial markers to examine associations with postinjury outcomes in a large sample of children with either mTBI or orthopaedic injury (OI), with the goal of improving the diagnosis and prognostication of outcomes of paediatric mTBI. METHODS AND ANALYSIS A-CAP is a prospective, longitudinal cohort study of children aged 8.00-16.99 years with either mTBI or OI, recruited during acute emergency department (ED) visits at five sites from the Pediatric Emergency Research Canada network. Injury information is collected in the ED; follow-up assessments at 10 days and 3 and 6 months postinjury measure a variety of neurobiological and psychosocial markers, covariates/confounders and outcomes. Weekly postconcussive symptom ratings are obtained electronically. Recruitment began in September 2016 and will occur for approximately 24 months. Analyses will test the major hypotheses that neurobiological and psychosocial markers can: (1) differentiate mTBI from OI and (2) predict outcomes of mTBI. Models initially will focus within domains (eg, genes, imaging biomarkers, psychosocial markers), followed by multivariable modelling across domains. The planned sample size (700 mTBI, 300 OI) provides adequate statistical power and allows for internal cross-validation of some analyses. ETHICS AND DISSEMINATION The ethics boards at all participating institutions have approved the study and all participants and their parents will provide informed consent or assent. Dissemination will follow an integrated knowledge translation plan, with study findings presented at scientific conferences and in multiple manuscripts in peer-reviewed journals.
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Affiliation(s)
- Keith Owen Yeates
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Miriam Beauchamp
- Department of Psychology, Universite de Montreal and Ste Justine Hospital, Montreal, Québec, Canada
| | - William Craig
- Department of Pediatrics, University of Alberta and Stollery Children’s Hospital, Edmonton, Alberta, Canada
| | - Quynh Doan
- Department of Pediatrics, University of British Columbia and BC Children’s Hospital, Vancouver, British Columbia, Canada
| | - Roger Zemek
- Department of Pediatrics and Emergency Medicine, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Bruce H Bjornson
- Department of Pediatrics, University of British Columbia and BC Children’s Hospital, Vancouver, British Columbia, Canada
| | - Jocelyn Gravel
- Department of Pediatrics, Universite de Montreal and Ste Justine Hospital, Montreal, Québec, Canada
| | - Angelo Mikrogianakis
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Bradley Goodyear
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - Nishard Abdeen
- Department of Radiology, University of Ottawa and Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Christian Beaulieu
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Mathieu Dehaes
- Department of Radiology, Radiooncology and Nuclear Medicine, Université de Montréal and Ste Justine Hospital, Montreal, Québec, Canada
| | - Sylvain Deschenes
- Department of Radiology, Radiooncology and Nuclear Medicine, Université de Montréal and Ste Justine Hospital, Montreal, Québec, Canada
| | - Ashley Harris
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - Catherine Lebel
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - Ryan Lamont
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Medical Genetics, University of Calgary and Alberta Children’s Hospital, Calgary, Alberta, Canada
| | - Tyler Williamson
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Karen Maria Barlow
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary and Alberta Children’s Hospital, Calgary, Alberta, Canada
| | - Francois Bernier
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Medical Genetics, University of Calgary and Alberta Children’s Hospital, Calgary, Alberta, Canada
| | - Brian L Brooks
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary and Alberta Children’s Hospital, Calgary, Alberta, Canada
| | - Carolyn Emery
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Stephen B Freedman
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Kristina Kowalski
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Kelly Mrklas
- Research Innovation and Analytics, Alberta Health Services, Calgary, Alberta, Canada
| | - Lianne Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Kathryn J Schneider
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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Lavoie S, Sechrist S, Quach N, Ehsanian R, Duong T, Gotlib IH, Isaac L. Depression in Men and Women One Year Following Traumatic Brain Injury (TBI): A TBI Model Systems Study. Front Psychol 2017; 8:634. [PMID: 28529492 PMCID: PMC5418333 DOI: 10.3389/fpsyg.2017.00634] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 04/09/2017] [Indexed: 11/30/2022] Open
Abstract
In the general population, females experience depression at significantly higher rates than males. Individuals with traumatic brain injury (TBI) are at substantially greater risk for depression compared to the overall population. Treatment of, and recovery from, TBI can be hindered by depression; comorbid TBI and depression can lead to adverse outcomes and negatively affect multiple aspects of individuals’ lives. Gender differences in depression following TBI are not well understood, and relevant empirical findings have been mixed. Utilizing the Patient Health Questionnaire-9 (PHQ-9) 1 year after TBI, we examined whether women would experience more severe depressive symptoms, and would endorse higher levels of depression within each category of depression severity, than would men. Interestingly, and contrary to our hypothesis, men and women reported mild depression at equal rates; PHQ-9 total scores were slightly lower in women than in men. Men and women did not differ significantly in any PHQ-9 depression severity category. Item analyses, yielded significant gender differences on the following items: greater concentration difficulties (cognitive problems) in men and more sleep disturbances (psychosomatic issues) in women per uncorrected two-sample Z-test for proportions analyses; however, these results were not significant after the family-wise Bonferroni correction. Our results indicate that, in contrast to the general population, mild depression in persons with moderate to severe TBI may not be gender-specific. These findings underscore the need for early identification, active screening, and depression treatment equally for men and women to improve emotional well-being, promote recovery, and enhance quality of life following TBI.
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Affiliation(s)
- Sarah Lavoie
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San JoseCA, USA
| | - Samantha Sechrist
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San JoseCA, USA
| | - Nhung Quach
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San JoseCA, USA
| | - Reza Ehsanian
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San JoseCA, USA.,Department of Neurosurgery, Stanford University, StanfordCA, USA
| | - Thao Duong
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San JoseCA, USA.,Department of Physical Medicine and Rehabilitation, Stanford University, StanfordCA, USA
| | - Ian H Gotlib
- Department of Psychology, Stanford University, StanfordCA, USA
| | - Linda Isaac
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San JoseCA, USA.,Department of Physical Medicine and Rehabilitation, Stanford University, StanfordCA, USA
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Adams D, Dahdah M. Coping and adaptive strategies of traumatic brain injury survivors and primary caregivers. NeuroRehabilitation 2017; 39:223-37. [PMID: 27372358 DOI: 10.3233/nre-161353] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Qualitative research methods allowed the investigator to contribute to the development of new theories and to examine change in processes over time, which added rich detail to existing knowledge of the use of coping and adaptive strategies by traumatic brain injury survivors and their primary caregivers (Ponsford, Sloan, & Snow, 2013). The advantages of phenomenological study were that it allows flexibility to explore and understand meanings attached by people to well-studied concepts such as coping, resiliency, and adaptation or compensation. Phenomenological study was sensitive to contextual factors. It also permitted the study of in-depth dynamics of coping and adaptive strategies of TBI survivors and primary caregivers, while understanding the social and psychological implications of the phenomenon. OBJECTIVE To explore the needs and deficits of adult traumatic brain injury (TBI) survivors and primary caregivers; and to identify their self-initiated coping and adaptive strategies. Significant to this study was the development of coping and adaptive strategies by the participants after their discharge from inpatient and rehabilitation treatment. The compensatory skills taught in treatment settings did not transfer to the home environment. Therefore, these strategies developed independently from previous treatment recommendations contributed to the development of theory related to rehabilitation and counseling. Distinctive to this study was the similarity of coping and adaptive strategies developed from both mild and severe traumatic brain injury survivors. METHODS This study consisted of eleven with TBI and six primary caregivers (N = 17), who participated in a series of semi-structured interviews aimed at discovering the coping and adaptive strategies utilized in dealing with the effects of brain injury. A Qualitative Phenomenological design was employed. RESULTS Patience and understanding, support, and professional help were identified by TBI survivors and caregivers as being their most relevant needs. Self-reported deficits included short-term memory loss (STM), fatigue, anger, and personality changes, and the strategies that TBI survivors and caregivers identified tended to address their problems with these specific day-to-day deficits. Problem focused, emotion focused, and avoidant coping were utilized to some degree in their adjustment to home life and activities of daily living. Participants offered suggestions for mental health professionals addressing how to more effectively work with brain injury survivors and their primary caregivers. CONCLUSION TBI survivors and caregivers had multiple self-reported unaddressed needs following their discharge from facility-based treatment. They reported spontaneously engaging in various coping and adaptive strategies to address their needs and deficits. However, further education regarding potential post-TBI challenges and strategies for addressing them are needed, including a need for community and mental health resources.
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Affiliation(s)
- Deana Adams
- Hope After Brain Injury, Fort Worth, TX, USA.,Center for Counseling & Enrichment, Arlington, TX, USA
| | - Marie Dahdah
- Baylor Institute for Rehabilitation, Dallas, TX, USA.,Baylor Regional Medical Center of Plano, Plano, TX, USA
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Hou XL, Wang HZ, Guo C, Gaskin J, Rost DH, Wang JL. Psychological resilience can help combat the effect of stress on problematic social networking site usage. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.12.048] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Neils-Strunjas J, Paul D, Clark AN, Mudar R, Duff MC, Waldron-Perrine B, Bechtold KT. Role of resilience in the rehabilitation of adults with acquired brain injury. Brain Inj 2017; 31:131-139. [DOI: 10.1080/02699052.2016.1229032] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jean Neils-Strunjas
- Department of Communication Sciences and Disorders, Western Kentucky University, Bowling Green, KT, USA
| | - Diane Paul
- American Speech-Language-Hearing Association, Rockville, MD, USA
| | - Allison N. Clark
- Department of Physical Medicine & Rehabilitation, Baylor College of Medicine and Brain Injury Research Center at TIRR Memorial Hermann, Houston, TX, USA
| | - Raksha Mudar
- Department of Speech & Hearing Science, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Melissa C. Duff
- Department of Communication Sciences & Disorders, University of Iowa, Iowa City, IA, USA
| | | | - Kathleen T. Bechtold
- Department of Physical Medicine & Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
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Donnelly KZ, Linnea K, Grant DA, Lichtenstein J. The feasibility and impact of a yoga pilot programme on the quality-of-life of adults with acquired brain injury. Brain Inj 2016; 31:208-214. [PMID: 27936953 DOI: 10.1080/02699052.2016.1225988] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This pilot study measured the feasibility and impact of an 8-week yoga programme on the quality-of-life of adults with acquired brain injury (ABI). METHODS Thirty-one adults with ABI were allocated to yoga (n = 16) or control (n = 15) groups. Participants completed the Quality of Life After Brain Injury (QOLIBRI) measure pre- and post-intervention; individuals in the yoga group also rated programme satisfaction. Mann-Whitney/Wilcoxon and the Wilcoxon Signed Rank tests were used to evaluate between- and within-group differences for the total and sub-scale QOLIBRI scores, respectively. RESULTS No significant differences emerged between groups on the QOLIBRI pre- or post-intervention. However, there were significant improvements on overall quality-of-life and on Emotions and Feeling sub-scales for the intervention group only. The overall QOLIBRI score improved from 1.93 (SD = 0.27) to 2.15 (SD = 0.34, p = 0.01). The mean Emotions sub-scale increased from 1.69 (SD = 0.40) to 2.01 (SD = 0.52, p = 0.01), and the mean Feeling sub-scale from 2.1 (SD = 0.34) to 2.42 (SD = 0.39, p = 0.01). CONCLUSION Adults with ABI experienced improvements in overall quality-of-life following an 8-week yoga programme. Specific improvements in self-perception and negative emotions also emerged. High attendance and satisfaction ratings support the feasibility of this type of intervention for people with brain injury.
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Affiliation(s)
- Kyla Z Donnelly
- a The Dartmouth Institute for Health Policy and Clinical Practice , Dartmouth College , Lebanon , NH , USA
| | - Kate Linnea
- b Geisel School of Medicine at Dartmouth , Lebanon , NH , USA
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Hernández TD, Brenner LA, Walter KH, Bormann JE, Johansson B. Complementary and alternative medicine (CAM) following traumatic brain injury (TBI): Opportunities and challenges. Brain Res 2016; 1640:139-151. [PMID: 26806403 DOI: 10.1016/j.brainres.2016.01.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 01/13/2016] [Accepted: 01/14/2016] [Indexed: 11/15/2022]
Abstract
Traumatic brain injury (TBI) is highly prevalent and occurs in a variety of populations. Because of the complexity of its sequelae, treatment strategies pose a challenge. Given this complexity, TBI provides a unique target of opportunity for complementary and alternative medicine (CAM) treatments. The present review describes and discusses current opportunitites and challenges associated with CAM research and clinical applications in civilian, veteran and military service populations. In addition to a brief overview of CAM, the translational capacity from basic to clinical research to clinical practice will be described. Finally, a systematic approach to developing an adoptable evidence base, with proof of effectiveness based on the literature will be discussed. Inherent in this discussion will be the methodological and ethical challenges associated with CAM research in those with TBI and associated comorbidities, specifically in terms of how these challenges relate to practice and policy issues, implementation and dissemination. This article is part of a Special Issue entitled SI:Brain injury and recovery.
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Affiliation(s)
- Theresa D Hernández
- Department of Psychology and Neuroscience, University of Colorado at Boulder, United States; Center for Neuroscience, University of Colorado at Boulder, United States; Department of Veterans Affairs, Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), United States.
| | - Lisa A Brenner
- Department of Veterans Affairs, Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), United States; Department of Psychiatry, University of Colorado Anschutz Medical Campus, United States; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, United States; Department of Neurology, University of Colorado Anschutz Medical Campus, United States
| | | | - Jill E Bormann
- Department of Veteran Affairs, San Diego Healthcare System, Center of Excellence for Stress and Mental Health (CESAMH) and University of San Diego Hahn School of Nursing and Health Sciences/Beyster Institute of Nursing Research, United States
| | - Birgitta Johansson
- Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden
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Resilience Following Traumatic Brain Injury: A Traumatic Brain Injury Model Systems Study. Arch Phys Med Rehabil 2015; 97:708-13. [PMID: 26707459 DOI: 10.1016/j.apmr.2015.12.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 12/08/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine resilience at 3 months after traumatic brain injury (TBI). DESIGN Cross-sectional analysis of an ongoing observational cohort. SETTING Five inpatient rehabilitation centers, with 3-month follow-up conducted primarily by telephone. PARTICIPANTS Persons with TBI (N=160) enrolled in the resilience module of the TBI Model System study with 3-month follow-up completed. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Connor-Davidson Resilience Scale. RESULTS Resilience scores were lower than those of the general population. A multivariable regression model, adjusting for other predictors, showed that higher education, absence of preinjury substance abuse, and less anxiety at follow-up were significantly related to greater resilience. CONCLUSIONS Analysis suggests that lack of resilience may be an issue for some individuals after moderate to severe TBI. Identifying persons most likely at risk for low resilience may be useful in planning clinical interventions.
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