Research Development from Acceptance to the Meaning of Acquired Disability in People with Impaired Mobility in Japan

Acceptance of disability in stroke: a systematic review

BACKGROUND

Evidence for the association between acceptance of disability (AOD) and positive rehabilitation outcomes, as well as for the use of AOD measurements in stroke rehabilitation practice, has increased in the international literature in the last decade. However, measurement tools for AOD are heterogenous and there has not been a systematic review summarizing the current evidence on the use of AOD measures and factors associated with AOD.

OBJECTIVE

This study aimed to summarize current evidence on measurement tools used, present existing AOD scores in people with stroke and identify risk factors for and protective factors against poor AOD in people with stroke.

METHODS

The original design and protocol of this systematic review were registered with PROSPERO. The included studies were published from 2008 to 2020 and identified from 5 databases-PubMed, EMBASE, CINAHL Plus, PsycInfo, and the Cochrane Library-using the following inclusion criteria: participants diagnosed with stroke and aged ≥16 years, measurement of AOD, and published in English in a peer-reviewed scientific journal. Review articles were excluded.

RESULTS

Five measurement tools for AOD were reported. The Revised Acceptance of Disability Scale (ADS-R) and the acceptance subscale of the Illness Cognition Questionnaire (ICQ) had the highest internal consistency. Scores ranged from 71.7 to 74.2 on the ADS-R, 16.9-18.3 on the ICQ, 16.5-26.9 on the Acceptance of Illness Scale, and 87.8-93.2 on the Attitudes towards Disabled Persons Form A. Poorer function and depressive symptoms were associated with poor AOD, whereas religious beliefs, support from others, and an understanding of stroke were associated with better AOD.

CONCLUSIONS

The ADS-R and the acceptance subscale of the ICQ are currently the most reliable measurement tools for measuring AOD in people with stroke. Further research to validate the measurement tools is required. This may help to identify people who require additional support.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42017077063; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=77063.

Strategies employed in coping with physical disabilities acquired during adulthood in rural South Africa

Background

Society places people with physical disabilities acquired during adulthood in disadvantaged positions, especially when they cannot participate in activities like their non-disabled counterparts. The situation can be worse for individuals who acquire disabilities during adulthood, where they have to learn to cope with the adulthood-acquired physical disabilities.

Objectives

This study aimed to identify the types of physical disabilities acquired during adulthood and their causes and explore how participants defined their disabilities and the coping strategies they used.

Methods

The study used a phenomenological research design. Five adults (three women, two men) with adulthood-acquired disabilities were purposefully selected from a rural area in Limpopo, South Africa. Data were collected using semi-structured interviews. Thematic analysis was used to generate themes about coping strategies study participants used.

Results

The results show four types of adulthood-acquired disabilities amongst the participants: visual impairment, paraplegia, weakened muscles which led to bilateral amputation, loss of function on both hands and legs. Participants' meanings of their physical adulthood-acquired disabilities ranged from a punishment, pain, not a bother, black magic, to results of doing wrong things to someone. In coming to terms with their adulthood-acquired disabilities, participants used problem- and emotion-focused strategies. Four themes from the participants' responses were spiritual support, social support, substance dependency, access to health and rehabilitation services.

Conclusion

The study contributes to understanding the experiences of individuals who acquired disabilities in adulthood, how they define their disabilities and the divergent coping strategies they use. This study established that participants used problem-focused, positive emotion-focused and negative emotion-focused coping strategies.

Meaning of Disability and Management of its Visibility: a Review of a Qualitative Inquiry on People with Oligodactyly

In this commentary, I discuss the contribution of the target article (Sulaeman et al. 2020) and suggest further study in terms of research on psychosocial issues of people with physical disabilities. The authors of the target article qualitatively analyzed the disability-related experiences of people with oligodactyly in a rural village in Indonesia, employing the theories of stigma (Goffman 1963) and illness narrative (Kleinmann 1988). First, the authors effectively found the meanings of the participants' minor daily experiences by focusing on their physical organ abnormalities. Oligodactyly is visible and mild, rather than other disabilities such as spinal cord injury. A detailed analysis is required to clarify the effect of disability. The authors found that their bodily differences and disorders had multifaceted meanings rather than negative ones only. Another finding was that "God" was referred to as a mediator connecting diverse meanings and places revealing uncertain experiences. Additionally, I discuss that the visibility of oligodactyly depends on the context, and that visible or invisible dichotomy is not suitable for studying psychosocial issues. I argue that people with mild disabilities face the dilemma of disclosing their condition to others. My suggestion for further study is to examine the development of disability meaning from a long-term perspective to elucidate the meaning's evolution through the participant's interaction with family, community, and area outside that village. The concept of narratives in cultural psychology, such as Bruner (2002)'s narrative mode of thinking, was useful; narrative was interfering with the future, past, and present (Valsiner 2007).