Exploring Direct and Indirect Associations of Exercise and Sport Participation with Employment among Individuals with Disabilities: A Scoping Review

Purpose Exercise and sports have many positive benefits for persons with or without a disability. Despite this, the contribution of exercise and sport participation to employment is less documented. The purpose of this scoping review was to provide insight into the direct and indirect associations of exercise and sport participation with employment among persons with disabilities. Methods Six databases were searched (MEDLINE, Embase, Scopus, PsychINFO, CINAHL, and HealthStar) from their inception date to March 20, 2020. Peer-reviewed English and French articles were included if at least one outcome measure on employment or work-related outcomes as a result of participation in, or benefits of exercise and sport participation was the focus of the study. Results The research identified 2796 hits. Of which, 23 published between 1992 and 2019 met eligibility criteria. Seven studies identified a direct association between exercise and sport participation with employment and full-time positions. Sixteen studies reported on improved health/work-related outcomes such as occupational performance (i.e., self-care, functional independence), physical fitness (i.e., upper extremity strength, endurance) and psychological well-being (i.e., self-efficacy). Conclusions This scoping review highlights that exercise and sport participation have associations with employment and work-related outcomes. Benefits of exercise and sports may be considered to a greater extent, than in the past, in programs that facilitate employment for persons with disabilities. Additional research using longitudinal design should be conducted to further understand the strength of these associations and evaluate whether exercise and sport participation should be incorporated more intensely in vocational programs.

Resilience of patients with coronary heart diseases in Jordan: A cross-sectional study

Objectives

This study aimed to assess the level of resilience and related factors among patients with coronary heart disease.

Methods

A cross-sectional was used to determine the factors associated with the level of resilience. A convenience sampling technique was used to recruit 134 patients with coronary heart disease who attended the out-patients cardiology clinics at two leading public hospitals in Jordan from July to September 2017. The Connor-Davidson Resilience Scale (CD-RISC) was used to collect the data via a face-to-face structured interview. Mann-Whitney U test and Kruskal Wallis test were used to analyze the data.

Results

The results showed a moderate level of resilience among patients with coronary heart diseases. Patients who reported having no history of a cardiac procedure reported a higher total resilience score (69.50 [63.25, 75.00] vs. 65.50 [58.00, 72.00]) and a higher score in dimension 1,“personal competence, high standards, and tenacity” than their counterparts (22.00 [18.50, 26.00] vs. 21.00 [15.75, 23.00]) (P < 0.05). Dimension 3 “positive acceptance of change and secure relationships” score was higher for employed patients than retired patients (15.00 [14.00, 16.00] vs. 14.00 [12.00, 15.00]) (P < 0.05). However, no significant associations were found between other socio-demographic characteristics and resilience levels across the five dimensions.

Conclusion

Identifying the resilience level and related factors among patients with cardiac problems should be integrated into the comprehensive plan of care to improve patient quality of life, enhance effective coping strategies, improve mental health and well-being, and prevent further disease complications.

Development of employment indicators to advance the quality of spinal cord injury rehabilitation care: SCI-High Project

CONTEXT

Employment and Return to Work (RTW) rates following spinal cord injury/disease (SCI/D) are low due to individual and impairments characteristics, secondary health conditions, social and environmental barriers, prior work experience, workplace supports and resources, and physical or psychosocial work demands. To improve RTW, the SCI-High Project team developed a set of Employment structure, process, and outcome indicators for adults with SCI/D in the first 18 months after rehabilitation admission.

METHODS

A pan-Canadian Working Group of diverse stakeholders: (1) defined the Employment construct; (2) conducted a systematic search of available outcomes measures; (3) constructed a Driver diagram summarizing factors associated with employment. Subsequent facilitated meetings allowed for the creation of structure and process indicators, and the selection of outcome indicators.

RESULTS

The structure indicator is the proportion of SCI/D rehabilitation programs with an employment resource center. The process indicator is the proportion of SCI/D rehabilitation inpatients who receive an employment assessment during inpatient rehabilitation. The intermediary and final outcome measures are the Readiness for Return-to-Work Scale (RRTW) and Work Productivity and Activity Impairment (WPAI). Scale A of the RRTW for those who are unemployed and Scale B of RRTW and WPAI will be used for those who are employed.

CONCLUSION

This framework of Employment indicators intends to support the RTW needs of persons with SCI/D by ensuring that rehabilitation professionals provide opportunities to explore RTW within the first 18 months after rehab admission. Increased employment rates have the potential to enhance the wellbeing, health, and longevity of individuals with SCI/D.

Testing Kumpfer’s Resilience Model Among Adults With Serious Mental Illness

Having a serious mental illness (SMI) is often associated with significant adversities, and people respond differently to adversities. The existing research supports that people with SMI can achieve and maintain positive life outcomes despite experiencing adversities. Resilience, the ability to cope with (or bounce back quickly from) crisis, can help buffer the negative effects of various types of adversities, including chronic illness and disability, and facilitate the psychosocial adaptation process to SMI. Kumpfer’s resilience model, a person-process-context framework, has been widely used to conceptualize, and assess for, resilience in various populations, including people with chronic illnesses and disabilities. However, the research in resilience among people with SMI is very limited. The purpose of this study was to empirically assess the utility of Kumpfer’s resilience model and its proposed predictive components for conceptualizing the adaptation process to SMI. One hundred forty-four participants completed a Qualtrics survey containing demographic questions and a series of validated instruments representing the major components of Kumpfer’s resilience model. Hierarchical regression analysis was used to analyze the data, and the final model explained 71% of the variance of the dependent variable—adaptation to disability. Avoidance coping, internalized stigma, and optimism were significant independent predictors of adaptation to disability. This study supports the utilization of Kumpfer’s resilience model to conceptualize the adaptation to disability process among people with SMI. Implications for rehabilitation counseling practices are discussed.