Evaluating Snyder’s Hope Theory as a Motivational Model of Participation and Life Satisfaction for Individuals With Spinal Cord Injury: A Path Analysis

Effect of Hope Theory combined with active cycle of breathing techniques on pulmonary rehabilitation among COPD patients: A quasi-experiment study

BACKGROUND

Pulmonary rehabilitation plays a positive role in improving exercise tolerance and reducing readmission rates in patients with chronic obstructive pulmonary disease (COPD), while the adherence of pulmonary rehabilitation in COPD patients is still poor. The active cycle of breathing techniques based on the Hope Theory is a method to enhance patients' confidence in overcoming the disease and improve the intrinsic motivation of exercise through symptom improvement such as cough and sputum evacuation ability.

OBJECTIVES

To investigate the effect of Hope Theory education combined with the active cycle of breathing techniques on pulmonary rehabilitation of COPD patients, including exercise adherence, cough and sputum evacuation ability, hope index and exercise self-efficacy.

METHODS

The study assigned 70 COPD patients hospitalized into intervention and control groups to receive the active cycle of breathing techniques based on Hope Theory or routine treatment in order of admission. Data for cough and sputum evacuation ability, hope, exercise confidence were collected at baseline and after the program. Exercise adherence was assessed at the end of 1, 4 and 8 week following discharge.

RESULTS

The actual number of sample consisted of 65 patients divided into intervention (n = 33) and control (n = 32) groups due to severe complications, explicit refusal, disinterest and loss to follow-up. After two weeks of intervention, exercise adherence of the intervention group were better than those of the control group at the end of 4 and 8 week of discharge (P < 0.05). And there was an improvement in cough and sputum evacuation ability, hope and exercise self-efficacy outcomes in the intervention group, with a statistically significant difference between the two groups (P < 0.05).

CONCLUSION

The active cycle of breathing techniques based on Hope Theory education can improve cough and sputum evacuation ability, hope index, exercise self-efficacy, and exercise adherence of COPD patients.

Hope as experienced by people with acquired brain injury in a rehabilitation-or recovery process: a qualitative systematic review and thematic synthesis

Background

There has been an increasing interest in the concept of hope within the field of brain injury rehabilitation. Existing reviews have nevertheless focused on stroke, leaving out the broad population of people with acquired brain injury (ABI). Furthermore a majority of the included studies in those reviews excluded the subgroup of people with communication difficulties, thus primarily giving voice to a select group of people with ABI.

Methods

A qualitative systematic review was conducted with the purpose of systematically reviewing and thematically synthesise findings about hope as experienced by adults with ABI in a rehabilitation or recovery process. The search strategy included peer-reviewed qualitative studies published after 2000 in English or Scandinavian languages. Searches of EBSCO databases incorporating CINAHL, MEDLINE, and PsycINFO were conducted together with SocINDEX, Social Work Abstracts, Eric and Web of Science. Ten qualitative studies were included, and the Critical Appraisal Skills Program (CASP) was used for assessing the quality and relevance of the ten studies. Qualitative findings were synthesized using Thomas and Harden's methodology.

Results

Through a thematic synthesis eleven subthemes were identified relating to experiences of hope. These were grouped into four analytical themes: (1) hope a two folded phenomenon; (2) time and temporality; (3) progress, goals and visibility and (4) the alliance; a balancing act requiring good communication skills.

Conclusion

This review has shown that even though hope has both a positive and negative side to it, it is necessary as a driving force for people with ABI in terms of supporting them to keep going and not give up. Rehabilitation professionals are advised to embrace the ambiguity of hope, customizing the support of hope to each person with ABI. Attention is needed on how to make progress visible for persons with ABI during their rehabilitation process just as rehabilitation professionals should acknowledge the alliance with the person with ABI as a core component of rehabilitation. This requires a focus on professionals' communication skills if hope promoting relationships between professionals and persons with ABI are to be achieved.

Family Environment, Loneliness, Hope, and Subjective Well-Being of Asian Older Adults

The current study examined the interactions between family environment, hope, and loneliness, and their subsequent influence on the subjective well-being (SWB) of 345 noninstitutionalized older adults (aged 60 years and above) in Singapore. Door-to-door surveys information was collected on family environment (cohesiveness, relationship closeness, and support), hope, loneliness, and SWB (life satisfaction, happiness, and absence of negative affect). Structural equation modelling was conducted to test competing hypotheses derived from life stress and integrated resource theories. The results revealed that family environment influenced SWB both directly and indirectly. Family environment decreased loneliness and increased SWB. Additionally, family environment influenced SWB by offering increased hope. Family environment sets the context for the SWB of older adults in Singapore. Families should therefore be targeted for interventions to reduce loneliness, increase psychological resources, and raise SWB during old age.

The association between hope and employment among individuals with multiple sclerosis: A hierarchical logistic regression model

BACKGROUND

Most people with multiple sclerosis (MS) are employed at the time of their diagnosis; however, due to the unpredictable nature of MS, most exit the workforce shortly thereafter. A plethora of research has examined factors that negatively affect employment outcomes for people with MS. However, little is known about how hope, a modifiable positive psychology factor, affects employment.

OBJECTIVE

This study examined the role of hope and its association with employment outcomes for people with MS.

METHODS

Two-hundred and fifty-five adults with MS (mean ± SD age, 45.45 years ± 10.28) completed surveys about their MS, employment, disability-related stress, and hope. A three-step hierarchical logistic regression was conducted to examine the extent to which hope explains the variance in employment, over and above demographic and disability related covariates.

RESULTS

The final model explained 28% of the variance in employment, suggesting that the model was able to distinguish people with MS who were employed versus those who were unemployed. Higher levels of hope were associated with an increased probability of being employed (OR = 4.65; 95% CI [1.98, 10.92]).

CONCLUSION

This study supports that hope is associated with favorable employment outcomes for people with MS. Persons with MS may benefit from working with rehabilitation professionals to enhance their hope, and this study provides a foundation for the development of hope-based interventions to improve employment outcomes among this population.

Influences on Participation in Life After Spinal Cord Injury: Qualitative Inquiry Reveals Interaction of Context and Moderators

Background

Greater understanding of the influences on participation in life after spinal cord injury (SCI) can inform rehabilitation theory and practice. Careful qualitative inquiry can reveal subjective meanings associated with the relevant experiences, strategies, and perceptions of those with lived experience of SCI. A search of literature, followed by a thematic synthesis of qualitative studies, was undertaken to bring together these insights in a meaningful way.

Methods

The research question guiding the literature review and synthesis was, What do people with SCI perceive to be the influences on their participation in life? Three critical databases were searched for qualitative studies examining influences on participation in life after SCI. Peer-reviewed studies published after 2006, involving adults with SCI living in countries with advanced economies, were included. Data were extracted from 24 articles and subjected to three-level thematic synthesis—the coding of primary data from the studies, the development of descriptive themes based on an organization of those codes, and the generation of analytical themes.

Results

The synthesis yielded five analytical themes, supported by 17 descriptive themes. The analytical themes were (1) external contextual influences, (2) personal physical context, (3) personal psychological context, (4) potential moderators of participation outcomes, and (5) temporal dimensions of participating in life after SCI.

Interpretation

These themes highlight the complex interactions that shape participation from the perspective of people with SCI. Closer examination of the potential moderators may provide insights into effective rehabilitation interventions.

Conclusions

Synthesis of qualitative inquiry provides valuable insights into the perceptions of influences on participation in life from the point of view of people with SCI. The findings of this synthesis are instructive for rehabilitation theory and practice. It can complement what we learn from using the ICF to understand participation.

Factors Impacting Functioning Level of Cancer Survivors in Turkey

The purpose of this study was to investigate the relationships between demographic variables, personal factors, impairment-related variables, and functioning levels of cancer survivors in Turkey. Data for this study were collected from a major oncology institute and a nonprofit cancer organization in Turkey. Hierarchical regression analyses were conducted to investigate the sequential effect of demographic variables (i.e., age, gender, income, and education), personal factors (i.e., core self-evaluations, purpose in life, and religiosity), and impairment-related variables (i.e., pain, fatigue, perceived stress, and sleep disturbance) on the functioning level of Turkish cancer survivors (i.e., physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning). The results indicated that impairment-related variables explained a significant amount of variance in functioning scores above and beyond demographic and personal factors. Pain intensity and perceived stress were most prominent factors impacting functioning levels of Turkish cancer survivors. Pain and stress self-management training, psychotherapy and counseling, physical activity and exercise, and cognitive remediation training are recommended interventions to increase the functioning level and well-being of cancer survivors.

Reducing the Influence of Perceived Stress on Subjective Well-Being of Student Veterans With and Without Disabilities: The Protective Role of Positive Traits and Social Support

The transition from the regimented environment of military service to a less structured college lifestyle can be stressful for student veterans with and without disabilities, which highlights the importance of exploring protective person-environmental contextual factors that can help student veterans with and without disabilities manage their stress effectively, leading to enhanced well-being. The purpose of this cross-sectional correlational design study was to examine the role of positive person-environment contextual factors, including hope, resilience, core self-evaluations, and social support, to reduce the influence of perceived stress on the subjective well-being (SWB) of student veterans with and without disabilities. The sample included 205 student veterans (71.7% males; 80.5% White; Mage = 29.32; 39% with service-connected disability). Findings suggested that core self-evaluations and social support partially mediated the relationship between perceived stress and SWB in student veterans with and without disabilities. Implications for clinicians, university counselors, and university staff are also discussed.

Exploration of the Effects of Protective Person–Environment Factors Between Functional Impairments and Stress in Individuals With Multiple Sclerosis: Mediation and Moderation Analyses

Functional impairments can lead to stress in individuals with multiple sclerosis (MS). The study examined protective person and environment factors (i.e., positive cognitive stress appraisal, core self-evaluations [CSE], resilience, hope, spirituality, social support, and environmental supports) as both mediators and moderators of this association to guide understanding of the experience of stress in this population. The sample consisted of 373 participants with MS. In simple mediation analyses, positive cognitive stress appraisal, CSE, resilience, hope, social support, and environmental supports served as a partial mediator between functional impairments and stress. In a parallel mediation analysis, significant unique indirect effects were observed for two of the seven hypothesized mediator variables (CSE and environmental supports). Separate moderator tests provided support for the CSE variable as a protective factor. The positive association between functional impairments and stress was weaker for persons reporting high CSE compared with those reporting low CSE. The findings provide implications for rehabilitation counseling practices by promoting CSE and environmental supports in improving rehabilitation and psychosocial outcomes for individuals with MS.

Reducing the Effect of Functional Disability on Life Satisfaction Among Persons With a Lived Experience of an Infectious Viral Disease in Taiwan: A Tri-Mediation Model

The purpose of the study was to examine whether disability acceptance, hope, and resilience mediate the relationship between functional disability and life satisfaction in people with a lived experience of an infectious viral disease (i.e., polio and postpolio syndrome [PPS]). Participants consisted of 157 individuals diagnosed with polio or PPS who were recruited from two community support organizations in Taiwan. Participants completed self-report questionnaires. Data were analyzed with a simultaneous regression analysis. The tri-mediation model indicated that disability acceptance, hope, and resilience were associated with life satisfaction, accounting for a large effect size of 46% of the variance in the life satisfaction scores. The direct effect of functional disability on life satisfaction became insignificant when the mediators were controlled for in the model. Hope, disability acceptance, and resilience were found to fully explain the association between functional disability and life satisfaction. This study demonstrated that positive psychosocial factors might help to buffer the indirect and direct negative effects of functional disability on life satisfaction. Implications of these findings for future research and clinical practice when supporting individuals with a lived experience of an infectious viral disease, including COVID-19, are discussed.

Empowering the Career Development of Persons With Disabilities (PWD)

A narrative literature review was conducted with the intention of providing practitioners with foundational knowledge regarding the career development trajectory of persons with disabilities (PWD). The author selected scholarship from various disciplines including rehabilitation, psychology, and special education. In the article, the author provides an overview of career development barriers and facilitators for PWD, provides a review of self-determination theory as a framework that can be used alongside other career development interventions with PWD, discusses career development interventions that have been identified as effective with PWD within vocational rehabilitation, and lastly, provides recommendations for career intervention outcomes and research.

Evaluating the World Health Organization’s International Classification of Functioning, Disability and Health Framework as a Participation Model for Cancer Survivors in Turkey

Improvements in diagnosis and treatment options for cancer now allow cancer survivors to live longer, and as a result, services are necessary to help individuals live an active and meaningful life in the community. The purpose of this study was to evaluate the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) framework as a participation model for cancer survivors in Turkey. Results from simultaneous regression analyses indicated educational attainment, fatigue, perceived stress, role functioning, social functioning, core self-evaluations, independent self-construal, social support, and autonomy support were significantly associated with participation. Specific interventions including health education, psychological workshops, support groups, and assistive technology may improve cancer survivors’ motivation and desire to actively engage in community activities. Higher levels of participation were also found when cancer survivors were involved in the treatment decision-making process, and felt cared for and understood by their treatment providers.

Attachment and Employment Outcomes for People With Spinal Cord Injury

The purpose of this article is to evaluate the mediation effect of hope on the relationship between attachment and full-time employment for people with spinal cord injury (SCI). Quantitative descriptive research design using logistic regression, multiple regression, and correlational techniques were used. Eighty-four persons with SCI were recruited from several SCI advocacy organizations in Canada, the United Kingdom, and the United States. The results show that secure attachment, anxious attachment, and hope were significantly related to employment. Hope was found to be a significant mediator of the relationship between attachment and full-time employment. Results provide support for the use of hope-based interventions by vocational rehabilitation counselors working with individuals with SCI.

The psychosocial experiences of older palliative patients while participating in a Living with Hope Program

Objective:

Several studies have reported the effectiveness of a variety of psychosocial interventions in increasing levels of hope in palliative care patients. The experience of palliative patients while participating in these interventions is unknown. Understanding these experiences would provide a rich understanding of how the interventions work to foster hope. The purpose of the present study was to describe the psychosocial processes that participants with advanced cancer receiving palliative care experienced when taking part in a Living with Hope Program (LWHP).

Method:

In the context of a study evaluating the LWHP, data were collected from 13 dyads (persons with advanced cancer and their caregivers) at two timepoints (one week apart). A thematic qualitative analysis of 52 open-ended audiotaped interviews was conducted that focused on the psychosocial processes that occurred during the LWHP.

Results:

The average age of palliative participants was 67 (SD = 6.6) and of their family caregivers 61 years of age (SD = 13.9). A thematic analysis suggested that the participants experienced the following psychosocial processes while participating in the LWHP: (1) reminiscing, (2) leaving a legacy, (3) positive reappraisal, and (4) motivational processes. These processes are the mechanisms by which the LWHP fosters the positive outcomes of increasing hope and improving quality of life. As well, the finding of motivational processes suggested that the LWHP may also increase life satisfaction, which is an outcome of motivational processes.

Significance of the results:

The findings from our study underscore the importance of uncovering the psychosocial processes through which the LWHP works to foster hope. They will assist in making revisions to the intervention that will increase its effectiveness, as well as providing a better understanding of hope in persons with advanced cancer.

Psychosocial Adaptation to Disability Within the Context of Positive Psychology: Findings from the Literature

PURPOSE

This purpose of this article is to review of the trends of research that examined positive psychology constructs in the context of adapting to chronic illness and disability (CID). This article examines the empirical findings on the relationships between six selected positive psychology-associated constructs (optimism, hope, resilience, benefit-finding, meaning-making, and post-traumatic growth) and adaptation to disability.

METHODS

Six positive psychology constructs were selected to represent the trends found in recent literature published on CID. The process of choosing these six variables included reviewing chapters on positive psychology and CID, reviewing the top rehabilitation journals that typically publish articles on psychosocial adaptation to CID, using search engines to find relevant journal articles published since the year 2000, and selecting the most important constructs based on the authors’ professional judgment.

CONCLUSION

The available evidence supports the unique benefits of these six positive psychology constructs in predicting successful adaptation to a range of disabling conditions. Based on the available findings, the authors offer four suggestions for occupational rehabilitation researchers.

Mediators of the Relationship Between Core Self-Evaluations and Life Satisfaction in Individuals With Spinal Cord Injuries

The objective of this study was to test a meditational model of the relationship between core self-evaluations (CSE) and life satisfaction in persons with spinal cord injuries. A quantitative descriptive design using multiple regression analysis was used. Two hundred forty-seven persons with spinal cord injuries participated in the online study. Hope, perceived health, autonomy, and social support were found to partially mediate the relationship between CSE and life satisfaction. CSE affected life satisfaction by first increasing hopeful thinking, positive health perceptions, a sense of autonomy, and support from others in persons with spinal cord injuries. Future research should explore the development of interventions to increase CSE to increase the positive variables that affect life satisfaction in individuals with spinal cord injuries.