Evaluating a Self-Determination Model of Physical Activity and Exercise in People With Chronic Musculoskeletal Pain

BackgroundResearch evidence supports the assertion that healthy employees are happier and more productive. Employers prefer to hire healthy workers to reduce absenteeism. Rehabilitation counselors have started to explore health promotion interventions to help individuals with chronic health conditions and disability improve their physical and mental health as a strategy to increase their employment opportunities.PurposeThe present study evaluated a self-determination theory (SDT) model of physical activity and exercise in a sample of 218 individuals with chronic musculoskeletal pain using structural equation modeling.ResultsThe SDT model fit the data well, accounting for 54% of the variance in physical activity and exercise. Relatedness was significantly associated with autonomous motivation for physical activity and exercise. Autonomous motivation was associated with competency. Competency was associated with physical activity and exercise. Autonomous motivation and competency mediated relatedness and physical activity and exercise.ImplicationsThis study contributes to an emerging body of theory-informed health promotion literature and identifies the specific pathways that will increase the motivation to engage in physical activity and exercise. Findings can be used to design and validate theory-driven health promotion interventions as an employment strategy for people with chronic musculoskeletal pain receiving vocational rehabilitation services.

Psychometric Validation of a Simplified Version of the Multiple Sclerosis Self-Management Scale

PurposeThe purpose of this study was to evaluate the measurement structure of a simplified version of the Multiple Sclerosis Self-Management Scale (MSSMS) in a sample of 256 individuals with multiple sclerosis (MS).MethodsExploratory factor analysis was utilized to uncover meaningful and interpretable factors.ResultsThe study yielded three factors as both meaningful and interpretable (medication compliance, MS knowledge, and health maintenance behavior). These factors are reliable and correlated with functional disability and community participation in the theoretically expected directions.ConclusionResults show the MSSMS to be a promising rehabilitation assessment tool for individuals with MS and rehabilitation counselors to evaluate self-management support needs in the interview, assessment, and rehabilitation planning protocols.

The Helen Keller Question Applied to Workplace Discrimination: Hearing Loss vs. Visual Loss

BackgroundIn exploring the matter of sensory loss and job discrimination, the National EEOC ADA Research Project (NEARP) seeks to answer a singular question.ObjectiveHow do persons with hearing loss (HL) vs. visual loss (VL) experience the nature and scope of workplace discrimination differently, if at all?MethodsThe NEARP team uses an ex post facto, causal comparative quantitative design that includes descriptive and inferential, nonparametric statistics. Closed EEOC files involving ADA allegations of workplace discrimination filed by Americans with Hearing Loss (HL, N = 21,847) and Vision Loss (VL, N = 16,136) were compared in terms of demographics, issues, and investigatory outcomes.ResultsHL and VL groups show Demographic differences to one another and to population statistics of sensory impairment in the areas of Gender and Race/Ethnicity. Regarding Issues, HL and VL groups are different from one another with respect to several prevalent matters (i.e., Discharge, Reasonable Accommodation) and small-scale matters (i.e., Hiring and Terms/Conditions). With respect to the Merit of allegations following EEOC investigation, HL and VL are very similar.ConclusionWorkplace discrimination is experienced differently for Charging Parties who experience HL vs. VL. Moreover, important differences exist Charging Parties from both sensory impairments vs. those from a General Disability Population.

Participation and Psychological Capital in Adults With Parkinson's Disease: Mediation Analysis Based on the International Classification of Functioning, Disability, and Health

ObjectiveThe purpose of this study was to explore how the functional impact of Parkinson's disease affects participation and to evaluate whether positive psychological capital (PsyCap) mediates the relationship within the context of the World Health Organization International Classification of Functioning, Disability, and Health Model.MethodSurvey responses were analyzed from 144 adults with Parkinson's disease using a quantitative, correlational research design employing multiple regression and hierarchical regression analysis to examine hypothesized relationships.ResultsThe results of the correlation analysis indicated that there was a statistically significant, moderate-to-strong positive correlation between functioning and PsyCap and participation. Hierarchical regression analysis revealed that functioning accounted for 65% of the variance in participation. Although PsyCap was associated with participation, no mediating effect was observed.ConclusionsThe results are consistent with traditional clinical judgment that physical functioning is positively correlated with participation. This study represents the first evaluation of the role of PsyCap in people with Parkinson's disease, and the results of the correlational analysis suggest that continued investigation of these relationships is warranted.BackgroundParkinson's disease results in a variety of motor and non-motor features that frequently result in reduced participation in valued life activities.

Examining the Relationships Between Social Determinants of Health and Health-Related Quality of Life Among Individuals Living With HIV

PurposeThe current study examined the relationships between health-related quality of life (HRQOL) and social determinants of health (SDH), which are the individual and structural factors that contribute to health outcomes.MethodA hierarchical general linear model was used to assess the sequential effect of the SDH on the scores of the Short Form-12 among people living with HIV.ResultsResults show that many psychosocial, medical, demographic, financial, and vocational factors are significant predictors of HRQOL.ConclusionsGaining a deeper understanding of the impact of SDH on HRQOL is critical for rehabilitation counselors to develop effective assessments and interventions.

Using the Work Experience Survey and the Job Accommodation Network to Identify Reasonable Accommodations in the Workplace: Case Studies of African American Women With Multiple Sclerosis

PurposeFour African American women with multiple sclerosis (MS) participated in an evaluation of barriers to their continued employment.MethodsA trained interviewer completed the Work Experience Survey (WES) in teleconsultation sessions with each participant to identify their: (a) barriers to worksite access, (b) difficulties performing essential functions of their positions, (c) concerns regarding continued mastery of their careers, and (d) extent of job satisfaction.ResultsResulting largely from the physiological, sensory, and cognitive sequelae of their disease, participants reported a wide range of difficulties in performing essential functions of their jobs (15–45) that have the potential to significantly affect their productivity. Career mastery problems reflected issues associated with MS such as “believing that others think I do a good job” and “having the resources (e.g., knowledge, tools, supplies, and equipment) needed to do the job.” Other career mastery concerns reflected idiosyncratic aspects of a specific job setting such as “being able to speak with my supervisor about promotion.” Considering these barriers and relationships with employers, the majority of participants reported low levels of job satisfaction.ConclusionThe interviewer concluded the WES interview by recommending a job accommodation plan, which included suggestions from Job Accommodation Network (JAN) consultants. The interviewer also offered guidelines for the employee to follow in requesting job modifications and assistive technology.

Complex Posttraumatic Stress Disorder and Rehabilitation Counseling

PurposeComplex posttraumatic stress disorder (CPTSD) is a multifaceted disorder, and the specific diagnostic criteria developed by the World Health Organization (WHO), which highlight symptoms of CPTSD (i.e., affect dysregulation, negative self-concept, disturbed relationships), that occur along with PTSD symptoms speak to this. Understanding the disorder itself and its ramifications is essential as our society is exposed to seemingly more and more traumatic and long-lasting events, all of which may lead to an increase in the number of overall cases. CPTSD is characterized by changes in three primary areas of the brain – hippocampus, amygdala, and medial prefrontal cortex (mPFC)– which are usually smaller in individuals with CPTSD, and there are certain subsets of individuals who have an increased likelihood of developing this disorder (e.g., individuals with physical and psychiatric disabilities, children exposed to long-term trauma).MethodThe authors conducted a scoping literature review on CPTSD, treatment approaches for individuals with CPTSD, and rehabilitation implications.ResultsTreatment for CPTSD is generally more extensive than treatment for PTSD and should be made available for those in need. There is a dearth of research on this topic in the rehabilitation literature; however, disability research has consistently shown that employment plays a huge role in successful recovery among individuals with psychiatric disabilities, which includes CPTSD.ConclusionIn order to ensure client success, rehabilitation counselors, educators, and researchers must understand the complexities associated with CPTSD and then how to best go about incorporating this information into individual plans for employment and our classrooms as well as making research in this area a priority for the field.

Relationships Between Positive Human Traits and PERMA (Positive Emotion, Engagement, Relationships, Meaning, and Accomplishments) in Student Veterans With and Without Disabilities: A Canonical Correlation Analysis

PurposeWe explored the relationships between positive human traits and positive emotions, engagement, relationships, meaning, and achievement (PERMA) the core elements for Seligman's model of happiness and well-being.MethodTwo hundred and five student veterans (147 males and 58 females; 80 with service-related disability) were recruited from several colleges and universities across the United States. Participants completed positive human traits measures on resilience, hope, optimism, attachment, and coping, along with the PERMA Profiler that measures the five core elements of the well-being theory. Correlational techniques and canonical correlation analysis were computed to examine the canonical relationship between positive human traits and PERMA variables.ResultsOverall, the positive human traits set accounted for 37% of the variance in the PERMA set, whereas the PERMA set accounted for 51% of the variance in the positive human traits set.ConclusionsThe research findings suggest that human traits can be conceptualized as building blocks for PERMA, and PERMA are the core elements for happiness and well-being. Importantly, student veterans with disabilities had significantly lower resilience, secure attachment and PERMA scores. Positive psychology interventions to help student veterans, especially students with service-related disabilities, develop character strengths, and PERMA could improve college life adjustment and goal persistence of student veterans.

Advancing Rehabilitation Counseling Professional Identity in Australia

PurposeThe past few decades have witnessed significant growth in the disability sector and the rehabilitation counseling profession has responded by broadening its scope of practice to serve a range of people who experience illness, injury, and social disadvantage. Despite the sector's growth and the profession's flexible response to it, the rehabilitation counseling profession in Australia continues to face challenges in relation to its professional identity. The purpose of this article is to identify these challenges and present solutions by reviewing literature and professionalization responses in Australia and the United States.MethodIn this article, we examine ways of transcending the professional identity challenges faced by the Australian rehabilitation counseling community. This is achieved firstly by defining the characteristics of professions and their application to rehabilitation counseling and second, by suggesting possible actions to advance the profession.ResultsThe necessary responses identified include the need for stronger professional governance, further development of the evidence base, and strict professional membership regulations. These goals will require the input of professional bodies and members, universities, rehabilitation regulators, employers, people with disabilities, and their families.ConclusionsRehabilitation counseling is a valued allied health and human service profession in the Australian work injury and disability sectors. By drawing on the experience of the profession in the United States, the authors have identified issues and solutions to facilitate the sustainability and advancement of rehabilitation counseling in Australia.

Factor Structure of the Values in Action Inventory of Strengths-72 in Individuals With Multiple Sclerosis

BackgroundResearch on character strengths in individuals with multiple sclerosis (MS) is lacking. Moreover, measures of character strengths have not been validated in this population, limiting the opportunities for further investigation.ObjectiveTo investigate the factor structure of the Values in Action Inventory of Strengths (VIA)-72 in a sample of individuals with MS.MethodsThis quantitative descriptive study included 624 individuals with MS. The factor structure of the VIA-72 was examined using principal component analysis. The internal consistency reliability and validity were assessed by computing Cronbach's alphas and correlations of the VIA-72 with other psychosocial constructs, respectively.FindingsThe principal component analysis revealed an interpretable four-factor structure of the VIA-72: intellectual and emotional strengths, temperance, transcendence, and interpersonal strengths. The factors significantly correlated with measures of quality of life, resilience, social support, depression, fatigue, and personality traits, indicating good concurrent validity. The four factors did not completely align with Peterson and Seligman's (2004) classification system.ConclusionsThe four-factor structure of the VIA-72 seems to be interpretable, valid, and reliable. Measures like VIA-72 may help rehabilitation professionals learn more about the nature and development of character strengths among persons with MS and suggest ways to cultivate it. Further studies are indicated to confirm the factor structures and psychometric properties of this scale in persons with MS.