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Resilience and Function in Adults With Physical Disabilities: An Observational Study

Published:December 16, 2016DOI:https://doi.org/10.1016/j.apmr.2016.11.012

      Abstract

      Objectives

      To determine if resilience is uniquely associated with functional outcomes (satisfaction with social roles, physical functioning, and quality of life) in individuals with physical disabilities, after controlling for measures of psychological health (depression and anxiety) and symptom severity (pain, fatigue, and sleep disturbance); and to examine the potential moderating effect of sex, age, and diagnosis on the hypothesized associations between resilience and function.

      Design

      Cross-sectional survey study.

      Setting

      Surveys were mailed (81% response rate) to a community sample of 1949 individuals with multiple sclerosis, muscular dystrophy, postpoliomyelitis syndrome, or spinal cord injury. Participants were recruited through the Internet or print advertisement (28%), a registry of previous research participants who indicated interest in future studies (21%), a departmental registry of individuals interested in research (19%), disability-specific registries (18%), word of mouth (10%), or other sources (3%).

      Participants

      Convenience sample of community-dwelling adults aging with physical disabilities (N=1574), with a mean Connor-Davidson Resilience Scale (10 items) score of 29.

      Interventions

      Not applicable.

      Main Outcome Measures

      Patient-Reported Outcomes Measurement Information System measures of Satisfaction with Social Roles and Activities and Physical Functioning, the World Health Organization's brief Older People's Quality of Life Questionnaire, and the Connor-Davidson Resilience Scale (10 items).

      Results

      After controlling for age, age squared, sex, diagnosis, psychological health, and symptom severity, resilience was significantly and positively associated with satisfaction with social roles (β=.17, P<.001) and quality of life (β=.39, P<.001), but not physical function (β=.04, P>.05). For every 1-point increase in scores of resilience, there was an increase of .50 in the quality of life score and .20 in the satisfaction with social roles score. Sex also moderated the association between resilience and satisfaction with social roles (F1,1453=4.09, P=.043).

      Conclusions

      The findings extend past research, providing further evidence indicating that resilience plays a unique role in nonphysical functional outcomes among individuals with physical disabilities.

      Keywords

      List of abbreviations:

      CD-RISC10 (Connor-Davidson Resilience Scale (10 items)), MD (muscular dystrophy), MS (multiple sclerosis), OPQOL-brief (brief Older People's Quality of Life Questionnaire), PPS (postpoliomyelitis syndrome), PROMIS (Patient-Reported Outcomes Measurement System), SCI (spinal cord injury)
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      References

        • Lin S.F.
        • Beck A.N.
        • Finch B.K.
        • Hummer R.A.
        • Master R.K.
        Trends in U.S. older adult disability: exploring age, period, and cohort effects.
        Am J Pub Health. 2012; 102: 2157-2163
        • Amtmann D.
        • Borson S.
        • Salem R.
        • Johnson K.L.
        • Verrall A.
        Aging with disabilities: comparing symptoms and quality of life indicators of individuals aging with disabilities to U.S. general population norms [abstract].
        J Am Geriatr Soc. 2012; 60: S185
        • Rimmer J.H.
        • Chen M.D.
        • Hsieh K.
        A conceptual model for identifying, preventing, and managing secondary conditions in people with disabilities.
        Phys Ther. 2011; 91: 1728-1739
        • Jensen M.P.
        • Kuehn C.M.
        • Amtmann D.
        • Cardenas D.D.
        Symptom burden in persons with spinal cord injury.
        Arch Phys Med Rehabil. 2007; 88: 638-645
        • Bonanno G.A.
        Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events?.
        Am Psychol. 2004; 59: 20-28
        • Ong A.D.
        • Bergeman C.S.
        • Bisconti T.L.
        • Wallace K.A.
        Psychological resilience, positive emotions, and successful adaptation to stress in later life.
        J Pers Soc Psychol. 2006; 91: 730-749
        • White B.
        • Driver S.
        • Warren A.M.
        Considering resilience in rehabilitation of people with traumatic disabilities.
        Rehabil Psychol. 2008; 53: 9-17
        • Terrill A.L.
        • Molton I.R.
        • Ehde D.M.
        • et al.
        Resilience, age, and perceived symptoms in persons with long-term physical disabilities.
        J Health Psychol. 2016; 21: 640-649
        • Catalano D.
        • Chan F.
        • Wilson L.
        • Chiu C.Y.
        • Muller V.R.
        The buffering effect of resilience on depression among individuals with spinal cord injury: a structural equation model.
        Rehabil Psychol. 2011; 56: 200-211
        • Silverman A.M.
        • Molton I.R.
        • Alschuler K.N.
        • Ehde D.M.
        • Jensen M.P.
        Resilience predicts functional outcomes in people aging with disability: a longitudinal investigation.
        Arch Phys Med Rehabil. 2015; 96: 1262-1268
        • White B.
        • Driver S.
        • Warren A.M.
        Resilience and indicators of adjustment during rehabilitation from a spinal cord injury.
        Rehabil Psychol. 2010; 55: 23-32
        • Quale A.J.
        • Schanke A.K.
        Resilience in the face of coping with severe physical injury: a study of trajectories of adjustment in a rehabilitation setting.
        Rehabil Psychol. 2010; 55: 12-22
        • Ploughman M.
        • Austin M.W.
        • Murdoch M.
        • et al.
        Factors influencing healthy aging with multiple sclerosis: a qualitative study.
        Disabil Rehabil. 2012; 34: 6-33
        • Jensen M.P.
        • Smith A.E.
        • Bombardier C.H.
        • Yorkston K.M.
        • Miro J.
        • Molton I.R.
        Social support, depression, and physical disability: age and diagnostic group effects.
        Disabil Health J. 2014; 7: 164-172
        • Connor K.M.
        • Davidson J.R.
        Development of a new resilience scale: the Connor-Davidson resilience scale (CD-RISC).
        Depress Anxiety. 2003; 18: 76-82
        • Campbell-Sills L.
        • Stein M.B.
        Psychometric analysis and refinement of the Connor-Davidson Resilience Scale (CD-RISC): validation of a 10-item measure of resilience.
        J Trauma Stress. 2007; 20: 1019-1028
        • Black R.
        • Dorstyn D.
        A biopsychosocial model of resilience for multiple sclerosis.
        J Health Psychol. 2015; 20: 1434-1444
        • Hayter M.R.
        • Dorstyn D.S.
        Resilience, self-esteem and self-compassion in adults with spina bifida.
        Spinal Cord. 2014; 52: 167-171
        • Cella D.
        • Yount S.
        • Rothrock N.
        • et al.
        The Patient-Reported Outcomes Measurement Information System (PROMIS): progress of an NIH Roadmap cooperative group during its first two years.
        Med Care. 2007; 45: S3-S11
        • Cella D.
        • Riley W.
        • Stone A.
        • et al.
        The Patient-Reported Outcome Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008.
        J Clin Epidemiol. 2010; 63: 1179-1194
        • Cook K.F.
        • Bamer A.M.
        • Amtmann D.
        • Molton I.R.
        • Jensen M.P.
        Six patient-reported outcome measurement information system short form measures have negligible age- or diagnosis-related differential item functioning in individuals with disabilities.
        Arch Phys Med Rehabil. 2012; 93: 1289-1291
        • University of Washington Center on Outcomes Research in Rehabilitation
        UWCORR and PROMIS physical function scale for samples that use mobility aids.
        (Available at:) (Accessed July 28, 2016)
        • Hahn E.A.
        • DeVellis R.F.
        • Bode R.K.
        • et al.
        Measuring social health in the patient-reported outcomes measurement information system (PROMIS): item bank development and testing.
        Qual Life Res. 2010; 19: 1035-1044
        • Bowling A.
        • Hankins M.
        • Windle G.
        • Bilotta C.
        • Grant R.
        A short measure of quality of life in older age: the performance of the brief Older People’s Quality of Life questionnaire (OPQOL-brief).
        Arch Gerontol Geriatr. 2013; 56: 181-187
        • Power M.
        • Quinn K.
        • Schmidt S.
        Development of the WHOQOL-Old module.
        Qual Life Res. 2005; 14: 2197-2214
        • Tabachnick B.
        • Fidell L.
        Using multivariate statistics.
        3rd ed. HarperCollins, New York1996
        • Hair Jr., J.F.
        • Anderson R.E.
        • Tatham R.L.
        • Black W.C.
        Multivariate data analysis.
        3rd ed. Macmillan, New York1995
        • Cohen J.
        A power primer.
        Psychol Bull. 1992; 112: 115-159
        • Wallack E.M.
        • Wiseman H.D.
        • Ploughman M.
        Healthy aging from the perspectives of 683 people with multiple sclerosis.
        Mult Scler Int. 2016; 2016: 1845720
        • Lam C.B.
        McBride-Change CA Resilience in young adulthood: the moderating influences of gender-related personality traits and coping flexibility.
        Sex Roles. 2007; 56: 159-172
        • Addis M.E.
        • Mahalik J.R.
        Men, masculinity, and the contexts of help seeking.
        Am Psychol. 2003; 58: 5-14
        • Fletcher D.
        • Sarkar M.
        Psychological resilience: a review and critique of definitions, concepts, and theory.
        Eur Psychol. 2015; 18: 12-23
        • Thompson R.W.
        • Arnkoff D.B.
        • Glass C.R.
        Conceptualizing mindfulness and acceptance as components of psychological resilience to trauma.
        Trauma Violence Abuse. 2011; 12: 220-235
        • Chwastiak L.
        • Ehde D.M.
        • Gibbons L.E.
        • Sullivan M.
        • Bower J.D.
        • Kraft G.H.
        Depressive symptoms and severity of illness in multiple sclerosis: epidemiologic study of a large community sample.
        Am J Psychiatry. 2002; 159: 1862-1868
        • Washburn R.A.
        • Zhu W.
        • McAuley E.
        • Frogley M.
        • Figoni S.F.
        The physical activity scale for individuals with physical disabilities: development and evaluation.
        Arch Phys Med Rehabil. 2002; 83: 193-200