Resiliency and quality of life trajectories after injury

Injury can greatly impact patients' long-term quality of life. Resilience refers to an individual's ability to positively adapt after facing stress or trauma. The objective of this study was to examine the relationship between preinjury resiliency scores and quality of life after injury. METHODS: Two hundred twenty-five adults admitted with an Injury Severity Score greater than 10 but without neurologic injury were included. The 36-item Short Form was administered at the time of admission and repeated at 1 month, 2 months, 4 months, and 12 months after injury. The Connor-Davidson Resilience Scale was completed at admission and scores were categorized into high resiliency or not high resiliency. Group-based trajectory modeling was used to identify distinct recovery trajectories for physical component scores (PCS) and mental component scores (MCS) of the 36-item Short Form. Multinomial logistic regression was used to determine whether baseline resiliency scores were predictive of PCS and MCS recovery trajectories. RESULTS: Age, race, sex, mechanism of injury, Charlson Comorbidity Index, Injury Severity Score, presence of hypotension on admission, and insurance status were not associated with high resiliency. Compared with those who made less than US $10,000 per year, those who made more than US$50,000 per year had higher odds of being in the high resilience group (odds ratio, 10.92; 95% confidence interval, 2.58-46.32). Three PCS and 5 MCS trajectories were identified. There was no relationship between resilience and PCS trajectory. However, patients with high resiliency scores were 85% less likely to belong to trajectory 1, the trajectory that had the lowest mental health scores over the course of the study. Follow-up for the study was 93.8% for month 1, 82.7% for month 2, 69.4% for month 4, and 63.6% for month 12. CONCLUSION: Patient resiliency predicts quality of life after injury in regards to mental health with over 25% of patients suffering poor mental health outcome trajectories. Efforts to teach resiliency skills to injured patients could improve long-term mental health for injured patients. Trauma centers are well positioned to carry out such interventions. LEVEL OF EVIDENCE: Prognostic/epidemiologic study, level III

Factors Influencing the Decisions of Women Small Business Owners on Hiring People with Disabilities

Despite the passage of disability rights legislation in the United States, individuals with disabilities continue to experience high unemployment and underemployment rates than their counterparts without disabilities. The purpose of the study was to examine the attitudes of women small business owners towards hiring individuals with disabilities, and to determine what factors influence their hiring decisions. A total of 80 women small business owners in a southwestern U.S. state took part in the study. The Employer Attitudes Questionnaire (EAQ) and the Marlowe-Crowne Social Desirability Scale Short Form-C (M-C Form C) were used to assess participants’ attitudes. The results of a sequential multiple regression analysis indicated that the independent variables as a whole contributed 7.2% to the variance in the outcome of EAQ score. Scores of the EAQ were weakly correlated with scores on the M-C Form C (r = .276, p = .013). Working facilitates the development of a sense of self-worth, self-sufficiency, self-efficacy, and social networks. The bearing of unemployment and underemployment on the quality of life for individuals with disabilities cannot be underestimated. Women-led businesses offer a number of advantages for employees with disabilities, including their resilience to economic downturns, have a lower employee retrenchment rate, and possess a better understanding of employment and anti-discrimination legislation

Eugenics, euthanasia, and physician assisted suicide: An overview for rehabilitation professionals

Eugenics, euthanasia, and physician assisted suicide are controversial practices. These value-laden topics have polarized opinions across all segments of society. Advances in the Human Genome Project, increased knowledge of the Nazi atrocities against persons with disabilities, and recent court decisions regarding the right to die have combined to reignite old, or foster further debates about these practices. Rehabilitation professionals are noticeably absent from the discussion. Review of the literature reflects that the scholarly and popular writing on these topics lie outside the rehabilitation field. The present literature review provides the rehabilitation professional with a primer about these controversial topics, discuss models for conceptualizing the debate, reviews the implications for the field of rehabilitation and suggests areas for future research

The work environment of the private-for-profit rehabilitation counselor

The purpose of this study was to establish the prototype work environment for rehabilitation counselors employed in the private-for-profit sector through the framework of Holland\u27s career theory and the Position Classification Inventory (PCI). Data from a sample of 86 rehabilitation counselors employed in the private sector were analyzed following the administration of a web adaptation of the PCI. Results empirically establish the Holland code for the private sector work environment and examine its congruence with the prototypical rehabilitation counselor work environment. Implications for the education and training of qualified professionals are discussed

Rehabilitation counselor work environment: Examining congruence with prototypic work personality

The profession of rehabilitation counseling has undergone extensive empirical study. Absent from this research has been a theoretical basis for describing and understanding the profession and its associated work environment. The focus of this study was to further our understanding of the nature of the rehabilitation counselor\u27s work environment and the person- environment congruence through the framework of Holland\u27s career theory and the Position Classification Inventory (PCI). Data concerning the work environment of 366 rehabilitation counselors were collected using a Web adaptation of the PCI to empirically establish the Holland code for the prototypical rehabilitation counselor work environment and examine its congruence with the prototypical Strong Interest Inventory interest patterns. © Hammill Institute on Disabilities 2010

Judgment deferred: Reappraisal of rehabilitation counseling movement toward licensure parity

Fifteen years have passed since an analysis of the position of rehabilitation counselors in the national counselor licensure movement by Tarvydas and Leahy. This article addresses the question of how well their efforts to achieve licensure parity with other counselors have fared. This question will be addressed by discussing (a) rehabilitation counseling developments that have influenced licensure progress, (b) shifts in the nature of professionalization and efforts toward rehabilitation counseling parity, and (c) counselor licensure trends and rehabilitation counseling status within them. Specific recommendations are provided that would assist the field of rehabilitation counseling in meeting the urgent challenges that confront them in consolidating its position in the maturing counselor licensure movement before it is further disadvantaged. © 2009 Hammill Institute on Disabilities

Doctoral Dissertation Research in Rehabilitation Counseling: 2008-2010

This article continues the tradition of reviews documenting doctoral rehabilitation research. Doctoral dissertations completed during calendar years 2008-2010 from recognized doctoral rehabilitation programs were identified and reviewed using the same approach used by Tansey, Zanskas, and Phillips. Analysis of 88 dissertations resulted in a topical index of research topic, methodology, model, and type of statistical analysis that were considered independently and in relation to previous reviews. Among findings, the increase in predictive outcome studies observed in Tansey et al.was also observed in this review. An increase in research on specific clinical populations was also observed. Implications for the practice of rehabilitation counseling, rehabilitation education, and future research are discussed. © Hammill Institute on Disabilities 2012

The relationship between psychological distress and career thoughts

Dysfunctional career thoughts have been associated with a variety of psychological distress. The current study investigates the relationship between dysfunctional career thoughts and psychological distress for individuals with disabilities. The results support the relationship between dysfunctional career thoughts and psychological distress for those persons experiencing higher levels of commitment anxiety and external conflict but not for those experiencing decision-making confusion. Implications for rehabilitation counselors are discussed

Doctoral dissertation research in rehabilitation counseling: 2005-2007

Graduates of doctoral level programs are the stewards of their profession. Historically, doctoral dissertation research has been summarized as a service to improve research accessibility, analyze research trends, and suggest potential areas for future inquiry. The current review analyzes 99 doctoral dissertations from recognized rehabilitation counseling programs for the years 2005 through 2007. Departing from previous inquiries, the present study analyzed the methodology employed, the research model, and the type of statistical analyses implemented to answer the research questions posed by the dissertator. These additional points were included to reflect the growing emphasis in the field of rehabilitation counseling on evidence-based practice. A description of the methodology utilized to develop the reference citations, content summaries, observations, trends, and the annotated bibliography is provided. Potential implications for the practice of rehabilitation counseling, teaching, and future research are discussed. © Hammill Institute on Disabilities 2012