Catherine Coyle

Leisure-time physical activity and secondary conditions in women with physical disabilities

Purpose: To examine the relationship between secondary conditions and leisure-time physical activity participation (LTPA) in women with physical disabilities. Method: A survey was conducted in a metropolitan urban USA area of women (n = 170) with physical disabilities including MS, CP, polio, arthritis, TBI, and CVA among others and aged 21 – 65 years. Outcome measures were LTPA, secondary conditions (numbers and severity), and functional status. Results: Respondents experienced 11.99 ( ± 6.05) secondary conditions in the past year, self-rated their severity as ‘moderate problems’, and reported moderate levels of functional impairment. LTPA participation (excluding calisthenics/exercise) was reported to be 2.90 ( ± 5.12) times/week with 39.4% reporting no participation. After controlling for the interaction between severity of secondary conditions and functional status, the secondary conditions of physical deconditioning and isolation were significantly and inversely related to LTPA participation (r = − 0.164, p = 0.036; r = − 0.156, p = 0.045, respectively). Conclusion: Reported secondary conditions of physical deconditioning and isolation are inversely related to the ability of moderately impaired women with physical disabilities to participate in LTPA when functional status was controlled and should be considered in efforts to increase involvement in this health promoting behaviour.

Aerobic exercise training and depressive symptomatology in adults with physical disabilities

Abstract Objective: To test the effects of aerobic exercise on fitness and psychological health of adults with physical disabilities. Design: Nonrandomized control trial with before-after testing. Setting: Predata and postdata were collected at a clinical research center. Exercise occurred at home or at a community center. Participants: A volunteer sample of 47 adults with a physical disability were pretested; 19 completed posttesting. Intervention: Participants volunteered for either the exercise ( n = 7) or control groups ( n = 12). Exercisers participated in 12 weeks of aerobic exercise at an mean intensity of 73% HR max . Main Outcome Measures: Peak oxygen consumption (VO 2peak ), depressive symptomalogy, mastery, and self-esteem. Results: Exercisers increased VO 2peak by 23%, whereas controls decreased by 19% ( p p ≤ .05). A correlation of −.48 ( p ≤ .05) was observed between delta scores in VO 2peak and depressive symptoms. Significant differences ( p ≤ .05) between the exercise and control groups were found on the somatic and positive affect depressive subscales. Conclusion: Aerobic exercise improved aerobic fitness and decreased depressive symptoms in this sample. Reductions in depressive symptoms may result from physiological and/or behavioral mechanisms associated with aerobic exercise.

Leisure as a context for active living, recovery, health and life quality for persons with mental illness in a global context

Globally, the mental health system is being transformed into a strengths-based, recovery-oriented system of care, to which the concept of active living is central. Based on an integrative review of the literature, this paper presents a heuristic conceptual framework of the potential contribution that enjoyable and meaningful leisure experiences can have in active living, recovery, health and life quality among persons with mental illness. This framework is holistic and reflects the humanistic approach to mental illness endorsed by the United Nations and the World Health Organization. It also includes ecological factors such as health care systems and environmental factors as well as cultural influences that can facilitate and/or hamper recovery, active living and health/life quality. Unique to this framework is our conceptualization of active living from a broad-based and meaning-oriented perspective rather than the traditional, narrower conceptualization which focuses on physical activity and exercise. Conceptualizing active living in this manner suggests a unique and culturally sensitive potential for leisure experiences to contribute to recovery, health and life quality. In particular, this paper highlights the potential of leisure engagements as a positive, strengths-based and potentially cost-effective means for helping people better deal with the challenges of living with mental illness.

Role of Leisure in Recovery From Mental Illness

Conceptually supported by recovery, positive psychology, and health promotion perspectives, this study explored the role of leisure in recovery and health among culturally diverse individuals with mental illness. One-on-one survey interviews were conducted with Black (n = 35), Hispanic/Latino (n = 28), White (n = 28), and Asian (n = 8) adults (aged between 23 and 78) with mental illness (N = 101). A variety of mental health diagnoses were represented in the sample (e.g., bipolar disorder, n = 32; major depression, n = 23; schizophrenia, n = 22). Regression analyses were performed to estimate the predictive effects of leisure variables on recovery, health, and psychiatric symptoms. The findings emphasize the importance of: (a) meanings that persons with mental illness gain from leisure (e.g., connection/belonging, identity, freedom/autonomy) (i.e., meaning making via leisure) and (b) leisure opportunities to fight against or reduce perceptions of boredom (i.e., boredom reduction in leisure) as both of these were significant predictors of recovery. Also, a greater perception of being actively engaged/involved (i.e., perceived active living) was a significant predictor of recovery and overall physical and mental health and less frequent psychiatric symptoms, whereby leisure potentially provides a key context for the pursuit of active living. Furthermore, the use of leisure both for coping with stress (i.e., stress coping via leisure) and reducing boredom significantly predicted fewer psychiatric symptoms. The findings highlight the need to consider the experiences, feelings/emotions, and meanings that people with mental illness gain from leisure beyond simply behavioral forms of leisure (i.e., leisure activities) per se by respectfully appreciating the cultural diversity of people with mental illness.

Leisure-Generated Meanings and Active Living for Persons With Mental Illness

Leisure may potentially play a key role in rehabilitation counseling, including psychiatric rehabilitation. Based on recovery and positive psychology frameworks in which meaning-making is a central concept, this study examined the role of leisure-generated meanings (LGMs) experienced by culturally diverse individuals with mental illness in potentially helping them better cope with stress, adjust to and recover from mental illness, as well as feel more actively engaged in life. One-on-one survey interviews were conducted with African (n = 35), Hispanic/Latino (n = 28), Caucasian (n = 28), and Asian (n = 8) American adults (aged between 23 and 78) (total n = 101) with mental illness (e.g., bipolar disorder, n = 32; major depression, n = 23; schizophrenia, n = 22) in Philadelphia, Pennsylvania. Using general linear modeling, we found that LGMs significantly predicted the adjustment to and recovery from mental illness, leisure stress-coping, leisure satisfaction, and perceived active living positively, and lower leisure boredom. The findings have implications for psychiatric rehabilitation to better support persons with mental illness from a strengths-based, meaning-centered, and active-living promotion perspective in which leisure seems to play an important role.

Using Massage to Reduce Use of Sedative-Hypnotic Drugs With Older Adults A Brief Report From a Pilot Study

Despite known adverse effects, sedative-hypnotic drugs (SHDs) are widely used in institutional settings serving the elderly. Using a 2 (Intervention, Control) × 3 (Baseline, Intervention, Withdrawal) mixed design with random assignment to the intervention (n = 15) or control (n = 13) group, the authors sought to determine if a nonpharmacological sleep intervention (massage at bedtime) could reduce “as-needed” SHD (PRN-SHD) usage. Each phase of this pilot lasted 7 days and PRN-SHD usage was monitored via chart review. Results, indicating a 13% greater reduction in requests for PRN-SHD for the intervention group when it received massage, approached statistical significance for the quadratic planned comparisons (p = .17) despite limited power (.28) for the observed effect size of .07. While preliminary, results suggest that massage at bedtime may reduce PRN-SHD usage with older adults. Randomized controlled studies with larger samples are needed.

Effects of a Bedtime Massage on Relaxation in Nursing Home Residents with Sleep Disorders

This study evaluated the effectiveness of an activity-based intervention (massage) in producing a relaxation response and sleep in nursing home residents. Using a 2 (intervention, control) × 3 (baseline, intervention, withdrawal) mixed design with random assignment to the intervention (n = 15) or control (n = 13) group, results indicated that the massage produced a statistically significant relaxation response as measured by heart rate (p < .001), systolic and diastolic blood pressure (p = .01), and anxiety (p < .001) for individuals receiving the intervention. Analyses had sufficient power despite the sample size. Implications for future research using massage with nursing home residents are discussed.

Experiences and meanings of leisure, active living, and recovery among culturally diverse community-dwelling adults with mental illness

This paper presents the findings from Phase II of our multiphase, community-based research project that examined in-depth insights into the meanings of leisure and active living in the recovery experiences of culturally diverse, community-dwelling adults with mental illness. A series of three face-to-face, semistructured interviews were conducted once each week for 3 weeks with each individual who was purposefully selected from a pool of Phase I study participants. This case-study subsample (n = 23; 14 women and 9 men) included seven White, six Black, six Hispanic American, and four Asian American participants, aged between 23 and 78 years. The findings suggested that actively engaged leisure would act as a mechanism (i.e., “leisure space”) for “movement from” stress and tension and “movement to” something enjoyable and meaningful (e.g., a source of fulfillment, social connections, the reaffirmation of self-worth, hope for the future, altruism).

Statement of Correction: Using Massage to Reduce Use of Sedative-Hypnotic Drugs With Older Adults A Brief Report From a Pilot Study

Due to a production error, this article was published online and listed in the printed journal’s table of contents but did not appear in the issue. To remedy this, the article has been removed from the December 2009 online issue and will now appear in the February 2010 print and online issues.