Kanako Iwanaga

The Use of Evidence-Based Practice Among Japanese Vocational Rehabilitation Professionals

The current study surveyed 94 Japanese vocational rehabilitation (VR) professionals to determine their perceived self-efficacy, perceived benefits, perceived barriers, and readiness to use evidence-based practice (EBP). VR counselors in Japan generally see the potential benefits of using EBP to improve psychosocial and employment outcomes of people with disabilities. However, responses related to knowledge and skills were mixed with higher confidence reported in the ability to understand basic concepts of rehabilitation research designs, methods, and statistics but less confidence in the use of research databases to find empirically supported interventions and in their ability to understand the best evidence information from systematic reviews/meta-analyses. Perceived barriers to EBP were identified, including lack of support for the use of EBP from colleagues and senior management in the agency and not having supervisors who are experienced in EBP. As expected, Japanese VR counselors also reported EBP was not effectively used in VR service delivery practices. Implications for practice, education, and professional development are discussed

Relationships between self-determination theory and theory of planned behavior applied to physical activity and exercise behavior in chronic pain

Abstract This study examined the relationships between self-determination theory (SDT) and theory of planned behavior (TpB) applied to physical activity and exercise behavior (PA&E) in people with chronic pain. Two hundred and eleven adults with chronic musculoskeletal pain (28 males and 183 females, age range 18 to 82 years, mean age 43 years) were recruited from online support groups and clinic networks in the United States. Participants completed SDT measures relevant to PA&E on perceived autonomy support, autonomy, competence, and relatedness, as well as TpB measures relevant to PA&E on intention, attitudes, subjective norms, and perceived behavioral control. Correlational techniques and canonical correlation analysis were performed to examine the relationships and variance within and between theoretical dimensions. Overall, the SDT set accounted for 37% of the TpB variance and the TpB set accounted for 32% of the SDT set variance. The results indicate there are statistical similarities and differences between concepts in SDT and TpB models for PA&E. Using both empirical guidance and clinical expertise, researchers and practitioners should attempt to select and integrate non-redundant and complementary components from SDT, TpB, and other related health behavior theories.

Testing an integrated self-determined work motivation model for people with disabilities: A path analysis.

Objective: Individuals with disabilities are more likely to live in poverty, have more health issues, and be less likely to be employed than their same-aged peers. Although these issues may be attenuated by vocational rehabilitation services, amotivation and ambivalence to employment can limit the readiness of persons with disabilities to engage in these services. Drawing on self-efficacy, self-determination, and stages of change theories, the purpose of this study was to develop and test an integrated self-determined work motivation model for people with disabilities. Method: Participants included 277 people with disabilities recruited through vocational rehabilitation agencies across 8 states. Path analysis was used to evaluate the contribution of functional disability, self-determination, and social efficacy variables in a hypothesized integrated self-determined work motivation model. Model estimations used maximum likelihood estimation and model-data fit was examined using several goodness-of-fit indices. Results: The initial path analysis indicated a less than optimal fit between the model and the observed data. Post hoc model modifications were conducted based on examination of the critical ratios and modification indices and theoretical consideration. The respecified integrated self-determined work motivation model fit the data very well, &khgr;2/df = 1.88, CFI = .99, and RMSEA = 0.056. The R2 for the endogenous variables in the model ranged from .19 to .54. Conclusions: Findings from this study support the integrated self-determined work motivation model in vocational rehabilitation as a useful framework for understanding the relationship among functioning levels, self-determination and self-efficacy factors, vocational rehabilitation engagement, and readiness for employment.

Towards an integration of the health promotion models of self-determination theory and theory of planned behavior among people with chronic pain.

Purpose: People with chronic pain and related disability often report motivational difficulties with engaging in health-promoting behaviors. Although health promotion models of self-determination theory (SDT) and theory of planned behavior (TPB) have been shown to explain the motivational processes behind health behaviors in the general population, there is limited theoretical research among persons with chronic pain. This study examined the integration of such theories relevant to physical activity and exercise behavior among pain populations. Research Method: Secondary data analyses were conducted using cross-sectional surveys from 198 participants with chronic musculoskeletal pain recruited from U.S. clinics and community networks. The primary outcome was self-reported physical activity and exercise participation. Predictor variables included pain intensity, functional disability, and SDT and TPB measures. Hierarchical regression analysis was conducted to examine the associations between these variables. Results: Findings demonstrated that in the first step, functional disability was associated with physical activity and exercise; and in the second step, all SDT factors were associated with physical activity and exercise. In the final step of the model, only certain SDT and TPB factors were associated with physical activity and exercise. Conclusions: Despite preexisting pain and functional disability, the findings suggest that health behavior factors from both SDT and TPB are associated with physical activity and exercise participation. This line of research should encourage rehabilitation professionals to recommend regular physical activity and exercise, while simultaneously addressing and monitoring the SDT and TPB factors that are well-timed and appropriate for persons with chronic pain through motivation-oriented rehabilitation approaches.

Preliminary Validation of a Short-Form Version of the Attachment Style Questionnaire for Use in Clinical Rehabilitation Counseling Research and Practice:

The purpose of this study was to develop and validate a short-form version of the Attachment Style Questionnaire (ASQ) in people with disabilities. The construction sample consisted of 108 participants recruited from spinal cord injury (SCI) advocacy organizations. The cross-validation sample comprised 140 individuals with traumatic injuries recruited from a rehabilitation hospital. Measures administered were the ASQ, Trait Hope Scale, Sense of Coherence Scale, and Satisfaction With Life Scale. Results showed that the three subscales of secure, anxious, and avoidant attachment from the short-form ASQ had high correlations with the three subscales from the long-form ASQ. The reliability of the subscales for the short-form ASQ was adequate and similar to the long-form ASQ. Both the short- and long-form ASQ subscales were found to correlate with hope, sense of coherence, and subjective well-being in the expected theoretical directions. Confirmatory factor analysis also supported the three-factor measurement structure of the short-form ASQ. This study provides evidence to support the psychometric properties of the abbreviated ASQ in people with disabilities. The short-form version of the ASQ is a brief, reliable, and psychometrically sound measure of attachment that can be used in clinical rehabilitation counseling research and practice.

Psychometric Validation of the Multiple Sclerosis Environmental Supports Scale: A Brief Report:

The main objective of this study was to evaluate the measurement structure of the Multiple Sclerosis Environmental Supports Scale (MSESS) with 248 individuals with multiple sclerosis (MS). Exploratory factor analysis yielded three reliable factors (health and mental health services; rehabilitation, social, and support services; and independent living supports). The MSESS appears to be a promising rehabilitation assessment tool for individuals with MS, one that can be used by rehabilitation counselors to evaluate environmental support factors in their interview, assessment, and rehabilitation planning protocols.

Assessing College Life Adjustment of Students With Disabilities: Application of the PERMA Framework:

The clearest career path to the middle class generally involves access, and completion, of postsecondary education. However, persons with disabilities are less likely to enroll or graduate from college compared with their same-age peers without disabilities. The quality of life of students with disabilities, and their well-being, may be a root cause of low graduation rates. To flourish in life is to both feel good and function effectively. Seligman developed the Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment (PERMA) model that may be useful in understanding the well-being of individuals. The purpose of this study is to examine the factorial structure of the PERMA model in sample college students with disabilities and then examine the model’s relationship with outcomes important to college adjustment such as academic achievement, relationship problems, stress, life satisfaction, and core self-evaluation. Ninety-seven college students with disabilities enrolled in Science, Technology, Engineering, and Mathematics (STEM) were recruited for the study. Findings support a one-factor solution for the PERMA measurement model. Furthermore, PERMA was negatively correlated with factors associated with college difficulty and positively associated with factors linked to college success. The PERMA model also demonstrated that well-being mediates the relationship between functional disability and life satisfaction. Implications for rehabilitation researchers and practitioners are reviewed.

Personal and environmental contextual factors as mediators between functional disability and quality of life in adults with serious mental illness: a cross-sectional analysis

PurposeTo examine personal and environmental contextual factors as mediators of functional disability on quality of life (QOL) in a sample of individuals with serious mental illness (SMI).MethodsA cross-sectional analysis of 194 individuals with SMI (major depressive disorder = 38.1%; bipolar disorder = 35.6%; schizophrenia spectrum disorder = 25.8%) recruited from four psychosocial rehabilitation clubhouses was undertaken to test a multiple regression model assuming that personal (i.e., resilience, social competence, and disability acceptance) contextual factors and environmental (i.e., family support, support from friends, and support from significant others) contextual factors would mediate the relationship of functional disability on QOL. The bootstrap test for multiple mediators was then used to test for the significance of the indirect effects functional disability on QOL through the mediators.ResultsIn the simple regression model, functional disability had a strong relationship with QOL; however, after introducing the potential mediators, its effect was significantly reduced indicating partial mediation effects. The final regression model yielded a large effect, accounting for 44% of the variance in QOL. Controlling for all other potential mediating factors, social competence, disability acceptance, family support, and support from friends were found to partially mediate the relationship between functional disability and QOL. Bias-corrected bootstrap procedure results further supported the mediation model.ConclusionsThe findings from the study provide good support for the inclusion of person–environment contextual factors in conceptualizing the relationship between functional disability and QOL for individuals with SMI.

Measuring dispositional optimism in student Veterans: An item response theory analysis

ABSTRACT Background: The psychometric properties of the Life Orientation Test-Revised (LOT-R) have been established among college students, yet psychometric evidence is lacking for a sample of student Veterans in postsecondary education. Aims: The purpose of this study was to evaluate psychometric properties of the LOT-R for the assessment of dispositional optimism in student Veterans by using classical test theory (CTT) in conjunction with item response theory (IRT). Method: A sample of 205 student Veterans were recruited from universities across the United States. Exploratory factor analysis was conducted to test the unidimensionality of the LOT-R. A polychotomous IRT model using graded response model (GRM) was estimated. Reliability and concurrent validity of the LOT-R were tested. Results: CTT in conjunction with IRT validated that the LOT-R is a psychometrically sound unidimensional instrument for assessing the levels of dispositional optimism in student Veterans. The LOT-R was found to be associated with hope, resilience, PERMA, life satisfaction, depression, and anxiety in the theoretically expected directions. The internal consistency reliability coefficient was computed to be .86. Conclusions: Given its reliability and validity and applicability among this specific population, clinicians, educators, and researchers might use the LOT-R to assess and monitor dispositional optimism among student Veterans.

Person-environment contextual factors as mediators for the relationship between symptom cluster and employment outcome in multiple sclerosis

BACKGROUND: Multiple sclerosis (MS) symptoms often make it difficult for individuals with MS to stay at work or return to work. It is important to understand the relationship between symptom clusters and employment. Person-environment (P-E) contextual factors such as core self-evaluations (CSE) and social support have been found to be effective mediators for the relationship between disability and participation in rehabilitation research and may be able to reduce the adverse impact of MS symptom cluster on employment outcome of people with MS. OBJECTIVE: To evaluate the mediation effect of CSE and social support on the relationship between symptom cluster and employment in MS. METHOD: Quantitative descriptive research design using two simple mediation analyses. 154 persons with multiple sclerosis participated in this study. RESULTS: Results show that symptom cluster, CSE, and social support were significantly related to employment. Both CSE and social support were significant mediators of the relationship between symptom cluster and employment, with CSE a stronger mediator than social support. CONCLUSIONS: Managing MS symptoms and increasing CSE and social support will reduce the adverse impact of MS symptom cluster on employment outcome. Therefore, CSE and social support can be viewed as protective factors for maintaining employment in MS. These results provide support for the use of positive psychology interventions by vocational rehabilitation counselors working with individuals with multiple sclerosis.