Coping, social support and quality of life (QOL) were examined in 120 HIV+ people (mean age = 37). The sample came from ambulatory clinics and drop-in centres in Toronto: 29% had AIDS, 35% were HIV symptomatic, and 35% were asymptomatic. Information was gathered from self-administered questionnaires. Respondents had good levels of social support and used a variety of coping strategies. Their scores on the behavioural and subjective measures of QOL were somewhat below average. The illness-related measure indicated that their diagnosis had an almost neutral effect on QOL and showed several areas where QOL had been positively affected. Data from male subjects only (n = 107) were analysed using a hierarchical block regression for each QOL measure. Income, emotional social support, and problem-oriented and perception-oriented coping were positively related to QOL. Tangible social support and emotion-oriented coping were negatively related and symptom severity was not related at all. Close friends provided most types of support. Although respondents indicated high levels of satisfaction with support generally, they expressed a need for more emotional support. Unemployment was high despite participants being relatively healthy and well-educated.
Although decisions related to driving are vital to well-being in later life, little is known about how aging drivers who do not experience a medical condition that requires driving cessation regulate their driving. This exploratory, qualitative study used focus groups with 79 such community-dwelling individuals to examine driving self-regulation from the perspective of pre-senior (aged 55–64) drivers, senior (aged 65 years or over) drivers, and senior ex-drivers. Themes resulting from inductive analysis addressed the importance of driving, mechanisms of self-monitoring and self-regulation, people who influenced decision making, and opinions regarding licensing regulations. A preliminary model of the process of self-regulation that highlights intrapersonal, interpersonal, and environmental influences on why, how, and when aging drivers adapt or cease driving is presented. The model identifies areas for future research to enhance understanding of this process, including the effectiveness of self-regulation. Findings suggest that increased public awareness of issues related to driving and aging could assist aging drivers, their families, and their family physicians in optimizing driving safety for this population. Since a near accident or accident was seen as the only factor that would lead many informants to stop driving and few informants planned for driving cessation, there is a need for interventions that help aging drivers make the transition to ex-driver in a timely and personally acceptable way.
The numbers of occupational therapists in community practice are not yet large enough to provide fieldwork placements to accommodate all students. This article describes a project designed to educate community agencies that do not employ occupational therapists, about our service while at the same time securing new fieldwork placements. We used on-site different discipline and offsite same discipline supervision to provide students to selected agencies without cost. Funding for one year from the Ontario Ministry of Health to the Ontario University Programs in Rehabilitation Science enabled us to initiate and evaluate the project. Students in the project developed their ability to work independently and to see their potential role in health promotion and prevention. Despite the lack of ongoing government funding, four years later, community sites are not only being maintained, but the number of sites has increased from 28 to 39, providing a total of 75 student placements. By educating a growing number of community agencies about the work of occupational therapists, the project has also expanded the boundaries of practice.
Relationships among mild traumatic brain injury (MTBI), posttraumatic stress (PTS), and function were examined in 99 motor vehicle accident (MVA) admissions: 64 in an MTBI group and 35 in a no-MTBI comparison group. Assessments occurred within the first month and at 6 to 9 months. At follow-up, the sample was moderately disabled on the Sickness Impact Profile (SIP), 71% satisfied on the Reintegration of Normal Living Index (RNL), and 42% had returned to work. Only the SIP Psychosocial score was significantly different for MTBI groups; 24% of the sample showed definite symptoms of PTS. This group was significantly more disabled on the SIP, less satisfied on the RNL, and less likely to return to work. The proportion of variance in outcome explained in each model ranged from 32% (Physical SIP) to 44% (RNL). Results suggest the need for clinicians to be more aware of the strong influence of PTS on functional outcomes.
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