Rehabilitation Success: The Interrelationships of Multiple Criteria

Albrecht, Gary L.; Higgins, Paul C.

doi:10.2307/2955394

Cited by 41 publications

(18 citation statements)

References 7 publications

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“…According to this concept, LIS patients could not have a high QoL due to their low level of physical functioning. In reality, patients' perceptions of personal health, well-being, and life satisfaction are often discordant with their objective health status and disability (Albrecht and Higgins, 1977;Albrecht, 1994). Accordingly, LIS patients report a QoL often comparable to age-matched healthy controls and other chronically ill patients without severe motor impairment (Kü bler et al, 2005;Rabkin et al, 2000;Lulé et al, 2008;Laureys et al, 2005).…”

Section: Quality Of Lifementioning

confidence: 99%

Life can be worth living in locked-in syndrome

Lulé

Zickler

Häcker

et al. 2009

Progress in Brain Research

183

104

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The locked-in syndrome (LIS) describes patients who are awake and conscious but severely deefferented leaving the patient in a state of almost complete immobility and loss of verbal communication. The etiology ranges from acute (e.g., brainstem stroke, which is the most frequent cause of LIS) to chronic causes (e.g., amyotrophic lateral sclerosis; ALS). In this article we review and present new data on the psychosocial adjustment to LIS. We refer to quality of life (QoL) and the degree of depressive symptoms as a measure of psychosocial adjustment. Various studies suggest that despite their extreme motor impairment, a significant number of LIS patients maintain a good QoL that seems unrelated to their state of physical functioning. Likewise, depression is not predicted by the physical state of the patients. A successful psychological adjustment to the disease was shown to be related to problem-oriented coping strategies, like seeking for information, and emotional coping strategies like denial -the latter may, nevertheless, vary with disease stage. Perceived social support seems to be the strongest predictor of psychosocial adjustment. QoL in LIS patients is often in the same range as in age-matched healthy individuals. Interestingly, there is evidence that significant others, like primary caregivers or spouses, rate LIS patients' QoL significantly lower than the patients themselves. With regard to depressed mood, ALS patients without symptoms focus significantly more often on internal factors that can be retained in the course of the disease contrary to patients with depressive symptoms who preferably name external factors as very important, such as health, which will degrade in the course of the disease. Typically, ALS patients with a higher degree of depressive symptoms experience significantly less ''very pleasant'' situations. The herein presented data strongly question the assumption among doctors, health-care workers, lay persons, and politicians that severe motor disability necessarily is intolerable and leads to end-of-life decisions or euthanasia. Existing evidence supports that biased clinicians provide less-aggressive medical treatment in LIS patients. Thus, psychological treatment for depression, effective strategies for coping with the disease, and support concerning the maintenance of the social network are needed to cope with the disease. Novel communication devices and assistive technology now offers an increasing number of LIS patients to resume a meaningful life and an active role in society.

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Section: Quality Of Lifementioning

confidence: 99%

Life can be worth living in locked-in syndrome

Lulé

Zickler

Häcker

et al. 2009

Progress in Brain Research

183

104

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“…16 Measures include instruments designed to assess physical functioning; 17 23 and psychologic adjustment to disability. 24 Among the most widely used measures are those designed to assess the individual's ability to perform routine self care activities, such as the Barthel, Kenny, Katz and PULSES scales. M - 26 Of these scales, the Barthel has certain advantages 25 and was the measure of activities of daily living (ADL) used by the three CHSPs.…”

Section: Barthel Index Scoresmentioning

confidence: 99%

Community Hospital-based Stroke Programs: North Carolina, Oregon, and New York. II: Description of study population.

Becker

Howard

McLeroy

et al. 1986

Stroke

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SUMMARY The three Community Hospital-based Stroke Programs collected data on 4132 stroke patients admitted to acute care hospitals during 1979 and 1980. White female stroke patients were older than the white male, nonwhite female and nonwhite male stroke patients. Nearly one-fourth (23%) of stroke patients were employed at the time of the event. Most (77%) of the patients were hospitalized for first stroke episodes. Eighty-three percent of the patients had at least one of the four major risk factors for stroke, namely, hypertension, diabetes, transient Ischemic attacks and cardiac disease. Half (49%) of the patients were alert at the time of admission. The three diagnostic categories included infarction (60%), stroke not otherwise specified (30%) and hemorrhage (10%). Fourteen days was the median length of hospitalization; 50% of the stroke patients were discharged to a home setting, 31% were institutionalized and 19% died while in the hospital. The mean Barthel Index score for 2400 patients at the time of discharge was 61.8 (normal is 100). Of those patients who were working at the tune of the stroke, 22% returned to work.In comparison to the patients in the National Survey of Stroke, patients in this Study were less severe at the time of admission (49% of patients in the National Survey of Stroke were stuporous or comatose compared to 21% of the patients hi the current Study). The inhospital fatality was 30.7% in the National Survey of Stroke, and 19.7% hi the current Study. Stroke Vol 17, No 2, 1986 MAJOR PROBLEMS in the study of stroke trends have been reviewed. 1^1 These previous reviews have identified a number of issues that continue to plague the studies of stroke mortality, particularly the limitations of using the underlying cause of death as reported on death certificates, the broad range of clinical manifestations of stroke and the absence of widely used diagnostic procedures to determine definitive diagnoses.2 Despite these definitional problems, stroke remains the third leading cause of death, as determined by the underlying cause on death certificates, and a major cause of disability. 4 The three Community Hospital-based Stroke Programs (CHSPs) were originally designed to obtain more information concerning the impact of health careFrom the

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“…As indicated earlier, from a psycho-social stance, then, rehabilitation is conceptualized as readjustment (Albrecht and Higgins, 1977;Ben-Sira 1981a;1983a;CuU and Hardy 1973:98). Readjustment implies restoration of the individual's emotional homeostasis that has been disturbed due to inadequate coping with demands -inadequacy being a consequence of resource defidency.…”

Section: Readjustment: Personal and Societal Componentsmentioning

confidence: 99%

“…RehabUitation, from a psychosocial stance, has, in several studies, been conceptualized as readjustment or re-adaptation to social Ufe in the wake of an irreversible impairment (Albrecht and Higgins 1977;Ben-Sira 1981a;1983a;CuU and Hardy 1973:98;Dimond 1983;Levitin 1979;RusseU 1981;Safilios-Rothschild 1970;Smith and Midanik 1980;Stotsky 1963). However, though aware of the significance of the disabled persons' self conception, as well as of their perception of society's reaction toward them, most of the empirical evidence focuses mainly on the individual's coping capacity (Ben-Sira 1981a;Smith and Midanik 1980;Weinstein 1980).…”

Section: Introductionmentioning

confidence: 99%

Potency: a readjustment‐promoting link in the rehabilitation of disabled persons

Ben‐Sira

1989

Sociology Health & Illness

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A study among a stratified sample of IsraeU disabled war veterans ascertained the contribution of 'potency' -a recently discerned stress-moderating Unk in the coping process -in promoting the readaptation to sodal Ufe of traumatically disabled persons. Potency reflects a combination of selfconfidence and commitment to and tmst in society. The data suggest that potency is likely to weaken the deleterious impact of inadequate coping with the unprecedented demands inherent in disability. Disabled army veterans with strong potency are less Ukely than those with weak potency to be affected by occasional coping failures, by subjectively perceived 'demands', or by occasional resource deficiencies. The evident instrumentality of potency for readjustment suggests that societal and personal factors simultaneously play a significant role in readjustment. The contribution of this study is in its illumination of the importance of the disabled person's perception of society, in addition to his/her individual resources, for successful reintegration into social Ufe.

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Rehabilitation Success: The Interrelationships of Multiple Criteria

Cited by 41 publications

References 7 publications

Life can be worth living in locked-in syndrome

Life can be worth living in locked-in syndrome

Community Hospital-based Stroke Programs: North Carolina, Oregon, and New York. II: Description of study population.

Potency: a readjustment‐promoting link in the rehabilitation of disabled persons

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