Bogart Kathleen R
Oregon State University.
Rehabil Psychol. 2014 Feb;59(1):107-15. doi: 10.1037/a0035800.
PURPOSE/OBJECTIVE: Current theories of adaptation to disability do not address differences in adaptation to congenital or acquired disability. Although people with congenital disabilities are generally assumed to be better adapted than people with acquired disabilities, few studies have tested this, and even fewer have attempted to explain the mechanisms behind these differences. This study tested the proposition that whether a disability is congenital or acquired plays an important role in the development of the disability self-concept (consisting of disability identity and disability self-efficacy), which in turn, affects satisfaction with life. It was predicted that disability self-concept would be better developed among people with congenital, compared with acquired disabilities, predicting greater satisfaction with life in those with acquired conditions.
RESEARCH METHOD/DESIGN: 226 participants with congenital and acquired mobility disabilities completed a cross-sectional online questionnaire measuring satisfaction with life, self-esteem, disability identity, disability self-efficacy, and demographic information.
Self-esteem, disability identity, disability self-efficacy, and income were significant predictors of satisfaction with life. Congenital onset predicted higher satisfaction with life; disability identity and disability self-efficacy, but not self-esteem, partially mediated the relationship.
CONCLUSIONS/IMPLICATIONS: Findings highlight the distinction between adaptation to congenital versus acquired disability and the importance of disability self-concept, which are underresearched constructs. Results suggest that rather than attempting to "normalize" individuals with disabilities, health care professionals should foster their disability self-concept. Possible ways to improve disability self-concept are discussed, such as involvement in the disability community and disability pride.
目的/目标:当前关于适应残疾的理论并未涉及先天性残疾与后天性残疾在适应方面的差异。尽管一般认为先天性残疾患者比后天性残疾患者的适应能力更强,但很少有研究对此进行验证,试图解释这些差异背后机制的研究更是少之又少。本研究检验了这样一个命题,即残疾是先天性还是后天性在残疾自我概念(由残疾认同和残疾自我效能感组成)的形成中起着重要作用,而残疾自我概念又会影响生活满意度。研究预测,与后天性残疾患者相比,先天性残疾患者的残疾自我概念发展得更好,这预示着后天性残疾患者对生活的满意度更高。
研究方法/设计:226名先天性和后天性行动障碍患者完成了一项横断面在线问卷调查,该问卷测量了生活满意度、自尊、残疾认同、残疾自我效能感和人口统计学信息。
自尊、残疾认同、残疾自我效能感和收入是生活满意度的显著预测因素。先天性发病预示着更高的生活满意度;残疾认同和残疾自我效能感(而非自尊)部分介导了这种关系。
结论/启示:研究结果凸显了先天性残疾与后天性残疾在适应方面的差异以及残疾自我概念的重要性,而这些都是研究较少的概念。结果表明,医疗保健专业人员不应试图让残疾人士“正常化”,而应培养他们的残疾自我概念。文中讨论了改善残疾自我概念的可能方法,如参与残疾群体活动和培养残疾自豪感。