a Department of Occupational and Recreational Therapies , University of Utah , Salt Lake City , UT , USA.
b Department of Rehabilitation Medicine , University of Washington , Seattle , WA , USA.
Disabil Rehabil. 2019 Jul;41(15):1760-1767. doi: 10.1080/09638288.2018.1448466. Epub 2018 Mar 9.
Middle-age may be a challenging time for people with physical disabilities as life demands, secondary symptoms such as fatigue, and risk for depression increase, yet little is known about types, levels, and impact of life stressors in individuals aging with disability. Our aims were to describe aging- and disability-associated life stressors, explore gender differences, and evaluate effects of resilience on adjustment to these stressors. Longitudinal data analysis of self-report surveys completed by 541 middle-aged community-dwelling participants with long-term physical disability from baseline to 5-year follow-up. 97% of participants endorsed one or more stressful life events (M = 8.2, SD = 4.9), all of whom endorsed at least one life stressor with a negative impact. Reporting more life stressors and having lower resilience were significantly associated with developing more depressive symptoms. Interaction analyses indicated that women developed more depressive symptoms as negative impact increased than men. Findings suggest that middle-aged individuals with physical disability experience a range of life stressors, many with negative impact. Women are at higher risk of depressive symptoms than men. Resilience may buffer against negative impact of life stressors on development of depressive symptoms. Targeted intervention to increase resilience, especially in women, may decrease risk of depression in persons aging with disability. Implications for Rehabilitation Middle-age adults living with physical disability experience a number of aging- and disability-associated stressors that can have a negative impact and contribute to depression. Women aging with disability who experience more negative impact from life stressors may be more vulnerable to developing depression. Providing interventions that enhance resilience when faced with life stressors could prevent development of depression.
中年可能是身体残疾人士的一个挑战时期,因为生活需求、疲劳等次要症状以及抑郁风险增加,但人们对残疾人士衰老过程中的生活压力源的类型、水平和影响知之甚少。我们的目的是描述与衰老和残疾相关的生活压力源,探讨性别差异,并评估适应这些压力源的弹性的影响。 对 541 名长期身体残疾的中年社区居民参与者进行的自我报告调查的纵向数据分析,从基线到 5 年随访。97%的参与者表示经历过一次或多次压力生活事件(M=8.2,SD=4.9),所有人都表示经历过至少一次具有负面影响的生活压力源。报告更多的生活压力源和较低的适应力与发展更多的抑郁症状显著相关。交互分析表明,与男性相比,女性随着负面影响的增加,抑郁症状的发展越多。 研究结果表明,身体残疾的中年个体经历了一系列生活压力源,其中许多都有负面影响。与男性相比,女性患抑郁症状的风险更高。适应力可能缓冲生活压力源对抑郁症状发展的负面影响。 对康复的启示 患有身体残疾的中年成年人经历了许多与衰老和残疾相关的压力源,这些压力源可能产生负面影响,并导致抑郁。经历更多生活压力源负面冲击的残疾女性可能更容易患上抑郁症。当面临生活压力源时,提供增强适应力的干预措施可能会预防抑郁的发生。