University of Toledo, School of Population Health, 2801 W Bancroft St., Mail Stop 119, Toledo, OH, 43606, USA.
University of Toledo, School of Population Health, 2801 W Bancroft St., Mail Stop 119, Toledo, OH, 43606, USA.
Disabil Health J. 2021 Apr;14(2):101047. doi: 10.1016/j.dhjo.2020.101047. Epub 2020 Dec 5.
CDC estimated that 19.4 million (7.8%) US adults are living with mobility impairment, who are unable to walk a quarter mile. Individuals with physical disability reported greater depression and, in some cases, insufficient social support.
This study explores the extent of disparities in psychological health, social support, and coping mechanisms among those with mobility impairment as compared to those without such impairment, and the longitudinal effect of onset of mobility impairment on subsequent psychosocial health and coping.
Individuals with mobility impairment were matched to controls from a nationally representative sample, using the propensity score method. The final sample included 345 matched pairs. Regression models with robust standard errors were used to assess disparities in outcomes by mobility status. Autoregressive models were used to assess the longitudinal effect of the onset of mobility limitation on these outcomes.
Those with impaired mobility fared significantly higher on negative affect (p < .05) and pessimism (p < .05), and significantly lower on life satisfaction (p < .05) and positive affect (p = .001). In terms of coping, they showed disparities in health locus of control (self) (p < .05), planning (p < .05), active coping (p < .05), and problem-focused coping (p < .05), as compared to those without mobility limitation. The onset of mobility impairment had significant effects in similar psychological and coping domains.
Our work revealed a piece of reality of individuals living with mobility impairment and will inform designing effective interventions to mitigate psychosocial health disparities in this population.
美国疾病控制与预防中心估计,有 1940 万(7.8%)美国成年人存在行动障碍,无法行走四分之一英里。有身体残疾的人报告称抑郁程度更高,在某些情况下,社会支持不足。
本研究探讨了与无行动障碍者相比,行动障碍者在心理健康、社会支持和应对机制方面的差异程度,以及行动障碍的发生对随后的心理社会健康和应对的纵向影响。
使用倾向评分匹配方法,从全国代表性样本中匹配行动障碍者和对照组。最终样本包括 345 对匹配的个体。使用稳健标准误差的回归模型评估按行动状态划分的结果差异。自回归模型用于评估行动受限的发生对这些结果的纵向影响。
行动障碍者的负性情绪(p<.05)和悲观主义(p<.05)得分显著较高,生活满意度(p<.05)和正性情绪(p=.001)得分显著较低。在应对方面,他们在健康控制源(自我)(p<.05)、计划(p<.05)、积极应对(p<.05)和问题焦点应对(p<.05)方面存在差异,与无行动障碍者相比。行动障碍的发生在类似的心理和应对领域有显著影响。
我们的工作揭示了行动障碍者的生活现实,这将为设计有效干预措施以减轻该人群的心理社会健康差异提供信息。