Wellness perception in persons with traumatic brain injury and its relation to functional independence.

OBJECTIVES: To test the reliability and validity of a perceptual wellness measure in persons after traumatic brain injury (TBI) and to determine whether a relation exists between functional independence and wellness perceptions in the same population. DESIGN: Survey research. SETTING: A private, residential brain injury program. PARTICIPANTS: A convenience sample of 49 patients (43 men, 6 women) with TBI whose mean age was 32.1 years (range, 18-61yr) and mean time since injury was 10.47 years (range, 1-21yr). MAIN OUTCOME MEASURES: The Perceived Wellness Survey (PWS) assessed wellness. The PWS has 6 subscales measuring physical, psychologic, emotional, intellectual, spiritual, and social wellness. The FIM instrument was used to measure functional status. RESULTS: The mean PWS score (15.99) for the sample was comparable to published samples of adults (mean, 15.31-16.51); however, the reliability of the composite score (alpha = .58) and the subscales (alpha = .32-.64) was less than that obtained in previous samples (composite alpha = 0.91; subscale alpha = .64-.81). The correlations between the PWS and the FIM scores were not significant. CONCLUSIONS: The PWS in its composite form is a reliable measure for use with persons with TBI. The finding that perceived wellness and functional independence were not related suggests that these constructs are unique and thus should both be measured. The measurement of perceptions will enable the provider to consider a client holistically and to develop programs that address quality of life issues. Further, because perceptions influence behaviors, understanding a person's perceptions in multiple dimensions may provide a useful and necessary framework for developing intervention programs that address behavioral and cognitive issues that are important to that person.

The influence of personality type on decision making in the physical therapy admission process.

The purpose of this study was to identify the personality types of physical therapy (PT) interviewers and applicants, using the Personality Styles (PS) assessment tool, and to determine whether an interview team's personality type influences the rating score given. The PS was validated in a study of 298 students who completed the Myers-Briggs Type Indicator (MBTI) Form G and a PS assessment. By chi-square analysis the PS model appears to be a valid representation of the MBTI (chi 2 = 86.62, p < 0.00001). Subjects for the interview portion of the study were 282 student applicants, 19 faculty, and 47 clinicians from two PT programs. A randomly assigned faculty/clinician team interviewed each applicant. Two one-way ANOVAs were performed with interview score as the dependent variable and 1) applicant personality type in relation to faculty/clinician team (same, different from both, like one) and 2) applicant personality type as the independent variables. Internal consistency of the interview rating form was alpha = 0.89. Mean interview score was 33.97/42 (SD 4.59). Interview scores were not significantly different between applicants who interviewed with clinician/faculty teams that were "like" compared with "not like" the applicants (F0.864; p = 0.423), but were significantly different between applicants with different PS personality types (F3.159; p = 0.026). Although personality type of the interview team did not impact the score given, thereby refuting the presence of interviewer bias, the rating scores did vary according to personality type of the applicant, suggesting a possible stereotyping bias in the criteria used to rate applicants.

Conceptualization and measurement of the spiritual and psychological dimensions of wellness in a college population.

Wellness is commonly conceptualized as having many dimensions, but little effort has been made to evaluate how spiritual and psychological dimensions are related to overall wellness. To explore the relationship between measures of spiritual and psychological wellness and perceived wellness in a college student population, the authors administered a series of survey instruments to 112 undergraduate students under quiet classroom conditions. They used the Life Attitude Profile to measure spiritual wellness, the Life Orientation Test and the Sense of Coherence Scale to measure psychological wellness, and the Perceived Wellness Survey to measure overall wellness. Path analysis performed with a proposed theoretical model revealed that the effect of life purpose on perceived wellness was mediated by optimism and sense of coherence, which had independent effects on perceived wellness beyond that of life purpose. The findings suggested that an optimistic outlook and sense of coherence must be present for life purpose to enhance a sense of overall well-being.

Outcomes of a traditional weight control program and a nondiet alternative: a one-year comparison.

The purpose of this study was to evaluate the effectiveness of a traditional weight control program and nondiet alternative in improving behavioral (e.g., restrained, emotional, and external eating), psychological (e.g., body preoccupation, physical self-esteem), and biomedical (e.g., body weight, blood pressure, cholesterol) outcomes. There were 2 intervention groups--traditional weight control (TWC) and Diet Free Forever (DFF); a nonvolunteer comparison group; and a control group, all made up of employees of 3M (N = 357). The 2 intervention groups participated in 10-week eating programs. Outcome variables were assessed at baseline, at 10 weeks for the intervention groups only, and again at 1 year. At baseline, the 2 intervention groups had higher restrained, external, and emotional eating scores, greater body preoccupation, and lower physical self-esteem than the comparison and control groups. They also weighed more. At 1 year, both intervention groups had decreased their body preoccupation and increased their physical self-esteem. Participants in the DFF program reduced their restrained eating, whereas those in the TWC program increased their restrained eating. Neither eating program had an impact on the biomedical outcomes.

Hepatitis, hyperglycemia, pleural effusion, eosinophilia, hematuria and proteinuria occurring early in clozapine treatment.

This report describes a 48-year-old caucasian male with schizophrenia who developed hepatitis, hyperglycemia, pleural effusion, eosinophilia, hematuria and proteinuria early in clozapine treatment which resolved on drug discontinuation. The literature on similar cases is reviewed.

The conceptualization and measurement of perceived wellness: integrating balance across and within dimensions.

PURPOSE: The impact of individual perceptions on health is well-established. However, no valid and reliable measure of individual wellness perceptions exists. Therefore, the purpose was to introduce a measure called the Perceived Wellness Survey (PWS). DESIGN: Convenience sampling facilitated recruitment of a sample large enough to perform factor analysis with adequate power (.85). The appropriateness of factor analysis is supported by Bartlett's test (chi 2 = 7110, p < or = .01) and the Kaiser-Meyer-Olkin measure of sampling adequacy (.91). SETTING: The sample (n = 558) was composed of 3M Inc. employees from multiple sites in Austin, Texas (n = 393); employees from MuRata Electronics, Inc., College Station, Pennsylvania (n = 53); and students enrolled at the University of Texas at Austin (n = 112). SUBJECTS: Racial, gender, and age distribution was, respectively, 6.3% African-American (n = 35), 8.2% Asian (n = 46), 73.3% Caucasian (n = 409), 9.5% Hispanic (n = 53), and 2.7% other (n = 15); 47.8% male (n = 267), and 52.2% female (n = 291); and 36.8 years. MEASURES: Measures included the Perceived Wellness Survey, and two additional versions of the Perceived Wellness Survey designed to measure both discriminant and face validity. Perceived Wellness Survey subscales include physical, spiritual, intellectual, psychological, social, and emotional dimensions. RESULTS: All subscales were correlated (p < or = .05) with the Perceived Wellness Survey composite and with each other. Evidence of internal consistency (alpha = .88 to .93), and discriminant, face, and factorial validity was provided. Finally, the Perceived Wellness Survey appears to be a unidimensional scale. CONCLUSION: The unidimensional nature of the Perceived Wellness Survey suggests that perceptions of wellness in various dimensions are intertwined by their affective nature. The Perceived Wellness Survey appears to be reasonably valid and reliable; however, further research is needed.