Measuring older adults' wellbeing when transitioning into assisted living facilities: a confirmatory factor analysis of the Mueller assessment of transition (MAT).

OBJECTIVES: Older adults' wellbeing during the transition into an assisted living facility (ALF) is not well understood and may influence their wellbeing. The Mueller Assessment of Transition (MAT) was created to measure the impact of transition on older adults' wellbeing. Early developmental testing of the MAT revealed a hypothesized model with two constructs (adjustment strategies and constraints to wellbeing). Therefore, the purpose of this study was to confirm the factor structure of the MAT with a representative sample of older adults transitioning into ALFs. METHODS: In a nationwide sample, 108 older adult participants completed the MAT to measure wellbeing when relocating into ALFs. Confirmatory factor analysis (CFA) assessed the structural validity of the MAT. Internal consistency was evaluated, and chi-square tests of association for regional differences in MAT scores were also conducted. RESULTS: The CFA produced strong fit indices to confirm the hypothesized 2-factor (constraints to wellbeing and adjustment strategies) model of the MAT. Cronbach's alpha for the internal consistency was 0.784 and chi-square test indicated no significant regional differences. CONCLUSION: The MAT was established as a valid and reliable standardized assessment. Implications for using the MAT as a tool to measure older adults' wellbeing and future research are discussed.

Can scuba diving transform the lives of people with physical impairments? A mixed methods study.

PURPOSE: This study aimed to: (1) test and explain the type of experience scuba diving is among people with physical impairments based on the experience-type framework; (2) assess and describe their personality based on the Big Five domains; and (3) identify if personality, years diving, and diving level predict experience-type. METHODS: An explanatory sequential mixed methods design was employed. The quantitative phase used a cross-sectional survey (n = 103). The qualitative phase used follow-up interviews with 15 participants divided into 3 case study groups. Joint displays with meta-inferences integrated the data. RESULTS: Quantitative and qualitative findings concurred on scuba being a transformative experience. 82.52% of survey participants reported scuba as a transformative experience, with no significant differences on experience impact based on impairment category (p = 0.56), impairment onset (p = 0.66), gender (p = 0.08), race/ethnicity (p = 0.51), or age (p = 0.07). Big Five personality domains, years diving, or diving level did not predict experience impact (R2 = 0.14, F(12,90) = 1.304, p = 0.2305). Data strand results differed on salient personality domains. Seven qualitative themes emerged, five on experience-type and two on personality. CONCLUSIONS: We recommend the exploration of scuba diving as a prospective rehabilitation intervention.

Innovative rehabilitation interventions that provide positive experiences and long-term health benefits to people with physical impairments are needed.Participants reported that scuba diving had a positive transformative impact in their lives through positive emotions, peace/relaxation, personal growth, development of skills, social connections, physical and mental healing, and lasting behavioral changes.Reporting scuba diving as a transformative experience was not influenced by the scuba divers' personality domains, diving level, demographic characteristics, or the number of years they had been diving.Authors recommend the consideration and further exploration of scuba diving as a prospective physical and psychosocial rehabilitation intervention.

Exploring Constraints to Well-Being for Older Adults in Transition Into an Assisted Living Home: A Qualitative Study.

Transitions into an assisted living home (ALH) are difficult and may impact the well-being of older adults. A thematic analysis guided by grounded theory was employed to better understand how a transition into an ALH influenced older adults' overall well-being. Individual, face-to-face interviews were conducted with a convenience sample of 14 participants at an ALH in the rural, southeastern U.S. Two central findings that influenced well-being during the transition process were revealed: loss of independence (sub-themes include loss of physical and mental health and loss of driving) and downsizing in space and possessions. The themes support and broaden the Hierarchical Leisure Constraints Theory, a Modified Constraints to Wellbeing model is proposed, and implications for older adult health care practitioners in ALHs are recommended. Further research is needed on the Modified Constraints to Wellbeing model and how to better describe these constraints to older adults' well-being when relocating into ALHs.

Diving into Health: A Mixed Methods Study on the Impact of Scuba Diving in People with Physical Impairments.

The impacts of scuba diving on people with physical impairments are unknown. Grounded on the social identity approach to health, the aim of this study was to test and describe the relationships between scuba diving social identity, self-efficacy, social health, psychological health, physical health, health-related quality of life (HRQOL), and disability level among recreational scuba divers with physical impairments. A mixed methods explanatory sequential design was employed. The quantitative strand used an 80-item cross-sectional survey, with the data analyzed via a path analysis. The qualitative strand used 1:1 interviews across 3 case study groups; the data were analyzed using deductive and inductive analyses. Mixing occurred via a joint display with meta-inferences. The quantitative results (n = 78) indicated that self-efficacy was a significant predictor of social health, psychological health, physical health, HRQOL, and disability level. The qualitative findings (n = 15) consisted of six themes, whereby participants described scuba as a positive social identity that provides them with meaning, purpose, and belonging. Furthermore, they described scuba diving as a positive contributor to their self-efficacy, social health, psychological health, physical health, and quality of life. During the mixing of data, the quantitative and qualitative results did not match on the influence of scuba diving social identity on self-efficacy, social health, psychological health, physical health, HRQOL, and disability level. A further analysis revealed that the range restriction impaired the conclusive quantitative evidence on the scuba diving social identity variable. The meta-inferences derived from the data integration suggest that scuba diving plays a role in the self-efficacy, health, HRQOL, and disability level among scuba divers with physical impairments. The findings point to the potential of scuba diving as a health promotion recreational activity and rehabilitation modality for people with physical impairments.

An Exploration of Yoga in Occupational Therapy Practice for Multiple Sclerosis.

The purpose of this exploratory qualitative study was to provide insight on the use of yoga in occupational therapy (OT) for people with multiple sclerosis (PwMS). This study aimed to answer how and why OT practitioners (OTPs) integrate yoga into clinical practice for PwMS. Eight OTPs, half of whom have also completed yoga teacher training, participated in a semi-structured telephone interview. Interviews were transcribed verbatim, inductively open-coded, and analyzed using thematic data analysis. Themes that emerged were: (a) OT and yoga are a natural fit; (b) improved performance and participation; (c) leveraging personal ties to yoga; and (d) influenced by client factors and clinical environment. The qualitative data provide valuable information about OTPs' justification for, and unique application of, yoga in clinical practice for PwMS. Future researchers should further explore the use of yoga for OT-related outcomes and the experience of PwMS.

The integration of yoga in physical therapy clinical practice.

Health professionals are beginning to use yoga as a treatment modality. However, evidence explaining physical therapists' integration of yoga in clinical practice is lacking. OBJECTIVE: The purpose of this study was to explore how, why, and with whom physical therapists integrate yoga into clinical practice. DESIGN: This study is a secondary analysis of qualitative data collected during a larger multi-methods study. Thematic analysis of 13 interviews was conducted. RESULTS: Analysis indicated four themes, and six subthemes. Facilitating yoga in clinical practice and yoga training themes; including evaluation of outcomes, billing, terminology, and safety subthemes describe how physical therapists are using yoga in clinical practice. The perceived client outcomes theme, including physical and psychosocial outcomes explain why physical therapists use yoga in practice. The yoga with clinical populations theme addresses with whom physical therapists are using yoga. CONCLUSION: Physical therapists are using yoga with individuals with various health conditions to improve their physical and mental health. Findings support the need for physical therapists to increase their assessment and documentation of functional outcomes associated with client's yoga participation. Documentation could contribute to evidence-based literature related to how, why, and with whom physical therapists are using yoga. Documented outcomes could also provide rationale for yoga to receive classification as a reimbursable complementary and integrative health approach. Future research involving a larger, diverse sample (e.g., physical therapists with varying levels of education and yoga training) focused on how, why, and with whom physical therapists integrate yoga into clinical practice is recommended.

The impact of an autonomy-supportive yoga intervention on self-determination in adults with intellectual and developmental disabilities.

The aim of this study was to examine the impact of an autonomy-supportive yoga intervention on the self-determination of adults with intellectual and developmental disabilities. Research supports the use of autonomy-supportive interventions to increase positive health outcomes with this population. The present study utilized a qualitative approach with eight subjects participating in semi-structured qualitative interviews. Content analysis identified support for three themes related to the impact of yoga: autonomy, relatedness, competence. The results suggested that the yoga intervention may support self-determination for adults with IDD, as the participants' responses demonstrated increased feelings of autonomy, competence, and relatedness. The results also indicated that an autonomy-supportive yoga intervention can be achieved with adults with intellectual and developmental disabilities by targeting the key constructs of autonomy, relatedness, and competence.

Yoga for Functional Fitness in Adults with Intellectual and Developmental Disabilities.

BACKGROUND: Yoga is an effective intervention to improve functional fitness in adults with and without disabilities, but little research exists regarding yoga's impact on functional fitness for individuals with intellectual and developmental disabilities (IDDs). AIMS: The purpose of this study was to examine the benefits of a group yoga intervention on the functional fitness of adults with IDDs. METHODS AND MATERIALS: This yoga intervention included 12 sessions of yoga over 7 weeks (60-min sessions twice a week) at a special population recreation and leisure program. The functional fitness test was used to examine physical functioning before and after the yoga intervention. RESULTS AND CONCLUSIONS: Eight adults completed the baseline and posttest measures (age mean = 31; standard deviation = 6.55; 50% male). There were significant improvements in lower-body strength (9.00 ± 4.63 vs. 11.50 ± 3.16, P = 0.04, 28% improvement), upper-body strength (11.25 ± 3.54 vs. 14.25 ± 3.37, P = 0.018, 27% improvement), and agility and balance (9.29 ± 4.1 vs. 6.60 ± 1.54, P = 0.036, 29% improvement). Functional fitness often declines for people with IDD at a faster rate than the general population; thus, these significant changes indicate that a yoga intervention may enhance functional fitness for people with IDD. Clinicians or other healthcare providers might consider yoga as a means to improve functional fitness in adults with IDDs.

Changes in Nonmotor Symptoms Following an 8-Week Yoga Intervention for People with Parkinson's Disease.

Parkinson's disease (PD) is a neurodegenerative disorder marked by progressive degenerative motor symptoms (e.g., tremors, impaired balance and gait) and nonmotor symptoms (e.g., fatigue, sleep disturbances, pain) that can negatively influence health-related quality of life (HRQoL). Previous studies have shown that yoga for individuals with PD improves balance, strength, and mobility. However, little research has been conducted to determine the effect of yoga on nonmotor symptoms of PD. The purpose of this study was to examine changes in nonmotor symptoms among individuals with PD following an 8-week yoga intervention. Data used for analyses were part of a larger study that researched improvements in motor function for individuals with PD. Participants (N = 27) were randomly assigned to experimental (n = 15) and control (n = 12) groups and completed pre- and postintervention quantitative measures. Within-group improvements were statistically significant for fatigue measured by the Parkinson's Fatigue Scale, balance confidence measured by the Activities Balance Confidence Scale, the belief in one's ability to manage falls measured by the Falls Management Scale, activity constraints measured by the Activities Constraint Questionnaire, and PD-specific quality of life measured by the Parkinson's Disease Questionnaire-8. Across-group changes were statistically significant for activity constraints. Findings indicate yoga may be an efficacious intervention for improving nonmotor symptoms as well as HRQoL for individuals with PD.

Enhancing Problem- and Emotion-Focused Coping in Menopausal Women Through Yoga.

In varying degrees, all women experience menopause, the condition of infertility due to altered reproductive hormones. The menopausal transition includes three phases-perimenopause, menopause, and postmenopause-each associated with physical and psychological symptoms that can negatively affect women's successful functioning in everyday life. In addition to conventional therapies intended to decrease the frequency and severity of symptoms, menopausal women are in need of coping mechanisms to assist in managing symptoms as they occur. Using a deductive approach, a secondary analysis of 12 individuals' qualitative journal entries and semi-structured interviews obtained from a mixed-methods embedded research study was conducted to determine whether data exist to support yoga as a means for coping as presented by Lazarus and Folkman's transactional theory of stress and coping and by Iwasaki and Mannell's leisure stress coping conceptual framework. Results indicate that yoga has the potential for serving as a coping mechanism for women between the ages of 40 and 65 who are experiencing menopause and want to improve their health and/or enhance their ability to manage life's stressors. More specifically, findings discussed in this article advocate yoga as being a leisure activity in which problem- and emotion-focused coping strategies can develop, including mechanisms necessary for palliative coping, mood enhancement, and social companionship. To the authors' knowledge, data reported in this manuscript are the first to support the conceptual framework of Crowe, Van Puymbroeck, and Schmid, aimed at explaining yoga as a viable leisure coping strategy. Additional research focused on the psychosocial benefits of yoga, including yoga as coping, is recommended.

Contextual Facilitators and Barriers of Community Reintegration Among Injured Female Military Veterans: A Qualitative Study.

OBJECTIVE: To understand the facilitators and barriers to community reintegration (CR) among injured female veterans. DESIGN: Phenomenologic qualitative design. SETTING: Community. PARTICIPANTS: Community-dwelling female veterans with physical and/or psychological injury (N=13). INTERVENTIONS: None. MAIN OUTCOME MEASURES: None. RESULTS: Conventional content analysis revealed 3 types of facilitators, including (1) strong social support, (2) impactful programs, and (3) protective personal beliefs. Six types of barriers included (1) inadequate services, (2) lack of access to services, (3) poor social support, (4) difficulty trusting others, (5) nonsupportive personal beliefs, and (6) injury factors. Multiple environmental and personal factors acted as facilitators and barriers to CR. Findings are relatively consistent with previous veteran and civilian community reintegration research that indicates the importance of health-related services, attitudes of others, and social support. However, women in this study reported being effected by many of these facilitators and barriers because of their sex. CONCLUSIONS: This study supports the need to foster social support among injured female veterans throughout the rehabilitation process to promote CR. Long-term social support can be gained by incorporating services (eg, adjunctive therapies, recreation, other social programming) into the rehabilitation repertoire to help with CR for all veterans, particularly women.

Yoga as Coping: A Conceptual Framework for Meaningful Participation in Yoga.

Yoga facilitates relaxation and connection of mind, body, and spirit through the use of breathing, meditation, and physical postures. Participation in yoga has been extensively linked to decreased stress, and as a result, is considered a therapeutic intervention by many. However, few theories exist that explain the link between yoga participation and improved psychosocial wellbeing. The leisure-stress coping conceptual framework suggests that through participation in leisure, an individual can decrease stress while concurrently restoring and building up sustainable mental and physical capacities. Three types of leisure coping strategies exist: palliative coping, mood enhancement, and companionship. The purpose of this article is to propose the leisure-stress coping conceptual framework as a model for explaining benefits received from yoga participation via leisure coping strategies, which may explain or support improved ability to manage stress.

The Effects of Yoga Participation on Women's Quality of Life and Symptom Management During the Menopausal Transition: A Pilot Study.

Typically lasting 5-10 years, the menopausal transition is associated with symptoms including hot flashes, night sweats, and labile mood. As these symptoms often hinder a woman's successful functioning in everyday life, hormone therapy is commonly prescribed as a means to diminish symptoms. Many women, however, are seeking complementary and alternative treatments due to side effects and/or detrimental health-risks associated with conventional therapies. We completed a mixed methods study to determine changes in physiological symptoms associated with menopause and changes in women's quality of life, as a result of participation in a 10-week yoga intervention.