Links between meaning in life and physical quality of life after rehabilitation: Mediating effects of positive experiences with physical exercises and mobility.

BACKGROUND: Indicators of emotional processes (positive experiences with physical exercises) and functional processes (mobility) were previously found to be associated with positive cognitive resources (meaning in life), and the key outcome in the rehabilitation, namely physical quality of life (QOL). Yet, the mediating roles of such processes were not tested. Therefore, this prospective study investigated whether the relationship between meaning in life and physical QOL was mediated by positive experiences with physical exercises and mobility. METHODS: Prospective data were collected at two measurement points, 1 month apart. A total of N = 339 participants (aged 19-84 years old, 57.9% women) provided data at Time 1 (T1) at the beginning of inpatient rehabilitation from central nervous system diseases (CNSD, e.g., stroke; n = 89) or musculoskeletal system diseases (MSD, e.g., dorsopathies; n = 250), and n = 234 at Time 2 (T2, the end of rehabilitation; 4 weeks after T1). Mediation analysis with meaning in life as predictor (T1), positive experiences with physical exercises and mobility as sequential mediators (T2), and physical QOL (T2) as the outcome was conducted. RESULTS: Higher meaning in life (T1) predicted more positive experiences with physical exercises (T2), which were associated with a higher level of mobility (T2), which in turn was associated with better physical quality of life (T2). CONCLUSIONS: Meaning in life at the beginning of inpatient rehabilitation may trigger positive experiences with physical exercises and functional changes in mobility levels, leading to better physical quality of life. Screening for low meaning in life may allow to identify patients who are at risk for a lack of improvement of mobility and physical quality of life during rehabilitation.

Meaning in life and physical quality of life: Cross-lagged associations during inpatient rehabilitation.

OBJECTIVES: This study investigated reciprocal associations between meaning in life and physical quality of life (QOL) in the rehabilitation context. It was hypothesized that a higher level of meaning in life at Time 1 (T1) would predict better physical QOL at Time 2 (T2), and that better physical QOL (T1) would predict a higher level of meaning in life (T2). RESEARCH METHOD: This longitudinal study enrolled 339 participants (aged 19-84 years, 57.9% women) who provided self-report data (T1) at the beginning of the inpatient rehabilitation for central nervous system diseases (CNSD; e.g., stroke; n = 89) or musculoskeletal system diseases (MSD; e.g., dorsopathies; n = 250), and at the end of the inpatient rehabilitation (T2, 1-month follow-up). Data were collected in 6 inpatient rehabilitation centers. Manifest cross-lagged panel analyses were conducted for the total sample. RESULTS: Path analyses indicated a significant cross-lagged-effect (.126, p < .002 [95% BCI: 0.020, 0.132]) from meaning in life (T1) to physical QOL at the follow-up (T2). Physical QOL (T1) did not precede meaning in life (T2). CONCLUSIONS: Among patients participating in rehabilitation due to CNSD or MSD, a higher level of meaning in life may precede better physical QOL. Interventions aimed at physical QOL improvement among patients who participated in an inpatient rehabilitation may benefit from a focus on raising patients' meaning in life. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Self-efficacy and quality of life among people with cardiovascular diseases: A meta-analysis.

PURPOSE/OBJECTIVE: Self-efficacy forms key modifiable personal resources influencing illness management, rehabilitation participation, and their outcomes such as perceived health-related quality of life (HRQOL) among people with a cardiovascular disease (CVD). Yet, an overarching research synthesis of the self-efficacy-HRQOL association in the CVD context is missing. This systematic review and meta-analysis of research on the self-efficacy-HRQOL relationship among people with CVD investigates whether the strength of associations depends on conceptualizations of self-efficacy and HRQOL (general vs. specific), presence of cardiovascular surgery, the type of CVD diagnosis, and patients' age (up to 60 vs. older than 60). Research Method/Design: We searched the following databases: PsycINFO, PsycARTICLES, Academic Search Complete, Health Source: Nursing/Academic Edition, and MEDLINE. This search resulted in 17 original studies (k = 18 samples) included in the meta-analysis. RESULTS: Findings suggested that stronger self-efficacy was associated with better HRQOL (r = .37; 95% CI [.29, .44]). Moderator analyses indicated stronger associations when HRQOL was measured in a general way (compared to CVD-specific) and when self-efficacy was measured in a general or exercise-specific way (as opposed to CVD symptom-specific). Self-efficacy-HRQOL associations were similar in strength across age groups, regardless of presence of cardiovascular surgery, and among patients diagnosed with different forms of CVD. CONCLUSIONS/IMPLICATIONS: General and exercise-specific self-efficacy are moderately related with HRQOL among people with CVD after surgery or during rehabilitation. Results need to be interpreted with caution due to heterogeneity of original research and the dominance of cross-sectional designs. (PsycINFO Database Record

Meaning in life and physical health: systematic review and meta-analysis.

This systematic review and meta-analysis aimed to clarify the associations between meaning in life and physical health using random-effects models. Conceptualisation of meaning (order in world vs. purpose in life), type of health indicators, participants' health status, and age issues were investigated as moderators. Systematic searches of six databases resulted in inclusion of k = 66 studies (total N = 73,546). Findings indicated that meaning in life and physical health formed weak-to-moderate associations (the overall estimate of the average effect = 0.258). Conceptualisation of meaning, participants' health status, and their age did not moderate these associations. Operationalisation of health moderated the relationship between meaning in life and health. The strongest associations were found for subjective indicators of physical health. Significant albeit weak associations between meaning in life and objective indices of health were found. Furthermore, stronger effects were observed when the measures of meaning combined items referring to meaning in life and meaning-related sense of harmony, peace, and well-being, compared to measures focusing solely on meaning in life. Overall, the results point to the potential role of meaning in life in explaining physical health.