Barriers to the long-term recovery of individuals with disabilities following a disaster.

This study examines how pre-existing disabling conditions influenced the recovery process of survivors of Hurricane Katrina. It focuses specifically on the barriers that hindered the recovery process in these individuals. Focus groups were convened in four Gulf Coast states with 31 individuals with disabilities who lived in or around New Orleans, Louisiana, prior to Hurricane Katrina in August 2005. Qualitative data were analysed using grounded theory methodology. Five themes emerged as the most significant barriers to recovery: housing; transportation; employment; physical and mental health; and accessing recovery services. While these barriers to recovery were probably common to most survivors of the disaster, the research results suggest that disability status enhanced the challenges that participants experienced in negotiating the recovery process and in acquiring resources that accommodated their disabilities. The findings indicate that, when disaster recovery services and resources did not accommodate the needs of individuals with disabilities, recovery was hindered. Recovery efforts should include building accessible infrastructure and services that will allow for participation by all.

Depression among parents of children with disabilities.

We examined the rate of depression among 110 parents of children with disabilities and tested a model to determine the unique factors associated with parental depression. Consenting parents completed measures of depression, family satisfaction, physical health, problem-solving abilities, stress appraisals, and child functional impairment. Participants were categorized as depressed or nondepressed based on their responses to the Patient Health Questionnaire (PHQ9; Kroenke, Spitzer, & Williams, 2001). Nineteen percent of the parents met screening criteria for depression. Regression analyses revealed that threat appraisals, poorer physical health, and lower family satisfaction were uniquely associated with depression status with 83.3% accuracy. These findings highlight the importance of family satisfaction, problem solving ability, physical health, and the influence of appraisal processes on depression among parents of children with disabilities.

Evaluating a dynamic process model of wellbeing for parents of children with disabilities: a multi-method analysis.

PURPOSE: The purpose of this study was to evaluate possible determinants of parent wellbeing using a contextual model of parent adjustment. METHOD: One hundred forty parents of children with various disabilities (i.e., autism, intellectual disabilities, and other health impairments) participated in this investigation. Parents completed a survey consisting of basic demographic characteristics of the parent, child-disability characteristics, parent problem solving ability, access to information and resources, environmental/social supports, appraisals of threat and growth, and measures of life satisfaction and physical/mental health. Structural equation modeling was conducted to test a hypothesized contextual model of parent wellbeing. RESULTS: Results indicated strong fit to the a priori model. After controlling for the contribution of parent demographic variables, the largest contributors to the prediction of parent wellbeing were parent problem solving ability, access to resources, environmental/social supports, and parent appraisals of threat. Child functional impairment was not significantly associated with parent wellbeing. CONCLUSIONS: Access to resources and environmental/social supports have a greater direct effect on parent wellbeing than parent and child demographic variables and disability severity. Threat appraisals have direct and mediating effects on parent wellbeing. Implications related to the importance of resources and environmental/social supports, appraisals of threat and growth, and problem solving abilities on the wellbeing of parents of children with disabilities are discussed.

Giving parents a voice: A qualitative study of the challenges experienced by parents of children with disabilities.

BACKGROUND: This study sought to examine the specific sources of challenges as identified by parents of children with disabilities. METHOD: Focus groups were conducted with 40 parent caregivers. Data gathered were coded into themes which were then analyzed through an intentional process of data reduction that resulted in the cross site validation of four superordinate themes. RESULTS: Four themes emerged as the most prominent barriers to positive parent wellbeing: (a) access to information and services, (b) financial barriers, (c) school and community inclusion, and (d) family support. These four themes are indicative of problems associated with a lack of match between caregiver needs and services, resources, or support available in the community to meet those needs. CONCLUSION: Caring for a child with a disability can be challenging, but many of these challenges are likely due to a lack of necessary environmental supports. Future research should expand on these findings and policy makers, scientists and providers should give particular attention to the environmental support needs of parents in order to create policies and interventions that are more family-centered.

Family satisfaction predicts life satisfaction trajectories over the first 5 years after traumatic brain injury.

OBJECTIVES: Examined the influence of functional impairment, stable marital status, and family satisfaction on life satisfaction trajectories for 609 individuals (435 men, 174 women) over the first 5 years after traumatic brain injury (TBI). MEASURES: Participants completed the Family Satisfaction Scale (FSS), Functional Independence Measure (FIM), and the Life Satisfaction Index (LSI) at years 1, 2, 4, and 5 after sustaining a TBI. RESULTS: Trajectory modeling revealed that higher family satisfaction was associated with increases in life satisfaction for individuals with less functional impairment. Stable marital status was not significantly associated with life satisfaction trajectories. IMPLICATIONS: Family satisfaction appears to have pronounced beneficial effects on life satisfaction for persons with less functional impairment after TBI regardless of marital status. In contrast, a stable marriage appears to have no apparent benefits to self-reported life satisfaction over the first 5 years post-TBI. Theoretical and clinical implications of these results are discussed.

Trajectories of life satisfaction in the first 5 years following traumatic brain injury.

OBJECTIVES: The trajectories of life satisfaction for 609 individuals who sustained a traumatic brain injury (TBI) were studied. Hierarchical linear modeling analysis examined individual level growth trends over the first 5 years following TBI using gender, functional independence, age, and time to estimate life satisfaction trajectories. MEASURES: Participants completed the Functional Independence Measure and the Life Satisfaction Inventory at years 1, 2, 4, and 5 after sustaining TBI. RESULTS: Participants who reported higher functional independence at year 1 also had higher life satisfaction at year 1. Participants with lower functional independence across the 5-year period had life satisfaction trajectories that decreased at significantly greater rates than the individuals with more functional independence. The life satisfaction trajectory declined for the sample, but participants reporting lower cognitive and motor functional independence had significantly greater declines in life satisfaction trajectories. Age and gender were not significant factors in predicting life satisfaction trajectories following TBI. IMPLICATIONS: Individuals with greater cognitive and motor impairments following TBI are likely to experience significant declines in life satisfaction within 5 years of living with TBI.