Article

OBJECTIVE: To test mediating effects of positive emotion and activity restriction
on the associations of resilience and pain interference with distress reported by
individuals with traumatic upper limb loss evaluated for prosthetics. DESIGN:
Cross-sectional correlational study of several demographic and self-report
measures of resilience, pain interference, activity restriction, positive
emotions, and symptoms of depression and posttraumatic stress. SETTING: Six
regional centers throughout the United States. PARTICIPANTS:
A total of 263
prospective participants consented to be evaluated for eligibility and need for
upper extremity prosthetics; participants (N=202; 57 women [28.2%] and 145 men
[71.8%]; mean age, 41.81+/-14.83y; range, 18.01-72.95y) who sustained traumatic
injuries were retained in this study. Most of them were identified as white
(70.8%; n=143), followed by black (10.4%; n=21), Hispanic (9.9%; n=20), Asian
(3.0%; n=6), other (1.5%; n=3), and missing (4.5%; n=9). INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Primary Care Posttraumatic Stress Disorder
Screen and depression screen. RESULTS: Resilience and pain interference were
significantly correlated in predicted directions with positive emotions, activity
restriction, and the 2 distress variables. A path model revealed that the
associations of resilience and pain interference with both distress variables
were completely mediated by positive emotions and activity restriction. There
were no significant direct effects of resilience or pain interference on either
distress variable. CONCLUSIONS: Resilience may facilitate adjustment via
beneficial and predicted associations with positive emotions and active
engagement with the environment. These relations are independent of the
significant and inverse associations of pain interference with these same
variables. Longitudinal research is needed to understand interactions between
positive emotions and activity over time in promoting adjustment after traumatic
limb loss. Individuals reporting depression and/or posttraumatic stress disorder
symptoms may require interventions that reduce avoidance and promote activities
that may increase the likelihood of experiencing positive emotions.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS