Resilience and Function in Adults With Physical Disabilities: An Observational Study.

TitleResilience and Function in Adults With Physical Disabilities: An Observational Study.
Publication TypeJournal Article
AuthorsBattalio SL, Silverman AM, Ehde DM, Amtmann D, Edwards KA, Jensen MP
JournalArch Phys Med Rehabil
Date Published2016 Dec 18

OBJECTIVES: To determine if resilience is uniquely associated with functional outcomes (satisfaction with social roles, physical functioning, and quality of life) in individuals with physical disabilities, after controlling for measures of psychological health (depression and anxiety) and symptom severity (pain, fatigue, and sleep disturbance); and to examine the potential moderating effect of sex, age, and diagnosis on the hypothesized associations between resilience and function.

DESIGN: Cross-sectional survey study.

SETTING: Surveys were mailed (81% response rate) to a community sample of 1949 individuals with multiple sclerosis, muscular dystrophy, postpoliomyelitis syndrome, or spinal cord injury. Participants were recruited through the Internet or print advertisement (28%), a registry of previous research participants who indicated interest in future studies (21%), a departmental registry of individuals interested in research (19%), disability-specific registries (18%), word of mouth (10%), or other sources (3%).

PARTICIPANTS: Convenience sample of community-dwelling adults aging with physical disabilities (N=1574), with a mean Connor-Davidson Resilience Scale (10 items) score of 29.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Patient-Reported Outcomes Measurement Information System measures of Satisfaction with Social Roles and Activities and Physical Functioning, the World Health Organization's brief Older People's Quality of Life Questionnaire, and the Connor-Davidson Resilience Scale (10 items).

RESULTS: After controlling for age, age squared, sex, diagnosis, psychological health, and symptom severity, resilience was significantly and positively associated with satisfaction with social roles (β=.17, P<.001) and quality of life (β=.39, P<.001), but not physical function (β=.04, P>.05). For every 1-point increase in scores of resilience, there was an increase of .50 in the quality of life score and .20 in the satisfaction with social roles score. Sex also moderated the association between resilience and satisfaction with social roles (F1,1453=4.09, P=.043).

CONCLUSIONS: The findings extend past research, providing further evidence indicating that resilience plays a unique role in nonphysical functional outcomes among individuals with physical disabilities.

Full Text

What was this research about?

Living with a condition like spinal cord injury or muscular dystrophy can sometimes be challenging and stressful. Resilience describes how well we bounce back and keep going during stressful times. People with disabilities who are more resilient tend to be happier with their lives and their participation in social activities. They also tend to experience better moods, and lower levels of symptoms like pain and fatigue. In this study, we wanted to find out if the link between resilience and overall happiness held up for people regardless of their moods or physical symptoms.

What did the researchers do?

We surveyed about 1,600 people with either muscular dystrophy (MD), multiple sclerosis (MS), post-polio syndrome (PPS), or spinal cord injury (SCI). In the survey, we asked the respondents how resilient they felt. For example, we asked how much they felt that “having to cope with stress makes me stronger”. The respondents also answered questions about their overall quality of life, and questions about how satisfied they were with their involvement in important activities, like working, doing household chores, or spending time with family and friends. Finally, the respondents told us about their moods and physical symptoms, including experiences with depression, anxiety, pain, fatigue and sleep problems.

What did the researchers find?

We found that respondents who said they were more resilient also reported higher quality of life and were more satisfied with their participation in activities. These links held up even after we accounted for their mood and physical symptoms. This suggests that resilience is helpful even for people with depression, anxiety or more severe physical symptoms.

We also found that the link between resilience and satisfaction with activity participation was stronger for men than it was for women. This result is interesting and warrants more research to find out if men and women think of resilience differently.

How can you use this research?

Resilience helps keep us happy and engaged in life during times of stress. Some steps we can take to build our resilience include:

  • Finding meaning: Make time to participate in activities that have meaning to you, such as hobbies, spiritual activities, or volunteering.
  • Building connections: Focus on keeping up important relationships with friends and loved ones.
  • Mindfulness: Mindfulness meditation is a good way to practice managing your thoughts and feelings.
  • Gratitude: Focus on things you are grateful for, or the ways that stressful experiences might lead to growth. This can help build resilience.

Things you should know:

  • Developing our resilience can help us live satisfying lives despite stressful experiences.
  • People with physical disabilities may have a higher risk of becoming depressed. If you are concerned that you or a loved one might be depressed, take a look at our fact sheet on How to Cope with Depression.

Original research article:

Battalio SL, Silverman AM, Ehde DM, Amtmann D, Edwards KA, Jensen MP. (2017) Resilience and function in adults with chronic physical disabilities: An observational study. Archives Phys Med and Rehabil.

PubMed ID27993585