Transactional Model of Parental Adjustment and Caregiving Burden Following a Children's Acquired Disability

Objectives Pediatric-acquired disability is often a crossroads in the lives of children and their parents, as they set out to adjust to a new physical impairment. This longitudinal study examined associations between the severity of children’s-acquired disability, their parents’ caregiver burden and adjustment, and parents’ perception of the children’s adjustment over time. Methods Participants were parents and medical staff of 140 children with acquired disability, aged 1–18, hospitalized in pediatric or rehabilitation departments. Data were collected about 1 month after diagnosis (T1) and about 4 months later (T2). Parents completed background information, caregiver burden, child, and parental adjustment questionnaires. Medical staff contributed the disability severity indices. Results The severity of the child’s disability was negatively associated with parents’ adjustment and perception of the child’s adjustment. Caregiver burden was positively associated with the severity of the disability, and negatively with parents’ adjustment and perception of their child’s adjustment, at both time points. Over time, the severity of the disability and caregiver burden decreased, and parents’ adjustment and perception of the child’s adjustment improved. At T2, parents’ and children’s adjustment were strongly associated. Conclusions The findings revealed the relationship between objective severity indices and caregiver burden. They suggest that parents’ adjustment may affect their perception of the child’s adjustment to disability, and emphasize the role of parental perceptions over time. Therefore, parents who are less likely to adjust effectively should be identified early on to facilitate professional intervention.

Claimants’ views on total and permanent disability insurance claims

PurposeThis study aims to investigate Australian claimants’ experience of the total and permanent disability (TPD) insurance claims process and documents their recommendations for improvement.Design/methodology/approachA qualitative methodology was used. In all, 12 claimants with finalized TPD claims were recruited via their superannuation fund. Data collected from in-depth interviews were thematically analyzed and reported using the COREQ checklist. Extracts from verbatim transcription were included to represent the claimant without bias.FindingsMost interviewees described a flawed claims process in which important information was withheld or unclear, procedures were complicated and arduous, communication was poor and frequent need for “chasing up” was frustrating. The claims process undermined the well-being of many interviewees at a critical time in their adjustment to disability. Lump sum payment yielded unexpected consequences for ten interviewees. Some interviewees retained a desire to work despite serious disability.Research limitations/implicationsThe use of purposive sampling means that findings may not represent the experience of all claimants with finalized TPD claims. Saturation of knowledge was reached despite the relatively small number of in-depth interviews conducted. In the absence of previous research, this study identifies areas of concern in the TPD claimant experience and posits a set of important claimant issues for further investigation.Practical implicationsA person-centred approach is needed. Claimants would benefit from introduction of clear process information, a single point-of-contact throughout claim, advocacy/support and rehabilitation.Originality/valueThis inaugural study provides an understanding of challenges faced by TPD claimants. All interviewees provided suggestions for improvement in the TPD claims process.

The Importance of Educational Level and Occupation to Adjustment to Disability Among Mobility Impaired People

Every disability results in array of reactions ranging from negative affectivity to successful acceptance of disability among mobility impaired people. Previous studies suggest that educational level and occupation are potential variables affecting adjustment to disability but there is a lack of research analysing how these variables are related to individual’s reactions to disability. The aim of the study was to assess the importance of educational level and occupation to adjustment to disability among mobility impaired people. The study sample included 275 mobility impaired individuals, aged between 18 and 79. Their adjustment to disability was assessed using two questionnaires: 1) Reactions to Impairment and Disability Inventory (Livneh & Antonak, 1990), measuring six emotional reactions to disability: denial, depression, internalized anger, externalized hostility, acknowledgement and adjustment; 2) Acceptance of disability scale (Linkowski, 1971). The results revealed that individuals with higher educational level reported less internalized anger and externalized hostility compared to individuals with lower educational level. In addition, employed individuals expressed less depression and internalized anger and greater adjustment than unemployed individuals. Individuals who were students at the time reported less depression and greater denial, acknowledgement and adjustment to disability compared to those who were unemployed. Students also perceived greater externalized hostility than employed individuals. The results of linear regression indicated that employment and student status but not disability related variables significantly explained the variance of acceptance of disability.

Compassion and Self-compassion: Conceptualization of and Application to Adjustment to Disability

For many, disability may ignite feelings of grief, sadness, loss, and/or emotional pain. Others discover they harbor negative or self-critical thoughts and beliefs (i.e., blame) which compounds and complicates the personal coping process. Adjustment to disability models exist to help persons with disabilities and professionals understand or explain their negative thoughts, feelings, and experiences; yet, they do not overtly discuss or address emerging skills and approaches such as compassion and selfcompassion as a part of the disability adjustment process. In an effort to change this trend, an eclectic theoretical model which infuses self-compassion and compassion-based techniques has been developed. Rehabilitation counselors are provided with an explanation of the ways existing research on compassion and self-compassion can be used to strengthen their application to the adjustment needs of persons with disabilities. Information about how to incorporate compassion and self-compassion into the rehabilitation counseling adjustment process and recommendations are also provided.