HEALING PATHWAYS: A PROGRAM FOR WOMEN WITH PHYSICAL DISABILITIES AND DEPRESSION

2.50
Hdl Handle:
http://hdl.handle.net/10755/211665
Type:
Research Study
Title:
HEALING PATHWAYS: A PROGRAM FOR WOMEN WITH PHYSICAL DISABILITIES AND DEPRESSION
Abstract:
Purposes/Aims: The purpose of this research was to develop the Healing Pathways program and to test its efficacy. We tested the following two hypotheses: H1: Women with physical disabilities (WPD) receiving Healing Pathways will demonstrate a greater improvement in depressive symptom scores than WPD in the wait-list control group. H2: WPD receiving Healing Pathways will demonstrate a greater improvement in coping, health behavior, global self-esteem, body and sexual self-esteem, and loneliness compared to WPD in the wait-list control group. Rationale/Conceptual Basis/Background: Depression in WPD is associated with increased risk of subsequent physical illness, premature mortality, and decreased physical functioning. Up to 50% of WPD experience clinically significant depressive symptoms. To help address this problem and expand treatment access we developed and tested a successful peer-implemented group therapy program named Healing Pathways (HP). HP draws on strengths-based and cognitive behavioral therapy approaches to treatment and is grounded in Independent Living philosophy. Methods: Healing Pathways was developed and tested across two community-based participatory research studies using mixed methods. The first study provided support for initial development of the HP program and allowed us to test the feasibility of the study design. The second study was an efficacy trial. WPD requiring some form of accommodation who also reported significant depressive symptoms as measured by the Center for Epidemiologic Depression Scale were the target population for both studies (n= 88 and 90). Efficacy trial participants were randomized to an initial intervention group or a wait-list group. Data were collected over 7 time points. We conducted both per protocol (PP) and intent-to-treat (ITT) analyses on the first four time points. Analysis of data from the remaining three time points is still in progress. Results and Implications: We found support for H1 based on both PP and ITT analyses. Depressive symptom scores significantly improved for WPD in the treatment compared to the control group F(3,192)=6.70, p<.001, partial η2=.10. We found partial support for H2 based on both PP and ITT. Global self-esteem F(2.80,179.47)=10.08, p<.001, partial η2=.14 and positive health behavior F(2.79,178.35)=4.61, p<.01, partial η2=.07 scores both significantly improved for the treatment compared to the control group. Based on PP analysis we also found support for improvement in loneliness scores F(3,192)=7.89, p<.001, partial η2=.11 for the treatment compared to the control group. Finally using either PP or ITT we found significant improvements in scores for four coping sub-scales measured by the brief COPE. No significant improvement in body and sexual-self esteem scores was found. All results were sustained over three month follow-up. Implications: HP has demonstrated efficacy in treating depressive symptoms in WPD. This efficacious program offers WPD a meaningful treatment option outside of the mainstream health care system that is low cost, accessible, and culturally appropriate. This research was funded by the National Institute of Disability and Rehabilitation Research H133G060135 and the National Institute of Mental Health 1R01MH079818-1A.
Keywords:
Physical disability; Women; Depression in women
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
4761
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleHEALING PATHWAYS: A PROGRAM FOR WOMEN WITH PHYSICAL DISABILITIES AND DEPRESSIONen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211665-
dc.description.abstractPurposes/Aims: The purpose of this research was to develop the Healing Pathways program and to test its efficacy. We tested the following two hypotheses: H1: Women with physical disabilities (WPD) receiving Healing Pathways will demonstrate a greater improvement in depressive symptom scores than WPD in the wait-list control group. H2: WPD receiving Healing Pathways will demonstrate a greater improvement in coping, health behavior, global self-esteem, body and sexual self-esteem, and loneliness compared to WPD in the wait-list control group. Rationale/Conceptual Basis/Background: Depression in WPD is associated with increased risk of subsequent physical illness, premature mortality, and decreased physical functioning. Up to 50% of WPD experience clinically significant depressive symptoms. To help address this problem and expand treatment access we developed and tested a successful peer-implemented group therapy program named Healing Pathways (HP). HP draws on strengths-based and cognitive behavioral therapy approaches to treatment and is grounded in Independent Living philosophy. Methods: Healing Pathways was developed and tested across two community-based participatory research studies using mixed methods. The first study provided support for initial development of the HP program and allowed us to test the feasibility of the study design. The second study was an efficacy trial. WPD requiring some form of accommodation who also reported significant depressive symptoms as measured by the Center for Epidemiologic Depression Scale were the target population for both studies (n= 88 and 90). Efficacy trial participants were randomized to an initial intervention group or a wait-list group. Data were collected over 7 time points. We conducted both per protocol (PP) and intent-to-treat (ITT) analyses on the first four time points. Analysis of data from the remaining three time points is still in progress. Results and Implications: We found support for H1 based on both PP and ITT analyses. Depressive symptom scores significantly improved for WPD in the treatment compared to the control group F(3,192)=6.70, p<.001, partial η2=.10. We found partial support for H2 based on both PP and ITT. Global self-esteem F(2.80,179.47)=10.08, p<.001, partial η2=.14 and positive health behavior F(2.79,178.35)=4.61, p<.01, partial η2=.07 scores both significantly improved for the treatment compared to the control group. Based on PP analysis we also found support for improvement in loneliness scores F(3,192)=7.89, p<.001, partial η2=.11 for the treatment compared to the control group. Finally using either PP or ITT we found significant improvements in scores for four coping sub-scales measured by the brief COPE. No significant improvement in body and sexual-self esteem scores was found. All results were sustained over three month follow-up. Implications: HP has demonstrated efficacy in treating depressive symptoms in WPD. This efficacious program offers WPD a meaningful treatment option outside of the mainstream health care system that is low cost, accessible, and culturally appropriate. This research was funded by the National Institute of Disability and Rehabilitation Research H133G060135 and the National Institute of Mental Health 1R01MH079818-1A.en_GB
dc.subjectPhysical disabilityen_GB
dc.subjectWomenen_GB
dc.subjectDepression in womenen_GB
dc.date.available2012-02-20T12:07:12Z-
dc.date.issued2012-02-20T12:07:12Z-
dc.date.accessioned2012-02-20T12:07:12Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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