EFFECTS OF A LEISURE EDUCATION PROGRAM ON ADJUSTMENT TO DISABILITY OF

249 Pages·2000·13.13 MB·English

EFFECTS OF A LEISURE EDUCATION PROGRAM
ON ADJUSTMENT TO DISABILITY
OF PERSONS WITH SPINAL CORD INJURY
AUDREY M. MCILRAITH
A Thesis
Submitted to the Faculty of Graduete Studies
in Partial Fulfillment of the Requirements
for the Degree of
MASTER OF SCIENCE
Faculty of Physical Education and Recreation Studies
University of Manitoba
Winnipeg, Manitoba
1*1 National Library Bibliothwue nationale
acanacîa du Canada
Acquisitions and Acquisitions et
Bibliogrephic Semices setvices bibliographiques
The author has granted a non- L'auteur a accordé une licence non
exclusive licence allowing the exclusive permettant à la
National Library of Canada to Bibliothèque nationale du Canada de
reproduce, loan, distribute or sel1 reproduire, prêter, distribuer ou
copies of this thesis in rnicrofonn, vendre des copies de cette thèse sous
paper or electronic formats. la forme de microfichelfilm, de
reproduction sur papier ou sur format
électronique.
The author retains ownership of the L'auteur conserve la propriété du
copyright in this thesis. Neither the droit d'auteur qui protège cette thèse.
thesis nor substantial extracts fiom it Ni la thèse ni des extraits substantiels
may be printed or otherwise de celle-ci ne doivent être imprimés
reproduced without the author's ou autrement reproduits sans son
permission. autorisation.
THE UNIVERSITY OF MANITOBA
FACULTY OF GRADUATE STUDIES
*****
COPYRIGHT PERMISSION PACE
Effects of a Leisun Education Program on Adjustment to Disability
of Penons with Spinal Cord Injury
Audrey M. Mcihaitb
A ThesislPracticum submitted to the Faculty of Gnduate Studies of The University
of Manitoba in partial fulfillment of the requirements of the degree
Master of Science
AUDREY M. MCILIRAITH O 2000
Permission hm ben granttd to the Library of The University of Manitoba to lend or seU
coplcr of this thesidpracticum, to the National Libnry of Canada to microlilm this
tbesis/pricdcum and to Iend or reU copies of the film, and to Dissertations Abstricts
Internationil to pubUsh an ibstract of this thcridpracticum.
The author rtservts other publication rights, and neithcr this theridpracticom nor extensive
estracts from it miy bt prlited or otbtrnist reproductd without the iuthor's written
permission.
TABLE OF CONTENTS
Page
.......................................................................................................................
ABSTRACT vi
ACKNOWLEDGEMENTS ........................................................................................... viii
LIST OF FIGURES ..........................................................................................................x.. .
LIST OF TABLES ...........................................................................................................x.i.
1 . INTRODUCTION .....................................................................................................1. ..
1 .0 Statement of the Problem ..................................................................................7..
1 .1 Hypotheses .........................................................................................................8
1.2 Assumptions ......................................................................................................8..
1.3 Delimitations ......................................................................................................8.
1.5 Definition of Terms ..........................................................................................1.0
2 . REVIEW OF LITERATURE ...................................................................................1. 2
2.0 Defining Adjustment to Disability ..................................................................1. 2
2.1 Measuring Adjustment to Disability ................................................................. 14
. .............................................................................
2.1 0 Measurcment Issues.. 16
2.2 Factors Studied in Adjustment to Disability ..................................................... 20
..................................................................................
2.2.0 Tirne Since Injury 20
.............................................
2.2.1 Level of Injury and Severity of Disability 24
.............................................................
2.2.2 Age and Age at Onset of Injury 26
.....................................................................................................
2.2.3 Pain 27
...............................................................
2.2.4 Other Demographic Variables 27
2.2.5 Penonality ........................................................................................ 29
..........................................................................
2.2.6 Environmental Factors 29
.......................................................................................
2.2.7 Social Support 30
..............................................................................................
2.3 Perceived Control 33
.......................................
2.4 Psychological Indicators of Adjustment to Disability 35
....................................................................................
2.4.0 Life Satisfaction 35
.................................
2.4.0.0 Life Satisfaction and Perceived Control 37
...........................................................................................
2.4.1 Depression -37
2.4.1 .0 Misconceptions About Post-SC1 Depression ........................3
...............................
2.4.1.0.0 Staff attitudes and depression 39
2.4.1 .0 . 1 Stage theories and depression ..............................4 0
. .........................................
2.4.1 1 Depression and Perceived Control 41
2.5 Leisure and Adjustment to Disability .............................................................4..2.
2.5 .0 Leisure and Perceived Control ............................................................4..3
.................
2.5.0.0 Perceived Control and Perceived Leisure Control 44
.................................................................
2.5.1 Leisure and Life Satisfaction 46
2.5.1 .0 Life Satisfaction and Leisure Satisfaction ........................ ... ...4 7
........................................................................
2.5.2 Leisure and Depression -49
.............................................................................................
2.6 Leisure Education 5 1
iii
....................
2.6.0 Leisure Education and Persons with Physical Disabilities 53
2.6.1 Leisure Education and Outcomes related to Psychological
Well-being ............................................................................................. 58
2.6.2 Leisure Education and Adjustment to Disability ..................................6 3
2.6.2.0 How Leisure Education Can Effect
Perceived Control and Perceived Leisure Control .................6 5
2.6.2.1 How Leisure Education Can Effect
Leisure Satisfaction and Life Satisfaction .............................. 67
2.6.2.2 How Leisure Education Can Effcct Depression .....................6 8
2.6.2.3 Flow Leisure Education Can Facili tate Community
Reintegration ......................................................................... 69
2.6.2.4 Timing of Leisure Education in SC1 Rehabilitation ...............7 0
2.7 Summary ..........................................................................................................7 2
...................................................................................................................
METHOD 73
.......................................................................................................
Participants 73
Design .................. . .......................................................................................7..4
......................................................................
Leisure Education Intervention 77
...........................................................................................................
Procedure 83
..................................................................................................
Instrumentation 88
............................................................................................................
Analysis 94
...................................................................................................................
RESULTS 95
......................................................................................
4.0 Correlational Analysis 99
.........................................................................
4.1 Social Validity Questionnaire 101
......................................................................................................
4.2 Field Notes 10 7
.........................................
4.3 Helps and Hindrances in Adjustment to Disability 113
4.3.0 Helpful Factors in Adjustment to Disability ................................... 113
4.3.1 Hindrances in Adjustment to Disability ................................... .....114
5. DISCUSSION ........................................................................................................1..1 7
........................................................................................
Pearson Correlations 121
Social Validity Questionnaire .......................................................................1..2 3
Field Notes ...................................................................................................1..2. 8
Factors that Help and Hinder Adjustment to Disability .................................1.3 3
Summary and Recommendations ....................................................................1 36
REFERENCES .............................................................................................................. 141
..............................................................................................................
APPENDICES 1 5 6
Initial Telephone Contact Protocol ................... . .....................................1 5 6
.................................................................................
Informed Consent Form 158
.....................................................................................................
Test Battery 163
C 1 Life Satisfaction Scale ........................................................................1. 64
......................................................................
C2 Perceived Control Scale 166
-
C3 Center for Epidemiological Studies Depression Scale. .....................1 67
........................................................
C4 Perceived Leisure Control Scale -168
...................................................................
C 5 Leisure Satisfaction Scale 170
.............................................................................
Leisure Education Program 172
......................................................................
Social Validity Questio~aire 1 8 3
Telephone Contact Protocol for Social Validity Questionnaire ......................1 85
............................................................................................
Participant Profile 187
.................................................................
Pre- and Post-test Battery Protocol 190
....................................................................................
CRP Participant Guide 194
ABSTRACT
The purpose of this study was to determine the effects of a leisure education prograrn on
life satisfaction, depression, perceived control, perceived leisure control, and leisure
satisfaction among adults who had sustained spinal cord injury (SCI)w ithin the previous
7 ycars and were living in the community. Thirty participants were matched on hoth
gender and age at onset and then randomly assigned to experimental and control group
conditions. AAer attrition, there were 12 experimental and 13 control groiip participants.
The experimental group received a leisure education program which occurred an average
of one and one third hours every week and a half over an average 7.5 weeks plus 4 weeks
of fading. Both groups were administered a test battery before and after the program to
assess the impact of the leisure education prognm on the five dependent variables.
Results of ANCOVA indicated the leisure education progrnm did noi have a statistically
significant effect on the five adjustment measures. The hypotheses, therefore, were
rejected. Pearson correlations indicated that life satisfaction, leisure satisfaction,
perceived control and perceived leisure control were positively correlated with each other
and that depression was negatively correlated with them. Independent samples t-tests
conducted on demographic variables showed no significant differences between the
control and experimental groups, indicating the groups were similar. Social validi t y
results suggested the leisure education had a positive impact on leisure satisfaction of
experirnental group participants, and identified baniers that hindered leisure participation.
Field notes also highlighted leisure barriers, and supported the person-centred, non-
vi
directional mode1 of leisure education. Pre-test findings on independent samples t-tests,
ANOVA, and Pearson correlations indicated that gender was a significant factor in
depression and perceived control, that time since injury was a factor in leisure
satisfaction, and that level of injury was a significant factor in depression. Participants'
comments highlighted both environmental and personal factors that helped and hindered
adjustment to disability, suggesting tliat leisure education interventions may be limited to
influencing persona1 factors related to adjustment to disability of persons with SCI.
vii
ACKNO WLEDGEMENTS
1 wish to gratefully acknowledge the people who have helped to make the
completion of this thesis possible. First, thank you to my advisor, Dr. Michael Mahon,
who very patiently encouraged me and wisely guided me through the rnany brainstonns
sessions that occurred during this research process. Your belief in my abilities and
ongoing support over the years has undoubtedly helped me to pursue and eam this
degree. Thank you to Dr. Jennifer Mactavish for her invaluable knowledge and attention
to detail, which helped guide and strengthen tliis research study. 1 also would like to
express my gratitude to Dr. Joe Kaufert, whose advice, expertise and insight into the
qualitative aspects of research enhanced this study immensely .
Thank you Dr. Dan Bailis for patiently assisting me to interpret the research
rcsults. To fellow student, Erika Bockstael, thank you for your generous and willing
assistance in this research. 1 would be remiss not to thank other fellow students including
Sandra Goatcher and Wendy Stewart for their support and friendship throughout this
process. A big bouquet to Maureen Rodrigue and Janice McGonigle for your ongoing
support as well.
The endless love and encouragement from my parents, Maria and Louis Baltus,
has made this joumey possible. Thanks Mom and Dad for believing in me and for helping
me always. Thank you so much to Mom and Dad McIlraith for your patience and support
throughout this joumey as well.
viii