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Predictors of Psychological Distress and Confidence Negotiating Physical and Social Environments Among Mobility
W Ben Mortenson1, François Routhier, Atiya Mahmood
1From the Department of Occupational Sciences and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (WBM, MP, DL, WCM); International Collaboration on Repair Discoveries (ICORD), Vancouver, British Columbia, Canada (WBM); Rehabilitation Research Program, Vancouver Coastal Health Research Institute (VCHRI), Vancouver, British Columbia, Canada (WBM, MP, DL, WCM); Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, Québec, Canada (FR); Centre interdisciplinaire de recherche en réadaptation et en intégration sociale, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Québec, Canada (FR); Department of Gerontology, Faculty of Arts and Social Sciences, Simon Fraser University, Burnaby, British Columbia, Canada (AM); Disability and Human Development Department, University of Illinois at Chicago, Chicago, Illinois (DL); Reichwald Family UBC Southern Medical Program Chair in Preventive Medicine, Vancouver, British Columbia, Canada (KAM); and Department of Medicine, Faculty of Medicine, School of Health and Exercise Sciences, Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, British Columbia, Canada (KAM).
Objective:
We conducted an intersectional analysis to explore how demographic characteristics and mobility device use were associated with psychological distress (depression and anxiety) and confidence negotiating physical and social environments.
Design:
Cross-sectional data were collected using the Hospital Anxiety and Depression Scale, modified Wheelchair Use Confidence Scale, and self-reported functional independence scale.
Participants:
The sample included 105 participants. Primary mobility devices used included mobility scooters (27%), power wheelchairs (26%), manual wheelchairs (25%), walkers (11%), and cane or crutch (12%). The mean age of participants was 58 yrs, 53% were female, and 52% lived alone and were functionally independent with the use of assistive technology.
Results:
We were able to explain between 39% and 65% of the variance (adjusted R2) in the dependent variables with parsimonious regression models. Age was an independent predictor of all outcomes. Women were less confident negotiating the physical environment, and walker use was associated with depression and lower confidence negotiating physical environments, but increased confidence negotiating social environments.
Conclusions:
Age is associated with psychosocial outcomes for assistive device users, and those who use walkers may experience increased challenges with depression and negotiating the physical environment. Pending confirmatory research, the findings may have important implications for targeted interventions related to device provision.
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