Community Integration Scores Research Articles

Professional reintegration of stroke survivors and their mental health, quality of life and community integration.

To assess the association between professional reintegration and mental health, quality of life (QoL) and community reintegration of stroke survivors. Using a cross-sectional study design, a structured questionnaire was administered to previously working stroke survivors, 18-24 months post-stroke. Data on sociodemographic characteristics, professional reintegration (prevalence of return to work (RTW), period of RTW, job placement, function at work, reintegration support, association of stroke with work and number of working hours), mental health (Hospital Anxiety and Depression Questionnaire), QoL (Stroke Specific Quality of Life Scale) and community integration (Community Integration Questionnaire) were reported by 553 stroke survivors. Twenty months after stroke, 313 (56.6%; 95%CI 52.4-60.8) stroke survivors had return to work. RTW was positively associated with both global and sub-domains scores of Community Integration Questionnaire (CIQ) (global CIQ β = 3.50; 95%CI 3.30-3.79) and with depressive symptomatology (β = 0.63; 95%CI 0.20-1.46) measured by the Hospital Anxiety and Depression Scale. No significant differences were found regarding QoL, according to RTW status. For those who RTW, no significant associations were found between any of the professional reintegration determinants assessed and mental health, QoL and community integration scores. RTW seems to be associated to better community integration after stroke, but appears to be negatively associated to stroke survivor's mental health, namely considering depression symptoms. Future studies should explore the barriers to stroke survivors' RTW and the challenges and strategies used to overcome them, to allow the development of professional reintegration policies.

Variables associated with higher community integration among permanent supportive housing residents

ABSTRACT Few studies have used a framework for exploring a broad range of resident characteristics, housing, and service use features that might increase community integration among permanent supportive housing (PSH) residents who have lived in scattered-site or single-site PSH for 6 months to 5+ years. This study is original in identifying predisposing, enabling, and need factors associated with higher community integration among PSH residents. PSH residents from Quebec (Canada) were recruited through 25 housing organizations between January 2020 and April 2022. Structured interviews using numerous standardized scales were conducted, each lasting about 90 minutes. Based on the Gelberg-Andersen Behavioral Model, independent variables, measured mostly within 12 months of the interview, were categorized into predisposing, need, and enabling factors. Multivariate linear regression analysis was produced on community integration. Those experiencing moderate to severe psychological distress and having more unmet needs had lower community integration scores. Conversely, residents in single-site PSH located in neighborhoods with good physical conditions and high collective effectiveness, and those who received more outpatient services showed better community integration. Enhancing intergovernmental collaboration to develop high-quality PSH in well-maintained neighborhoods, focusing on socialization and community participation, especially for scattered-site PSH residents, may contribute to improved community integration.

Association of social integration with cognitive function trajectories among Chinese older adults: evidence from the China health and retirement longitudinal study (CHARLS).

The prevalence of cognitive impairment among older adults remains high. It has been proven that social integration is related to cognitive function. However, limited research has examined the association of social integration and its different dimensions with cognitive function trajectories of older adults. The data were from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2013 (T1) to 2018 (T3). A total of 3,977 older adults were included in the final analysis. Cognitive function was measured with items from an adapted Chinese version of the Mini-Mini-Mental Mental State Examination (MMSE), while the measurement of social integration included three dimensions: economic integration, relational integration and community integration. A group-based trajectory model (GBTM) was used to identify cognitive trajectory groups among participants and an unordered multinomial logistic regression was employed to explore the association of baseline social integration and its three dimensions with cognitive function trajectories. Three cognitive function trajectory groups were identified: low-decline group (24.1%), medium-decline group (44.2%) and high-stable group (31.7%). Comparing to the medium-decline trajectory group, older adults with higher social integration scores were more likely to be in the high-stable trajectory group (OR = 1.087, 95%CI: 1.007 ~ 1.174), while less likely to be in the low-decline group (OR = 0.806, 95%CI: 0.736 ~ 0.882). Among the different dimensions of social integration, older adults with higher community integration scores were more likely to be in the high-stable trajectory group (OR = 1.222, 95%CI: 1.026 ~ 1.456); Older adults with higher relational integration scores were less likely to be in the low-decline trajectory group (OR = 0.816, 95%CI: 0.734 ~ 0.906). The economic integration was not found to correlate with the cognitive function trajectories. Stratified analyses revealed that the association between community integration and cognitive trajectories was only significant among older adults aged 60 to 69, and the association between relational integration and cognitive trajectories was only significant among older adults who was agricultural household registration. The developmental trajectories of cognitive function among Chinese older adults are heterogeneous. Social integration is significantly related to the trajectories of cognitive function in Chinese older adults. Measures should be taken to promote social integration of Chinese older adults to reduce the decline of cognitive function.

'The Big Island Model': Resident experiences of a novel permanent supportive housing model for responding to rural homelessness.

Research on rural homelessness focuses primarily on describing the experiences and prevalence of homelessness in rural contexts, with little focus on intervention strategies. We conducted a case study of the 'Big Island Model' (BIM), a novel approach to providing housing and support to individuals experiencing homelessness that has been developed for, and reflects, a rural context. We interviewed 13 participants (n=10 men; n=3 women) supported by the BIM using mixed interviews including qualitative and quantitative components exploring experiences of living within this model and aspects of psychosocial well-being. Descriptive statistics were calculated to represent demographic data and participants' scores on standardised measures. Wilcoxon signed-rank tests were conducted with threshold scores and population norms derived from existing literature to identify any differences between residents' median scores on each standardised scale and scores derived from published literature. Qualitative data were analysed using thematic analysis. On measures of meaningful activity, residents reported significantly lower levels of boredom (p < 0.01) and a greater degree of engagement in productivity (p < 0.01) compared with participants in other studies. Mental well-being was reported to be higher (p < 0.05) and drug use was significantly lower than a low-moderate range (p < 0.01). Community integration scores revealed significantly lower physical integration (p < 0.05) and significantly higher psychological integration than individuals who had transitioned to housing in another study (p < 0.001). Our analysis of qualitative interviews resulted in the identification of a central essence characterising residents' experiences: 'Becoming Through Belonging'. This essence was represented by four distinct themes: (1) the healing qualities of nature; (2) being meaningfully occupied; (3) living in a mutually supportive environment; and (4) this place is here to help.

Racial/Ethnic Disparities in Longitudinal Trajectories of Community Integration After Burn Injury.

The aim of this study was to examine potential racial/ethnic disparities in community integration for the 2 yrs after burn injury. A sample of 1773 adults with burn injury from the Burn Model Systems database was used with data on community integration collected at discharge (preinjury recall), 6, 12, and 24 mos after discharge. Four sets of hierarchal linear models determined the most appropriate model for understanding racial/ethnic differences in Community Integration Questionnaire trajectories over time. Data indicated a decrease in community integration between discharge and 6 mos, a slight increase between 6 mos and 1 yr, and then a plateau between 1 and 2 yrs. White individuals had higher community integration score trajectories over time than black (b = 0.53, P < 0.001) and Hispanic (b = 0.58, P < 0.001) individuals, and community integration scores were similar between black and Hispanic individuals (b = -0.05, P = 0.788). These racial/ethnic disparities remained after accounting for age, sex, total burned surface area, number of days in rehabilitation, and active range of motion deficits. Additional rehabilitation resources should be targeted to helping black and Hispanic individuals integrate back into their communities after burn injury.

Community Integration and Quality of Life: Stroke Survivors as Recipients of Rehabilitation by Village Health Volunteers (VHVs) in Thailand

This study investigated the effectiveness of rehabilitation services provided by trained Village Health Volunteers (VHVs) on community integration and quality of life (QOL) for stroke patients in Thailand. Community integration and QOL were measured before receiving rehabilitation and at three months post-intervention. Twenty-five stroke subjects from four rehabilitation centers were recruited by purposive sampling. The statistics used were descriptive and paired t-test. The community integration scores increased significantly (p < .05) from pre-test (mean = 9.80 ± 3.96) to post-test (mean = 11.44 ± 4.68). The QOL scores also significantly (p < .05) increased from pre-test (mean = 71.44 ± 8.38) to post-test (mean = 84.88 ± 12.07). Results demonstrate that rehabilitation services provided by trained VHVs can promote community integration and QOL for stroke survivors.

Community integration of adults with disabilities post discharge from an in-patient rehabilitation unit in the Western Cape.

IntroductionCommunity integration is an important outcome of rehabilitation, because the ultimate focus of rehabilitation is to enable people to participate in their life roles.AimTo determine community integration scores achieved by adults with disabilities post discharge from an in-patient rehabilitation centre in the Western Cape Province.MethodFifty-nine individuals participated in this cross-sectional study. Community integration was determined using the Reintegration to Normal Living Index (RNLI). Descriptive analysis of age, gender, medical diagnosis and RNLI scores was performed. Kruskal–Wallis test and t-tests were used to determine whether there exists any relationship between age, gender, medical diagnosis and RNLI scores (p < 0.05).ResultsParticipants’ mean age was 45 (± 15.9) years. Of the study participants, 54% were women. The most common diagnosis was stroke (41%), followed by spinal cord injury (30%). The mean overall RNLI score was 66.3 (± 25.5). Persons with brain trauma (stroke or head injury) had a mean of 60.9 (±20.3); those with spinal cord injury had a mean of 75.2 (± 25.8) and those with peripheral impairments had a mean of 65.5 (± 30.5). The RNLI domains ‘personal relationships’ 73.45 (± 31.6) and ‘presentation of self’ 72.13 (± 35.4) recorded the highest mean scores. The domain ‘work or meaningful activities’ had the lowest mean score 52.54 (± 35.3). ‘Community mobility’ (59.9; ± 34.6) and ‘recreation’ (57.3; ± 37.2) also had mean scores below 60. No statistically significant relationships were found between age, gender and medical diagnosis and RNLI scores.ConclusionThe relatively low mean scores indicate that participants achieved poor community reintegration.

A mixed methods analysis of housing and neighbourhood impacts on community integration among vulnerably housed and homeless individuals

The current longitudinal study used mixed methods to examine the relationship of housing and neighborhood characteristics and community integration among a population of homeless and vulnerably housed individuals. Participants were recruited at homeless shelters, meal programs, and rooming houses in Ottawa, Canada, and participated in 3 in-person interviews, each approximately 1 year apart. Participants were placed into either a “high” or a “low” integration group based on their community integration scores at Follow-up 1 and Follow-up 2. There were 14 high and 32 low integration participants at Follow-up 1, and 17 high and 35 low participants at Follow-up 2. A general inductive approach to analyzing qualitative data was used to code the data. The most salient themes that affected community integration involved substance use in one's housing and neighborhood, neighborhood safety and location, and housing quality. Implications for service provision and policy advancements to better address community integration are discussed.

Schizophrenia Remission Is Unstable in Older Adults

Schizophrenia Remission Is Unstable in Older Adults

Introduction to the Special Section: Toward Social Inclusion

Introduction to the Special Section: Toward Social Inclusion

Community integration following moderate to severe traumatic brain injury: A longitudinal investigation

To evaluate the course and identify determinants of community integration for up to 3 years following moderate to severe traumatic brain injury. Prospective cohort study. A total of 119 moderate to severe traumatic brain injury patients aged 16-67 years. The Community Integration Questionnaire was completed at 3, 6, 12, 18, 24 and 36 months post-injury. Repeated measures analysis of variance was performed to determine changes over time in the Community Integration Questionnaire and its subscales. Bivariate and multivariate regression analyses were used to identify determinants of community integration 36 months post-injury. Compared with pre-injury, mean home integration, social integration, productivity, and total questionnaire scores decreased 3 months post-injury. Patient scores showed maximal improvement during the first year post--injury. Mean home integration, productivity, and total scores increased to a lesser extent during years 1-3 post-injury. Age, Barthel Index scores, hospital discharge destination, and pre-injury community integration scores were the major determinants of community integration 36 months post-injury (R2 = 60%). After an initial decline, mean community integration scores gradually improve following moderate to severe traumatic brain injury. Understanding the course and determinants of community integration is necessary in order to determine functional prognosis following traumatic brain injury.

A Trial of Neuropsychologic Rehabilitation in Mild-Spectrum Traumatic Brain Injury

To test the effectiveness of a neuropsychologic rehabilitation program consisting of psychotherapy and cognitive remediation in the treatment of the affective and neuropsychologic sequelae of mild-spectrum traumatic brain injury (TBI). Single-blind randomized, wait-listed controlled trial, with repeated measures and multiple baselines. Outpatient clinic in northern New Jersey. Twenty persons with persisting complaints after mild and moderate TBI (11 in treatment group, 9 controls). The experimental group received both 50 minutes of individual cognitive-behavioral psychotherapy and 50 minutes of individual cognitive remediation, 3 times a week for 11 weeks. The control group was wait-listed and received treatment after conclusion of follow-up. Symptom Check List-90R General Symptom Index, plus scales of depression, anxiety, coping, attention, and neuropsychologic functioning. Compared with the control group, the treatment group showed significantly improved emotional functioning, including lessened anxiety and depression. Most significant improvements in emotional distress were noted at 1 month and 3 months posttreatment. Performance on a measure of divided auditory attention also improved, but no changes were noted in community integration scores. Cognitive behavioral psychotherapy and cognitive remediation appear to diminish psychologic distress and improve cognitive functioning among community-living persons with mild and moderate TBI.

Head injury in young adults: long-term outcome

Objective: To describe the long-term outcome 5 years after injury of young adults who were 15 to 19 years old at the time of their head injuries. Design: A retrospective cohort. The health records of 62 consecutive eligible subjects were abstracted for baseline sociodemographic, health, and injury variables. A telephone interview was administered to assess quality of life, impairment, disability, and handicap. Setting: Canada's largest trauma center, Sunnybrook Health Science Centre, Toronto, Canada. Subjects: Of the 58 subjects (94%) who were traced at follow-up, 51 agreed to participate. Main Outcome Measures: The Medical Outcomes Study SF-36, Head Injury Symptom Checklist, selected disability measures, Community Integration Questionnaire. Results: Of the 8 summary items of the Medical Outcomes Study SF-36, subjects scored lowest on mental health. There were no significant differences between mild and more severely injured groups in all quality of life measures. Subjects classified with mild head injury overall reported more symptoms from the Head Injury Symptom Checklist. Subjects with more severe injuries had lower community integration scores ( p < .05). Conclusions: Overall, mental health is an important area of concern at follow-up for all subjects. Adolescents with apparent mild head injury can have disabling symptoms many years after injury.

Social and psychological consequences of intergenerational occupational mobility.

Studies relating intergenerational mobility to disturbed emotional states and decreased participation in solidary groups present contradictory evidence. Recent theoretical work suggests that the relationship between mobility and its hypothesized detrimental consequences will hold to a greater extent in a traditional and static social order and to a lesser extent in a society already "modernized." Aside from conflicting empirical findings, methods used to determine the effects of mobility have been unable to control simultaneously for prior and current socioeconomic level. Using dummy-variable multiple-regression analysis, scores for Community Integration, Primary Affiliation, Family Participation, Manifest Anxiety, and Psychosomatic Symptoms show few overall systematic effects of mobility. Respondents moving upward two or more socioeconomic levels have significantly lower Community Integration scores and significantly higher Manifest Anxiety and Psychosomatic Symptom scores. Scores on the dependent variables are unaffected by moderate amounts of either upward or downward mobility. Among very downwardly mobile respondents, the scores are the reverse anticipated by theory. The results and implications for mobility theory are discussed.