Doctoral Dissertation Research: Social Interaction Barriers and Mental Health among Older Adults with Physical Disabilities.

University Of Nebraska-Lincoln, Lincoln NE

Investigators

Abstract

Abstract: This project will explore perceived barriers to social interaction among older adults with physical disabilities in order to understand how these perceptions shape mental health. This research will enhance basic understanding of disability and older adult mental health by moving beyond understanding physical disability as directly linked to poorer mental health to emphasize how and why disability compromises emotional well-being. The findings will have a positive impact through their utility for various stakeholders of older adults' health by: informing intervention strategies of rehabilitation hospitals; helping families provide a supportive environment for recovery that enhances well-being; allowing health insurers to develop early and effective practices that reduce additional mental and physical health declines; and informing architects and designers of the ways in which older adults with physical disabilities encounter the physical environment to optimize implementation of the Americans with Disabilities Act (ADA). Over a third of older adults in the U.S. are physically disabled. Disablement likely restricts the ability to engage in interpersonal interactions and thus the mental health of older adults with physical disabilities may reflect unmet social needs. Understanding the processes that lead to lower social interaction among those with physical disabilities is important because social isolation is associated with not only poor mental health but also lower self-rated health, greater healthcare use and cost, and even mortality. The main objective of the project is to identify and explore how perceived interpersonal and environmental barriers to social interaction shape mental health among older adults with physical disabilities. To do this, the proposed project will employ a mixed methods design. Analyses of nationally representative survey data from the National Social Life, Health, and Aging Project (NSHAP) will be combined with in-depth interviews with older adults with physical disabilities. The survey data will be used to establish the association between physical disability, social interaction, and mental health. However, assessment of perceived barriers to social interaction, given their individualized nature, would be difficult to achieve through the standardized closed-response questionnaire design of large surveys. Consequently, semi-structured interviews with 60 older adults with physical disabilities who are (former) patients at a rehabilitation center in the Midwest will be used to allow for detailed exploration of individuals? perceptions of factors that make social interaction difficult. This project advances and the findings will test an expanded theoretical model that integrates biopsychosocial and stress process theories to identify perceived interpersonal and environmental barriers to social interaction as situationally dependent and thus intermittent stressors that shape the mental health of older adults with physical disabilities