title: Stress self-management: an intervention for women with physical disabilities.
abstract: OBJECTIVE
  We sought to develop and evaluate the efficacy of an innovative, theory-driven, group stress self-management intervention designed to ameliorate stress and promote health among women with physical disabilities such as spinal cord injury, multiple sclerosis, and arthritis.
  
  
  METHODS
  We recruited a voluntary sample of 78 community-living women with disabilities who were randomly assigned to either the group stress management intervention or the wait-listed control group, and we used a within- and between-groups pretest/posttest design with a 3-month follow-up.
  
  
  RESULTS
  Group differences in changes over time on measures of perceived stress and mental health offer support for the efficacy of the intervention. At the 3-month follow-up assessment, the intervention group also showed greater improvement on measures of pain and role limitations owing to physical health when compared the wait-listed control group. Perceived stress was supported as a mediator of the effect of the intervention on mental health. We found support for social connectedness and self-efficacy as mediators of the relation between the intervention and perceived stress; however, there was relatively weak evidence for differential change over time in those proposed mediators.
  
  
  CONCLUSIONS
  This study provides the first of its kind, that is, an evaluation of the efficacy of a stress self-management intervention designed specifically for women with physical disabilities. The results are consistent with a model in which the stress management intervention enhances self-efficacy and social connectedness, which leads to reduced stress, which then contributes to improved mental health.
authors.affiliation: Center for Research on Women with Disabilities, Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA. rhughes@ruralinstitute.umt.edu
authors.forename: Rosemary B
authors.initials: RB
authors.lastname: Hughes
authors.forename: Susan
authors.initials: S
authors.lastname: Robinson-Whelen
authors.forename: Heather B
authors.initials: HB
authors.lastname: Taylor
authors.forename: John W
authors.initials: JW
authors.lastname: Hall
mesh_terms: D000328:Adult; D000368:Aged; D001168:Arthritis / Q000523:psychology; D001294:Attitude to Health; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods*; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D012944:Social Support; D013119:Spinal Cord Injuries / Q000523:psychology; D013315:Stress, Psychological / Q000628:therapy*; D011795:Surveys and Questionnaires; D016387:Women's Health