From 2011 to 2031, the Canadian population living with neurological conditions is expected to double, but the population able to give informal care is not keeping pace, leading to a greater care burden. One element of this increasing care burden is emotional care. However, the effects of giving emotional care on caregiver health outcomes have not been sufficiently explored in the caregiving literature, where the majority of studies focus on instrumental forms of care, or fail to differentiate between different aspects of caregiving. This problem is further complicated by findings from other contexts which indicate that emotional supporting and helping others actually benefits the supporter or helper. Informed by the stress process and other ancillary theories, I use data from the 2012 General Social Survey to test several hypotheses which may help us understand the mental health, functional health, and caregiver burden of caregivers of persons with neurological conditions who emotionally support their care receivers, and of caregivers who are the sole provider of emotional support. The results suggest that emotionally supporting a care receiver with a neurological condition is detrimental to caregiver mental health, and that being the sole emotional supporter is detrimental to caregiver mental health, functional health, and experience of burden. A significant interaction effect also exists between emotional supporting and caregiver gender for functional health. These findings have important implications for future research, for intervention planners, and for caregivers themselves. / Graduate / 2020-08-06

Contexte : Plusieurs approches thérapeutiques sont utilisées afin d’améliorer la mobilité en contexte de réadaptation. La danse-thérapie fait partie des approches innovantes auprès de populations ayant des troubles neurologiques. Une étude quasi expérimentale avec un groupe témoin n'a pas apporté d’évidence de l'efficacité d'un programme de danse-thérapie de 12 semaines, dispensé une fois par semaine à des personnes souffrant d'un handicap physique (DTDP) et visant à améliorer leur mobilité. Étant donné les avantages perçus de l'intervention, il était important de poursuivre les recherches. Méthode : Nous avons mené une étude expérimentale à cas unique avec la statistique Tau-U sur 28 semaines avec des mesures répétées (quatre outils pour évaluer la mobilité) dans la phase pré-danse (A1), la phase du programme de danse (B) et la phase post-danse (A2). L'échelle de l’état de flow (Flow State Scale, FSS) et l'échelle de confiance de l’équilibre spécifique à l'activité (ABC Scale) ont fourni des scores avant et après l'intervention. Résultats : Cinq participants ont amélioré de manière significative (p <0,05) leurs scores pour le Mini BESTest (MBT), 2/5 pour le 4 Square Step Test (4Sq) et 4/5 pour le Multi Directional Reach Test - Behind (MDRT-behind) avec de très grandes tailles d'effet (TE). Les TE agrégés pour A1 et A2 sont passés de modérés à très grandes. Les changements sur les échelles FSS et ABC n'étaient pas significatifs. Les objectifs personnels ont été perçus et mesurés comme atteints. Conclusions : Ces résultats suggèrent l'efficacité du programme DTDP pour les adultes souffrant de troubles neurologiques et l'utilisation du devis expérimental à cas unique avec la statistique Tau- U pour explorer l'efficacité des interventions en danse pour des cohortes hétérogènes. Les outils utilisés pour mesurer la mobilité semblent prometteurs pour détecter les changements dus à la danse. / Background: Several therapeutic approaches are used to improve mobility in rehabilitation settings. Dance therapy is one of the innovative approaches for populations with neurological disorders. A quasi-experimental study with a control group did not provide evidence to support the effectiveness of a 12-week weekly outpatient dance therapy program for persons with physical disability (DTPD) aimed at improving their mobility. Given the perceived benefits of the intervention, further investigation was important. Method: We conducted a single case experimental design (SCED) with the Tau-U statistic over 28 weeks with repeated measures (4 tools to assess mobility) in the pre-dance phase (A1), dance program phase (B) and post-dance phase (A2). The Flow State Scale and the Activity-specific balance confidence scale (ABC) provided scores pre-and post intervention. Results: Five participants significantly (p <0.05) improved scores for the Mini BESTest (MBT), 2/5 for the 4 Square Step Test (4Sq) and 4/5 for the Multi-Directional Reach Test – Behind (MDRT- behind) with very large effect sizes (ES). Aggregated ES for A1 and A2 went from moderate to very large. Changes on the FSS and ABC scales were not significant. Personal objectives were perceived and measured as attained. Conclusions: These results support the effectiveness of the DTPD program for adults with neurological conditions, and for the use of SCED with the Tau-U statistic to explore effectiveness of dance interventions for heterogeneous cohorts. The tools used to measure mobility appear promising to detect changes due to dance.