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Bray EA, Hogan C, Mitchell J, Geraghty T, Ownsworth T. Impact of Early Personal Resources on Long-Term Psychosocial Outcomes After Moderate-to-Severe Traumatic Brain Injury: A Systematic Review. J Head Trauma Rehabil 2024:00001199-990000000-00157. [PMID: 38758101 DOI: 10.1097/htr.0000000000000958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
OBJECTIVE To investigate the relationship between preinjury or early personal resources and long-term psychosocial outcomes following moderate-to-severe traumatic brain injury (TBI) and examine evidence for the stability of personal resources over time. METHODS The review protocol was registered with the International Register of Systematic Reviews (PROSPERO, Registration No. CRD4202341056). A search of PsycINFO, Cumulative Index to Allied Health Literature (CINAHL), MEDLINE, Scopus, and Web of Science was conducted from inception to February 23, 2023, for longitudinal studies involving adults with moderate-to-severe TBI that examined: (1) the relationship between preinjury or early personal resources (measured ≤6 months postinjury) and later psychosocial outcomes or (2) stability of personal resources over time with a minimum reassessment interval of 3 months. Two reviewers independently assessed eligibility and rated methodological quality of studies using a checklist informed by Strengthening the Reporting of Observational Studies in Epidemiology. RESULTS A narrative synthesis was conducted on 14 eligible articles summarizing 12 studies (N = 826). Nine studies examined the impact of preinjury or early personal resources on long-term psychosocial outcomes, most typically at 12 months postdischarge. Out of 9 studies 7 indicated that self-reported preinjury or early personal resources, including productive coping, higher self-esteem and resilience, and lower neuroticism, were associated with better psychosocial outcomes. Evidence from 7 studies examining the stability of personal resources over time was generally mixed, with personality changes (eg, neuroticism, conscientiousness, and extraversion) more evident from informant ratings than self-ratings. CONCLUSION Preinjury or early personal resources may influence later psychosocial outcomes after TBI. Further research is needed to investigate the stability of personal resources and factors mediating or moderating change across the adjustment trajectory.
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Affiliation(s)
- Emily Alice Bray
- The Hopkins Centre, Menzies Health Institute Queensland (Drs Bray, Hogan, and Mitchell, Dr Geraghty, and Dr Ownsworth), School of Applied Psychology (Dr Ownsworth) Griffith University, Brisbane, Queensland, Australia; and Division of Rehabilitation (Dr Geraghty), Metro South Health Hospital and Health Service, Brisbane, Queensland, Australia
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Hodel J, Sabariego C, Galvis Aparicio M, Scheel-Sailer A, Seijas V, Ehrmann C. Revisiting functioning recovery in persons with spinal cord injury undergoing first rehabilitation: Trajectory and network analysis of a Swiss cohort study. PLoS One 2024; 19:e0297682. [PMID: 38335188 PMCID: PMC10857630 DOI: 10.1371/journal.pone.0297682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/10/2024] [Indexed: 02/12/2024] Open
Abstract
Information about an individual's functioning and its longitudinal development is key to informing clinical rehabilitation. However, the description and understanding of the detailed longitudinal course of functioning, i.e., functioning trajectories, is rare in the current SCI literature. The aim of this study was to re-estimate previously identified functioning trajectories of individuals with spinal cord injury (SCI) undergoing initial rehabilitation in Switzerland using trajectory analysis, and to identify highly influential functioning domains that could become trajectory-specific targets for clinical interventions using network analysis. The study was based on data from the Swiss SCI Cohort Study and included individuals with SCI (N = 1099) who completed their rehabilitation in one of four collaborating centers between May 2013 and March 2022. For the trajectory analysis, functioning was operationalized using the total sum score of the Spinal Cord Independence Measure version III (SICM III), which was assessed at up to four time points (T1-T4) during rehabilitation. For the network analysis, individual SCIM III items were used to operationalize relevant functioning problems at T1 (admission) and T4 (discharge). The re-estimation of trajectory analysis confirmed the previously identified mean functioning trajectory classes of stable high functioning (N = 239; 21.75%), early (N = 33; 3.00%), moderate (N = 753; 68.52%), and slow (N = 74; 6.73%) functioning improvement. The network analysis revealed highly connected functioning problems at T1 for the moderate functioning improvement class, including "Feeding", "Dressing upper body", and "Dressing lower body", "Mobility in bed", and "Use of toilet". These functioning domains might indicate potential trajectory-specific targets for clinical interventions. This study has increased our knowledge about functioning trajectories of individuals with SCI undergoing initial rehabilitation in Switzerland and its findings may inform discussions about the application and use of functioning trajectories in clinical practice. Due to the exploratory nature of this study, further research is needed to confirm the findings presented.
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Affiliation(s)
- Jsabel Hodel
- Swiss Paraplegic Research, Nottwil, Lucerne, Switzerland
| | - Carla Sabariego
- Swiss Paraplegic Research, Nottwil, Lucerne, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center for Rehabilitation in Global Health Systems, Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | | | - Anke Scheel-Sailer
- Swiss Paraplegic Research, Nottwil, Lucerne, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Centre, Nottwil, Lucerne, Switzerland
| | - Vanessa Seijas
- Swiss Paraplegic Research, Nottwil, Lucerne, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center for Rehabilitation in Global Health Systems, Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Khong CM, Chan J, Pasipanodya E, Dirlikov B, Shem K. Risk Factors Associated With Suicidal Ideation in Individuals With Spinal Cord Injury. Arch Rehabil Res Clin Transl 2023; 5:100284. [PMID: 37744203 PMCID: PMC10517356 DOI: 10.1016/j.arrct.2023.100284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
Objective To assess the frequency of suicidal ideation (SI) among individuals with chronic spinal cord injury (SCI) and to identify risk factors associated with SI. Design Cross-sectional. Setting Community setting. Participants Two hundred and forty-six individuals with chronic SCI participating in the Spinal Cord Injury Model Systems at a Level 1 Trauma center. Interventions Not applicable. Main Outcome Measure SI, as assessed by question 9 of the Patient Health Questionnaire-9. Results Twenty-seven (11.0%) participants endorsed SI; 6 (22.2%) of whom endorsed active SI with a plan of self-harm. Participants who endorsed SI had significantly higher depressive symptoms, lower resilience, and lower satisfaction with life (all Ps<.001). They also had lower perceived health (P<.001), Craig Handicap Assessment & Reporting Technique Short Form (CHART-SF) physical independence (P=.013), and Spinal Cord Injury - Functional Index with Assistive Technology domains of basic mobility (P=.003), self-care (P=.042), and fine motor skills (P=.035). However, participants who endorsed SI were not significantly different in re-hospitalization rates and in other domains of CHART-SF and SCI-AT. Logistic regression, with a forward selection procedure, was used to identify significant predictors of endorsing SI in the context of multiple associated variables. Depressive symptoms (odds ratio [OR]=1.18, P=.020), resilience (OR=0.85, P=.003), and physical independence (OR=0.98, P=.019) remained significant predictors of SI. Conclusion Study findings suggest higher levels of SI among people with SCI, a substantial proportion of whom have active SI. Individuals with SCI who endorse SI have greater burden of poor physical and mental health, as well as poorer functional status and adaptation. Interventions targeting multiple dimensions of quality of life may help reduce risk of SI and suicide among individuals with SCI.
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Affiliation(s)
- Cria-May Khong
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, CA
| | - John Chan
- Department of Physical Medicine and Rehabilitation, Santa Clara Valley Medical Center, San Jose, CA
| | | | - Benjamin Dirlikov
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, CA
| | - Kazuko Shem
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, CA
- Department of Physical Medicine and Rehabilitation, Santa Clara Valley Medical Center, San Jose, CA
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Levelink M, Voigt-Barbarowicz M, Ahlers C, Brütt AL. [Identification and Prioritization of Research Questions on Paraplegia Caused by Traumatic Spinal Cord Injury with Those Affected, Their Relatives and Health Care Professionals]. DAS GESUNDHEITSWESEN 2023; 85:250-257. [PMID: 36084944 PMCID: PMC10125339 DOI: 10.1055/a-1829-6781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 03/23/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Objective With expertise based on experience, paraplegics, their relatives and health care professionals can contribute to the development of research questions relevant for those affected and those in health care practice. For this purpose, the James Lind Alliance (JLA) has provided a methodological approach. The aim of this study was to develop a research agenda for paraplegia resulting from traumatic spinal cord injury with an adapted JLA approach. METHODS Four consecutive online surveys of people with paraplegia caused by traumatic spinal cord injury, their relatives and caregivers were conducted. In the first survey, the respondents freely formulated research questions unanswered from their point of view. These were synthesized and checked to see if they can already be answered by available evidence. The unresolved questions were prioritized stepwise in the subsequent surveys. In the second survey, the relevance of questions was rated on a five-point rating scale (1-5). Questions with a mean value of 4 or higher were taken up in the third survey, in which the 10 most relevant questions were determined. These were ranked in the fourth survey as a top-10 list. RESULTS Based on the first survey (n=52), 38 unresolved research questions were identified. Of these, 26 questions were rated as important (2nd survey; n=53), from which 10 questions were selected (3rd survey; n=17) and ranked (4th survey; n=12) as a top-10 list. Four prioritized questions related to treatment of spinal cord injury or associated health issues, three to aspects of the health care system with regard to assistive devices and the implementation of new therapies, two to possibilities of those affected to improve their own situation, and one to research on the course of disease. CONCLUSIONS Nine priorities focus on research that could help improve the life and health care situation of paraplegic patients and one on curative treatment. The prioritized questions should be taken up by researchers and research funders for the benefit of patients and to help health care providers. For some priorities, a need for research was consistently identified in present guidelines or systematic reviews.
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Affiliation(s)
- Michael Levelink
- Department für Versorgungsforschung, Carl von Ossietzky
Universitat Oldenburg, Oldenburg, Germany
| | - Mona Voigt-Barbarowicz
- Department für Versorgungsforschung, Carl von Ossietzky
Universitat Oldenburg, Oldenburg, Germany
| | | | - Anna Levke Brütt
- Department für Versorgungsforschung, Carl von Ossietzky
Universitat Oldenburg, Oldenburg, Germany
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Christofi AASN, Tate DG, Witter C, Alonso AC, Greve JMD. Predictors of quality of life of individuals living in Brazil with spinal cord injury/disease. Spinal Cord 2023; 61:253-259. [PMID: 36792662 DOI: 10.1038/s41393-023-00881-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 01/29/2023] [Accepted: 02/07/2023] [Indexed: 02/17/2023]
Abstract
STUDY DESIGN A cross-sectional, descriptive study. OBJECTIVES To investigate the demographic, clinical behavioral, and rehabilitation predictors of the quality of life (QoL) of people with spinal cord injury/disease (SCI/D) in a middle-income country. METHOD Ninety-five participants living in the community were evaluated with the following instruments: World Health Organization Quality of Life - Bref; International SCI Core DataSet; Clinical Interview; Spinal Cord Secondary Conditions Scale and Patient Health Questionnaire; Numerical Pain Intensity Scale; Short-Form 12 Health Survey - Item 8 (how much pain hinders activities); Patient Health Questionnaire 2, Numerical Fatigue Scale. Data were analyzed via Spearman correlation, univariate analysis, and multiple regression to explain the effects associated with quality-of-life predictors. RESULTS The main factors that decreased quality of life were fatigue (by 11.5%), depression (by 5.5-12.8%), pain (by 1.3 in total life quality, in the physical domain by 8.6-9.6%), sores (15.6% in the physical domain only). The practice of sports increased the total quality of life by 14.4%, in the physical domain by 11.9%, in the psychological domain by 17.2%, and in the social domain by 23.7%. CONCLUSIONS Fatigue, risk of depression, pain, and the presence of sores are predictors of poor quality of life, and sports are a predictor of a better quality of life, for people with spinal cord injury. Multidisciplinary rehabilitation, in addition to policies, to increase accessibility and social inclusion, and incentives or subsidies for the practice of sports could improve QoL following SCI/D.
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Affiliation(s)
- Alice A S N Christofi
- Institute of Orthopedics and Traumatology, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil.
| | - Denise G Tate
- Department of Physical Medicine and Rehabilitation, The University of Michigan Medical School, Ann Arbor, MI, USA
| | - Carla Witter
- University Center of The Americas, Sao Paulo, Brazil
| | - Angelica Castilho Alonso
- Program in Aging Science, São Judas Tadeu University, São Paulo, Brazil.,Laboratory for the Study of the Movement, Institute of Orthopedics and Traumatology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Julia Maria D'Andrea Greve
- Laboratory for the Study of the Movement, Institute of Orthopedics and Traumatology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
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Gounelle M, Cousson-Gelie F, Nicolas B, Kerdraon J, Gault D, Tournebise H, Goossens D, Leynaert V, Middleton J, Coffy A, Gelis A. French cross-cultural adaptation and validity of the Moorong Self-Efficacy scale: the MSES-FR, a measure of Self-Efficacy for French people with spinal cord injury. Disabil Rehabil 2022; 44:8066-8074. [PMID: 34802337 DOI: 10.1080/09638288.2021.2003452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE To adapt the Moorong Self-Efficacy Scale (MSES) in the French language and determine its psychometric proprieties. MATERIALS AND METHODS After a back-translation process, an expert committee was solicited to develop the French Self Efficacy Scale, thanks to a Delphi method, regarding theoretical framework and concepts explored. A total of 201 patients with SCI were included to explore internal consistency, internal and external structure validity assessed with the General Self-Efficacy scale, MOS Health Survey Short-Form, Hospital Anxiety and Depression Scale, Way of Coping Check-list, Perceived Stress Scale, Social Support Questionnaire, Self-Esteem questionnaire, and Satisfaction With Life Scale. The retest was performed 4 days later with a randomized version of the MSES-Fr. RESULTS The 16 items are distributed in 3 different dimensions: Interpersonal Self-Efficacy (4 items), Instrumental Self-Efficacy (4 items) and Participation Self-Efficacy (6 items). The internal consistency was excellent (Cronbach α = .87). Results evidenced significant correlations with the MSES-Fr and other related psychological constructs (self-esteem, mood, quality of life). Reproducibility was good for the total score of the MSES-Fr (ICC = .74) and for the 3 dimensions of the scale. CONCLUSIONS The MSES-Fr is a valid and reliable tool to assess self-efficacy in persons with spinal cord injury.Implications for rehabilitationThe Moorong Self-Efficacy Scale (MSES) is commonly used in persons with SCI for evaluating the level of perceived effectiveness in living with a disability.Validity and reliability studies of the MSES-Fr show good psychometrics properties in people with SCI.The French version of the MSES has been cross-culturally translated and is ready to be used clinically.
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Affiliation(s)
- Marion Gounelle
- Université Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, Montpellier, France.,Centre Neurologique Mutualiste Propara, Montpellier
| | - Florence Cousson-Gelie
- Université Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, Montpellier, France.,Institut régional du Cancer de Montpellier-ICM, Epidaure, Montpellier, France
| | | | | | - Dominique Gault
- Institut de Réadaptation Fonctionnelle Clémenceau, Strasbourg, France
| | | | | | | | - James Middleton
- University of Sydney, Kolling Institute of Medical Research, Sydney, Australia
| | - Amandine Coffy
- Institut Universitaire de Recherche Clinique (IURC), Laboratoire de Biostatistiques et d'Epidémiologie EA2415, Montpellier, France
| | - Anthony Gelis
- Université Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, Montpellier, France.,Centre Neurologique Mutualiste Propara, Montpellier
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Sandalic D, Arora M, Pozzato I, Simpson G, Middleton J, Craig A. A Narrative Review of Research on Adjustment to Spinal Cord Injury and Mental Health: Gaps, Future Directions, and Practice Recommendations. Psychol Res Behav Manag 2022; 15:1997-2010. [PMID: 35957761 PMCID: PMC9363004 DOI: 10.2147/prbm.s259712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/31/2022] [Indexed: 11/23/2022] Open
Abstract
Spinal cord injury (SCI) results in autonomic, motor, and sensory impairments that can compromise mental health. Guidelines directing the management of mental health following SCI presently address clinical anxiety, depression, post-traumatic stress, substance use disorders, and suicide. However, evidence suggests that perhaps as many as 70% of individuals with SCI do not develop a clinically diagnosable mental health disorder. Therefore, the authors contend that understanding non-clinical cognitive and psychological aspects of adjustment post-SCI is paramount and that the application of this knowledge to the formulation of adjustment-enhancing interventions is crucial. To assist with this endeavour, we examine existing mental health guidelines targeting SCI, and present a narrative review of research on the under-represented topics of adjustment, coping, grief, and resilience. We include mild cognitive impairment, which reflects a common factor that can compromise adjustment. Loss and stress trigger processes of adjustment, coping, grief, and resilience. SCI involves loss and stress triggering these processes, arguably without exception. Our study applied a narrative review methodology searching Google Scholar and PsychInfo databases for terms adjustment, coping, grief, resilience, and cognitive impairment. Qualitative studies and quantitative studies were selected to capture bottom-up and top-down perspectives. Reference lists of retrieved papers were searched as appropriate. Reviewed literature suggested that existing guidelines concerning mental health following SCI neglect positive processes of adjustment and suggest this neglect contributes to a deficits-based view of mental health following SCI. Research into “positive” or adjustment-enhancing processes is mostly cross-sectional, heterogenous, and poorly positioned to inform future guideline-development. Researchers should achieve consensus over the operationalisation of essential processes and overcome a fixation with “outcomes” to better inform management of mental health after SCI.
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Affiliation(s)
- Danielle Sandalic
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Mohit Arora
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Ilaria Pozzato
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Grahame Simpson
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - James Middleton
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Ashley Craig
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Correspondence: Ashley Craig, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia, Email
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Eroğlu S, Solak S, Dündar Ü. The association of Type D personality with functional outcomes, quality of life and neuropathic pain in persons with spinal cord injury. Spinal Cord 2022; 60:567-573. [PMID: 35124701 DOI: 10.1038/s41393-022-00760-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES This study aimed to investigate the association of Type D personality (TDP) with functional outcomes, health-related quality of life (HRQoL) and neuropathic pain in persons with spinal cord injury (SCI), using dichotomous and continuous analysis methods. SETTING Tertiary rehabilitation center. METHODS This study included 105 persons with SCI. Independence level was determined using the Functional Independence Measure (FIM)-motor subscale. The Short Form-36 questionnaire (SF-36) was used to assess HRQoL. TDP (combined existence of negative affectivity and social inhibition) was assessed using Type D Scale-14 (DS-14). Presence of chronic pain was questioned and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Pain Scale was used to distinguish neuropathic pain from others. RESULTS In dichotomous method, the FIM-motor score was significantly lower in persons with TDP (41 persons, 39%) (p = 0.025). Persons with TDP had significantly lower scores in vitality, emotional role and mental health. There was no significant difference between the groups, regarding neuropathic pain and LANSS scores (p > 0.05 for all). Negative affectivity and total DS-14 scores had negative correlation with mental health and vitality. In continuous interaction method, TDP predicted mainly the mental health components of SF-36 (particularly, vitality and mental health). Negative affectivity was the driving factor. TDP was not associated with FIM-motor, VAS pain or LANSS scores. CONCLUSIONS Mental component of HRQoL is associated with Type D in persons with SCI in both analyses. Assessment of potential differences related with TDP may be beneficial to develop and apply person-specific goals in SCI rehabilitation.
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Affiliation(s)
- Selma Eroğlu
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
| | - Samed Solak
- Department of Physical Medicine and Rehabilitation, Kahta State Hospital, Adıyaman, Turkey
| | - Ümit Dündar
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Byra S, Gabryś A. Coping Strategies of Women With Long-Term Spinal Cord Injury: The Role of Beliefs About the World, Self-Efficacy, and Disability. REHABILITATION COUNSELING BULLETIN 2022. [DOI: 10.1177/00343552211063649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present study aimed to investigate the indirect effect of appraisal of disability on the relationship between basic hope and coping strategies in women with long-term spinal cord injury (SCI), taking into account the moderating role of general self-efficacy. A cross-sectional study with 187 women with paraplegia was conducted. Main outcome measures, the Coping Orientations to Problems Experienced (COPE), the Basic Hope Inventory (BHI), Appraisals of Disability Primary and Secondary Scale (ADAPSS), and General Self-Efficacy Scale (GSES), were used. Our study showed that the strategies most commonly used by participants are seeking emotional support, religion, and acceptance. More than 45% of the respondents reveal average levels of basic hope, 58.82% reveal high levels of general self-efficacy, and most of them assessed their disability as determined resilience while noticing its negative aspects. The indirect effect of disability appraisal on the relationship between basic hope and coping strategies (denial, focus on emotions, seeking emotional support, religion, and acceptance) was confirmed. The moderating role of general self-efficacy in this analysis of mediating was also confirmed. General self-efficacy plays a significant role in explaining the relationship between basic hope and coping strategies mediated by appraisals of disability in women with long-term SCI.
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Five Different Lives after Suffering from Spinal Cord Injury: The Experiences of Nurses Who Take Care of Spinal Cord Injury Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031058. [PMID: 35162081 PMCID: PMC8834452 DOI: 10.3390/ijerph19031058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/13/2022] [Accepted: 01/15/2022] [Indexed: 02/05/2023]
Abstract
According to statistics of Ministry of Health and Welfare, accidents were the sixth common causes of death in Taiwan in 2016. A total of 1200 new cases of spinal cord injury each year are caused by accidents and adverse effects. This study explored nurses' experience of caring for patients with spinal cord injury. Hermeneutic phenomenology was used in the data analysis. The five themes emerged: dramatic changes in life, life lost control, life after catastrophic injury, life takes turns for the worse for family, and the power of rebirth. This study revealed that accidents were the primary cause of spinal cord injury, and that nurses may neglect patients' mental and social care. Career guidance should be offered to spinal cord injury patients to ensure that they retain sociality. This study provides recommendations regarding a patient's and their family's post-injury adaption process. The sexual desire of patients should be further explored in future research.
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Goraczko A, Zurek A, Lachowicz M, Kujawa K, Zurek G. The Relationship between Cognitive Performance and Quality of Life in Elite Athletes after Spinal Cord Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020948. [PMID: 35055769 PMCID: PMC8775381 DOI: 10.3390/ijerph19020948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The present investigation was designed to determine cognitive performance and quality of life (QoL) in a group of elite athletes who sustained spinal cord injury (SCI). METHODS nine participants suffering a SCI participated in the study. Different cognitive functions were evaluated through the following tests: COWAT, Digit Span, Stroop color-word and QoL through the WHOQoL-BREF scale. RESULTS Generally, participants positively assessed their overall quality of life and health status. Although the tests conducted indicate reduced cognitive function among the athletes, it did not affect the reduction in QoL. Single correlations between the results of cognitive tests and QoL could be treated as coincidental. CONCLUSIONS Despite the observed decline in selected cognitive functions, the participants positively assessed their quality of life and physical health.Reduced cognitive functioning could be influenced by the impact of sleep-disordered breathing, pain, depressive disorders and medication. This indicates the need for an individualized approach to define the patient's deficits, needs and best care. Further studies with a larger group of participants are needed.
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Affiliation(s)
- Agata Goraczko
- Department of Biostructure, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland; (A.G.); (M.L.); (K.K.)
- Clinic of Neurorehabilitation, 54-519 Wroclaw, Poland
| | - Alina Zurek
- Institute of Psychology, University of Wroclaw, 50-527 Wroclaw, Poland;
| | - Maciej Lachowicz
- Department of Biostructure, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland; (A.G.); (M.L.); (K.K.)
| | - Katarzyna Kujawa
- Department of Biostructure, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland; (A.G.); (M.L.); (K.K.)
- Clinic of Neurorehabilitation, 54-519 Wroclaw, Poland
| | - Grzegorz Zurek
- Department of Biostructure, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland; (A.G.); (M.L.); (K.K.)
- Correspondence: ; Tel.: +48-600-081-799
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Swinney MJ, Sepehri A, Stokic DS. Perception and predictors of health locus of control at rehabilitation discharge and 1 year after traumatic spinal cord injury. Int J Rehabil Res 2021; 44:370-376. [PMID: 34678844 DOI: 10.1097/mrr.0000000000000500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This retrospective study examined the perception and predictors of health locus of control (LOC) in 71 individuals with a spinal cord injury (SCI) at discharge from inpatient rehabilitation (average age 39 years, 77% male, 54% black, 51% cervical SCI, 51% incomplete SCI and average time post-SCI 20 days). We also determined if health LOC beliefs and predictors change over the 1st year after SCI in a representative subsample of 36 individuals. The participants completed surveys regarding the health LOC, self-esteem and depression whereas demographic and SCI information were retrieved from medical records. At inpatient discharge, 55% of SCI individuals endorsed the doctor LOC category compared to internal (14%), other people (6%), chance (3%) or multiple LOC categories (22%). A similar pattern was found at 1-year postinjury (doctor LOC 44% and non-doctor LOC combined 56%). A backward stepwise regression revealed that white race (P = 0.093), >12 years of education (P = 0.001) and cervical level of SCI (P = 0.033) were significant predictors of the doctor LOC category at inpatient discharge (overall classification accuracy 76%). Similarly, >12 years of education (P = 0.055), cervical level of SCI at inpatient discharge (P = 0.033) and higher self-esteem at 1-year post-SCI (P = 0.113) were significant predictors of the doctor LOC category at 1-year post-SCI (overall classification accuracy 78%). We conclude that health LOC remains stable over the 1st year after SCI with the majority of individuals believing that the control over outcomes of their health is in the hands of doctors. These findings have implications for the provision of rehabilitation services after SCI.
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Affiliation(s)
| | - Arash Sepehri
- Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, Jackson, Mississippi, USA
| | - Dobrivoje S Stokic
- Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, Jackson, Mississippi, USA
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Is Self-Efficacy Related to the Quality of Life in Elite Athletes after Spinal Cord Injury? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010866. [PMID: 34682606 PMCID: PMC8535663 DOI: 10.3390/ijerph182010866] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/06/2021] [Accepted: 10/14/2021] [Indexed: 11/17/2022]
Abstract
Background: A spinal cord injury (SCI) is a traumatic event that affects every aspect of life: physical, mental, economic, and social. The main aim of this study was to investigate self-efficacy, quality of life, and their correlations among outstanding athletes who have suffered spinal cord injuries, and to determine whether these individuals have specific psychological characteristics that contribute to a better quality of life. Methods: The study involved nine athletes with at least national-level achievements in sports prior to an SCI. Participation in the study consisted of an interview via an online communicator, followed by an online questionnaire consisting of a personal questionnaire and two scales: The World Health Organization Quality of Life Scale (WHOQoL-BREF), and the General Self-Efficacy Scale (GSES). Results: Spearman’s correlation showed a correlation between general self-efficacy, perception of quality of life, and satisfaction with own physical health, as well as psychological resources and environmental support. Conclusions: Involvement in an environment that was important to the injured person before the accident, in either a passive (in the absence of functional capacity) or active form, promotes a greater sense of self-efficacy and good QoL, regardless of the time that has passed since the accident, and despite high levels of pain or secondary health issues. To fill the gap in professional long-term healthcare services for athletes after SCIs, intervention programs should be considered that support self-efficacy, which is an important factor that can be subject to improvement.
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Moon JY, Kim JH. Association between self-esteem and efficacy and mental health in people with disabilities. PLoS One 2021; 16:e0257943. [PMID: 34613985 PMCID: PMC8494337 DOI: 10.1371/journal.pone.0257943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 09/14/2021] [Indexed: 11/21/2022] Open
Abstract
This study aimed to investigate the association among self-evaluations-such as self-esteem and self-efficacy-self report of depression, and perceived stress among Korean individuals with disabilities. Data from the second wave of the Panel Survey of Employment for the Disabled (collected from 2016-2018) were used. In 2016 and the follow-up in 2018, 4,033 participants were included. We estimated the annual change in both independent variables and the probability of self-report of depression and stress. Generalized estimating equation model and chi-square test were used. Compared with those whose self-esteem and self-efficacy scores were ≥30, those with scores ≤19 were, respectively, 5.825 (95% Confidence Interval [CI]: 4.235-8.011; p < .0001) and 1.494 times (95% CI: 1.233-1.810; p < .0001) more likely to have self-report of depression. The perceived stress of those with self-esteem scores ≤19 or ranging from 20-24 were, respectively, 2.036 (95% CI: 1.510-2.747; p < .0001) and 1.451 times higher (95% CI: 1.269-1.659; p < .0001) than those with self-esteem scores ≥30. There exists an inverse correlation between self-evaluations, such as self-efficacy and self-esteem, and mental health in people with disabilities. The results of this study can be used as a basis for developing interventional strategies and training and intervention programs for people with disabilities. Future research is needed to investigate potential mediating factors among Korean individuals.
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Affiliation(s)
- Jong Youn Moon
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Republic of Korea
- Center for Public Health, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jae-Hyun Kim
- Department of Health Administration, College of Health Science, Dankook University, Cheonan, Republic of Korea
- Institute for Digital Life Convergence, Dankook University, Cheonan, Republic of Korea
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Taylan S, Gözüyeşil E, Manav Aİ, Işık Eİ. An evaluation of the factors that affect the sexual satisfaction of people with spinal cord injuries. J Spinal Cord Med 2021; 44:590-597. [PMID: 31603386 PMCID: PMC8288136 DOI: 10.1080/10790268.2019.1672955] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objective: To evaluate the relationships between the variables that affect the sexual satisfaction of patients with spinal cord injuries.Design: Descriptive and cross-sectional survey.Setting: The physical medicine and rehabilitation outpatient clinic of a university hospital in Turkey.Participants: This study was performed from July to December2018. It included 103 patients with spinal cord injuries.Outcome Measures: The data were collected using an introductory information form, the American Spinal Injury Association Impairment Scale and the Golombok Rust Inventory of Sexual Satisfaction. Data were evaluated using the chi-square test, the Mann-Whitney U test, the Kruskal-Wallis test and linear regression.Results: The total mean scores on the Golombok Rust Inventory of Sexual Satisfaction were 40.2 ± 21.6 for males and 44.9 ± 18.1 for females. According to the linear regression analysis, model VII presented the best results of the relationship between physiological and psychological determinants that affect the sexual satisfaction of patients with spinal cord injuries. Model VII consisted of the variables of ASIA A and B scores, age, injury due to falling from height, being a housewife, and thinking of being unable to reach future goals. These explained 75.4% of the variation in sexual satisfaction scores.Conclusion: The participants' mean scores on the Golombok Rust Inventory of Sexual Satisfaction were found to be affected by various variables. A significant relationship between their mean scores on the American Spinal Injury Association (ASIA) Impairment Scale and the Golombok Rust Inventory of Sexual Satisfaction was determined.
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Affiliation(s)
- Seçil Taylan
- Kumluca Faculty of Health Sciences, Surgical Nursing Department, Akdeniz University, Kumluca-Antalya, Turkey
| | - Ebru Gözüyeşil
- Faculty of Health Sciences, Nursing Department, Osmaniye Korkut Ata University, Osmaniye, Turkey
| | - Ayşe İnel Manav
- Faculty of Health Sciences, Nursing Department, Osmaniye Korkut Ata University, Osmaniye, Turkey
| | - Emir İbrahim Işık
- Therapy and Rehabılıtatıon Department, Vocatıonal School of Health Servıces, Cukurova University, Adana, Turkey
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Purpose in Life of Elite Athletes after Spinal Cord Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115563. [PMID: 34070973 PMCID: PMC8197014 DOI: 10.3390/ijerph18115563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/14/2021] [Accepted: 05/20/2021] [Indexed: 11/23/2022]
Abstract
Background: Searching for the meaning of human existence is man’s fundamental orientation. People are free to find meaning in their lives, and while they are not always free to choose the conditions of life, they are free to choose their attitude toward the conditions in which they find themselves. When people experience an unchangeable situation, the most important thing is the attitude they take toward it. This study aimed to identify the sense of meaning in life among elite athletes after a spinal cord injury (SCI) and to analyze the different aspects contributing to this domain. Methods: The study involved five athletes with at least national-level achievements in sports prior to a SCI. The study consisted of an interview using a communicator and filling out two online questionnaires—a personal questionnaire and the Purpose in Life Scale. Results: Analyzing the quantitative results, four participants achieved results indicating a high sense of meaning in life, while one participant achieved a significantly lower result. Conclusions: What affects one’s purpose in life is not so much the objective physical limitation but how much physicality one perceives to have lost as a result of the injury. Elite athletes stay involved in the sporting environment, which prevents the loss of purpose and maintains a sense of meaning at a high level. Both telling the story of your own illness and listening to the stories of others help the process of self-healing.
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Rigot SK, Boninger ML, Ding D, McKernan G, Field-Fote EC, Hoffman J, Hibbs R, Worobey LA. Toward Improving the Prediction of Functional Ambulation After Spinal Cord Injury Though the Inclusion of Limb Accelerations During Sleep and Personal Factors. Arch Phys Med Rehabil 2021; 103:676-687.e6. [PMID: 33839107 DOI: 10.1016/j.apmr.2021.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 01/21/2021] [Accepted: 02/07/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To determine if functional measures of ambulation can be accurately classified using clinical measures; demographics; personal, psychosocial, and environmental factors; and limb accelerations (LAs) obtained during sleep among individuals with chronic, motor incomplete spinal cord injury (SCI) in an effort to guide future, longitudinal predictions models. DESIGN Cross-sectional, 1-5 days of data collection. SETTING Community-based data collection. PARTICIPANTS Adults with chronic (>1 year), motor incomplete SCI (N=27). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Ambulatory ability based on the 10-m walk test (10MWT) or 6-minute walk test (6MWT) categorized as nonambulatory, household ambulator (0.01-0.44 m/s, 1-204 m), or community ambulator (>0.44 m/s, >204 m). A random forest model classified ambulatory ability using input features including clinical measures of strength, sensation, and spasticity; demographics; personal, psychosocial, and environmental factors including pain, environmental factors, health, social support, self-efficacy, resilience, and sleep quality; and LAs measured during sleep. Machine learning methods were used explicitly to avoid overfitting and minimize the possibility of biased results. RESULTS The combination of LA, clinical, and demographic features resulted in the highest classification accuracies for both functional ambulation outcomes (10MWT=70.4%, 6MWT=81.5%). Adding LAs, personal, psychosocial, and environmental factors, or both increased the accuracy of classification compared with the clinical/demographic features alone. Clinical measures of strength and sensation (especially knee flexion strength), LA measures of movement smoothness, and presence of pain and comorbidities were among the most important features selected for the models. CONCLUSIONS The addition of LA and personal, psychosocial, and environmental features increased functional ambulation classification accuracy in a population with incomplete SCI for whom improved prognosis for mobility outcomes is needed. These findings provide support for future longitudinal studies that use LA; personal, psychosocial, and environmental factors; and advanced analyses to improve clinical prediction rules for functional mobility outcomes.
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Affiliation(s)
- Stephanie K Rigot
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA
| | - Michael L Boninger
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA; Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA; Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
| | - Dan Ding
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA; Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA
| | - Gina McKernan
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
| | - Edelle C Field-Fote
- Crawford Research Institute, Shepherd Center, Atlanta, GA; Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA; Program in Applied Physiology, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA
| | - Jeanne Hoffman
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
| | - Rachel Hibbs
- Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA; Physical Therapy, University of Pittsburgh, Pittsburgh, PA
| | - Lynn A Worobey
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA; Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA; Physical Therapy, University of Pittsburgh, Pittsburgh, PA.
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Li Y, Chien WT, Zhu B, He H, Bressington D. Predictors of Self-Efficacy Among People With Spinal Cord Injury During Inpatient Rehabilitation: A Cross-Sectional Study. J Nurs Scholarsh 2021; 53:218-226. [PMID: 33555118 DOI: 10.1111/jnu.12632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to investigate the predictors of self-efficacy among Chinese people with spinal cord injury (SCI). DESIGN A cross-sectional, descriptive, correlational design was adopted. METHODS 121 participants were recruited from two rehabilitation hospitals in Shaanxi, China, from August 2016 to June 2017. The Moorong Self-Efficacy Scale was used to assess participants' self-efficacy levels. Participants' sociodemographic or clinical characteristics, functional independence, coping ability (measured using the Brief Coping Orientations to Problems Experienced Inventory), and social support (measured using the Six-item Social Support Questionnaire) were assessed as potential predictors of self-efficacy. A multiple linear regression model was conducted to identify the factors predicting self-efficacy score. RESULTS The mean age of the participants was 41 (SD 11.9) years and 90% were male. Participants' mean self-efficacy score was 53.9 (SD 15.7). Multiple linear regression results indicated that injury type (i.e., paraplegia or tetraplegia; β = 0.290, p < .001) and adaptive coping (β = 0.561, p < .001) were significant predictors, accounting for 62% of the variance in self-efficacy scores. CONCLUSIONS Our findings imply that psychosocial interventions that target enhancing various adaptive coping strategies could have positive effects on self-efficacy in people with SCI. CLINICAL RELEVANCE Injury type and adaptive coping ability are two key factors related to patients' self-efficacy post-SCI. Psychosocial interventions that target enhancing various adaptive coping strategies could have positive effects on self-efficacy in people with SCI.
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Affiliation(s)
- Yan Li
- Research Assistant Professor, School of Nursing, the Hong Kong Polytechnic University, Hong Kong
| | - Wai Tong Chien
- Professor and Director, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Bingqian Zhu
- Research Associate Professor, School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Honggu He
- Associate Professor & Director of Research, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Daniel Bressington
- Professor of Mental Health, College of Nursing and Midwifery, Charles Darwin University, Darwin, Australia
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Park EY, Kim JH. Interaction of Socio-demographic Characteristics on Acceptance of Disability Among Individuals With Physical Disabilities. Front Psychiatry 2021; 12:597817. [PMID: 33995137 PMCID: PMC8113681 DOI: 10.3389/fpsyt.2021.597817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 03/19/2021] [Indexed: 11/23/2022] Open
Abstract
This study aimed to investigate the interaction of sociodemographic characteristics on acceptance of disability among individuals with physical disabilities (IWPD). Data from the 8th Panel Survey of Employment for the Disabled in Korea (PSED) in the second wave were used. A sample concerning the first phase of disability was extracted using the one-step colony method to extract regions and was stratified based on the type of disability, disability grade, and age. To explore the association between acceptance of sociodemographic characteristics and of disability, we used a general linear model. A significant main effect was observed in employment, health status, degree of help, and subjective economic status. Regarding employment status, acceptance of disability in unemployment of IWPD with less than high school was lower as compared to those with more than high school. We observed that unemployed IWPD with low income or poor health status could be the group with the highest risk for acceptance of disability. Individuals in the low economic group were more religious than those in the high economic one. These findings indicate that specialized intervention programs that consider religion, economic status, employment, education, health, and their interactions would be effective for acceptance of disability. Interdisciplinary team members should consider the individual profiles of these populations and implement suitable support and rehabilitation programs.
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Affiliation(s)
- Eun-Young Park
- Department of Secondary Special Education, College of Education, Jeonju University, Jeonju, South Korea
| | - Jung-Hee Kim
- Department of Clinical Nursing, College of Nursing, The Catholic University of Korea, Seoul, South Korea
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Carrard V, Kunz S, Peter C. Mental health, quality of life, self-efficacy, and social support of individuals living with spinal cord injury in Switzerland compared to that of the general population. Spinal Cord 2020; 59:398-409. [PMID: 33235298 DOI: 10.1038/s41393-020-00582-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 01/22/2023]
Abstract
STUDY DESIGN Comparative study of survey self-report data. OBJECTIVES To compare individuals living with spinal cord injury (SCI) in Switzerland to the general population in terms of mental health, quality of life, self-efficacy, and social support. SETTING Community, Switzerland. METHODS Data from the 2017 community survey of the Swiss Spinal Cord Injury Cohort Study were compared to data from two matched (1:3 nearest neighbor propensity score) general population surveys collected in the same year. Measures of mental health (mental health index, psychological distress item, vitality scale, and energy item), quality of life (WHOQOL-BREF item), self-efficacy (General Self-Efficacy Scale item), and social support (items of relationship satisfaction, living alone, and marital status) were compared across datasets using regression adjusted for non-response correction weights. The analyses were then replicated in subgroups defined by sociodemographic, lesion-related, and secondary health issues factors. RESULTS Individuals with SCI had significantly higher psychological distress and poorer mental health, vitality, energy, and quality of life than the general population, with medium to large effect sizes (Cohen's d: 0.35-1.08). They also had lower self-efficacy and relationship satisfaction, lived more frequently alone, and were more frequently single. Individuals with less severe secondary health issues reported mental health and quality of life more similar to the general population than those reporting more severe issues. CONCLUSIONS This study highlights a significant long-term impact of SCI on well-being and psychosocial resources, underlining the need for ongoing biopsychosocial care beyond inpatient rehabilitation.
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Affiliation(s)
- Valerie Carrard
- Swiss Paraplegic Research (SPF), 6207, Nottwil, Switzerland. .,National Center of Competence in Research LIVES, 1022, Lausanne, Switzerland. .,Department of Health Sciences and Medicine, University of Lucerne, 6002, Lucerne, Switzerland.
| | - Simon Kunz
- Swiss Paraplegic Research (SPF), 6207, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, 6002, Lucerne, Switzerland
| | - Claudio Peter
- Swiss Paraplegic Research (SPF), 6207, Nottwil, Switzerland.,National Center of Competence in Research LIVES, 1022, Lausanne, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, 6002, Lucerne, Switzerland
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The mediating effect of self-efficacy on the relationship between health locus of control and life satisfaction: A moderator role of movement disability. Disabil Health J 2020; 13:100923. [DOI: 10.1016/j.dhjo.2020.100923] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 01/07/2023]
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Kunzler AM, Helmreich I, König J, Chmitorz A, Wessa M, Binder H, Lieb K. Psychological interventions to foster resilience in healthcare students. Cochrane Database Syst Rev 2020; 7:CD013684. [PMID: 32691879 PMCID: PMC7388680 DOI: 10.1002/14651858.cd013684] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Resilience can be defined as maintaining or regaining mental health during or after significant adversities such as a potentially traumatising event, challenging life circumstances, a critical life transition or physical illness. Healthcare students, such as medical, nursing, psychology and social work students, are exposed to various study- and work-related stressors, the latter particularly during later phases of health professional education. They are at increased risk of developing symptoms of burnout or mental disorders. This population may benefit from resilience-promoting training programmes. OBJECTIVES To assess the effects of interventions to foster resilience in healthcare students, that is, students in training for health professions delivering direct medical care (e.g. medical, nursing, midwifery or paramedic students), and those in training for allied health professions, as distinct from medical care (e.g. psychology, physical therapy or social work students). SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing any form of psychological intervention to foster resilience, hardiness or post-traumatic growth versus no intervention, waiting list, usual care, and active or attention control, in adults (18 years and older), who are healthcare students. Primary outcomes were resilience, anxiety, depression, stress or stress perception, and well-being or quality of life. Secondary outcomes were resilience factors. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post-test only). MAIN RESULTS We included 30 RCTs, of which 24 were set in high-income countries and six in (upper- to lower-) middle-income countries. Twenty-two studies focused solely on healthcare students (1315 participants; number randomised not specified for two studies), including both students in health professions delivering direct medical care and those in allied health professions, such as psychology and physical therapy. Half of the studies were conducted in a university or school setting, including nursing/midwifery students or medical students. Eight studies investigated mixed samples (1365 participants), with healthcare students and participants outside of a health professional study field. Participants mainly included women (63.3% to 67.3% in mixed samples) from young adulthood (mean age range, if reported: 19.5 to 26.83 years; 19.35 to 38.14 years in mixed samples). Seventeen of the studies investigated group interventions of high training intensity (11 studies; > 12 hours/sessions), that were delivered face-to-face (17 studies). Of the included studies, eight compared a resilience training based on mindfulness versus unspecific comparators (e.g. wait-list). The studies were funded by different sources (e.g. universities, foundations), or a combination of various sources (four studies). Seven studies did not specify a potential funder, and three studies received no funding support. Risk of bias was high or unclear, with main flaws in performance, detection, attrition and reporting bias domains. At post-intervention, very-low certainty evidence indicated that, compared to controls, healthcare students receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.43, 95% confidence interval (CI) 0.07 to 0.78; 9 studies, 561 participants), lower levels of anxiety (SMD -0.45, 95% CI -0.84 to -0.06; 7 studies, 362 participants), and lower levels of stress or stress perception (SMD -0.28, 95% CI -0.48 to -0.09; 7 studies, 420 participants). Effect sizes varied between small and moderate. There was little or no evidence of any effect of resilience training on depression (SMD -0.20, 95% CI -0.52 to 0.11; 6 studies, 332 participants; very-low certainty evidence) or well-being or quality of life (SMD 0.15, 95% CI -0.14 to 0.43; 4 studies, 251 participants; very-low certainty evidence). Adverse effects were measured in four studies, but data were only reported for three of them. None of the three studies reported any adverse events occurring during the study (very-low certainty of evidence). AUTHORS' CONCLUSIONS For healthcare students, there is very-low certainty evidence for the effect of resilience training on resilience, anxiety, and stress or stress perception at post-intervention. The heterogeneous interventions, the paucity of short-, medium- or long-term data, and the geographical distribution restricted to high-income countries limit the generalisability of results. Conclusions should therefore be drawn cautiously. Since the findings suggest positive effects of resilience training for healthcare students with very-low certainty evidence, high-quality replications and improved study designs (e.g. a consensus on the definition of resilience, the assessment of individual stressor exposure, more attention controls, and longer follow-up periods) are clearly needed.
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Affiliation(s)
| | | | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andrea Chmitorz
- Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Harald Binder
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Bhattarai M, Smedema SM, Maneewat K. An Integrative Review of Factors Associated With Resilience Post-Spinal Cord Injury. REHABILITATION COUNSELING BULLETIN 2020. [DOI: 10.1177/0034355220938429] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to analyze factors associated with resilience among persons with spinal cord injury (SCI). An integrative review was conducted. Electronic databases including PubMed, ProQuest, Cumulative Index of Nursing and Allied Health Literature, and Web of Science were searched using relevant search terms and keywords. A total of two qualitative and nine quantitative studies were included in the review. Psychosocial factors such as social support, self-efficacy, spirituality, post-traumatic growth, life satisfaction, adaptive coping strategies, psychological strength, and being a role model were associated with higher resilience. Stress, anxiety, depression, external locus of control, and attachment avoidance correlated with lower resilience. Inconsistent results were reported for demographic and injury-related variables such as the age of the participants, gender, pain, and functional independence. The integrative review reported a number of factors associated with resilience in people with SCI. Rehabilitation counselors working with this population can design rehabilitation interventions targeting these variables to enhance the resilience of people with SCI. Consideration of cultural and contextual influences on resilience, as well as the design of effective interventions, are important directions for future research.
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Kunzler AM, Helmreich I, Chmitorz A, König J, Binder H, Wessa M, Lieb K. Psychological interventions to foster resilience in healthcare professionals. Cochrane Database Syst Rev 2020; 7:CD012527. [PMID: 32627860 PMCID: PMC8121081 DOI: 10.1002/14651858.cd012527.pub2] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Resilience can be defined as the maintenance or quick recovery of mental health during or after periods of stressor exposure, which may result from a potentially traumatising event, challenging life circumstances, a critical life transition phase, or physical illness. Healthcare professionals, such as nurses, physicians, psychologists and social workers, are exposed to various work-related stressors (e.g. patient care, time pressure, administration) and are at increased risk of developing mental disorders. This population may benefit from resilience-promoting training programmes. OBJECTIVES To assess the effects of interventions to foster resilience in healthcare professionals, that is, healthcare staff delivering direct medical care (e.g. nurses, physicians, hospital personnel) and allied healthcare staff (e.g. social workers, psychologists). SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results. SELECTION CRITERIA Randomised controlled trials (RCTs) in adults aged 18 years and older who are employed as healthcare professionals, comparing any form of psychological intervention to foster resilience, hardiness or post-traumatic growth versus no intervention, wait-list, usual care, active or attention control. Primary outcomes were resilience, anxiety, depression, stress or stress perception and well-being or quality of life. Secondary outcomes were resilience factors. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post-test only). MAIN RESULTS We included 44 RCTs (high-income countries: 36). Thirty-nine studies solely focused on healthcare professionals (6892 participants), including both healthcare staff delivering direct medical care and allied healthcare staff. Four studies investigated mixed samples (1000 participants) with healthcare professionals and participants working outside of the healthcare sector, and one study evaluated training for emergency personnel in general population volunteers (82 participants). The included studies were mainly conducted in a hospital setting and included physicians, nurses and different hospital personnel (37/44 studies). Participants mainly included women (68%) from young to middle adulthood (mean age range: 27 to 52.4 years). Most studies investigated group interventions (30 studies) of high training intensity (18 studies; > 12 hours/sessions), that were delivered face-to-face (29 studies). Of the included studies, 19 compared a resilience training based on combined theoretical foundation (e.g. mindfulness and cognitive-behavioural therapy) versus unspecific comparators (e.g. wait-list). The studies were funded by different sources (e.g. hospitals, universities), or a combination of different sources. Fifteen studies did not specify the source of their funding, and one study received no funding support. Risk of bias was high or unclear for most studies in performance, detection, and attrition bias domains. At post-intervention, very-low certainty evidence indicated that, compared to controls, healthcare professionals receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.45, 95% confidence interval (CI) 0.25 to 0.65; 12 studies, 690 participants), lower levels of depression (SMD -0.29, 95% CI -0.50 to -0.09; 14 studies, 788 participants), and lower levels of stress or stress perception (SMD -0.61, 95% CI -1.07 to -0.15; 17 studies, 997 participants). There was little or no evidence of any effect of resilience training on anxiety (SMD -0.06, 95% CI -0.35 to 0.23; 5 studies, 231 participants; very-low certainty evidence) or well-being or quality of life (SMD 0.14, 95% CI -0.01 to 0.30; 13 studies, 1494 participants; very-low certainty evidence). Effect sizes were small except for resilience and stress reduction (moderate). Data on adverse effects were available for three studies, with none reporting any adverse effects occurring during the study (very-low certainty evidence). AUTHORS' CONCLUSIONS For healthcare professionals, there is very-low certainty evidence that, compared to control, resilience training may result in higher levels of resilience, lower levels of depression, stress or stress perception, and higher levels of certain resilience factors at post-intervention. The paucity of medium- or long-term data, heterogeneous interventions and restricted geographical distribution limit the generalisability of our results. Conclusions should therefore be drawn cautiously. The findings suggest positive effects of resilience training for healthcare professionals, but the evidence is very uncertain. There is a clear need for high-quality replications and improved study designs.
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Affiliation(s)
| | | | - Andrea Chmitorz
- Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Harald Binder
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Bloom J, Dorsett P, McLennan V. Vocational rehabilitation to empower consumers following newly acquired spinal cord injury. JOURNAL OF VOCATIONAL REHABILITATION 2020. [DOI: 10.3233/jvr-201091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Julia Bloom
- School of Human Services and Social Work, Griffith University, Meadowbrook, QLD, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
- The Hopkins Centre, Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, QLD, Australia
| | - Pat Dorsett
- School of Human Services and Social Work, Griffith University, Meadowbrook, QLD, Australia
- The Hopkins Centre, Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, QLD, Australia
| | - Vanette McLennan
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
- The Hopkins Centre, Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, QLD, Australia
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Hodel J, Ehrmann C, Stucki G, Bickenbach JE, Prodinger B. Examining the complexity of functioning in persons with spinal cord injury attending first rehabilitation in Switzerland using structural equation modelling. Spinal Cord 2020; 58:570-580. [PMID: 32055042 PMCID: PMC7214256 DOI: 10.1038/s41393-020-0428-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/16/2020] [Accepted: 01/23/2020] [Indexed: 12/17/2022]
Abstract
STUDY DESIGN Cross-sectional. OBJECTIVES To examine the associations between activities, body structures and functions, and their relationship with aetiology, age and sex in persons with spinal cord injury (SCI) at discharge from first rehabilitation. SETTING Swiss SCI Cohort Study (SwiSCI). METHODS The study included 390 participants with newly acquired SCI and the International Classification of Functioning, Disability and Health (ICF) as conceptual frame of reference. Body structures were represented by injury level and severity; body functions by cardiovascular, pulmonary, skin, bowel and urinary functions and pain; mental functions by anxiety, depression, optimism and self-esteem; and activities by independence in performing activities of daily living (ADL). Using structural equation modelling (SEM), indirect effects of body structures and functions on independence in performing ADL through mental functions were tested for each mental function separately. For each structural model, fit was assessed using several indices and differences in aetiology, age and sex groups were explored. RESULTS The structural model about optimism showed good fit in all indices; the models about anxiety, depression and self-esteem showed conflicting fit indices, respectively. Within all models, effects on independence in performing ADL were mainly direct. Pain showed significant (P < 0.05) indirect effects on independence in performing ADL within the depression, optimism and self-esteem models. The model about anxiety showed differences in aetiology groups. CONCLUSIONS Using an ICF-based modelling approach, this study presents an attempt towards a more comprehensive understanding of functioning in first rehabilitation of persons with SCI, which might be fundamental for rehabilitation planning.
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Affiliation(s)
- Jsabel Hodel
- Swiss Paraplegic Research, Nottwil, Switzerland.
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
| | - Cristina Ehrmann
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Gerold Stucki
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Jerome E Bickenbach
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Birgit Prodinger
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Faculty of Applied Health and Social Sciences, Technical University of Applied Sciences Rosenheim, Rosenheim, Germany
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Profiles of Psychological Adaptation Outcomes at Discharge From Spinal Cord Injury Inpatient Rehabilitation. Arch Phys Med Rehabil 2020; 101:401-411. [DOI: 10.1016/j.apmr.2019.08.481] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 08/17/2019] [Indexed: 11/22/2022]
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Robinson-Whelen S, Hughes RB, Taylor HB, Markley R, Vega JC, Nosek TM, Nosek MA. Promoting psychological health in women with SCI: Development of an online self-esteem intervention. Disabil Health J 2019; 13:100867. [PMID: 31757776 DOI: 10.1016/j.dhjo.2019.100867] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 10/01/2019] [Accepted: 10/22/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND There are no known interventions addressing self-esteem in women following spinal cord injury (SCI). OBJECTIVES To test the feasibility of an online self-esteem intervention for women with disabilities, as modified for women with SCI. METHOD We conducted a randomized, controlled feasibility test of a self-esteem intervention (N = 21). Participants were randomly assigned to the intervention or control group that received intervention materials at the end of the study. Intervention participants met as avatars for 7 weekly real-time group sessions in Second Life (SL), a free online virtual world. Feasibility indicators were study engagement, acceptability of SL and the intervention, and improvements on measures of psychological health promoting behaviors, social support, self-efficacy, self-esteem, and depression. RESULTS Intervention participants (n = 10) were highly engaged, and most described the SL program as more enjoyable and more convenient than in-person programs. All rated the intervention as "good" (n = 4) or "very good" (n = 6), and all 10 rated themselves has having made positive life changes as a result of the program. Intervention participants experienced significantly greater change than controls on two measures of health-promoting behavior (Health Promoting Lifestyle Profile-II Spiritual Growth/Self-actualization; Interpersonal Relations). Examining change in the intervention group using regression analyses, we found medium-to-large effects of the intervention on these behaviors and measures of depression (CESD-10, PHQ-9). The intervention had small effects on remaining measures. CONCLUSION We found preliminary support for the feasibility of this modified self-esteem intervention offered in SL. Such programming may help circumvent barriers to community-based psychological services and may improve psychological health.
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Affiliation(s)
- Susan Robinson-Whelen
- Spinal Cord Injury and Disability Research Center, TIRR Memorial Hermann, Houston, TX, USA; Center for Research on Women with Disabilities, H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
| | - Rosemary B Hughes
- The Rural Institute for Inclusive Communities, University of Montana, Missoula, MT, USA; Department of Psychology, University of Montana, Missoula, MT, USA
| | - Heather B Taylor
- Spinal Cord Injury and Disability Research Center, TIRR Memorial Hermann, Houston, TX, USA; McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), USA
| | - Rachel Markley
- Spinal Cord Injury and Disability Research Center, TIRR Memorial Hermann, Houston, TX, USA
| | - José C Vega
- Spinal Cord Injury and Disability Research Center, TIRR Memorial Hermann, Houston, TX, USA
| | - Thomas M Nosek
- Department of Physiology and Biophysics, Case Western Reserve University, School of Medicine, Cleveland, OH, USA
| | - Margaret A Nosek
- Center for Research on Women with Disabilities, H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
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Ordway AR, Johnson KL, Amtmann D, Bocell FD, Jensen MP, Molton IR. The Relationship Between Resilience, Self-Efficacy, and Employment in People With Physical Disabilities. REHABILITATION COUNSELING BULLETIN 2019. [DOI: 10.1177/0034355219886660] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this cross-sectional study was to determine the importance of resilience and self-efficacy in explaining employment status for people with long-term physical disabilities when other sociodemographic and symptom variables were also examined. A multiple logistic regression with sequential predictor entry was used to predict employment status. Participants were individuals, 18 to 65 years of age, with a diagnosis of multiple sclerosis, muscular dystrophy, post-polio syndrome, or spinal cord injury ( N = 882). Results indicated resilience but not self-efficacy was uniquely predictive of employment status. The combined effects of resilience and self-efficacy, however, did not significantly contribute to the variance in employment status above and beyond the sociodemographic and symptom variables. Other variables uniquely predictive of employment included education, age, marital status, disability benefits, and anxiety. We found in this study preliminary evidence to suggest that rehabilitation counseling practitioners should consider a client’s resilience with respect to employment. Knowledge of sociodemographic and symptom factors in conjunction with psychometrically sound measures of resilience and self-efficacy may be used to identify individuals with long-term physical disabilities whose beliefs and behaviors may limit the extent to which they prepare for, obtain, or maintain employment.
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Effects of a coping-oriented supportive programme for people with spinal cord injury during inpatient rehabilitation: a quasi-experimental study. Spinal Cord 2019; 58:58-69. [DOI: 10.1038/s41393-019-0320-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/11/2019] [Accepted: 06/18/2019] [Indexed: 11/08/2022]
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Littooij E, Widdershoven GAM, Leget CJW, Dekker J. Inner posture as aspect of global meaning in healthcare: a conceptual analysis. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2019; 22:201-209. [PMID: 30054860 DOI: 10.1007/s11019-018-9853-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Based on our empirical research on global meaning in people with spinal cord injury and people with stroke, we formulated 'inner posture' as a concept in rehabilitation. Inner posture, as we concluded from our empirical data, refers to the way in which people bear what cannot be changed. It helps them to live with their injury. Considering that much has already been written about meaning from a variety of disciplines, the question arises whether the concept of inner posture adds something new to the existing literature, or is just another name for a phenomenon that has already been described before in different terms. In this paper, we aim to investigate this and to clarify our conceptualization, by comparing the concept of inner posture with influential concepts in healthcare literature which seem to be more or less related. In the work of Puchalski regarding spirituality, Pargament regarding religion, Eliott regarding hope and Frankl regarding attitude, we found definitions and descriptions that seemed to come close to the phenomenon we refer to as inner posture. Because these concepts have various theoretical backgrounds, the comparison can help to better understand our concept of inner posture, through a process of dialogue between traditions, following Gadamer's notion of dialogue as fusion of horizons of understanding. We conclude that inner posture differs from the other concepts in several ways. Some of these differences are more fundamental, other are partial. This suggests that we identified a new perspective on a phenomenon partially described earlier. The comparison also inspired us to slightly adjust our definition and to formulate new research questions.
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Affiliation(s)
- Elsbeth Littooij
- Amsterdam Rehabilitation Research Center Reade, PO Box 58271, 1040 HG, Amsterdam, The Netherlands.
| | - Guy A M Widdershoven
- Department of Medical Humanities, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands
| | - Carlo J W Leget
- Department of Care Ethics, University of Humanistic Studies, PO Box 797, 3500 AT, Utrecht, The Netherlands
| | - Joost Dekker
- Department of Rehabilitation Medicine and Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
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Gupta S, Jaiswal A, Norman K, DePaul V. Heterogeneity and Its Impact on Rehabilitation Outcomes and Interventions for Community Reintegration in People With Spinal Cord Injuries: An Integrative Review. Top Spinal Cord Inj Rehabil 2019; 25:164-185. [PMID: 31068748 DOI: 10.1310/sci2502-164] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Various injury characteristics such as cause, level, severity, and time since injury divide individuals with spinal cord injury (SCI) into many subgroups. The heterogeneity among individuals' injuries and personal characteristics has significant implications for SCI rehabilitation practice, specifically directed toward community reintegration, which is a key goal of rehabilitation interventions for people with disabilities. Purpose: This study aims to summarize the evidence on attributes that make the SCI population heterogeneous, the impact of these attributes on community reintegration, and the implications of heterogeneity for rehabilitation interventions directed toward optimizing community reintegration. Methods: We used an integrative review approach to conduct this study. MEDLINE, PubMed, CINAHL, EMBASE, Google Scholar, and PsycINFO were searched from inception until May 2017. Out of 670 articles retrieved, 49 provided evidence on the impact of various attributes that make SCI heterogeneous on rehabilitation outcomes related to community reintegration. Results: An array of injury-related, personal, social, and environmental factors are associated with various rehabilitation outcomes that affect community reintegration of people with SCI. There is level 1 evidence that social support, self-efficacy, and self-esteem facilitate community reintegration among people with SCI while there is level 5 evidence that presence of psychological or medical complications decreases it. There is lack of clarity on the impact of injury-related factors on community reintegration. Conclusion: This integrative review found that social support and individuals' self-efficacy can improve community reintegration of people with SCI. However, evidence regarding the impact of injury characteristics on community reintegration is still underdeveloped. Approaches directed at community reintegration should involve components of psychosocial, physical, and vocational rehabilitation while considering personal and societal aspects of an individual's life.
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Affiliation(s)
- Shikha Gupta
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Atul Jaiswal
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Kathleen Norman
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Vincent DePaul
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
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Craig A, Tran Y, Guest R, Middleton J. Trajectories of Self-Efficacy and Depressed Mood and Their Relationship in the First 12 Months Following Spinal Cord Injury. Arch Phys Med Rehabil 2019; 100:441-447. [DOI: 10.1016/j.apmr.2018.07.442] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 07/18/2018] [Accepted: 07/21/2018] [Indexed: 01/10/2023]
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Badenhorst M, Brown JC, Lambert MI, Van Mechelen W, Verhagen E. Quality of life among individuals with rugby-related spinal cord injuries in South Africa: a descriptive cross-sectional study. BMJ Open 2018; 8:e020890. [PMID: 29961017 PMCID: PMC6045750 DOI: 10.1136/bmjopen-2017-020890] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 04/10/2018] [Accepted: 06/06/2018] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Rugby-related spinal cord injuries (SCIs) are rare but life altering and traumatic events. Little is known about the long-term consequences and outcomes of players who have sustained these injuries. This study investigated current quality of life (QoL) and factors associated with QoL, among individuals with rugby-related SCI in South Africa, by using the International Classification of Functioning, Disability and Health (ICF) framework. DESIGN Descriptive cross-sectional study. SETTING Rugby-related SCI population of South Africa, as captured in the BokSmart/Chris Burger Petro Jackson Players' Fund database. PARTICIPANTS Ninety (n=90) of the 102 eligible players on the database agreed to participate in the study. MAIN OUTCOME MEASURE The relationship between QoL, as measured with the WHO Quality of Life questionnaire (WHOQOL-BREF) and specific independent variables (demographic information, level of independence and participation in various activities and life roles) was investigated. Variables that were significantly associated with QoL in bivariate analyses were included in multiple linear regression analyses. RESULTS The mean score and SD of the WHOQOL-BREF was 15.1±2.3 arbitrary units. Participation (an ICF framework construct) and income were significantly associated with overall QoL (p<0.001). Participation was the only variable significantly associated with all QoL subdomains (p<0.001). Additionally, number of health concerns, type of healthcare (public vs private) and level of education were significantly associated with various QoL domains (p<0.001). CONCLUSIONS On average, these individuals with rugby-related SCI presented with higher QoL scores than other comparable SCI studies. However, lower levels of participation and income, certain levels of education, increased health concerns and use of public healthcare were associated with lower levels of QoL. Sporting bodies have a responsibility to optimise player welfare, by acting on the modifiable factors associated with QoL.
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Affiliation(s)
- Marelise Badenhorst
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, Western Cape, South Africa
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - James Craig Brown
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, Western Cape, South Africa
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Mike I Lambert
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, Western Cape, South Africa
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Willem Van Mechelen
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, Western Cape, South Africa
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
| | - Evert Verhagen
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, Western Cape, South Africa
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Australia
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Rapidi CA, Tederko P, Moslavac S, Popa D, Branco CA, Kiekens C, Varela Donoso E, Christodoulou N. Evidence-based position paper on Physical and Rehabilitation Medicine (PRM) professional practice for persons with spinal cord injury. The European PRM position (UEMS PRM Section). Eur J Phys Rehabil Med 2018; 54:797-807. [PMID: 29952157 DOI: 10.23736/s1973-9087.18.05374-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Spinal cord injury (SCI) is a devastating condition and a challenge for every health system and every society. This EBPP represents the official position of the European Union through the UEMS PRM Section and designates the professional role of PRM physicians for people with SCI. The aim of the paper was to improve Physical and Rehabilitation Medicine (PRM) physicians' professional practice for persons with SCI in order to improve their functionality, social and community reintegration, and to overcome activity limitations and/or participation restrictions. EVIDENCE ACQUISITION A systematic review of the literature and a consensus procedure by means of a Delphi process have been performed involving the delegates of all European countries represented in the UEMS PRM Section. EVIDENCE SYNTHESIS The systematic literature review is reported together with thirty-eight recommendations resulting from the Delphi procedure. CONCLUSIONS The professional role of PRM physicians who have expertise in the rehabilitation of SCI is to run rehabilitation programmes in multi-professional teams, working in an interdisciplinary way in a variety of settings to improve the functioning of people with SCI.
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Affiliation(s)
| | - Piotr Tederko
- Department of Rehabilitation, Medical University of Warsaw, Warsaw, Poland
| | - Sasa Moslavac
- Department of Physical and Rehabilitation Medicine, Special Hospital for Medical Rehabilitation, Varaždinske Toplice, Croatia
| | - Daiana Popa
- Clinical Rehabilitation Hospital Felix-Spa Bihor County, Oradea, Romania
| | - Catarina A Branco
- Department of Physical and Rehabilitation Medicine, Centro Hospitalar de Entre o Douro e Vouga E.P.E, Porto, Portugal
| | - Carlotte Kiekens
- Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Enrique Varela Donoso
- Physical and Rehabilitation Medicine Department, Complutense University School of Medicine, Madrid, Spain
| | - Nicolas Christodoulou
- Medical School, European University Cyprus, Nicosia, Cyprus.,UEMS PRM Section, Brussels, Belgium
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Post MWM, Adriaansen JJE, Peter C. Rasch analysis of the University of Washington Self-Efficacy Scale short-form (UW-SES-6) in people with long-standing spinal cord injury. Spinal Cord 2018; 56:1095-1101. [DOI: 10.1038/s41393-018-0166-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 05/10/2018] [Indexed: 11/10/2022]
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Atobatele KO, Olaleye OA, Fatoye FA, Hamzat TK. Relationships Between Community Reintegration and Clinical and Psychosocial Attributes in Individuals With Spinal Cord Injury in a Nigerian City. Top Spinal Cord Inj Rehabil 2018; 24:306-314. [PMID: 30459493 DOI: 10.1310/sci16-00055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background: The bio-psychosocial model for comprehensive understanding of community reintegration among individuals with spinal cord injury (SCI) varies across communities. Yet, information about community reintegration in Nigeria is not available. Objective: To investigate the association between community reintegration and clinical and psychosocial attributes among Nigerians with SCI. Methods: Fifty individuals (31 females; 19 males) with SCI aged 38.6 ± 11.1 years participated in this longitudinal survey. Pain, functional ability, and severity of injury were assessed at discharge and at 1, 2, and 3 months post-discharge from inpatient care using the Visual Analogue Scale (VAS), FIM®, and American Spinal Injury Association Impairment Scale (AIS), respectively. Self-esteem (SE), social support (SS), and depression were also assessed using the Self-Esteem Questionnaire, Social Support Questionnaire, and Beck Depression Inventory, respectively. CR was assessed at 1, 2, and 3 months post-discharge using the Reintegration to Normal Living Index (RNLI). Data were analyzed using Spearman's rho correlation and Friedman test. Results: The psychosocial and clinical attributes were significantly different from baseline and across the 3 months post-discharge (p < .0001), except for SS. CR significantly correlated with level of injury, function ability, SE, and depression across the 3 months post-discharge (p < .01). CR was significantly correlated with SS only at 1 month post-discharge (p = .027). Conclusion: Individuals with SCI had significant improvement in clinical and psychosocial attributes from discharge to 3 months post-discharge. Improvements in these variables were associated with better reintegration into the community.
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Affiliation(s)
| | | | - Francis A Fatoye
- Department of Health Professions, Faculty of Health, Psychology & Social Care, Manchester Metropolitan University, Manchester, UK
| | - Talhatu Kolapo Hamzat
- Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Bhattarai M, Maneewat K, Sae-Sia W. Psychosocial factors affecting resilience in Nepalese individuals with earthquake-related spinal cord injury: a cross-sectional study. BMC Psychiatry 2018; 18:60. [PMID: 29499688 PMCID: PMC5833058 DOI: 10.1186/s12888-018-1640-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 02/26/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND One of many types of injuries following an earthquake is spinal cord injury (SCI) which is a life-long medically complex injury and high-cost health problem. Despite several negative consequences, some persons with SCI are resilient enough to achieve positive adjustment, greater acceptance, and better quality of life. Since resilience is influenced by several factors and can vary by context, it is beneficial to explore factors that affect the resilience of people who sustained spinal cord injury from the 2015 earthquake in Nepal. METHODS A descriptive cross-sectional study included 82 participants from the Spinal Injury Rehabilitation Center and communities in Nepal. Participants completed the Demographic and Injury-related Questionnaire, Connor-Davidson Resilience Scale, Multidimensional Scale of Perceived Social Support, Moorong Self-efficacy Scale, Intrinsic Spirituality Scale, and Patient Health Questionnaire-9. Pearson's correlation and point biserial correlation analyses were performed to examine associations between resilience and independent variables. A hierarchical regression analysis was used to identify the influence of certain factors. RESULTS Findings indicated significant associations between resilience and social support (r = 0.42, p < 0.001), self-efficacy (r = 0.53, p < 0.001), depressive mood (r = - 0.50, p < 0.001) and demographic variables which included sex (r = 0.47, p < 0.001), employment (r = 0.27, p = 0.016), and current living location (r = 0.24, p = 0.029). There was a non-significant association between resilience and spirituality (r = - 0.12, p > 0.05). In hierarchical regression analysis, an overall regression model explained 46% of the variance in resilience. Self-efficacy (β = 0.28, p = 0.007) and depressive mood (β = - 0.24, p = 0.016) significantly determined resilience after controlling the effect of demographic variables. Among the demographic factors, being male significantly explained the variance in resilience (β = 0.31, p = 0.001). CONCLUSIONS Multiple psychosocial and demographic factors were associated with resilience in people who sustained an earthquake-related SCI. Mental health professionals should demonstrate concern and consider such factors in allocating care in this group. Development of intervention research concerning resilience is recommended to strengthen resilience in order to improve rehabilitation outcomes and enhance reintegration of individuals with SCI into their communities.
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Affiliation(s)
| | - Khomapak Maneewat
- Faculty of Nursing, Prince of Songkla University, Hat Yai, Songkhla Thailand
| | - Wipa Sae-Sia
- Faculty of Nursing, Prince of Songkla University, Hat Yai, Songkhla Thailand
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van Diemen T, Scholten EW, van Nes IJ, Geertzen JH, Post MW. Self-Management and Self-Efficacy in Patients With Acute Spinal Cord Injuries: Protocol for a Longitudinal Cohort Study. JMIR Res Protoc 2018; 7:e68. [PMID: 29483066 PMCID: PMC5847820 DOI: 10.2196/resprot.8054] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 08/18/2017] [Accepted: 09/25/2017] [Indexed: 01/03/2023] Open
Abstract
Background People with recently acquired spinal cord injury (SCI) experience changes in physical, social and psychological aspects of their lives. In the last decades, attention has grown for aspects of self-management and self-efficacy in SCI research. However, we still do not know what the self-management and self-efficacy outcomes of first rehabilitation are and whether utilizing these skills may prevent secondary health conditions (SHCs) and increase participation and psychological adjustment early after SCI. Objective To describe the course and determinants of self-management and self-efficacy during and after first SCI rehabilitation; and to determine theory-based associations between self-management and self-efficacy with SHCs, participation and psychological adjustment. Methods Multicenter prospective longitudinal cohort study. All people with a newly acquired SCI admitted to one of the 8 specialized SCI rehabilitation centers in the Netherlands will be considered for inclusion in this study. Main assessments will take place during the first and last week of admission and 3, 6 and 12 months after discharge. The target sample is 250 participants. The primary outcomes are self-management (knowledge and execution of self-care) and self-efficacy (confidence in the ability to manage the consequences of SCI and of self-care). Secondary outcome measures are SHCs, participation and psychological adjustment to SCI. Results The first results with the complete set of data are expected in June 2019. Conclusions This protocol describes the SELF-SCI cohort study investigating self-management and self-efficacy of initial inpatient SCI rehabilitation. Second, associations will be investigated with SHCs, participation and psychological adjustment early after onset of SCI, until 1 year after discharge. The results will be used to test theories about motivation to perform health-promoting behaviors and adjustment to SCI.
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Affiliation(s)
- Tijn van Diemen
- Sint Maartenskliniek, Department of Rehabilitation, Nijmegen, Netherlands.,Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands.,University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, Groningen, Netherlands
| | - Eline Wm Scholten
- Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - Ilse Jw van Nes
- Sint Maartenskliniek, Department of Rehabilitation, Nijmegen, Netherlands
| | | | - Jan Hb Geertzen
- University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, Groningen, Netherlands
| | - Marcel Wm Post
- Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands.,University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, Groningen, Netherlands
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Hug K, Stumm C, Debecker I, Fellinghauer CS, Peter C, Hund-Georgiadis M. Self-Efficacy and Pressure Ulcer Prevention After Spinal Cord Injury-Results From a Nationwide Community Survey in Switzerland (SwiSCI). PM R 2017; 10:573-586. [DOI: 10.1016/j.pmrj.2017.11.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 09/30/2017] [Accepted: 11/29/2017] [Indexed: 11/17/2022]
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Li Y, Bressington D, Chien WT. Pilot evaluation of a coping-oriented supportive program for people with spinal cord injury during inpatient rehabilitation. Disabil Rehabil 2017; 41:182-190. [PMID: 28994618 DOI: 10.1080/09638288.2017.1386238] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To report the feasibility and preliminary effects of a psychosocial care program entitled "coping-oriented supportive program" (COSP) for people with spinal cord injury (SCI) during inpatient rehabilitation. METHODS This was a pilot test of the COSP using a convenience sample of 22 participants with SCI (11 participants per group) with pre- and post-test, comparison group design. The feasibility, acceptability, and preliminary effects of the COSP were examined. RESULTS Nine patients with SCI in the intervention group and 11 in the comparison group who completed five or more sessions of the intervention were included in the data analysis. The COSP was feasible with high levels of recruitment, retention and protocol adherence. Good acceptability was suggested by the participants' feedback on the intervention program. The intervention group had a statistically significant greater improvement in self-efficacy (z = -1.978, p = 0.048), life enjoyment and satisfaction (z = -2.801, p = 0.005), and satisfaction of social support (z = -2.298, p = 0.022) at post-test, when compared to the comparison group. Whereas, no significant improvement was found for coping. CONCLUSIONS Our findings support the feasibility and acceptability of the COSP, and suggest that this intervention is a promising psychosocial care program to enhance people's life satisfaction and well-being as well as the satisfaction of social support after SCI. Further testing of this program with a larger-sized and diverse sample of people with SCI is needed. Implications for Rehabilitation The Chinese culturally-sensitive psychosocial care program (coping-oriented supportive program) is feasible, and has the potential to enhance people's self-efficacy in coping with spinal cord injury, and improve their psychosocial well-being and life satisfaction. The conventional inpatient spinal cord injury rehabilitation services could be improved by providing this "first-line" psychosocial care program in line with the current medical rehabilitation service.
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Affiliation(s)
- Yan Li
- a School of Nursing, The Hong Kong Polytechnic University , Hung Hom , Kowloon , Hong Kong
| | - Daniel Bressington
- a School of Nursing, The Hong Kong Polytechnic University , Hung Hom , Kowloon , Hong Kong
| | - Wai-Tong Chien
- a School of Nursing, The Hong Kong Polytechnic University , Hung Hom , Kowloon , Hong Kong
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Determinants of resilience among people who sustained spinal cord injury from the 2015 earthquake in Nepal. Spinal Cord 2017; 56:78-83. [PMID: 28809391 DOI: 10.1038/sc.2017.93] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 06/14/2017] [Accepted: 07/12/2017] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES To assess the level of resilience, compare resilience by demographic and injury-related characteristics, and identify significant determinants of resilience in Nepalese people who sustained spinal cord injury (SCI) from the 2015 earthquake. SETTING Spinal Injury Rehabilitation Center, Kavre and 14 communities in Nepal. METHODS Eighty-two participants were included using a convenience sampling technique. A demographic and injury-related questionnaire was used to identify the characteristics of the participants. The Connor-Davidson Resilience Scale was used to measure resilience. Linear regression analysis was performed to determine the demographic and injury-related factors that contribute to resilience. RESULTS Almost 54% of the participants had low level of resilience. Independent samples t-tests and ANOVA showed that participants with higher resilience outcome were more likely to be male, employed, paraplegic level of injury and pain free. The regression analysis revealed that only gender was a unique determinant of resilience (β=0.38, t=3.40, P=0.001) in Nepalese with earthquake-related SCI. CONCLUSION More than half of Nepalese who sustained SCI from the 2015 earthquake in Nepal had not achieved a high level of resilience 2 years later. Gender was a significant determinant of resilience. The results highlighted the importance of providing appropriate intervention and allocating continuing support to the Nepalese people with SCI. A further longitudinal study is recommended to determine predictive factors of the dynamic nature of resilience.
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Correlates of self-reported physical function in individuals with spinal cord injuries and disorders: does self-efficacy matter? Spinal Cord 2017; 55:1096-1102. [DOI: 10.1038/sc.2017.35] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 03/01/2017] [Accepted: 03/07/2017] [Indexed: 11/08/2022]
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Ahmed N, Quadir MM, Rahman MA, Alamgir H. Community integration and life satisfaction among individuals with spinal cord injury living in the community after receiving institutional care in Bangladesh. Disabil Rehabil 2017. [PMID: 28637130 DOI: 10.1080/09638288.2017.1283713] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE This study reports level of community integration and life satisfaction among individuals who sustained traumatic spinal cord injuries, received institutional rehabilitation care services, and went back to live in the community in Bangladesh. It examines the impact of type of injury, demographic characteristics, socio-economic profile, and secondary health conditions on community integration and life satisfaction and explores the association between these two measures. METHOD Individuals with spinal cord injury were telephone interviewed by the Centre for the Rehabilitation of the Paralysed, Bangladesh from February to June of 2014. Data were collected from the subjects on type of injury, demographic and socio-economic profile, and secondary health conditions. The outcome measures were determined by using two validated tools - Community Integration Questionnaire and Life Satisfaction 9 Questionnaire. RESULTS Total community integration and life satisfaction scores were 15.09 and 3.69, respectively. A significant positive relationship between community integration and life satisfaction was revealed. Type of injury, gender, and age were found to be significant predictors of both community integration and life satisfaction scores. Higher education was significantly related to community integration and life satisfaction scores. CONCLUSION Participants scored low in total community integration and life satisfaction, suggesting there is a great need to develop interventions by governmental and non-governmental organizations to better integrate individuals with spinal cord injury in the community. Implications for Rehabilitation Government and non-government organizations should offer disability friendly public transportation facilities for individuals with spinal cord injury so that they can return to education, resume employment, and involve in social activities. Entrepreneurs and businesses should develop assistive devices featuring low technology, considering the rural structure and housing conditions in Bangladesh. Innovations being made in assistive technology should be supported by subsidies and grants. They should also plan to offer injury appropriate employment opportunities for individuals who suffer major injuries like spinal cord injury in Bangladesh. Housing facilities with accessible bathrooms, kitchens and stairs should be designed and offered for this population to improve their ability to self-care and decrease the dependence on caregivers for household tasks such as - cooking meals and taking care of children.
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Affiliation(s)
- Nayeema Ahmed
- a School of Public Health, University of Texas , Houston , USA
| | | | | | - Hasanat Alamgir
- c Department of Health Policy and Management, School of Health Sciences and Practice , New York Medical College , New York , USA
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Helmreich I, Kunzler A, Chmitorz A, König J, Binder H, Wessa M, Lieb K. Psychological interventions for resilience enhancement in adults. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2017. [DOI: 10.1002/14651858.cd012527] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Isabella Helmreich
- University Medical Center of the Johannes Gutenberg University Mainz; German Resilience Center (DRZ); Untere Zahlbacher Str. 8 Mainz Rhineland-Palatinate Germany 55131
- University Medical Center of the Johannes Gutenberg University Mainz; Department of Psychiatry and Psychotherapy; Mainz Germany
| | - Angela Kunzler
- University Medical Center of the Johannes Gutenberg University Mainz; German Resilience Center (DRZ); Untere Zahlbacher Str. 8 Mainz Rhineland-Palatinate Germany 55131
- University Medical Center of the Johannes Gutenberg University Mainz; Department of Psychiatry and Psychotherapy; Mainz Germany
| | - Andrea Chmitorz
- University Medical Center of the Johannes Gutenberg University Mainz; German Resilience Center (DRZ); Untere Zahlbacher Str. 8 Mainz Rhineland-Palatinate Germany 55131
- University Medical Center of the Johannes Gutenberg University Mainz; Department of Psychiatry and Psychotherapy; Mainz Germany
| | - Jochem König
- University Medical Center of the Johannes Gutenberg University Mainz; Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI); Obere Zahlbacher Str. 69 Mainz Rhineland-Palatinate Germany 55131
| | - Harald Binder
- University Medical Center of the Johannes Gutenberg University Mainz; Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI); Obere Zahlbacher Str. 69 Mainz Rhineland-Palatinate Germany 55131
| | - Michèle Wessa
- University Medical Center of the Johannes Gutenberg University Mainz; German Resilience Center (DRZ); Untere Zahlbacher Str. 8 Mainz Rhineland-Palatinate Germany 55131
- Johannes Gutenberg University Mainz; Department of Clinical Psychology and Neuropsychology, Institute for Psychology; Wallstraße 3 Mainz Rhineland-Palatinate Germany 55122
| | - Klaus Lieb
- University Medical Center of the Johannes Gutenberg University Mainz; German Resilience Center (DRZ); Untere Zahlbacher Str. 8 Mainz Rhineland-Palatinate Germany 55131
- University Medical Center of the Johannes Gutenberg University Mainz; Department of Psychiatry and Psychotherapy; Mainz Germany
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Fekete C, Brinkhof MWG, Tough H, Siegrist J. Longitudinal study of social participation and well-being among persons with spinal cord injury and their partners (pro-WELL). BMJ Open 2017; 7:e011597. [PMID: 28122827 PMCID: PMC5278270 DOI: 10.1136/bmjopen-2016-011597] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Social participation is an important determinant of well-being. Among persons with disabilities, and with spinal cord injury (SCI) in particular, opportunities for social participation are restricted and may impact well-being. The longitudinal pro-WELL study aims to investigate associations of 2 major domains of social participation with well-being: (1) availability and quality of close social relationships and (2) acting in core social roles (eg, paid work). The joint inclusion of persons with SCI and their partners is a major innovative aspect of this study enabling an in-depth analysis of interpersonal dynamics in coping with disability. PARTICIPANTS Pro-WELL is a nested project of the Swiss Spinal Cord Injury Cohort Study (SwiSCI) and involves community-dwelling persons aged 30-65 with SCI and their partners living in Switzerland. Baseline data were collected from mid-2015 to early 2016 by telephone interviews and questionnaires. The first and second follow-up assessments are scheduled with a 6 months interval. FINDINGS TO DATE The baseline sample consists of 133 persons with SCI and their partners. We provide an overview of baseline characteristics and well-being and describe recruitment outcomes and participation rates. A comprehensive non-response analysis demonstrates adequate representation of the source population with negligible selection bias regarding sociodemographic and lesion characteristics. FUTURE PLANS The prospective data collection and analysis of month 6 and 12 assessments are ongoing and tests of the main research hypotheses will be performed. Findings will be disseminated through peer-reviewed journals and scientific conferences. A workshop and a newsletter on study findings are proposed to feed back findings to participants and other stakeholders.
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Affiliation(s)
| | - Martin W G Brinkhof
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Hannah Tough
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Johannes Siegrist
- Faculty of Medicine, Senior Professorship ‘Work Stress Research’, University of Duesseldorf, Life-Science-Center, Duesseldorf, Germany
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Jørgensen V, Roaldsen KS. Negotiating identity and self-image: perceptions of falls in ambulatory individuals with spinal cord injury - a qualitative study. Clin Rehabil 2016; 31:544-554. [PMID: 27170274 PMCID: PMC5405812 DOI: 10.1177/0269215516648751] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Objective: Explore and describe experiences and perceptions of falls, risk of falling, and fall-related consequences in individuals with incomplete spinal cord injury (SCI) who are still walking. Design: A qualitative interview study applying interpretive content analysis with an inductive approach. Setting: Specialized rehabilitation hospital. Subjects: A purposeful sample of 15 individuals (10 men), 23 to 78 years old, 2-34 years post injury with chronic incomplete traumatic SCI, and walking ⩾75% of time for mobility needs. Methods: Individual, semi-structured face-to-face interviews were recorded, condensed, and coded to find themes and subthemes. Results: One overarching theme was revealed: “Falling challenges identity and self-image as normal” which comprised two main themes “Walking with incomplete SCI involves minimizing fall risk and fall-related concerns without compromising identity as normal” and “Walking with incomplete SCI implies willingness to increase fall risk in order to maintain identity as normal”. Informants were aware of their increased fall risk and took precautions, but willingly exposed themselves to risky situations when important to self-identity. All informants expressed some conditional fall-related concerns, and a few experienced concerns limiting activity and participation. Conclusion: Ambulatory individuals with incomplete SCI considered falls to be a part of life. However, falls interfered with the informants’ identities and self-images as normal, healthy, and well-functioning. A few expressed dysfunctional concerns about falling, and interventions should target these.
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Affiliation(s)
- Vivien Jørgensen
- 1 Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Sweden.,2 Sunnaas Rehabilitation Hospital, Department of Research, Norway
| | - Kirsti Skavberg Roaldsen
- 1 Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Sweden.,2 Sunnaas Rehabilitation Hospital, Department of Research, Norway
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Jörgensen S, Iwarsson S, Norin L, Lexell J. The Swedish Aging With Spinal Cord Injury Study (SASCIS): Methodology and Initial Results. PM R 2016; 8:667-77. [DOI: 10.1016/j.pmrj.2015.10.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/26/2015] [Accepted: 10/31/2015] [Indexed: 11/16/2022]
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Associations between disability-management self-efficacy, participation and life satisfaction in people with long-standing spinal cord injury. Spinal Cord 2016; 55:47-51. [DOI: 10.1038/sc.2016.80] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/26/2016] [Accepted: 04/06/2016] [Indexed: 11/09/2022]
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Psychosocial aspects of spinal cord injury pain: a meta-analysis. Spinal Cord 2016; 54:640-8. [PMID: 27163453 DOI: 10.1038/sc.2016.66] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 03/24/2016] [Accepted: 03/24/2016] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Meta-analysis. OBJECTIVES Although the association between modifiable psychosocial factors and spinal cord injury (SCI) pain has been identified, the full range of psychological and social difficulties for those who experience acute and/or persistent pain remains unclear. This meta-analysis consolidates the available evidence, using the International Classification of Functioning, Disability and Health (ICF) as a reference framework. METHODS Nineteen studies that examined persistent neuropathic, nociceptive or mixed pain subtypes in adults with a SCI (newly acquired and chronic; Nparticipants=2934) were identified from electronic database searches. Standardised mean differences between SCI pain and no-pain groups on self-reported psychosocial outcomes were calculated, along with 95% confidence intervals, fail-safe Ns and heterogeneity statistics. RESULTS Twenty individual outcomes were grouped into nine ICF-related categories. Emotional functions were the most frequent (100%) psychosocial outcomes assessed, with pain contributing to heightened stress (d=-0.85), depression (d=-2.49) anxiety (d range=-0.85 to -1.45), poor self-efficacy (d=-0.77), lowered wellbeing (d range=-0.67 to -1.02) and decreased use of adaptive coping, such as illness acceptance (d=-0.85). Activity limitations and participation restriction were examined by seven studies (43%), although these findings were largely characterised by single studies. CONCLUSIONS Multicomponent treatments that target mood disturbance and foster community connections are important in SCI pain management. However, to improve the comparability of future studies, SCI pain research must adopt definitions of pain consistent with the International Spinal Cord Injury Pain Classification along with validated outcomes that map onto the ICF framework.
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