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Westphal M, Carrard V, Braunwalder C, Debnar C, Post M, Fekete C, Galvis M, Scheel-Sailer A. Reciprocal association between pain and quality of life after newly acquired spinal cord injury. Qual Life Res 2024; 33:1347-1357. [PMID: 38459349 DOI: 10.1007/s11136-024-03615-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 03/10/2024]
Abstract
PURPOSE Pain is highly prevalent in spinal cord injury (SCI) and a key determinant of quality of life (QoL). This is the first study to examine reciprocal associations between pain and QoL in patients undergoing their first inpatient rehabilitation after SCI. METHODS Longitudinal data, with three measurement time points (1 month and 3 months after SCI onset, and at discharge from inpatient rehabilitation) from the Inception Cohort of the Swiss Spinal Cord Injury Cohort Study. Participants were 381 individuals aged ≥ 16 years with a newly diagnosed traumatic or non-traumatic SCI. 75.1% were male and the average age was 53.2 years. Random intercept cross-lagged panel models were conducted to examine the reciprocal association between pain intensity and QoL, as measured with the International SCI QoL Basic Data Set three individual items (satisfaction with life, physical health, and psychological health) and total score (mean of the three individual items). RESULTS Both item and total QoL scores increased over time. 1 month: 5.3 (SD = 2.7), 3 months: 5.9 (SD = 2.3), discharge: 6.6 (SD = 2.0). Participants reported relatively low levels of pain intensity that remained stable over the course of inpatient rehabilitation. 1 month: 2.7 (SD = 2.3), 3 months: 2.6 (SD = 2.4), discharge: 2.7 (SD = 2.5). There were no significant cross-lagged associations between QoL and pain intensity across time. CONCLUSION Results indicate that pain intensity does not predict changes in QoL during first rehabilitation, and vice versa. Associations between pain intensity and QoL reported by previous studies may be attributable to individual characteristics and timely events that simultaneously influence pain and QoL.
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Affiliation(s)
- Maren Westphal
- Department of Psychology, Pace University, 861 Bedford Rd, Pleasantville, NY, 10570, USA.
| | - Valerie Carrard
- Swiss Paraplegic Research, Nottwil, Switzerland
- Psychiatric Liaison Service, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Céline Braunwalder
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Institute of Complementary and Integrative Medicine, University of Bern, Bern, Switzerland
| | - Caroline Debnar
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Marcel Post
- Center of Excellence in Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Christine Fekete
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Mayra Galvis
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Anke Scheel-Sailer
- Swiss Paraplegic Research, Nottwil, Switzerland
- Psychiatric Liaison Service, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Centre, Nottwil, Switzerland
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Debnar C, Peter C, Morselli D, Michel G, Bachmann N, Carrard V. Reciprocal association between social support and psychological distress in chronic physical health conditions: A random intercept cross-lagged panel model. Appl Psychol Health Well Being 2024; 16:376-394. [PMID: 37740583 DOI: 10.1111/aphw.12495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/08/2023] [Indexed: 09/24/2023]
Abstract
The onset of a chronic physical health condition (CHC) can highly impact individuals' well-being and mental health. Social support has been shown to help people rebound after the onset of a CHC. Nonetheless, little is known about the longitudinal pattern of social support and its reciprocal association with mental health in CHC. This study aimed to illustrate the longitudinal pattern of perceived social support and to examine the reciprocal association between perceived social support and psychological distress across 6 years. Two random intercept cross-lagged panel models were conducted, one for emotional and one for practical support, using yearly assessments of 582 Swiss Household Panel's participants reporting a CHC. A reciprocal association was found, with psychological distress 1 year after the onset being linked to less emotional support in the following year and vice versa, more emotional support being linked to less psychological distress the following year. A unidirectional association was found for practical support, with more psychological distress 1 year before the CHC onset being linked to more practical support at the onset year. This study underlines the importance of involving the social environment of individuals living with a CHC, especially around the first year after the onset.
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Affiliation(s)
- Caroline Debnar
- Empowerment, Participation and Social Integration Unit, Swiss Paraplegic Research, Nottwil, Switzerland
- Swiss National Centre of Competence in Research LIVES, University of Lausanne, Lausanne, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Claudio Peter
- Empowerment, Participation and Social Integration Unit, Swiss Paraplegic Research, Nottwil, Switzerland
- Swiss National Centre of Competence in Research LIVES, University of Lausanne, Lausanne, Switzerland
- Swiss Health Observatory (OBSAN), Neuchâtel, Switzerland
| | - Davide Morselli
- Swiss National Centre of Competence in Research LIVES, University of Lausanne, Lausanne, Switzerland
| | - Gisela Michel
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Nicole Bachmann
- School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
| | - Valerie Carrard
- Empowerment, Participation and Social Integration Unit, Swiss Paraplegic Research, Nottwil, Switzerland
- Swiss National Centre of Competence in Research LIVES, University of Lausanne, Lausanne, Switzerland
- Psychiatric Liaison Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Fekete C, Debnar C, Scheel-Sailer A, Gemperli A. Does the socioeconomic status predict health service utilization in persons with enhanced health care needs? Results from a population-based survey in persons with spinal cord lesions from Switzerland. Int J Equity Health 2022; 21:94. [PMID: 35821147 PMCID: PMC9275068 DOI: 10.1186/s12939-022-01693-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Evidence suggests that the socioeconomic status (SES) affects individuals’ health service utilization. Spinal cord injury is a condition that often leads to physical impairments and enhanced health care needs. It therefore presents an informative and yet under-researched case in point to investigate social inequalities in health service utilization. This study aims to describe associations between SES and health service utilization in adults with spinal cord injury from Switzerland. Methods We use cross-sectional data from 1,294 participants of the Swiss Spinal Cord Injury Cohort Study community survey 2017. SES was operationalized with education, household income, perceived financial hardship, subjective status, and granting of supplementary financial benefits. Health service utilization was assessed with information on visits to 13 different health care providers and four health care institutions (inpatient stays, outpatient clinics, emergency departments, specialized spinal cord centers) during the past 12 months. The dichotomized outcomes on service utilization (visited vs. not visited) were regressed on SES indicators, including adjustments for sociodemographics, lesion characteristics, and health status. Results Persons with higher SES reported higher likelihood for specialist, dentist, and dental hygienist visits and reported utilizing a larger number of different care providers. Further, specific SES indicators were associated with certain care provider visits (i.e., higher education and subjective status: higher odds for pharmacist visits; higher income: higher odds for natural healer visits; higher subjective status: higher odds for chiropractor visits; supplementary benefit granting: higher odds for general practitioner and home care service visits). We found statistically non-significant trends towards lower likelihood for inpatient stays, outpatient clinic and emergency department visits and enhanced likelihood for specialized spinal cord-center visits in higher SES groups. Conclusions This study generally supports the claim that basic health care provision is guaranteed for all patients with spinal cord injury in Switzerland, independently of their SES. However, social inequalities were still observed for the utilization of specific providers, such as oral health care providers. Given that oral health is key for health maintenance in persons with spinal cord injury, specific interventions to enhance regular dental check-ups in lower SES groups are highly recommended. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-022-01693-6.
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Affiliation(s)
- Christine Fekete
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland. .,Department of Health Sciences & Medicine, University of Lucerne, Frohburgstrasse 2, 6003, Lucerne, Switzerland. .,Work Mastery, Corporate Health Consulting, Pilatusstrasse 19, 6003, Lucerne, Switzerland.
| | - Caroline Debnar
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland.,Department of Health Sciences & Medicine, University of Lucerne, Frohburgstrasse 2, 6003, Lucerne, Switzerland
| | - Anke Scheel-Sailer
- Department of Health Sciences & Medicine, University of Lucerne, Frohburgstrasse 2, 6003, Lucerne, Switzerland.,Swiss Paraplegic Center, Guido A. Zäch Strasse 1, 6207, Nottwil, Switzerland
| | - Armin Gemperli
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland.,Department of Health Sciences & Medicine, University of Lucerne, Frohburgstrasse 2, 6003, Lucerne, Switzerland.,Center of Primary and Community Care, University of Lucerne, Frohburgstrasse 2, 6003, Lucerne, Switzerland
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Debnar C, Carrard V, Morselli D, Michel G, Bachmann N, Peter C. The longitudinal impact of a chronic physical health condition on subjective well-being. Health Psychol 2021; 40:357-367. [PMID: 34323538 DOI: 10.1037/hea0001090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Chronic health conditions (CHC) can have severe impacts on an individual's life, affecting well-being and mental health. Nonetheless, individuals can show different response patterns of psychological adaptation following a CHC onset. This study aimed to identify profiles of subjective well-being (SWB) at 1 year before (T - 1), 1 year after (T + 1), and 4 years after (T + 4) the onset of a physical CHC using seven indicators (health satisfaction, life satisfaction, energy, joy, worry, sadness, anger), examine transitions between the identified profiles, and determine predicting factors of these transitions. METHOD Latent profile analysis and latent transition analysis was conducted using a sample of 357 participants reporting a physical CHC drawn from the Swiss Household Panel dataset. RESULTS Three profiles were identified at T - 1: low, high, and very high SWB. At T + 1 and T + 4, a fourth vulnerable profile emerged. Transition analysis showed that, overall, the most probable transition was to stay in similar profiles across time. However, recovery toward higher SWB profiles and delayed reaction toward lower SWB profiles appeared between 1 and 4 years following the CHC onset. Factors predicting recovery patterns from low to high SWB are better health status, fewer negative life events, and financial scarcity, whereas lower emotional stability was related to a delayed reaction from high to low SWB. CONCLUSION This study underlines the importance of personal factors in the adaptation following CHC onset. Routine assessment of personality traits would enable identifying individuals at greater risk of lower SWB following the onset of a CHC. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | - Davide Morselli
- Swiss Centre of Expertise in Life Course Research LIVES, University of Lausanne
| | - Gisela Michel
- Department of Health Sciences and Medicine, University of Lucerne
| | - Nicole Bachmann
- Institute for Social Work and Health, University of Applied Sciences and Arts Northwestern Switzerland
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Debnar C, Carrard V, Morselli D, Michel G, Bachmann N, Peter C. Psychological distress trajectories in chronic physical health conditions. Health Psychol 2019; 39:116-126. [PMID: 31789560 DOI: 10.1037/hea0000820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The onset of a chronic health condition (CHC) can have a severe impact on an individual's life, affecting mental and physical health. This study's goal was to investigate psychological distress trajectories starting from 1 year before to 4 years after the onset of a physical CHC. The specific aims were to identify the number and shape of longitudinal psychological distress trajectories and to test health-related, psychological, social, and demographic factors predicting these trajectories. METHOD Two samples were drawn from the Swiss Household Panel data set: a CHC sample (n = 361) and a 1-to-1 matched comparison sample of healthy individuals. Latent growth mixture modeling was used to identify psychological distress trajectories over 6 years. Factors predicting trajectories were then tested using multinomial logistic regression. RESULTS Four psychological distress trajectories were identified in the CHC sample: resilience (53.9%), chronic (22.2%), delayed (15.0%), and recovery (8.9%). In the comparison sample, two trajectories were identified: low psychological distress (90%) and elevated psychological distress (10%). Protective factors associated with resilient trajectory membership in the CHC sample were higher emotional stability, higher relationship satisfaction, and male gender. CONCLUSION Individuals living with a CHC had an increased risk of vulnerability compared with a sample of healthy individuals. This advocates awareness of mental health issues following the onset of a CHC. In this regard, biopsychosocial factors (gender, emotional stability, and relationship satisfaction) offer prevention and intervention opportunities for more vulnerable individuals. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Caroline Debnar
- Emowerment, Participation and Social Integreation Unit, Swiss Paraplegic Research
| | - Valerie Carrard
- Emowerment, Participation and Social Integreation Unit, Swiss Paraplegic Research
| | | | - Gisela Michel
- Department of Health Sciences and Medicine, University of Lucerne
| | - Nicole Bachmann
- School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland
| | - Claudio Peter
- Emowerment, Participation and Social Integreation Unit, Swiss Paraplegic Research
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