Abstract
Objectives
To establish self-efficacy and depressive mood trajectories in adults with spinal
cord injury (SCI), determine their interrelationship over time, and determine the
influence that appraisals and comorbid physical conditions have on the development
of self-efficacy.
Design
A prospective cohort design.
Setting
Inpatient rehabilitation and community settings.
Participants
Adults (N=88) admitted consecutively into 3 SCI units (mean age, 42.6 years, 70.4%
male, 61% paraplegia).
Interventions
Multidisciplinary inpatient SCI rehabilitation.
Main Outcome Measures
The Moorong Self-Efficacy Scale and Hospital Anxiety and Depression Scale were used
to model self-efficacy and depressive mood trajectories. Appraisals were assessed
using the Appraisals of Disability Scale and frequency/type of secondary conditions
using the Secondary Conditions Scale. Growth mixture modeling was used to determine
trajectories. Dual trajectory probability analysis was used to determine concurrent
changes in self-efficacy and depressive mood. Linear mixed modeling incorporating
repeated measures determined the contribution of appraisals and physical complications
to self-efficacy trajectories.
Results
Modeling identified 4 trajectories of self-efficacy and depressive mood. The majority
(around 60%) of the sample was estimated to have moderate to high self-efficacy and
low levels of depressive mood. Dual trajectory analysis revealed that robust self-efficacy
was strongly connected to low depressive mood over time, while low self-efficacy was
strongly linked to clinically elevated depressive mood. Low self-efficacy was related
to higher severity of secondary conditions and negative appraisals.
Conclusions
Findings highlight the importance of self-efficacy not only as a strategic clinical
measure for assessing adjustment following SCI but also in relation to the implications
it raises for improving SCI rehabilitation.
Keywords
List of abbreviations:
ADAPSS (Appraisals of Disability Primary and Secondary Scale), BIC (Bayesian information criterion), DM (depressive mood), GBTM (group-based trajectory modeling), HADS (Hospital Anxiety and Depression Scale), MSES (Moorong Self-Efficacy Scale), SCI (spinal cord injury), SCI-SCS (SCI Secondary Conditions Scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 12, 2018
Footnotes
Supported by a competitive grant from the Lifetime Care Support Authority (New South Wales, Australia) (grant no. LTCSA 08/209); the Australian Research Council (grant no. LP0560590); and the Australian Rotary Health.
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
