Abstract
Objective
To evaluate the effect of a newly acquired spinal cord injury (SCI) by identifying
profiles of psychological adaptation outcomes at discharge from inpatient rehabilitation,
using several outcome measures in parallel and to examine biopsychosocial factors
associated with profile membership.
Design
Cross-sectional analysis of data from the Swiss Spinal Cord Injury inception cohort
study.
Setting
Inpatient rehabilitation.
Participants
Individuals 16 years old or older with recently diagnosed SCI who finished clinical
rehabilitation in 1 of the 4 major national rehabilitation centers (N=370).
Interventions
Not applicable.
Main Outcome Measures
Life satisfaction, general distress, and symptoms of depression and anxiety were assessed
using a single item from the International SCI Quality of Life Basic Data Set, the
Distress Thermometer, and the Hospital Anxiety and Depression Scale respectively.
Results
Using latent profile analysis, 4 profiles of psychological adaptation outcomes were
identified displaying different levels of impact, ranging from Minimal to Severe.
Regarding covariates associated with profile membership, higher optimism, purpose
in life, and self-efficacy indicated a higher probability of having a Minimal impact
profile. Additionally, males, individuals with better functional independence, and
those with an absence of pain were more likely to show a Minimal impact profile.
Conclusions
Among the participants, 70% showed Minimal or Low impact profiles. Our findings support
that individuals can show positive responses across several outcome measures even
at an early time after the injury onset (eg, at discharge from inpatient rehabilitation).
Moreover, our results indicate that beyond functional independence, improvement, and
pain management, a rehabilitation process that strengthens psychological resources
might contribute to better adaptation outcomes.
Keywords
List of abbreviations:
BIC (Bayesian information criterion), BLRT (bootstrapped likelihood ratio test), HADS (Hospital Anxiety and Depression Scale), LMR (Lo-Mendell-Rubin likelihood ratio test), LPA (latent profile analysis), SwiSCI (Swiss Spinal Cord Injury inception cohort study), SCI (spinal cord injury)To read this article in full you will need to make a payment
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References
- Spinal cord injury.in: Brodwin M.G. Siu F.W. Howard J. Brodwin E.R. Medical, psychosocial and vocational aspects of disability. Elliott & Fitzpatrick, Inc, Athens, Greece2009: 289-304
- Rehabilitation of spinal cord injuries.World J Orthop. 2015; 6: 8-16
- Adaptation to living with a genetic condition or risk: a mini-review.Clin Genet. 2008; 74: 401-407
- Psychosocial adaptation to chronic illness and disability: a conceptual framework.Rehabil Couns Bull. 2001; 44: 151-160
- Psychological challenges in treating persons with spinal cord injury.in: Craig A. Tran Y. Psychological aspects associated with spinal cord injury rehabilitation: new directions and best evidence. Nova Science Publisher, NY2008: 3-53
- Theory of adjustment following severe neurological injury: evidence supporting the Spinal Cord Injury Adjustment Model.in: Costa A. Villalba E. Horizons in neuroscience research. Nova Science Publishers Inc, New York, NY2017: 117-140
- Psychosocial issues in spinal cord injury: a review.Spinal Cord. 2012; 50: 382-389
- Prospective study of the occurrence of psychological disorders and comorbidities after spinal cord injury.Arch Phys Med Rehabil. 2015; 96: 1426-1434
- Prevalence of depression after spinal cord injury: a meta-analysis.Arch Phys Med Rehabil. 2015; 96: 133-140
- Trajectories of resilience, depression, and anxiety following spinal cord injury.Rehabil Psychol. 2012; 57: 236-247
- Depression trajectories during the first year after spinal cord injury.Arch Phys Med Rehabil. 2016; 97: 196-203
- Trajectories and predictors of the course of mental health after spinal cord injury.Arch Phys Med Rehabil. 2012; 93: 2170-2176
- Trajectories in the course of life satisfaction after spinal cord injury: identification and predictors.Arch Phys Med Rehabil. 2011; 92: 207-213
- Resilience and happiness after spinal cord injury: a qualitative study.Top Spinal Cord Inj Rehabil. 2016; 22: 99-110
- Quality of life, social participation, appraisals and coping post spinal cord injury: a review of four community samples.Spinal Cord. 2006; 44: 95-105
- The experience of posttraumatic growth for people with spinal cord injury.Qual Health Res. 2008; 18: 877-890
- Post-traumatic growth following spinal cord injury.J Spinal Cord Med. 2014; 37: 218-225
- Annual research review: positive adjustment to adversity: trajectories of minimal-impact resilience and emergent resilience.J Child Psychol Psychiatry. 2013; 54: 378-401
- Resilience to loss and potential trauma.Ann Rev Clin Psychol. 2011; 7: 511-535
- The multidimensional nature of resilience to spousal loss.J Pers Soc Psychol. 2017; 112: 926-947
- Psychological adjustment.in: Lopez S. The encyclopedia of positive psychology. Wiley-Blackwell, Hoboken, NJ2009: 796-801
- Health psychology: psychological adjustment to chronic disease.Ann Rev Psychol. 2007; 58: 565-592
- Subjective well-being and adaptation to life events: a meta-analysis.J Pers Soc Psychol. 2012; 102: 592-615
- Parents' adjustment following the death of their child: resilience is multidimensional and differs across outcomes examined.J Res Pers. 2017; 68: 38-53
- Patterns of psychological adaptation to spousal bereavement in old age.Gerontology. 2015; 61: 456-468
- Patterns of psychological adaptation to divorce after a long-term marriage.J Soc Pers Relat. 2014; 32: 386-405
- The pattern of coping in persons with spinal cord injuries.Disabil Rehabil. 2000; 22: 501-507
- Patterns of psychosocial adaptation to chronic illness and disability: a cluster analytic approach.Psychol Health Med. 2004; 9: 411-430
- Psychological factors and mental health in persons with spinal cord injury: an exploration of change or stability.J Rehabil Med. 2015; 47: 531-537
- Depression in spinal cord injury: assessing the role of psychological resources.Rehabil Psychol. 2015; 60: 67-80
- Psychological resources, appraisals, and coping and their relationship to participation in spinal cord injury: a path analysis.Arch Phys Med Rehabil. 2014; 95: 1662-1671
- Psychological resources in spinal cord injury: a systematic literature review.Spinal Cord. 2012; 50: 188-201
- Recovery of life satisfaction in persons with spinal cord injury during inpatient rehabilitation.Am J Phys Med Rehabil. 2009; 88: 887-895
- Life satisfaction in people with spinal cord injury during the first five years after discharge from inpatient rehabilitation.Disabil Rehabil. 2012; 34: 76-83
- Secondary health conditions experienced by people with spinal cord injury within community living: implications for a national disability insurance scheme.Aus Occup Ther J. 2015; 62: 246-254
- Design of the Swiss Spinal Cord Injury Cohort Study.Am J Phys Med Rehab. 2011; 90: S5-S16
- International spinal cord injury quality of life basic data set.Spinal Cord. 2012; 50: 672-675
- Good validity of the international spinal cord injury quality of life basic data set.Spinal Cord. 2016; 54: 314-318
- Rapid screening for psychologic distress in men with prostate carcinoma. a pilot study.Cancer. 1998; 82: 1904-1908
- The clinical utility of the distress thermometer: a review.Br J Nurs. 2011; 20: 220-227
- Use of distress and depression thermometers to measure psychosocial morbidity among southern European cancer patients.Supp Care Cancer. 2005; 13: 600-606
- The Hospital Anxiety and Depression Scale.Acta Psychiatr Scand. 1983; 67: 361-370
- Rasch analysis of the Hospital Anxiety and Depression Scale in spinal cord injury.Rehabil Psychol. 2012; 57: 214-223
- The Hospital Anxiety And Depression Scale.Health Qual Life Outcomes. 2003; 1: 29
- The Hospital Anxiety and Depression Scale.Occup Med. 2014; 64: 393-394
- The Spinal Cord Independence Measure (SCIM) version III: reliability and validity in a multi-center international study.Disabil Rehabil. 2007; 29: 1926-1933
- A multicenter international study on the Spinal Cord Independence Measure, version III: Rasch psychometric validation.Spinal Cord. 2007; 45: 275-291
- Generalized Self-efficacy Scale.in: Weinman J. Wright S. Johnston M. Measures in health psychology: a user's portfolio. Causal and control beliefs Windsor. NFER-Nelson Publishing Company, Bershire1995: 35-36
- Rasch analysis of the General Self-Efficacy Scale in spinal cord injury.J Health Psychol. 2014; 19: 544-555
- The Purpose in Life Test-Short Form: development and psychometric support.J Happiness Stud. 2011; 12: 861-876
- Rasch analysis of measurement instruments capturing psychological personal factors in persons with spinal cord injury.J Rehabil Med. 2016; 48: 175-188
- Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a re-evaluation of the Life Orientation Test.J Pers Soc Psychol. 1994; 67: 1063-1078
- Psychometric properties and population-based norms of the Life Orientation Test Revised (LOT-R).Br J Health Psychol. 2012; 17: 432-445
- State or trait: effects of state optimism on job-related outcomes.J Organ Behav. 2009; 30: 209-231
- The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.PLOS Med. 2007; 4: e296
- Mixture models: latent profile and latent class analysis.in: Robertson J. Kaptein M. Modern statistical methods for HCI: a modern look at data analysis for HCI research. Springer, Basel, Switzerland2016: 275-287
- Non-normal and categorical data in structural equation modeling.in: Hancock G.R. Mueller R.O. A second course in structural equation modeling. Information Age, Greenwich2006: 269-314
- Modeling unobserved heterogeneity using latent profile analysis: a Monte Carlo simulation.Struct Equ Modeling. 2013; 20: 616-639
- K-means may perform as well as mixture model clustering but may also be much worse: comment on Steinley and Brusco (2011).Psychol Methods. 2011; 16: 82-88
- Higher-order growth curves and mixture modeling with Mplus: a practical guide.Taylor & Francis, New York2016
- Using Mplus TECH11 and TECH14 to test the number of latent classes.(Available at:) (Accessed August 14, 2018)
- Latent class modeling with covariates: two improved three-step approaches.Political Anal. 2010; 18: 450-469
- Auxiliary variables in mixture modeling: three-step approaches using Mplus.Struct Equ Modeling. 2014; 21: 329-341
- Covariates and mixture modeling: results of a simulation study exploring the impact of misspecified effects on class enumeration.Struct Equ Modeling. 2016; 23: 782-797
- Applied missing data analysis.Guilford Press, New York2010
- Multiple imputation strategies for multiple group structural equation models.Struct Equ Modeling. 2011; 18: 35-54
- Identifying trajectories of adolescent smoking: an application of latent growth mixture modeling.Health Psychol. 2001; 20: 127-135
- Resilience in the face of coping with a severe physical injury: a study of trajectories of adjustment in a rehabilitation setting.Rehabil Psychol. 2010; 55: 12-22
Swiss Federal Statistical Office. Equality of People with Disabilities: Individual well-being 2017. Available at: https://www.bfs.admin.ch/bfs/en/home/statistics/economic-social-situation-population/equality-people-disabilities/individual-well-being.html. Accessed February 22, 2019.
- Resilience to major life stressors is not as common as thought.Perspect Psychol Sci. 2016; 11: 175-194
- Anxiety prevalence following spinal cord injury: a meta-analysis.Spinal Cord. 2016; 54: 570-578
- Associations between self-efficacy and secondary health conditions in people living with spinal cord injury: a systematic review and meta-analysis.Arch Phys Med Rehabil. 2017; 98: 2566-2577
- Modeling life satisfaction in spinal cord injury: the role of psychological resources.Qual Life Res. 2014; 23: 2693-2705
- Predicting the long-term impact of acquired severe injuries on functional health status: the role of optimism, emotional distress and pain.Spinal Cord. 2011; 49: 1193-1197
- Experience of rehabilitation following spinal cord injury: a meta-synthesis of qualitative findings.Spinal Cord. 2007; 45: 260-274
- Leaving a spinal unit and returning to the wider community: an interpretative phenomenological analysis.Disabil Rehabil. 2013; 35: 1164-1173
- Systematic review of psychosocial interventions for people with spinal cord injury during inpatient rehabilitation: implications for evidence-based practice.Worldviews Evid Based Nurs. 2017; 14: 499-506
- Pilot evaluation of a coping-oriented supportive program for people with spinal cord injury during inpatient rehabilitation.Disabil Rehabil. 2019; 41: 182-190
- Using peer mentoring for people with spinal cord injury to enhance self-efficacy beliefs and prevent medical complications.J Clin Nurs. 2011; 20: 351-358
- Predictors of psychosocial adaptation among people with spinal cord injury or disorder.Arch Phys Med Rehabil. 2005; 86: 1182-1192
- Depressive mood in adults with spinal cord injury as they transition from an inpatient to a community setting: secondary analyses from a clinical trial.Spinal Cord. 2017; 55: 926-934
- Depression after spinal cord injury: relation to gender, ethnicity, aging, and socioeconomic indicators.Arch Phys Med Rehabil. 2000; 81: 1099-1109
- Psychological adjustment to spinal cord injury: the contribution of coping, hope and cognitive appraisals.Psychol Health Med. 2009; 14: 17-33
- Anxiety and depression in patients with traumatic spinal cord injury: a nationwide population-based cohort study.PLoS One. 2017; 12e0169623
- Spinal cord injury, coping and psychological adjustment: a literature review.Spinal Cord. 2009; 47: 778-782
- Predictors of life satisfaction: a spinal cord injury cohort study.Arch Phys Med Rehabil. 2002; 83: 555-561
- Predicting life satisfaction after spinal cord injury in a Canadian sample.Spinal Cord. 2008; 46: 380-385
- Marital status, marital transitions, well-being, and spinal cord injury: an examination of the effects of sex and time.Arch Phys Med Rehabil. 2011; 92: 433-440
- The role of social support and social skills in people with spinal cord injury — a systematic review of the literature.Spinal Cord. 2012; 50: 94-106
- Relationship quality and perceived social support in persons with spinal cord injury.Spinal Cord. 2014; 53: 120
Article info
Publication history
Published online: September 25, 2019
Footnotes
Supported by the Swiss National Science Foundation (grant no. 100019_165484).
Disclosures: none.
This study has been conducted in the framework of the Swiss Spinal Cord Injury Cohort Study (SwiSCI, www.swisci.ch), supported by the Swiss Paraplegic Foundation. The members of the SwiSCI Steering Committee are Xavier Jordan, Bertrand Léger (Clinique Romande de Réadaptation, Sion); Michael Baumberger, Hans Peter Gmünder (Swiss Paraplegic Center, Nottwil); Armin Curt, Martin Schubert (University Clinic Balgrist, Zürich); Margret Hund-Georgiadis, Kerstin Hug (REHAB Basel, Basel); Thomas Troger (Swiss Paraplegic Association, Nottwil); Daniel Joggi (Swiss Paraplegic Foundation, Nottwil); Hardy Landolt (representative of persons with spinal cord injury, Glarus); Nadja Münzel (Parahelp, Nottwil); Mirjam Brach, Gerold Stucki (Swiss Paraplegic Research, Nottwil); Christine Fekete (SPF Coordination Group at Swiss Paraplegic Research, Nottwil).
Identification
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© 2019 by the American Congress of Rehabilitation Medicine
