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Profiles of Psychological Adaptation Outcomes at Discharge From Spinal Cord Injury Inpatient Rehabilitation

Published:September 25, 2019DOI:https://doi.org/10.1016/j.apmr.2019.08.481

      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)
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