Abstract
Objective
Self-efficacy (SE) is an important determinant for the psychological adjustment of
people with spinal cord injury (SCI). However, little is known about the course of
SE during inpatient rehabilitation up to 1 year after discharge. The aim of this study
was to determine latent trajectory classes of SE, depressive mood, and anxiety in
people with SCI, as well as the interrelationships between these trajectories.
Design
Longitudinal inception cohort study.
Setting
Eight specialized SCI rehabilitation centers.
Participants
The participants (N=268) were mainly men 183 of 268 (68.3%) with a mean age of 55.6
years. Almost half had a traumatic SCI 135 of 268 (50.4%) and tetraplegia (53.7%),
and the minority had a motor complete SCI (32.2%).
Interventions
Not applicable.
Main Outcome Measures
SE was measured using the University of Washington Self-Efficacy Scale. In addition,
the Hospital Anxiety and Depression Scale was used to asses distress and perform dual
trajectory modeling analyses.
Results
Three trajectories of SE, indicating low, middle, and high SE, could be distinguished.
Furthermore, a 2-class trajectory solution for depressive mood and a 4-class solution
for anxiety were found to be most suitable. All trajectories were stable over time.
Developmental connections between SE and depressive mood and between SE and anxiety
were revealed. In particular, participants who adjusted well, reporting low scores
on depressive mood and anxiety, could be identified by their high SE scores. However,
the group of participants with high depressive mood scores and anxiety scores could
not always be identified based on their SE trajectory.
Conclusions
In accordance with our hypotheses, distinct trajectories of SE, depressive mood, and
anxiety were identified and high probabilities that SE trajectories were interrelated
to the trajectories from depressive mood and anxiety were confirmed. Concurrent screening
for SE and distress might best detect people at risk for adjustment problems.
Keywords
List of abbreviations:
GBTM (group-based trajectory modeling), HADS (Hospital Anxiety and Depression Scale), SCI (spinal cord injury), SE (self-efficacy), UW-SES (University of Washington self-efficacy Scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 22, 2021
Accepted:
April 25,
2021
Received in revised form:
April 7,
2021
Received:
February 4,
2021
Footnotes
Supported by the Dutch Rehabilitation foundation (Revalidatiefonds; grant no. 2014039). The funder had no role in designing the study or in data collection or the analysis of the data.
Disclosures: none.
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
