Attributional cognitions, coping behavior, and self-esteem in inpatients with severe spinal cord injuries

Lay Etiology, Self-Efficacy and Patient Activation Among Cancer Patients

BACKGROUND

We aimed at clarifying correlations between lay etiologies, self-efficacy, and patient activation among cancer patients.

METHODS

Patients with different kinds of cancer answered a questionnaire on self-efficacy, lay etiology, and patient activation.

RESULTS

639 patients participated. Psychological reasons/stress (43.3%) and destiny (41.6%) were the most cited causes. Lay etiology was influenced by demographics, self-efficacy, and patient activation. Men, younger people, and active patients more often described internal causes of cancer, women and religious patients more often external causes. Patients with higher scores of self-efficacy were more often convinced of external cancer causes.

CONCLUSION

By identifying individual disease theories, physicians may improve patient-physician communication.

Modeling social reintegration in persons with spinal cord injury

PURPOSE

This study was undertaken to identify and develop a model of the factors related to social reintegration in persons with spinal cord injury (SCI).

METHOD

A convenience sample of 145 persons with SCI living in two cities in South Korea anonymously completed a questionnaire that comprised the assessment of social reintegration, a tool developed to measure the degree of adjustment to community living in persons with SCI. Structural equation modeling was used to examine the direct and indirect effects of self-esteem, social barriers, physical function, family support, informational support, perceived stress, emotion-focused coping (EFC), and problem-focused coping (PFC) on social reintegration.

RESULTS

The model explained 65% of the variance in social reintegration in persons with SCI. The results indicated that the social integration of persons with SCI was influenced most by EFC. Family support, informational support, perceived stress and social barriers were also significantly related to social reintegration.

CONCLUSIONS

These findings suggest implications for developing the interventions at various levels including family and community and specific to individual coping strategies to enhance social reintegration in persons with SCI.

Psychological aspects of mutilating hand injuries

The immediate and long-term outcome of a mutilating hand injury can be positively influenced by health care professionals adopting a biopsychosocial perspective toward treatment and management. Such an injury produces a psychological and social impact that should be openly and candidly addressed with the injured individual and with the family. The earlier and the more skillfully these issues are addressed, the more likely it is that psychological factors will not impede functional outcome.

Linkages between coping and psychological outcome in the spinal cord lesioned: development of SCL-related measures

STUDY DESIGN

Cross-sectional.

OBJECTIVES

To investigate relationships between coping and mental well-being with clinical relevance to spinal cord lesion (SCL).

SETTING

The Gothenburg Spinal Injuries Unit in Sweden.

METHODS

The study sample comprised 274 persons. From in-depth interviews, literature reviews, and the transactional theory of stress and coping, items reflecting coping and psychological outcome, respectively were generated. Principal components factor analysis, multi-trait analysis, and structural equation modelling were used.

RESULTS

The coping scale comprised three factors: Acceptance (i.e. revaluation of life values); Fighting spirit (i.e. efforts to behave independently); Social reliance (i.e. a tendency towards dependent behaviour). The outcome scale included the factors: Helplessness (i.e. feeling perplexed, out of control and low self-esteem); Intrusion (i.e. bitterness and brooding); Personal growth (i.e. positive outcomes of life crisis). Acceptance showed a positive relation to Personal growth and was inversely related to both Helplessness and Intrusion. Fighting spirit had a weak negative association to Helplessness and a weak positive association to Personal growth. Social reliance was positively related to Helplessness and Intrusion. Only Social reliance showed any association to neurological status. Those lesioned 1-4 years reported more Helplessness, Intrusion, Social reliance, and less Acceptance than those lesioned >or=5 years.

CONCLUSION

Coping is related to psychological outcome in SCL. Our situational coping measure may be a candidate to assess intervention effects.

The impact of coping on emotional adjustment to spinal cord injury (SCI): review of the literature and application of a stress appraisal and coping formulation

OBJECTIVES

This article reviews literature examining the psychological adjustment to Spinal Cord Injury (SCI) and illustrates the applicability of a Stress Appraisal and Coping model (SAC) for rehabilitation of this population.

METHOD

Articles concerning psychological adjustment to SCI from the previous three decades have been reviewed and critiqued. When possible the articles have been discussed in a SAC framework.

RESULTS

The literature indicates that psychological adjustment to SCI is largely predictable from psychological variables including coping, appraisal and psychosocial resources. Recent literature has suggested psychological intervention can promote positive psychological adjustment following SCI for those individuals at risk of developing clinical levels of depression.

CONCLUSION

The SAC model provides a comprehensive formulation to incorporate the heterogeneity of populations with SCI. Suggestions for future research include developing assessment and treatment regimes specifically tailored to the strengths and weaknesses of an individual as highlighted in the model.

A meta-analytic review of coping with illness: do causal attributions matter?

OBJECTIVE

The present meta-analytic review assessed the relations between causal attributions, coping, and psychological adjustment in individuals with physical illnesses or undergoing medical procedures. A theoretical model predicting psychological adjustment was proposed. It was hypothesized that causal attributions would be both directly related to psychological adjustment and indirectly related to psychology adjustment via coping strategies.

METHODS

Relevant methodological and statistical information was extracted from 27 target studies. Weighted correlations from 27 studies were used as the unit of analysis to test the theoretical model.

RESULTS

Overall, internal, unstable, and controllable attributions were indirectly associated with positive psychological adjustment through the use of Approach and Emotion-Focused coping (P<.01). In addition, stable and uncontrollable attributions were indirectly associated with negative psychological adjustment through the use of Avoidance coping (P<.01).

CONCLUSION

These results suggest that attributions guide some motivated cognitions and behaviors within the context of illness, and are related to specific coping strategies. The discussion focuses on the predictive validity of these findings using the proposed theoretical model.

Personal styles and ways of coping in individuals who use wheelchairs

To obtain information about the psychological needs of wheelchair users, 45 subjects participating in a university-based drop-in physical activity centre and outpatient rehabilitation program completed the Personal Styles Inventory and the Ways of Coping Inventory. Three groups of subjects were formed, differentiated by etiology for their disability. Results suggested that subjects with brain injury possessed the most limited coping resources. Subjects with multiple sclerosis were highest of the three groups in the frequency of utilization of emotional coping, they also revealed a fundamentally introverted and stability-based personality style. Subjects with spinal cord injuries utilized a predominantly Problem-solving means of coping: and they revealed a basic personality style characterized as extroverted and stable. The findings suggest that disease process (perhaps through common preexisting psychological characteristics, the nature of the onset and progression of the disease process, and/or tissue damage) may modify the ability to adapt and cope with the need to use a wheelchair. The nature of psychological support to be offered should reflect not only the use of a wheelchair but also the underlying personality and its modification by the nature of the disease process.

Causal factors in spinal cord injury: patients' evolving perceptions and association with depression

Do spinal cord injured patients who accept responsibility for their injury cope better than those who blame others? Previous investigations have yielded conflicting answers to this question. On the assumption that some portion of the disparity in earlier findings derives from the failure of early investigators to conceptualize "blame" as a dynamic phenomenon, the present study approached the question via a longitudinal study. Specifically, we examined: (1) the evolution of patients' perceptions of responsibility for spinal cord injury, and (2) the changing association of this factor with depression over a 2-year period, beginning with inpatient rehabilitation. Eighteen men with traumatic spinal cord injury were evaluated during acute rehabilitation and again at 18 to 24 months following discharge. Patients assigned proportions of blame for their injury to four possible causal factors (self, environment, chance, others). Three indices of depression were derived from the Beck Depression Inventory (BDI). Eighty-nine percent of the subjects displayed shifts in pattern of blame assignment between initial and follow-up evaluations. Individuals whose self-blame score increased over time exhibited increased depression, as did those who came to attribute to "chance" lesser blame for their injury. During inpatient rehabilitation, no aspect of blame correlated significantly with any of the three BDI indices, although "other blame" and the cognitive/affective BDI index just failed to reach conventional levels (r = .43, p = .07). By contrast, at follow-up evaluation, "self blame" was positively correlated with both the cognitive/affective (r = .51, p = .03) and Total (r = .46, p = .05) BDI scores. All other correlations were not statistically meaningful.(ABSTRACT TRUNCATED AT 250 WORDS)

Psychological consequences of spinal injury: a review of the literature

The traumatic nature of spinal cord injury necessitates adjustments for the individual physically, socially, vocationally and sexually, as well as placing great strain on the family. Although one would suspect a high prevalence of psychological disruption following spinal cord injury, there is still much debate concerning the extent of the psychological reaction to such a trauma. This situation can partly be attributed to the lack of systematic research characteristic of most studies in this area. This paper reviews more recent literature which has investigated psychological morbidity in persons with spinal cord injury. The inadequacies of this research are discussed and suggestions for future research and psychological treatment for the spinal injured are provided.