1
|
Mair L, Moses J. Adaptations to adult attachment and intimacy following spinal cord injury: a systematic review. Disabil Rehabil 2024; 46:1962-1978. [PMID: 37326037 DOI: 10.1080/09638288.2023.2218650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/04/2023] [Accepted: 05/21/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE Experiencing spinal cord injury (SCI) can be life-changing for individuals and their families. Previous reviews have focused on coping and psychological adjustment, sexual function and sexuality, or factors facilitating or impeding interpersonal relationships after SCI. However, there is a very little synthesis of research focusing on changes to adult attachment and emotional intimacy post-SCI. This review aims to examine the mechanisms of change in adult attachment and intimacy in romantic relationships following SCI. MATERIALS AND METHODS Four online databases (Psycinfo, Medline, CINAHL, and Scopus) were searched for qualitative papers concerning romantic relationships, attachments, and intimacy post-SCI. Sixteen of the 692 papers met the inclusion criteria. These were quality assessed and analysed using meta-ethnography. RESULTS Three main themes emerged from the analysis: (a) strengthening and maintaining adult attachment; (b) changes in roles; and (c) changing views of intimacy. CONCLUSION Many couples face significant changes to adult attachment and intimacy following SCI. Systematic ethnographic analysis of their negotiations enabled the identification of underlying relational processes and adaptation strategies associated with changes to inter-dependence, communication, role revision, and re-definition of intimacy. The findings indicate that healthcare providers should assess and respond to challenges faced by couples post-SCI using evidence consistent with adult attachment theory.
Collapse
Affiliation(s)
- Luned Mair
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Cardiff, UK
| | - Jenny Moses
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Cardiff, UK
| |
Collapse
|
2
|
Austin PD, Siddall PJ, Lovell MR. Posttraumatic growth in palliative care settings: A scoping review of prevalence, characteristics and interventions. Palliat Med 2024; 38:200-212. [PMID: 38229018 DOI: 10.1177/02692163231222773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND Posttraumatic growth refers to positive psychological change following trauma. However, there is a need to better understand the experience of posttraumatic growth in the palliative care setting as well as the availability and efficacy of interventions that target this phenomenon. AIMS To provide a review of the prevalence, characteristics and interventions involving posttraumatic growth in adults receiving palliative care and to collate recommendations for future development and utilisation of interventions promoting posttraumatic growth. DESIGN We performed a systematic scoping review of studies investigating posttraumatic growth in palliative care settings using the Arksey and O'Malley six-step scoping review criteria. We used the PRISMA guidelines for scoping reviews. DATA SOURCES Articles in all languages available on Ovid Medline [1946-2022], Embase [1947-2022], APA PsycINFO [1947-2022] and CINAHL [1981-2022] in November 2022. RESULTS Of 2167 articles located, 17 were included for review. These reported that most people report low to moderate levels of posttraumatic growth with a decline towards end-of-life as distress and symptom burden increase. Associations include a relationship between posttraumatic growth, acceptance and greater quality-of-life. A limited number of interventions have been evaluated and found to foster posttraumatic growth and promote significant psychological growth. CONCLUSION Posttraumatic growth is an emerging concept in palliative care where although the number of studies is small, early indications suggest that interventions fostering posttraumatic growth may contribute to improvements in psychological wellbeing in people receiving palliative care.
Collapse
Affiliation(s)
- Philip D Austin
- Department of Palliative Care, HammondCare, Greenwich Hospital, Sydney, NSW, Australia
| | - Philip J Siddall
- Department of Pain Management, HammondCare, Greenwich Hospital, Sydney, NSW, Australia
- Sydney Medical School-Northern, University of Sydney, Sydney, NSW, Australia
| | - Melanie R Lovell
- Department of Palliative Care, HammondCare, Greenwich Hospital, Sydney, NSW, Australia
- Sydney Medical School-Northern, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
3
|
Clifton S, Bray E, Dong S, McCabe R, Siddall P. Co-design of an intervention exploring meaning and purpose after spinal cord injury. Disabil Rehabil 2024:1-10. [PMID: 38258447 DOI: 10.1080/09638288.2023.2300655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024]
Abstract
PURPOSE Rebuilding a strong sense of meaning and purpose following trauma is a vital contributor to post-traumatic growth and adapting well to a spinal cord injury. This project aimed to develop an intervention that used the concept of post-traumatic growth to foster a stronger sense of meaning and purpose in people with a spinal cord injury. METHODS Using participatory action research methodology, the intervention was designed in an iterative process with health professionals and people with lived experience of spinal cord injury. We developed a ten-week online group program and delivered two pilot programs to 13 participants. We used their feedback to further refine the program before finalisation. RESULTS A participatory action research approach resulted in a positive intervention well received by participants and consumer organisations. Feedback suggests the intervention shows promise for improvements in functional and psychosocial outcomes and has long-term viability. CONCLUSIONS The project successfully developed and delivered a novel program that uses the concept of post-traumatic growth to foster a stronger sense of meaning and purpose. Further implementation of the program with larger numbers will allow for evaluation of the program's effectiveness.
Collapse
Affiliation(s)
- Shane Clifton
- Centre for Disability Research and Policy, Faculty of Health Sciences, The University of Sydney, Camperdown, Australia
| | - Emily Bray
- Spinal Cord Injuries Australia, Sydney, Australia
| | - Skye Dong
- Melanoma Institute Australia, Wollstonecraft, Australia
| | | | - Philip Siddall
- Hammondcare, Sydney, Australia
- Sydney Medical School-Northern, The University of Sydney, Camperdown, Australia
| |
Collapse
|
4
|
Budd MA, Gater DR, Channell I. Psychosocial Consequences of Spinal Cord Injury: A Narrative Review. J Pers Med 2022; 12:jpm12071178. [PMID: 35887675 PMCID: PMC9320050 DOI: 10.3390/jpm12071178] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/09/2022] [Accepted: 07/15/2022] [Indexed: 11/26/2022] Open
Abstract
Consequences of a spinal cord injury (SCI) entail much more than damage to the spinal cord. The lives of people with SCI, along with those around them, experience profound long-lasting changes in nearly every life domain. SCI is a physical (biological) injury that is inextricably combined with various psychological and social consequences. The objective of this review is to present psychosocial challenges following SCI through the biopsychosocial model, beginning with acknowledgement of the larger societal effects of ableism and stigma before addressing the many unique psychosocial aspects of living with SCI. Included in this review are qualitative studies and systematic reviews on current psychosocial outcomes and consequences. This paper attempts to structure this information by dividing it into the following sections: relationships and family; changes in finances and employment; issues related to the person’s living situation; community reintegration; factors associated with mood and coping (e.g., depression, anxiety, substance use, and PTSD); self-harm behaviors (ranging from nonadherence to suicide); effects of traumatic brain injury; considerations regarding sexual health; aging with SCI; and concludes with a brief discussion about post-traumatic growth. Cultivating an understanding of the unique and interrelated psychosocial consequences of people living with SCI may help mitigate the psychosocial aftermath and serve as a reminder to providers to maintain a person-centered approach to care.
Collapse
Affiliation(s)
- Maggi A. Budd
- Spinal Cord Injury/Disease Service, VA Boston Healthcare System, Boston, MA 02130, USA;
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
- Center for Bioethics, Harvard Medical School, Boston, MA 02115, USA
- Correspondence:
| | - David R. Gater
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL 33136, USA;
- Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, Miami, FL 33136, USA
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Isabella Channell
- Spinal Cord Injury/Disease Service, VA Boston Healthcare System, Boston, MA 02130, USA;
- Mental Health Counseling and Behavioral Medicine Graduate Program, Boston University School of Medicine, Boston, MA 02128, USA
| |
Collapse
|
5
|
Restored Life of Elite Athletes after Spinal Cord Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148441. [PMID: 35886292 PMCID: PMC9318341 DOI: 10.3390/ijerph19148441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/06/2022] [Accepted: 07/09/2022] [Indexed: 11/29/2022]
Abstract
Spinal cord injury (SCI) affects every aspect of human life: medical, psychological, social, material. People with SCI face a variety of secondary conditions (e.g., chronic pain, urinary tract infections, cognitive impairment) that place a significant emotional burden, resulting in an increased risk of depression and reduced quality of life. The purpose of this study was to better understand the coping strategies and to identify factors that promote or hinder the successful adjustment of elite athletes after SCI. Individual semi-structured interviews were conducted with eight top athletes after spinal cord injury. The interviews were recorded, transcribed, and then thematically analyzed using MAXQDA software. Thematic analysis identified the following categories: coping, athletic identity, and adjustment. The results of the study indicate that loss of functional ability does not cause loss of athlete identity. Elite athletes live a life consistent with this identity, attempting to maintain it despite the loss of physical fitness. Involvement in sports provides meaning and is a positive factor in the process of disability acceptance, which is essential in the process of adjustment to injury and also provides group belonging.
Collapse
|
6
|
Kalbas Y, Halvachizadeh S, Kumabe Y, Luidl AT, Steel JL, Zelle BA, Cinelli P, Pape HC, Pfeifer R. Post-traumatic growth in polytraumatized patients after 20+ years: a long-term follow-up study of 337 patients treated at a level 1 trauma center. Eur J Trauma Emerg Surg 2022; 49:1279-1286. [PMID: 35763055 DOI: 10.1007/s00068-022-02022-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/27/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE There is limited research on the long-term psychiatric outcomes of polytraumatized patients. Existing studies focus mainly on the negative sequelae. Post-traumatic growth (PTG) describes positive personal development after severe physical or mental distress. In this study, we investigated post-traumatic growth in polytraumatized patients at least 20 years after trauma. METHODS Patients treated for polytrauma at a German level 1 trauma center between 1971 and 1990, were contacted 20+ years later. A questionnaire with 37 questions from the stress-related growth scale (SRGS) and the post-traumatic growth inventory (PGI) was administered. PTG was quantified in five specific areas. PTG and patient demographics were then analyzed using logistic regression. RESULTS Eligible questionnaires were returned by 337 patients. 96.5% of patients reported improvements regarding at least one of the 37 questions. Approximately, a third of patients noticed distinct improvements regarding their relationship to others (29.2%), appreciation of life (36.2%) and attitudes towards new possibilities (32.5%). Patient demographics were significant predictors for the development of PTG: Older (p < 0.001), female (p = 0.042) and married patients (p = 0.047) showed a greater expression of PTG. We also saw significantly more PTG in patients with higher injury severity (p = 0.033). CONCLUSION 20 years after polytrauma, patients report improvements in their relationship with others, appreciation of life and attitude towards new possibilities. Women and married patients show higher expression of PTG. Furthermore, there is higher expression of PTG with higher age and injury severity. Post-traumatic growth should be identified and fostered in clinical practice. LEVEL OF EVIDENCE III-prospective long-term follow-up study.
Collapse
Affiliation(s)
- Yannik Kalbas
- Department of Trauma Surgery and Harald-Tscherne Laboratory, University Hospital Zurich, University of Zurich, Ramistr. 100, 8091, Zurich, Switzerland.
| | - Sascha Halvachizadeh
- Department of Trauma Surgery and Harald-Tscherne Laboratory, University Hospital Zurich, University of Zurich, Ramistr. 100, 8091, Zurich, Switzerland
| | - Yohei Kumabe
- Department of Trauma Surgery and Harald-Tscherne Laboratory, University Hospital Zurich, University of Zurich, Ramistr. 100, 8091, Zurich, Switzerland
| | | | - Jennifer Lynne Steel
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Boris A Zelle
- Department of Orthopaedics, UT Health San Antonio, Joe R. & Teresa Lozano Long School of Medicine, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Paolo Cinelli
- Department of Trauma Surgery and Harald-Tscherne Laboratory, University Hospital Zurich, University of Zurich, Ramistr. 100, 8091, Zurich, Switzerland
| | - Hans-Christoph Pape
- Department of Trauma Surgery and Harald-Tscherne Laboratory, University Hospital Zurich, University of Zurich, Ramistr. 100, 8091, Zurich, Switzerland
| | - Roman Pfeifer
- Department of Trauma Surgery and Harald-Tscherne Laboratory, University Hospital Zurich, University of Zurich, Ramistr. 100, 8091, Zurich, Switzerland
| |
Collapse
|
7
|
Jörgensen S, Lennman E, Lexell J. Sense of coherence and changes over six years among older adults aging with long-term spinal cord injury. Spinal Cord 2021; 59:1278-1284. [PMID: 34593987 DOI: 10.1038/s41393-021-00713-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional and longitudinal. OBJECTIVES To (i) describe sense of coherence (SOC) and changes over six years in older adults aging with long-term spinal cord injury (SCI) and (ii) investigate how changes in SOC are associated with injury characteristics and changes in sociodemographics and secondary health conditions (SHCs; bowel-related and bladder-related problems, pain and spasticity). SETTING Community in Southern Sweden. METHODS From the initial 123 participants in the Swedish Aging with Spinal Cord Injury Study (SASCIS), 76 individuals (33% women, median age 66 years, median time since injury 30 years, AIS A-D, 30% complete) responded to the 13-item SOC scale (range 13-91) twice with a 6-year interval. Data were analyzed with multivariable hierarchical regression. RESULTS The participants rated a strong SOC at both assessments (median 73 and 76.5, respectively) which significantly increased over time. Overall, their marital status and vocational situation remained stable whereas SHCs increased. A change from not having a partner to having one was the only significant explanatory factor for a positive change in SOC. CONCLUSIONS The present study describes, for the first time, changes in SOC over time and associated factors in older adults aging with long-term SCI. They generally maintain a strong ability to understand, handle, and being motivated when dealing with stressful events arising in their lives as a result of their SCI. The associations emphasize the importance of the social context for successful adaptation to living with SCI along the aging process.
Collapse
Affiliation(s)
- Sophie Jörgensen
- Department of Health Sciences, Lund University, Lund, Sweden. .,Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.
| | - Elsa Lennman
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Jan Lexell
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| |
Collapse
|
8
|
Betz S, Cadematori C, Mulcahey MJ. Thriving after pediatric spinal cord injury: two life stories. Spinal Cord Ser Cases 2021; 7:25. [PMID: 33771968 DOI: 10.1038/s41394-021-00392-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 01/29/2021] [Accepted: 02/12/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The primary objective of this qualitative study was to explore the lived experience of spinal cord injury (SCI) as described by life story interviews with two adults who sustained SCI as children. CASE PRESENTATION Data were collected by conducting 15 life story interviews with two individuals with SCI. Atkinson's Life Story Interview approach along with open-ended questions was utilized to capture the narrative data. Polkinghorne's narrative analysis of eventful data approach was used to configure the data elements into a story with the purpose of understanding the lived experience of SCI of these two individuals. Four themes relevant to the experience of living with a chronic condition emerged: adjustment to life with SCI, hardiness, interdependence, and post-traumatic growth. DISCUSSION This study illustrated how the two participants' personal development and life trajectories were deeply shaped by pediatric-onset SCI. The life story interview process proved to be an effective approach to understanding the lived experience of SCI as told by two adults with pediatric-onset SCI. While the two participants represented unique contexts, their stories conveyed several cohesive, transcendent themes relevant to the experience of living with a chronic condition. Future narrative inquiry research in individuals with pediatric-onset SCI is necessary to build a representation of this population's lived experiences.
Collapse
Affiliation(s)
- Samantha Betz
- Department of Occupational Therapy and the Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Caitlin Cadematori
- Department of Occupational Therapy and the Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - M J Mulcahey
- Department of Occupational Therapy and the Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA.
| |
Collapse
|
9
|
Byra S. Associations between post-traumatic growth and wisdom in people with long-term paraplegia - the role of disability appraisals and participation. Disabil Rehabil 2021; 44:3510-3517. [PMID: 33417504 DOI: 10.1080/09638288.2020.1867903] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The number of people with long-term spinal cord injury (SCI) is growing but our knowledge about their successful functioning is still limited. The goal of this study was to investigate the correlations between posttraumatic growth (PTG) and wisdom in people with long-term paraplegia, exploring the mediating effect of disability appraisals, and participation/autonomy (P/A). METHODS One-hundred and sixty-six persons with paraplegia completed a set of questionnaires, which included: The three-dimensional Wisdom Scale; The Post-traumatic Growth Inventory; Appraisals of Disability Primary and Secondary Scale; Impact on Participation and Autonomy Questionnaire. Mediation was tested using bootstrapping and a multiple mediation model with two mediators. RESULTS Positive and significant correlations between PTG, disability appraisals (as determined resilience), P/A, and wisdom were found. PTG is associated with wisdom when disability appraisals and P/A are mediators. Higher PTG was related to higher determined resilience and smaller restrictions in participation, both of which were associated with higher wisdom. CONCLUSIONS The relationship between PTG and wisdom is complex and indirect in people with long-term paraplegia. The mediating variables of disability appraisals and P/A explained the variance in PTG, with P/A playing a more significant role. Findings suggest that long-term SCI may correlate with experiencing high levels of PTG and wisdom, and more positive disability appraisals.Implications for rehabilitationPTG is associated with life wisdom in people with long-term SCI, with a significant contribution of disability appraisal and P/A.Therapists can increase these people's awareness about the possibility of experiencing PTG and maintaining positive changes, despite long-term SCI.Therapists can support people with long-term SCI in maintaining or extending the possibilities of participation and autonomous decision-making about their daily activities, which in consequence may be important for increasing their life wisdom.
Collapse
Affiliation(s)
- Stanisława Byra
- Faculty of Education and Psychology, Institute of Pedagogy, Maria Curie-Skłodowska University, Lublin, Poland
| |
Collapse
|
10
|
Park EY, Kim JH. Interaction of Socio-demographic Characteristics on Acceptance of Disability Among Individuals With Physical Disabilities. Front Psychiatry 2021; 12:597817. [PMID: 33995137 PMCID: PMC8113681 DOI: 10.3389/fpsyt.2021.597817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 03/19/2021] [Indexed: 11/23/2022] Open
Abstract
This study aimed to investigate the interaction of sociodemographic characteristics on acceptance of disability among individuals with physical disabilities (IWPD). Data from the 8th Panel Survey of Employment for the Disabled in Korea (PSED) in the second wave were used. A sample concerning the first phase of disability was extracted using the one-step colony method to extract regions and was stratified based on the type of disability, disability grade, and age. To explore the association between acceptance of sociodemographic characteristics and of disability, we used a general linear model. A significant main effect was observed in employment, health status, degree of help, and subjective economic status. Regarding employment status, acceptance of disability in unemployment of IWPD with less than high school was lower as compared to those with more than high school. We observed that unemployed IWPD with low income or poor health status could be the group with the highest risk for acceptance of disability. Individuals in the low economic group were more religious than those in the high economic one. These findings indicate that specialized intervention programs that consider religion, economic status, employment, education, health, and their interactions would be effective for acceptance of disability. Interdisciplinary team members should consider the individual profiles of these populations and implement suitable support and rehabilitation programs.
Collapse
Affiliation(s)
- Eun-Young Park
- Department of Secondary Special Education, College of Education, Jeonju University, Jeonju, South Korea
| | - Jung-Hee Kim
- Department of Clinical Nursing, College of Nursing, The Catholic University of Korea, Seoul, South Korea
| |
Collapse
|
11
|
Profiles of Psychological Adaptation Outcomes at Discharge From Spinal Cord Injury Inpatient Rehabilitation. Arch Phys Med Rehabil 2020; 101:401-411. [DOI: 10.1016/j.apmr.2019.08.481] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 08/17/2019] [Indexed: 11/22/2022]
|
12
|
Byra S. Basic hope and posttraumatic growth in people with traumatic paraplegia- the mediating effect of acceptance of disability. Spinal Cord 2018; 57:301-307. [PMID: 30374064 DOI: 10.1038/s41393-018-0215-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 09/14/2018] [Accepted: 09/17/2018] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES Investigating the correlations between basic hope, acceptance of disability, and posttraumatic growth (PTG) in people with traumatic paraplegia, exploring the mediating effect of acceptance of disability. SETTING Community-dwelling people with traumatic paraplegia in Poland. METHODS Data were obtained from 281 individuals with paraplegia. The set of questionnaires included: The Posttraumatic Growth Inventory (PTGI); Basic Hope Inventory (BHI); and The Multidimensional Acceptance of Loss Scale. Four dimensions of disability acceptance were measured: subordinating physique relative to other values, enlarging the scope of values, transforming comparative-status values into asset values, and containing the effects of disability. Mediation was tested with the Baron and Kenny's approach. RESULTS A positive and statistically significant correlation between basic hope, acceptance of disability, and posttraumatic growth was found. Using a hierarchical regression analysis, a mediating effect of acceptance of disability was found for explaining the relationship between basic hope and posttraumatic growth in people with paraplegia. Only two dimensions of disability acceptance, subordinating physique relative to other values and transforming comparative-status values into asset values, were found to play a mediating role. CONCLUSION Beliefs about the world and the transformation of values that constitute acceptance of disability are important for explaining PTG in people with paraplegia. Correlations between these variables are complex. The correlation between basic hope and posttraumatic growth in individuals with paraplegia may be understood better by taking into account the mediating role of acceptance of disability.
Collapse
Affiliation(s)
- Stanisława Byra
- Faculty of Education and Psychology, Institute of Pedagogy, Maria Curie-Skłodowska University, Lublin, Poland, Narutowicza 12, 20-004, Lublin, Poland.
| |
Collapse
|
13
|
Roddy C, Rickard N, Tamplin J, Baker FA. Personal identity narratives of therapeutic songwriting participants following Spinal Cord Injury: A case series analysis. J Spinal Cord Med 2018; 41:435-443. [PMID: 28835174 PMCID: PMC6055979 DOI: 10.1080/10790268.2017.1364559] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
CONTEXT/OBJECTIVE Spinal Cord Injury (SCI) patients face unique identity challenges associated with physical limitations, higher comorbid depression, increased suicidality and reduced subjective well-being. Post-injury identity is often unaddressed in subacute rehabilitation environments where critical physical and functional rehabilitation goals are prioritized. Therapeutic songwriting has demonstrated prior efficacy in promoting healthy adjustment and as a means of expression for post-injury narratives. The current study sought to examine the identity narratives of therapeutic songwriting participants. DESIGN Case-series analysis of the individual identity trajectories of eight individuals. SETTING Subacute rehabilitation facility, Victoria, Australia. PARTICIPANTS Eight individuals with an SCI; 7 males and 1 female. INTERVENTION Six-week therapeutic songwriting intervention facilitated by a music therapist to promote identity rehabilitation. OUTCOME MEASURES Identity, subjective well-being and distress, emotional state. RESULTS Three participants demonstrated positive trajectories and a further three showed negative trajectories; remaining participants were ambiguous in their response. Injury severity differentiated those with positive trajectories from those with negative trajectories, with greater injury severity apparent for those showing negative trends. Self-concept also improved more in those with positive trajectories. Core demographic variables did not however meaningfully predict the direction of change in core identity or wellbeing indices. CONCLUSION Identity-focused songwriting holds promise as a means of promoting healthy identity reintegration. Further research on benefits for those with less severe spinal injuries is warranted.
Collapse
Affiliation(s)
- Chantal Roddy
- School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Nikki Rickard
- School of Psychological Sciences, Monash University, Clayton, VIC, Australia
- Centre for Positive Psychology, Graduate School of Education, University of Melbourne, Parkville, VIC, Australia
| | - Jeanette Tamplin
- Faculty of VCA & MCM, University of Melbourne, Southbank, VIC, Australia
- Royal Talbot Rehabilitation Centre, Austin Health, Kew, VIC, Australia
| | | |
Collapse
|
14
|
Wang Y, Xie H, Zhao X. Psychological morbidities and positive psychological outcomes in people with traumatic spinal cord injury in Mainland China. Spinal Cord 2018; 56:704-711. [PMID: 29426946 DOI: 10.1038/s41393-017-0044-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 11/14/2017] [Accepted: 11/14/2017] [Indexed: 01/03/2023]
Abstract
STUDY DESIGN Cross-sectional survey. OBJECTIVES To explore the prevalences of three psychological morbidities (posttraumatic stress disorder, anxiety, and depression) and two positive psychological outcomes (resilience and posttraumatic growth) in people with spinal cord injury (SCI). To examine the relationships between the five aforementioned variables and to determine the predictors of the three psychological morbidities. SETTING Shanghai Sunshine Rehabilitation Center, Mainland China. METHODS Participants included 300 adults with SCI in one rehabilitation center in Shanghai. Standardized self-report measures were used. Sociodemographic, injury, and psychological variables were assessed. Descriptive analyses were used to calculate the prevalences of five psychological outcome variables. Pearson correlation analyses were conducted to examine the relationships between the five psychological variables and regression analyses were conducted to determine the predictors of posttraumatic stress disorder (PTSD), anxiety, and depression. RESULTS Of the 300 respondents, 35%, 29%, and 27% exceeded the clinical cutoff score for PTSD, anxiety, and depression, respectively. About 32% reported good resilience, and 51% reported moderate to high levels of posttraumatic growth (PTG). Three psychological morbidities showed positive correlations between each other while significant negative relationships with the resilience and PTG. Hierarchical regressions indicated that both the extent of environmental barriers and resilience were the significant predictors of PTSD, anxiety, and depression. CONCLUSION High prevalences of psychological morbidities were found in the SCI population in Mainland China. They should be identified and intervened early in the rehabilitation process. Some positive psychological techniques that focus on increasing resilience and promoting PTG would likely be beneficial for the SCI population.
Collapse
Affiliation(s)
- Yanbo Wang
- Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Haixia Xie
- Department of Occupational and Social Rehabilitation, Sunshine Rehabilitation Center, Shanghai, China
| | - Xudong Zhao
- Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
| |
Collapse
|
15
|
Gagnon DH, Vermette M, Duclos C, Aubertin-Leheudre M, Ahmed S, Kairy D. Satisfaction and perceptions of long-term manual wheelchair users with a spinal cord injury upon completion of a locomotor training program with an overground robotic exoskeleton. Disabil Rehabil Assist Technol 2017; 14:138-145. [PMID: 29256640 DOI: 10.1080/17483107.2017.1413145] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM The main objectives of this study were to quantify clients' satisfaction and perception upon completion of a locomotor training program with an overground robotic exoskeleton. METHODS A group of 14 wheelchair users with a spinal cord injury, who finished a 6-8-week locomotor training program with the robotic exoskeleton (18 training sessions), were invited to complete a web-based electronic questionnaire. This questionnaire encompassed 41 statements organized around seven key domains: overall satisfaction related to the training program, satisfaction related to the overground robotic exoskeleton, satisfaction related to the program attributes, perceived learnability, perceived health benefits and risks and perceived motivation to engage in physical activity. Each statement was rated using a visual analogue scale ranging from "0 = totally disagree" to "100 = completely agree". RESULTS Overall, respondents unanimously considered themselves satisfied with the locomotor training program with the robotic exoskeleton (95.7 ± 0.7%) and provided positive feedback about the robotic exoskeleton itself (82.3 ± 6.9%), the attributes of the locomotor training program (84.5 ± 6.9%) and their ability to learn to perform sit-stand transfers and walk with the robotic exoskeleton (79.6 ± 17%). Respondents perceived some health benefits (67.9 ± 16.7%) and have reported no fear of developing secondary complications or of potential risk for themselves linked to the use of the robotic exoskeleton (16.7 ± 8.2%). At the end of the program, respondents felt motivated to engage in a regular physical activity program (91.3 ± 0.1%). CONCLUSION This study provides new insights on satisfaction and perceptions of wheelchair users while also confirming the relevance to continue to improve such technologies, and informing the development of future clinical trials. Implications for Rehabilitation All long-term manual wheelchair users with a spinal cord injury who participated in the study are unanimously satisfied upon completion of a 6-8-week locomotor training program with the robotic exoskeleton and would recommend the program to their peers. All long-term manual wheelchair users with a spinal cord injury who participated in the study offered positive feedback about the robotic exoskeleton itself and feel it is easy to learn to perform sit-stand transfers and walk with the robotic exoskeleton. All long-term manual wheelchair users with a spinal cord injury who participated in the study predominantly perceived improvements in their overall health status, upper limb strength and endurance as well as in their sleep and psychological well-being upon completion of a 6-8-week locomotor training program with the robotic exoskeleton. All long-term manual wheelchair users with a spinal cord injury who participated in the study unanimously felt motivated to engage in a regular physical activity program adapted to their condition and most of them do plan to continue to participate in moderate-to-strenuous physical exercise. Additional research on clients' perspectives, especially satisfaction with the overground exoskeleton and locomotor training program attributes, is needed.
Collapse
Affiliation(s)
- Dany H Gagnon
- a School of Rehabilitation , Université de Montréal , QC , Canada.,b Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut de réadaptation Gingras-Lindsay-de-Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal , QC , Canada
| | - Martin Vermette
- b Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut de réadaptation Gingras-Lindsay-de-Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal , QC , Canada
| | - Cyril Duclos
- a School of Rehabilitation , Université de Montréal , QC , Canada.,b Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut de réadaptation Gingras-Lindsay-de-Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal , QC , Canada
| | - Mylène Aubertin-Leheudre
- c Faculty of Science, Department of Exercise Science , Université du Québec à Montréal , QC , Canada
| | - Sara Ahmed
- b Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut de réadaptation Gingras-Lindsay-de-Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal , QC , Canada.,d School of Physical and Occupational Therapy , McGill University , Montreal, QC , Canada
| | - Dahlia Kairy
- a School of Rehabilitation , Université de Montréal , QC , Canada.,b Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut de réadaptation Gingras-Lindsay-de-Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal , QC , Canada
| |
Collapse
|
16
|
Torregrosa-Ruiz M, Tomás-Miguel JM. Diferencias de sexo en el uso de estrategias de afrontamiento en personas con lesión medular. AQUICHAN 2017. [DOI: 10.5294/aqui.2017.17.4.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objetivo: profundizar en la experiencia de afrontamiento en personas con lesión medular (LM), teniendo en cuenta tanto el afron- tamiento actual como el afrontamiento durante momentos iniciales tras sufrir la LM. Materiales y métodos: estudio transversal de encuesta. Participaron 127 personas con LM de larga evolución, 95 hombres y 32 mujeres. Los datos fueron recogidos por medio de un cuestionario online con información sociodemográfica y el Cuestionario de Afrontamiento del Estrés (CAE). Se han realizado análisis descriptivos, pruebas t de Student y análisis multivariados de la varianza (Manovas) Resultados: las comparaciones intrasujetos muestran que la estrategia de focalización en solución de problemas se usa más en el afrontamiento actual. La autofocalización negativa es más utilizada en el afrontamiento pasado, en los momentos iniciales tras sufrir la LM. Los resultados de los Manovas muestran que no existen diferencias en función del sexo en el afrontamiento rememorado ni en el actual. Los Anova de seguimiento para el afrontamiento actual evidencian que las mujeres utilizan más las estrategias de búsqueda de apoyo social y expresión emocional abierta. Conclusiones: no hay diferencias de sexo en el uso de las estrategias de afrontamiento en la LM. Se sugiere seguir investigando cómo el género puede actuar en este proceso.
Collapse
|
17
|
Curtis K, Hitzig SL, Bechsgaard G, Stoliker C, Alton C, Saunders N, Leong N, Katz J. Evaluation of a specialized yoga program for persons with a spinal cord injury: a pilot randomized controlled trial. J Pain Res 2017; 10:999-1017. [PMID: 28496356 PMCID: PMC5422575 DOI: 10.2147/jpr.s130530] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objectives The purpose of this randomized controlled trial was to evaluate the effects of a specialized yoga program for individuals with a spinal cord injury (SCI) on pain, psychological, and mindfulness variables. Materials and methods Participants with SCI (n=23) were outpatients or community members affiliated with a rehabilitation hospital. Participants were randomized to an Iyengar yoga (IY; n=11) group or to a 6-week wait-list control (WLC; n=12) group. The IY group participated in a twice-weekly 6-week seated IY program; the WLC group participated in the same yoga program, after the IY group’s yoga program had ended. Pain, psychological, and mindfulness measures were collected at two time points for both groups (within 1–2 weeks before and after program 1 and at a third time point for the WLC group (within 1 week after program 2). Results Linear mixed-effect growth models were conducted to evaluate the main effects of group at T2 (postintervention), controlling for T1 (preintervention) scores. T2 depression scores were lower (F1,18=6.1, P<0.05) and T2 self-compassion scores higher (F1,18=6.57, P< 0.05) in the IY group compared to the WLC group. To increase sample size and power, the two groups were combined and analyzed across time by comparing pre- and postintervention scores. Main effects of time were found for depression scores, (F1,14.83=6.62, P<0.05), self-compassion, (F1,16.6=4.49, P<0.05), mindfulness (F1,16.79=5.42, P<0.05), mindful observing (F1,19.82=5.06, P<0.05), and mindful nonreactivity, (F1,16.53=4.92, P<0.05), all showing improvement after the intervention. Discussion The results indicated that a specialized 6-week yoga intervention reduced depressive symptoms and increased self-compassion in individuals with SCI, and may also have fostered greater mindfulness.
Collapse
Affiliation(s)
- Kathryn Curtis
- Department of Psychology, Faculty of Health, York University
| | - Sander L Hitzig
- St John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre.,Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network
| | | | | | - Charlene Alton
- Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network
| | - Nicole Saunders
- Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network
| | - Nicole Leong
- Community Care Access Centre, London, ON, Canada
| | - Joel Katz
- Department of Psychology, Faculty of Health, York University
| |
Collapse
|
18
|
Khanjani MS, Younesi SJ, Khankeh HR, Azkhosh M. Exploring Facilitators of Post-traumatic Growth in Patients with Spinal Cord Injury: A Qualitative Study. Electron Physician 2017; 9:3544-3553. [PMID: 28243405 PMCID: PMC5308493 DOI: 10.19082/3544] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 06/16/2016] [Indexed: 11/29/2022] Open
Abstract
Introduction There is increasing evidence regarding people’s reactions to life stressors in which people also may show positive experiences following a traumatic event. The aim of the present study was to explain the facilitators of post-traumatic growth based on the experiences of patients with a spinal cord injury. Methods This was a qualitative study conducted on 16 Iranian patients with a spinal cord injury using semistructured, in-depth interviews, and content analysis in 2015. These participants, despite their spinal cord injury, were successful in their lives and were considered successful members of society. A purposive sampling method was used until reaching data saturation, and then the collected data were analyzed using a content analysis method. Results The study revealed several factors as facilitators of post-traumatic growth in the patients. The extracted facilitators were put into seven categories of main concepts, including existence of support resources, contact with spinal cord injury associations, spiritual beliefs, positive attitude toward injury, access to proper facilities, enhancement of knowledge and awareness, and active presence in society. Conclusion Different factors may facilitate post-traumatic growth in patients with a spinal cord injury. Understanding these facilitators may help us in designing educational, support, and consulting programs for patients and their families as well as to the correct the support programs.
Collapse
Affiliation(s)
- Mohammad Saeed Khanjani
- Ph.D. of Rehabilitation Counseling, Department of Counseling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Jalal Younesi
- Ph.D. of Clinical Psychology, Associate Professor, Department of Counseling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hamid Reza Khankeh
- Ph.D. of Nursing, Professor, Department of Health in Emergency and Disaster and Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Manouchehr Azkhosh
- Ph.D. of Clinical Psychology, Assistant Professor, Department of Counseling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| |
Collapse
|
19
|
Affiliation(s)
- Thomas M. Dixon
- Correspondence to: Thomas M. Dixon, Louis Stokes Cleveland DVA Medical Center, Psychology Service, 10701 East Boulevard, Cleveland, OH 44106, USA.
| |
Collapse
|
20
|
Graham D, Becerril-Martinez G, Tang J. Who is the surgically resilient individual with traumatic spinal cord injury? JOURNAL OF SPINE SURGERY 2016; 2:230-233. [PMID: 27757438 DOI: 10.21037/jss.2016.08.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- David Graham
- Faculty of Medicine, University of Sydney, Sydney, Australia;; TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Australia
| | | | - Jonathan Tang
- Faculty of Medicine, University of Sydney, Sydney, Australia
| |
Collapse
|
21
|
Wilson CS, Forchheimer M, Heinemann AW, Warren AM, McCullumsmith C. Assessment of the relationship of spiritual well-being to depression and quality of life for persons with spinal cord injury. Disabil Rehabil 2016; 39:491-496. [DOI: 10.3109/09638288.2016.1152600] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Catherine S. Wilson
- James A. Haley Veterans’ Hospital, Tampa, FL, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Martin Forchheimer
- Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Allen W. Heinemann
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL, USA
| | - Anne Marie Warren
- Baylor Institute for Rehabilitation, Baylor University Medical Center, Dallas, TX, USA
| | - Cheryl McCullumsmith
- Department of Psychiatry and Behavioral Science, University of Cincinnati, Cincinnati, OH, USA
| |
Collapse
|
22
|
Littooij E, Widdershoven GA, Stolwijk-Swüste JM, Doodeman S, Leget CJ, Dekker J. Global meaning in people with spinal cord injury: Content and changes. J Spinal Cord Med 2016; 39:197-205. [PMID: 25615571 PMCID: PMC5072500 DOI: 10.1179/2045772314y.0000000290] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND After spinal cord injury (SCI), people are confronted with abrupt discontinuity in almost all areas of life, leading to questions on how to live a meaningful life again. Global meaning refers to basic ideas and goals that guide people in giving meaning to their lives, in specific situations. Little is known about global meaning relating to SCI and whether global meaning changes after SCI. PURPOSE The purpose of this study was twofold: (i) to explore the content of global meaning of people with SCI, and (ii) to explore whether or not global meaning changes after SCI. METHODS In-depth semi-structured interviews were conducted with 16 people with SCI. Interviews were analyzed according to the method of grounded theory. RESULTS (i) Five aspects of global meaning were found: core values, relationships, worldview, identity and inner posture. (ii) Overall, little change in the content of global meaning was found after SCI; specific aspects of global meaning were foregrounded after SCI. CONCLUSION Five aspects of global meaning were found in people with SCI. Global meaning seems hardly subject to change.
Collapse
Affiliation(s)
- Elsbeth Littooij
- Amsterdam Rehabilitation Research Center, Reade, The Netherlands,Correspondence to: Elsbeth Littooij, Amsterdam Rehabilitation Research Center
- Reade, PO Box 58271, 1040 HG Amsterdam, The Netherlands.
| | - Guy A.M. Widdershoven
- Department of Medical Humanities, VU University Medical Center, Amsterdam, The Netherlands,EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | | | - Suzan Doodeman
- Amsterdam Rehabilitation Research Center, Reade, The Netherlands
| | - Carlo J.W. Leget
- Department of Care and Welfare, University of Humanistic Studies, Utrecht, The Netherlands
| | - Joost Dekker
- EMGO Institute for Health and Care Research, Amsterdam, The Netherlands,Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands,Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
23
|
Byra S. Posttraumatic growth in people with traumatic long-term spinal cord injury: predictive role of basic hope and coping. Spinal Cord 2015; 54:478-82. [PMID: 26643986 DOI: 10.1038/sc.2015.177] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 08/11/2015] [Accepted: 09/04/2015] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Participants with spinal cord injury (SCI) sustained at least 15 years before the study completed questionnaires measuring posttraumatic growth (PTG), basic hope and coping strategies. OBJECTIVES To determine contribution of basic hope and coping strategies to accounting for PTG variability in participants with traumatic long-term SCI. SETTING Polish rehabilitation centres, foundations and associations implementing social inclusion and professional activation programmes. Participants were enrolled based on their medical history by trained rehabilitation specialists and psychologists. METHODS The set of questionnaires included the following: The Post-traumatic Growth Inventory; The Coping Orientations to Problems Experienced (COPE); and Basic Hope Inventory. RESULTS A study of 169 individuals with paraplegia in the range of PTG showed the highest degree of positive changes in appreciation of life (AL) and the lowest in self-perception. Regression analysis showed that coping strategies such as religion (REL), focus on the problem, humour, alcohol/drug use ideation and basic hope jointly account for 60% of variance of PTG. The highest contribution to accounting for this variability had REL. Also, it was found that coping strategies and basic hope allow to predict variance of individual growth aspects. Age at trauma exposure positively correlated with changes in AL and spiritual change. No significant relationship between growth and age of participants was confirmed. CONCLUSION PTG occurring in people with long-term traumatic SCI is primarily manifested in increased AL. Specific coping strategies and basic hope have a significant role in fostering positive changes.
Collapse
Affiliation(s)
- S Byra
- Faculty of Pedagogy and Psychology, Institute of Pedagogy, Maria Curie-Skłodowska University, Lublin, Poland
| |
Collapse
|
24
|
January AM, Zebracki K, Chlan KM, Vogel LC. Understanding post-traumatic growth following pediatric-onset spinal cord injury: the critical role of coping strategies for facilitating positive psychological outcomes. Dev Med Child Neurol 2015; 57:1143-9. [PMID: 26095798 DOI: 10.1111/dmcn.12820] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2015] [Indexed: 12/22/2022]
Abstract
AIM The aim of this study was to explore positive psychological growth in individuals who had sustained spinal cord injuries (SCIs) in childhood, and to identify factors correlating with such growth. METHOD Data were drawn from ongoing research aimed at assessing the long-term outcomes of pediatric-onset SCIs in adults. Participants were assessed using measures of demographics, coping ability, post-traumatic growth, life satisfaction, happiness, and mental health. The study sample included 161 adults with a mean age of 33 years and 2 months (SD 7y 3mo, range 19-50y). The participants had sustained SCIs between the ages of 7 years and 18 years (mean 14y 10mo, SD 2y 6mo) and were injured for an average of 17 years and 9 months (SD 7y 7mo, range 1-36y). Sixty-four percent of participants were male, 81% were white, 63% had tetraplegia, and 70% had complete injuries. RESULTS The vast majority of participants (99%) recognized that at least one positive change had occurred in their life as a result of their SCI. Post-traumatic growth was significantly associated with behavioral (r=0.29, p<0.001) and cognitive (r=0.39, p<0.001) coping strategies, as well as with increased life satisfaction (r=0.18, p=0.024) and happiness (r=0.27, p=0.001), but was unrelated to psychological distress. Additional analyses indicated that post-traumatic growth mediated effects of cognitive coping on happiness, but not on life satisfaction. INTERPRETATION The majority of individuals with pediatric-onset SCIs experienced positive psychological growth. Coping strategies are crucial to this growth process.
Collapse
Affiliation(s)
- Alicia M January
- Department of Clinical Research, Shriners Hospitals for Children, Chicago, IL, USA.,Orthopaedic and Rehabilitation Engineering Center, Marquette University, Milwaukee, WI, USA
| | - Kathy Zebracki
- Department of Psychology, Shriners Hospitals for Children, Chicago, IL, USA.,Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Kathleen M Chlan
- Department of Clinical Research, Shriners Hospitals for Children, Chicago, IL, USA
| | - Lawrence C Vogel
- Department of Pediatrics, Shriners Hospitals for Children, Chicago, IL, USA.,Department of Pediatrics, Rush Medical College, Chicago, IL, USA
| |
Collapse
|
25
|
Bombardier CH, Adams LM, Fann JR, Hoffman JM. Depression Trajectories During the First Year After Spinal Cord Injury. Arch Phys Med Rehabil 2015; 97:196-203. [PMID: 26525525 DOI: 10.1016/j.apmr.2015.10.083] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 09/15/2015] [Accepted: 10/05/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine the number and type of longitudinal depression trajectories during the first year after spinal cord injury (SCI) and to identify baseline predictors of these trajectories. DESIGN Cohort study. SETTING Rehabilitation and postacute community settings. PARTICIPANTS Of 168 consecutive admissions to inpatient rehabilitation for acute SCI, 141 (115 men, 26 women) patients were enrolled in a randomized controlled trial telephone follow-up intervention, which showed no outcome differences, and completed assessments on at least 2 of the 4 follow-up occasions (3, 6, 9, and 12 months after SCI). Participants were on average 41 years old, most were non-Hispanic (96%) and white (86%), and 61.7% had tetraplegia. INTERVENTIONS Data were drawn from the ineffective randomized controlled trial. MAIN OUTCOME MEASURE Patient Health Questionnaire-9 (PHQ-9). RESULTS Unconditional linear latent class growth analysis models of PHQ-9 total scores revealed an optimal 3-class solution: stable low depression (63.8%), mild to moderate depression (29.1%), and persistent moderate to severe depression (7.1%). Preinjury mental health history and baseline pain, quality of life, and grief predicted class membership. CONCLUSIONS The modal response to SCI was stable low depression, whereas persistent moderate to severe depression primarily represented a continuation or relapse of preinjury depression. This line of research has the potential to improve identification of subgroups destined for poor outcomes and to inform early intervention studies.
Collapse
Affiliation(s)
- Charles H Bombardier
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA.
| | | | - Jesse R Fann
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA
| | - Jeanne M Hoffman
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
| |
Collapse
|
26
|
Wang Y, Wang H, Wang Z, Xie H, Shi J, Zhao X. The process of posttraumatic growth in individuals with traumatic spinal cord injury in Mainland China: An interpretative phenomenological analysis. J Health Psychol 2015; 22:637-649. [PMID: 26466850 DOI: 10.1177/1359105315610812] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aims to explore the process of posttraumatic growth for individuals who have sustained a traumatic spinal cord injury. Semi-structured interviews were conducted with 12 participants with spinal cord injury from the local community. Interviews were recorded on audiotape and transcribed verbatim. Transcripts were analyzed using interpretative phenomenological analysis. Three superordinate themes emerged: struggling in hopelessness, disentangling from disability, facing challenge, and achieving positive growth. Our findings reveal how individuals with spinal cord injury overcome their disability to achieve personal growth, and can contribute to clinicians' understanding of psychological responses to spinal cord injury while promoting physical and psychological recovery in these individuals.
Collapse
Affiliation(s)
- Yanbo Wang
- 1 School of Medicine, Tongji University, China
| | | | | | - Haixia Xie
- 3 Shanghai Sunshine Rehabilitation Center, China
| | - Jingyu Shi
- 1 School of Medicine, Tongji University, China
| | - Xudong Zhao
- 1 School of Medicine, Tongji University, China
| |
Collapse
|