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

Mayra Galvis Aparicio; Valerie Carrard; Davide Morselli; Marcel W M Post; Claudio Peter; SwiSCI Study Group

doi:10.1016/j.apmr.2019.08.481

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

Arch Phys Med Rehabil. 2020 Mar;101(3):401-411. doi: 10.1016/j.apmr.2019.08.481. Epub 2019 Sep 25.

Authors

Mayra Galvis Aparicio¹, Valerie Carrard², Davide Morselli³, Marcel W M Post⁴, Claudio Peter²; SwiSCI Study Group

Collaborators

SwiSCI Study Group:
Xavier Jordan, Bertrand Léger, Michael Baumberger, Hans Peter Gmünder, Armin Curt, Martin Schubert, Margret Hund-Georgiadis, Kerstin Hug, Thomas Troger, Daniel Joggi, Hardy Landolt, Nadja Münzel, Mirjam Brach, Gerold Stucki, Christine Fekete

Affiliations

¹ Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland. Electronic address: mayra.galvis@paraplegie.ch.
² Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland.
³ Swiss National Center of Competence in Research LIVES, University of Lausanne, Switzerland.
⁴ Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat, Utrecht, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands.

PMID: 31562877
DOI: 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: Emotional adjustment; Optimism; Rehabilitation; Spinal cord injuries.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adaptation, Psychological*
Adolescent
Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Pain Measurement
Patient Discharge*
Psychiatric Status Rating Scales
Quality of Life
Rehabilitation Centers
Self Efficacy
Spinal Cord Injuries / psychology*
Spinal Cord Injuries / rehabilitation*
Switzerland