Cognitive appraisals, coping and quality of life outcomes: a multi-centre study of spinal cord injury rehabilitation

Abstract

Study design: Longitudinal, multiple wave panel design. Objectives: To investigate the degree to which current thinking in terms of early appraisals and coping predicts adjustment and quality of life outcomes after spinal cord injury, and to what degree social and demographic variables are involved. Setting: Data were analysed from 266 patients recruited as part of an ongoing study from specialist units in selected British, Swiss, German and Irish spinal centres. Method: Questionnaire booklets were administered as soon as possible after injury onset and after 12 weeks to patients with newly acquired spinal cord injuries. Individuals included had sustained their injury between the ages of 16 and 83. Results: Significant improvements in outcome measures were found across the data set within the first 12 weeks after spinal cord injury and changes observed in the appraisals and coping strategies employed. Significant differences were found between participating centres on both outcome measures and in the coping and appraisal processes used. Coping and appraisal processes at 6 weeks after injury were found to contribute significantly to the variation in psychological well-being at 12 weeks after injury. Conclusion: This study shows the process of adjustment to spinal cord injury to begin in the early stages of rehabilitation, and initial appraisals are important to how an individual will cope with their injury and to their psychological well-being. Support is also given to the importance of psychological factors to functional outcomes.

Appraisals, coping and adjustment pre and post SCI rehabilitation: a 2-year follow-up study

“…The current study extends research by Kennedy, Lude, Elfström and Smithson 18 by following up participants at 1 and 2 years post injury. The questions to be explored are:…”

“…Previous analysis of this sample 18 and results from the current study revealed that, as with SRG, scores on measures of Perceived Manageability and the Appraisal of Life Events (ALE) questionnaires plateaued at 12 weeks, with no further increases observed at 1 and 2 years post injury. These findings highlight the importance of nurturing patients' self-efficacy and positive appraisals during this time to facilitate adjustment and long-term psychological wellbeing.…”

“…It extended research by Kennedy et al 18 by exploring outcomes for this patient group at 2 years post injury.…”

“…In the initial analysis of this sample, Kennedy et al 18 found an increase in SRG between 6 and 12 weeks post injury. This suggests that in this sample, the first 12 weeks following injury was the time period for patients to reflect on positive changes in personal resources, social relationships and coping skills.…”

Associations between psychological factors and quality of life ratings in persons with spinal cord injury: a systematic review

“…[32][33][34] SOC was strongly associated with greater psychological well-being, [32][33][34] and moderately with lower levels of depression and anxiety. 33,34 Positive factors. Seven out of eight associations between hope and QOL were significant.…”