Determining the Level of Occupational Performance and its Association with Depression among Patients with Spinal Cord Injury

Abstract

Background: Spinal Cord Injury (SCI) presents a significant challenge to healthcare systems worldwide, often leading to severe physical disability and psychological distress, including depression. The rehabilitation process for SCI patients is complex, necessitating a multidimensional approach that addresses both the physical and psychological aspects of recovery. The interplay between occupational performance and mental health among individuals with SCI remains a critical area of investigation, particularly in regions like Peshawar, Pakistan, where such studies are scarce. Objective: The primary objective of this study was to explore the association between occupational performance and depression among individuals with SCI in Peshawar, with a secondary aim of comparing occupational performance levels and their relationship with depression in this demographic. Methods: A cross-sectional study was conducted at the Paraplegic Centre Peshawar over a six-month period, utilizing convenience sampling to recruit 120 participants. Depression and occupational performance were assessed using the Beck Depression Inventory and the Barthel Index Scale, respectively. Data analysis was performed using SPSS version 22, with statistical significance set at p<0.05. Results: The study found that 35.8% of participants experienced moderate depression, while mild mood disturbances and borderline clinical depression were reported by 21.7% and 12%, respectively. Severe and extreme depression were less common, observed in 9.8% and 1.1% of the sample. Regarding occupational performance, 37% were totally dependent, 50% were severely dependent, and 13% were moderately independent. Statistical analysis revealed a significant association between occupational performance and depression levels (Pearson Chi-Square = 17.986, p=.05; Likelihood Ratio = 18.683, p=.04; Fisher Exact Test = 9.214, p=.002). Conclusion: The study highlights a notable correlation between occupational performance and depression among SCI patients, emphasizing the need for integrated rehabilitation programs that address both physical disabilities and mental health concerns. Enhancing occupational performance through targeted interventions may reduce depression levels, thereby improving overall quality of life for SCI patients.