Factors predicting resilience in people with spinal cord injury during transition from inpatient rehabilitation to the community

Abstract

Study Design: This is a longitudinal design study. Objectives: The objective of this study was to determine factors that predict resilience in people with spinal cord injury (SCI) at discharge from inpatient rehabilitation and after reintegration into the community 6 months post discharge. Setting: This study was conducted in SCI rehabilitation units and the community in New South Wales, Australia. Methods: Participants included 88 adults with SCI admitted over almost 3 years into three SCI Units in Sydney. Standardized selfreport and clinician-based measures were used. Longitudinal assessment occurred up to 6 months post discharge. Sociodemographic, injury and psychological variables were assessed at admission, before discharge and 6 months post discharge. Standard multiple regression was used to determine factors that predict resilience at discharge from hospital and 6 months post discharge. Results: Almost 70% of the participants were classified as resilient at discharge and 66% after 6 months of living in the community. Multiple factors significantly predicted resilience at discharge and 6 months post discharge, including self-efficacy, low levels of negative mood and lower functional independence, whereas social support and low severity of secondary conditions trended to significance. Demographic and injury variables did not contribute significantly. Conclusion: Self-efficacy and low levels of negative mood states strongly contribute to resilience. The determination of these predictors will assist in improving rehabilitation programs to strengthen the resilience of people with SCI. However, given that 40-44% of the variance in resilience was explained by the group of factors entered, future longitudinal research is needed to determine not only whether resilience correlates but also whether these associations change over time.

Resilience and the rehabilitation of adult spinal cord injury survivors: A qualitative systematic review

“…However, a stepwise approach whereby the clients and rehabilitation team identify small goals and steps to achieve enable the various threads of daily activities to be entwined while simultaneously increasing motivation, a sense of achievement and independence. Continuous reinforcement of the individual's capabilities build self‐efficacy (Craig et al., ) and in turn resilience among SCI survivors (Berry, Elliott, & Rivera, ; Driver et al., ; Guest, Craig, Tran, & Middleton, ). Importantly, self‐efficacy and resilience are acknowledged factors influencing rehabilitation outcomes following SCI (Middleton, Tate, & Geraghty, ).…”

“…Of importance, people with high levels of self-efficacy and social support and low levels of catastrophization are associated with a low risk of psychological disturbance. Poor self-efficacy is associated with an increased risk of psychological disorders in those who sustain a SCI (Craig et al, 2015). In a cross-sectional survey which examined factors that contribute to the process of positive adjustment, or resilience, in a community sample of SCI survivors, 58% of the 60 respondents reported moderate to high levels of resilience and resilience correlated significantly with high self-efficacy with self-efficacy contributing to resilient behaviour (Kilic et al, 2013).…”

Evaluation of a specialized yoga program for persons with a spinal cord injury: a pilot randomized controlled trial

“…A cross-sectional study employing a convenience population found that self-efficacy was positively correlated with resilience while in hospital and at 3 months post-SCI, and that levels of self-efficacy predicted levels of resilience while in hospital 21. Similarly, self-efficacy, as well as low levels of depressed mood, predict resilience in individuals with SCI at discharge and 6 months postdischarge from an inpatient rehabilitation setting into the community 22. It has been recommended that rehabilitation strategies enhance self-efficacy by strengthening the relationship between behaviors and perceived goals through increased self-monitoring and self-awareness 4…”

Recovery of Biopsychosocial Functions Following 15 Years after Spinal Cord Injury

“…People with better physical capacity indicators are more active in daily and community life, better manage self-control mechanisms, and feel more emotionally stable [24,25]. According to authors [26,27], it is important during the inpatient rehabilitation program to promote physically active lifestyle and activities in daily life as well as to increase motivation to engage in vigorous physical activity not only during exercise, training or active leisure, but also during household activities.…”