Life satisfaction, appraisals and functional outcomes in spinal cord-injured people living in the community

Abstract

Study design: Multi-centre, single cohort. Objectives: To assess the relationship between cognitive appraisals in a spinal cord-injured population living in the community, and examine how these factors affect social participation, life satisfaction and functional outcomes. Setting: The National Spinal Injuries Centre, Stoke Mandeville, UK; Princess Royal Spinal Injuries Centre, Sheffield UK; Midlands Centre for Spinal Injuries, Oswestry, UK. Method: Participants (n ¼ 81) sustaining injury aged 18 or above were recruited from one of three spinal cord injuries units 3-18 months after discharge. Postal packs containing questionnaires, consent forms and information were distributed and a 2-week reminder sent. Results: Participation was found to be strongly related to life satisfaction, negative appraisals of disability were found to explain 12.9% of the variance in total participation scores. The variance in scores on Life Satisfaction Questionnaires was explained by appraisals, participation and secondary complications to a total of 69.6%. Functional Independence Scores were explained by negative perceptions of disability, growth and resilience and total secondary complication scores, explaining 49.4% of the variance in this measure. Conclusion: Participation, functional independence and life satisfaction were significantly related to appraisal styles in this population. Negative perceptions of disability, fearful despondency and overwhelming disbelief were themes that impacted on the likelihood of participation and independence and involved in expressed levels of life satisfaction. Our results suggest the need to tackle cognitive styles of SCI patients before discharge to improve the rehabilitation process.

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

“…39 The passive and disengaged coping strategy 'social reliance' was found to be significant in explaining the variance in these outcome measures. Clinically, if patients are assessed using these measures prior to commencing active rehabilitation, those tending to see their injury as a loss or those patients prone to using passive and avoidant behavioural strategies to deal with the emotional sequelae of their injury could receive additional support, psycho-education or participate in Coping Effectiveness Training.…”

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

“…Perceived manageability (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Across the whole sample, there was a significant increase in scores for perceived manageability t(200) ¼ À2.831, P ¼ 0.005.…”

“…In relation to people with SCI, not only have appraisals been indicated in long-term psychological adjustment 15 but also in terms of functional outcome measures. Using the Appraisals of Disability: Primary and Secondary Scale, 16 Kennedy et al 17 found appraisals to explain 49.4% of the variance of Functional Independence Measure (FIM) scores. The current research builds on findings from an earlier cohort study that investigated appraisals, coping and QOL across four community samples.…”

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

“…33,34,37,56,57 Overwhelming disbelief, fearful despondency and negative perceptions of one's disability were associated with lower life satisfaction, 56 whereas growth and resilience were associated with greater life satisfaction. 56,57 The appraisals threat, challenge and loss have been employed in two studies. 33,34 Moreover, one study examined the appraisals threat, challenge and control.…”

“…The way in which an individual thinks about or 'appraises' a situation 33 Appraisal of Life Events (ALE); 33,34 The Pakenham scale; 37 APAPSS Scale; 56 Illness Cognition Questionnaire (ICQ) 57 Higher order cognitive processes and an evaluation on the availability of coping resources, their sufficiency in the current environment and the likelihood that they can be used in the current situation (Galvin and Godfrey, 2001) 56 anxiety. 33,34,37 Loss appraisals were associated with lower life satisfaction, and higher levels of depression and anxiety.…”