Boston College, William F. Connell School of Nursing, Chestnut Hill, MA, USA.
J Neurosci Nurs. 2012 Oct;44(5):271-83. doi: 10.1097/JNN.0b013e3182666203.
Biopsychosocial adaptation remains a multifaceted challenge for individuals with spinal cord injury, their families, and healthcare providers alike. The development of frequent medical complications necessitating healthcare interventions is an ongoing, debilitating, and costly problem for those living with spinal cord injuries. Although several demographic variables have been correlated with positive adaptation in individuals with spinal cord injury, the research outcome data present limitations in understanding and facilitating which coping techniques work best to augment biopsychosocial adaptation in this population. Coping facilitates adaptation and adjustment to stress and can help to increase quality of life in people living with spinal cord injury and reduce common complications. The purpose of this study was to determine the extent to which sociodemographic characteristics and hardiness explain coping in 243 adults living with a spinal cord injury. In addition, this study examined which predictors of coping explain biopsychosocial adaptation. A descriptive explanatory design was utilized. Standardized instruments were administered nationally to assess hardiness, coping, and physiological and psychosocial adaptation. Canonical correlation and multiple regression analyses indicated that less educated, less hardy, and recently injured participants were more likely to use escape-avoidance coping and less likely to use social support, problem solving, and positive reappraisal coping behaviors (p < .05). Individuals with paraplegia had a higher level of functional ability, spent less time in rehabilitation, had a greater sense of control, and experienced less frequent complications. The control dimension of hardiness was the only dimension that significantly related to biopsychosocial adaptation within this sample.
生物-心理-社会适应仍然是脊髓损伤患者、他们的家庭和医疗保健提供者面临的一个多方面挑战。频繁发生需要医疗干预的医疗并发症是脊髓损伤患者面临的一个持续存在的、使人衰弱的和昂贵的问题。尽管已经有几个人口统计学变量与脊髓损伤患者的积极适应相关,但研究结果数据在理解和确定哪些应对技术最能增强这一人群的生物-心理-社会适应方面存在局限性。应对有助于适应和应对压力,并有助于提高脊髓损伤患者的生活质量,减少常见并发症。本研究的目的是确定社会人口统计学特征和坚韧程度在多大程度上解释了 243 名脊髓损伤成年人的应对方式。此外,本研究还探讨了哪些应对方式的预测因素可以解释生物-心理-社会适应。本研究采用描述性解释设计。全国范围内使用标准化工具评估坚韧程度、应对方式以及生理和心理社会适应。典型相关和多元回归分析表明,受教育程度较低、坚韧程度较低、受伤时间较短的参与者更有可能使用逃避应对方式,而不太可能使用社会支持、问题解决和积极重新评估应对方式(p<.05)。截瘫患者的功能能力更高,康复时间更短,控制感更强,并发症发生频率更低。坚韧的控制维度是该样本中与生物-心理-社会适应显著相关的唯一维度。