Guest R, Craig A, Tran Y, Middleton J
Rehabilitation Studies Unit, John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, The University of Sydney, Kolling Institute of Medical Research, St Leonards, New South Wales, Australia.
Key University Centre for Health Technologies, University of Technology, Sydney, Broadway, New South Wales, Australia.
Spinal Cord. 2015 Sep;53(9):682-6. doi: 10.1038/sc.2015.32. Epub 2015 Feb 24.
This is a longitudinal design study.
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.
This study was conducted in SCI rehabilitation units and the community in New South Wales, Australia.
Participants included 88 adults with SCI admitted over almost 3 years into three SCI Units in Sydney. Standardized self-report 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.
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.
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.
这是一项纵向设计研究。
本研究的目的是确定在住院康复出院时以及出院后6个月重新融入社区时，预测脊髓损伤（SCI）患者恢复力的因素。
本研究在澳大利亚新南威尔士州的SCI康复单位和社区进行。
参与者包括近3年内在悉尼的三个SCI单位收治的88名成年SCI患者。使用标准化的自我报告和基于临床医生的测量方法。纵向评估在出院后长达6个月进行。在入院时、出院前和出院后6个月评估社会人口统计学、损伤和心理变量。使用标准多元回归来确定在出院时和出院后6个月预测恢复力的因素。
近70%的参与者在出院时被归类为具有恢复力，在社区生活6个月后这一比例为66%。多个因素在出院时和出院后6个月显著预测恢复力，包括自我效能感、低水平的负面情绪和较低的功能独立性，而社会支持和较低的继发性疾病严重程度有显著趋势。人口统计学和损伤变量没有显著贡献。
自我效能感和低水平的负面情绪状态对恢复力有很大贡献。确定这些预测因素将有助于改进康复计划，以增强SCI患者的恢复力。然而，鉴于所纳入的因素组解释了恢复力中40 - 44%的方差，未来需要进行纵向研究，不仅要确定恢复力是否相关，还要确定这些关联是否随时间变化。
