van Leeuwen Christel M C, Edelaar-Peeters Yvette, Peter Claudio, Stiggelbout Anne M, Post Marcel W M
De Hoogstraat Rehabilitation, Rembrandtkade 10, NL-3583 TM Utrecht, The Netherlands. E-mail:
J Rehabil Med. 2015 Jun;47(6):531-7. doi: 10.2340/16501977-1953.
To examine the course of mental health and psychological factors over time in persons with a recent spinal cord injury and to determine whether change in psychological factors is associated with change in mental health.
Prospective cohort study in the Netherlands with 3 measurement time-points.
A total of 60 persons with recently acquired spinal cord injury.
Standardized validated measurement instruments were used to assess mental health, self-efficacy, mastery, optimism, illness cognitions, purpose in life, and social comparison. Descriptive statistics and multilevel analysis were used.
Multilevel regression analyses showed that neither mental health nor psychological factors, except for social comparison-upward identification, showed statistically significant change over time. However, increasing scores for self-efficacy, mastery, acceptance cognitions, and purpose in life were significantly associated with increasing mental health. In contrast, increasing scores for optimism, social comparison, helplessness cognitions, and disease benefits cognitions were not significantly associated with increasing mental health in persons with spinal cord injury.
Most psychological factors showed stability up to 6 months post-discharge. Purpose in life, acceptance cognitions, self-efficacy, and mastery showed more variability and seem to be most promising as targets for interventions, which may lead to an improvement in mental health in persons with spinal cord injury.
研究近期脊髓损伤患者心理健康和心理因素随时间的变化过程，并确定心理因素的变化是否与心理健康的变化相关。
在荷兰进行的前瞻性队列研究，有3个测量时间点。
共有60名近期发生脊髓损伤的患者。
使用标准化的有效测量工具来评估心理健康、自我效能感、掌控感、乐观主义、疾病认知、生活目的和社会比较。采用描述性统计和多水平分析。
多水平回归分析显示，除了向上认同的社会比较外，心理健康和心理因素随时间均未显示出具有统计学意义的变化。然而，自我效能感、掌控感、接纳认知和生活目的得分的增加与心理健康的改善显著相关。相比之下，乐观主义、社会比较、无助认知和疾病益处认知得分的增加与脊髓损伤患者心理健康的改善无显著关联。
大多数心理因素在出院后6个月内表现出稳定性。生活目的、接纳认知、自我效能感和掌控感表现出更大的变异性，似乎是最有希望的干预目标，这可能会改善脊髓损伤患者的心理健康。
