Geyh Szilvia, Kunz Simon, Müller Rachel, Peter Claudio
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
J Rehabil Med. 2016 Feb;48(2):219-34. doi: 10.2340/16501977-2027.
To describe and explore functioning and health of persons with spinal cord injury from the perspective of psychological-personal factors in the light of the International Classification of Functioning, Disability and Health (ICF) framework.
Data from 511 participants regarding feelings, thoughts and beliefs, motives, and patterns of experience and behaviour were analysed. Measurement instruments included the Mental Health Index-5, Positive and Negative Affect Schedule, Hospital Anxiety and Depression Scale, Appraisal of Life Events Scale, 5 items from the World Health Organization Quality of Life Scale, Purpose in Life Test-Short Form, General Self-Efficacy Scale, Big Five Inventory-21, Social Skills Inventory-SF, Brief COPE. The distribution of the selected psychological-personal factors-indicators was examined using descriptive statistics. Differences between SCI subgroups by sex, age, age at injury, time since injury, aetiology and severity of injury were explored using analysis of variance (ANOVA) and F-tests.
Participants who were older and sustained their spinal cord injury more recently experienced more depressed mood, less positive affect, less challenge appraisal, lower life satisfaction, lower purpose in life, and lower self-efficacy. They reported lower social skills, less usage of the coping strategies humour, positive reframing, and acceptance, and more usage of the coping strategies denial and self-distraction. Overall, effect sizes were small.
Although study participants appeared to be well adjusted to spinal cord injury, those who sustained their injury at an older age and more recently reported more negative experiences. Quantitative description and exploration of the psychological-personal aspects of health will enable hypotheses to be formulated for further research, and suggest a need for tailored interventions for those at risk of less favourable outcomes.
根据国际功能、残疾和健康分类(ICF)框架,从心理-个人因素的角度描述和探讨脊髓损伤患者的功能和健康状况。
分析了511名参与者关于情感、思想和信念、动机以及经验和行为模式的数据。测量工具包括心理健康指数-5、正负性情绪量表、医院焦虑抑郁量表、生活事件评估量表、世界卫生组织生活质量量表中的5个项目、生活目的测试简表、一般自我效能量表、大五人格量表-21、社交技能量表-简版、简易应对方式问卷。使用描述性统计方法检验所选心理-个人因素指标的分布情况。采用方差分析(ANOVA)和F检验探讨脊髓损伤亚组在性别、年龄、受伤年龄、受伤时间、病因和损伤严重程度方面的差异。
年龄较大且近期发生脊髓损伤的参与者情绪更抑郁,积极情绪更少,挑战性评估更低,生活满意度更低,生活目的更低,自我效能感更低。他们报告社交技能较低,应对策略幽默、积极重新评价和接受的使用较少,否认和自我分心等应对策略的使用较多。总体而言,效应量较小。
尽管研究参与者似乎已很好地适应了脊髓损伤,但那些年龄较大且近期受伤的人报告了更多负面经历。对健康的心理-个人方面进行定量描述和探索将有助于提出进一步研究的假设,并表明需要针对那些可能出现不太理想结果的人进行量身定制的干预。