Hope International College, Kathmandu, 44600, Nepal.
Faculty of Nursing, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
BMC Psychiatry. 2018 Mar 2;18(1):60. doi: 10.1186/s12888-018-1640-z.
One of many types of injuries following an earthquake is spinal cord injury (SCI) which is a life-long medically complex injury and high-cost health problem. Despite several negative consequences, some persons with SCI are resilient enough to achieve positive adjustment, greater acceptance, and better quality of life. Since resilience is influenced by several factors and can vary by context, it is beneficial to explore factors that affect the resilience of people who sustained spinal cord injury from the 2015 earthquake in Nepal.
A descriptive cross-sectional study included 82 participants from the Spinal Injury Rehabilitation Center and communities in Nepal. Participants completed the Demographic and Injury-related Questionnaire, Connor-Davidson Resilience Scale, Multidimensional Scale of Perceived Social Support, Moorong Self-efficacy Scale, Intrinsic Spirituality Scale, and Patient Health Questionnaire-9. Pearson's correlation and point biserial correlation analyses were performed to examine associations between resilience and independent variables. A hierarchical regression analysis was used to identify the influence of certain factors.
Findings indicated significant associations between resilience and social support (r = 0.42, p < 0.001), self-efficacy (r = 0.53, p < 0.001), depressive mood (r = - 0.50, p < 0.001) and demographic variables which included sex (r = 0.47, p < 0.001), employment (r = 0.27, p = 0.016), and current living location (r = 0.24, p = 0.029). There was a non-significant association between resilience and spirituality (r = - 0.12, p > 0.05). In hierarchical regression analysis, an overall regression model explained 46% of the variance in resilience. Self-efficacy (β = 0.28, p = 0.007) and depressive mood (β = - 0.24, p = 0.016) significantly determined resilience after controlling the effect of demographic variables. Among the demographic factors, being male significantly explained the variance in resilience (β = 0.31, p = 0.001).
Multiple psychosocial and demographic factors were associated with resilience in people who sustained an earthquake-related SCI. Mental health professionals should demonstrate concern and consider such factors in allocating care in this group. Development of intervention research concerning resilience is recommended to strengthen resilience in order to improve rehabilitation outcomes and enhance reintegration of individuals with SCI into their communities.
地震后会造成多种类型的损伤，其中包括脊髓损伤（SCI），这是一种终生的复杂医学损伤和高成本的健康问题。尽管存在许多负面影响，但一些 SCI 患者具有足够的适应能力，能够实现积极的调整、更高的接受度和更好的生活质量。由于适应能力受到多种因素的影响，并且可能因环境而异，因此探讨影响尼泊尔 2015 年地震后脊髓损伤患者适应能力的因素是有益的。
本研究采用描述性横断面研究设计，纳入了来自尼泊尔脊髓损伤康复中心和社区的 82 名参与者。参与者完成了人口统计学和损伤相关问卷、Connor-Davidson 适应能力量表、多维感知社会支持量表、Moorong 自我效能感量表、内在灵性量表和患者健康问卷-9。采用 Pearson 相关和点二列相关分析来检验适应能力与自变量之间的关联。采用分层回归分析来确定某些因素的影响。
研究结果表明，适应能力与社会支持（r = 0.42，p < 0.001）、自我效能感（r = 0.53，p < 0.001）、抑郁情绪（r = - 0.50，p < 0.001）和人口统计学变量（包括性别（r = 0.47，p < 0.001）、就业状况（r = 0.27，p = 0.016）和当前居住地点（r = 0.24，p = 0.029）之间存在显著关联。适应能力与灵性之间的关联不具有统计学意义（r = - 0.12，p > 0.05）。在分层回归分析中，一个总体回归模型可以解释适应能力 46%的方差。在控制人口统计学变量的影响后，自我效能感（β=0.28，p=0.007）和抑郁情绪（β=−0.24，p=0.016）显著决定了适应能力。在人口统计学因素中，男性显著解释了适应能力的方差（β=0.31，p=0.001）。
多种心理社会和人口统计学因素与地震相关 SCI 患者的适应能力相关。心理健康专业人员在为该群体分配护理时，应表现出关注并考虑这些因素。建议开展关于适应能力的干预研究，以增强适应能力，从而改善 SCI 患者的康复结果，并促进他们重新融入社区。
