Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands; Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, the Netherlands.
Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands.
Arch Phys Med Rehabil. 2018 Oct;99(10):2015-2021. doi: 10.1016/j.apmr.2018.05.032. Epub 2018 Aug 25.
Examine whether coping flexibility at admission to first spinal cord injury (SCI) rehabilitation was predictive of distress 1 year after discharge.
Longitudinal inception cohort study.
Rehabilitation center.
Of the 210 people admitted to their first inpatient SCI rehabilitation program, 188 met the inclusion criteria. n=150 (80%) agreed to participate; the data of participants (N=113) with a complete dataset were used in the statistical analysis.
Not applicable.
Coping flexibility was operationalized by (1) flexible goal adjustment (FGA) to given situational forces and constraints and (2) tenacious goal pursuit (TGP) as a way of actively adjusting circumstances to personal preference. The Assimilative-Accommodative Coping Scale was used to measure FGA and TGP. The Hospital Anxiety and Depression Scale was used to assess distress.
Scores on FGA and TGP measured at admission were negatively associated with the scales depression (r= -.33 and -.41, respectively) and anxiety (r= -.23 and -.30, respectively) 1 year after discharge. All demographic and injury-related variables at admission together explained a small percentage of the variance of depression and anxiety. FGA, TGP, and the interaction term together explained a significant additional 16% of the variance of depression and 10% of anxiety.
The tendency to pursue goals early postonset of the injury seems to have a protecting effect against distress 1 year after discharge. People with low TGP may experience protection against distress from high FGA.
探讨首次脊髓损伤（SCI）康复入院时的应对灵活性是否能预测出院 1 年后的痛苦程度。
纵向发病队列研究。
康复中心。
在 210 名进入首次住院 SCI 康复计划的人中，有 188 名符合纳入标准。n=150（80%）同意参与；在统计分析中使用了具有完整数据集的参与者（n=113）的数据。
不适用。
应对灵活性通过（1）灵活的目标调整（FGA）以适应特定的情境力量和限制，以及（2）顽强的目标追求（TGP）作为主动调整环境以适应个人偏好的方式来操作。采用同化-适应应对量表来测量 FGA 和 TGP。采用医院焦虑抑郁量表评估痛苦程度。
入院时测量的 FGA 和 TGP 得分与出院后 1 年时的抑郁（r=-.33 和 -.41）和焦虑（r=-.23 和 -.30）量表呈负相关。入院时的所有人口统计学和损伤相关变量一起仅能解释抑郁和焦虑的一小部分方差。FGA、TGP 和交互项共同解释了抑郁 16%的方差和焦虑 10%的方差。
受伤后早期追求目标的倾向似乎对出院后 1 年的痛苦有保护作用。TGP 较低的人可能会从较高的 FGA 中获得对痛苦的保护。
