Department of Health Sciences and Medicine.
Swiss National Center of Competence in Research LIVES.
Rehabil Psychol. 2021 Nov;66(4):491-506. doi: 10.1037/rep0000396. Epub 2021 Nov 4.
To determine average changes and individuals' patterns of change in depressive symptoms, anxiety symptoms, general distress, and life satisfaction between admission to spinal cord injury inpatient rehabilitation and discharge; and to identify factors associated with change.
Longitudinal data collection as part of a national cohort study ( = 281). Changes in the psychological adaptation outcomes were analyzed using latent change score models. Reliable change indexes were calculated for each outcome to identify individuals' patterns of change. Biopsychosocial factors were examined as covariates of change.
On average, depressive symptoms, anxiety symptoms, and general distress decreased between admission and discharge, while life satisfaction increased. According to the reliable change indexes, several adaptation patterns were identified. The proportion of individuals following each pattern varied depending on the analyzed outcome: resilience (absence of clinically relevant symptoms at admission and discharge) was the most common for symptoms of depression (61.57%) and anxiety (66.55%), whereas vulnerability (clinically relevant symptoms at both measurement times) was the most common for distress (57.32%). Improvement patterns (statistically significant decreases) were identified for 6.41%, 4.27%, and 7.83% of participants in depressive symptoms, anxiety symptoms and distress, respectively. For life satisfaction, improvement (statistically significant increases) was found for 8.54%. Male sex, tetraplegia, self-efficacy, optimism, and social support were associated with average changes in the psychological adaptation outcomes.
On average, participants showed improvement in all analyzed outcomes. Still, there is substantial variability in change. Self-efficacy, social support, and optimism are potential intervention targets during inpatient rehabilitation to promote a favorable psychological adaptation process. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
确定从脊髓损伤住院康复入院到出院期间抑郁症状、焦虑症状、一般困扰和生活满意度的平均变化和个体变化模式；并确定与变化相关的因素。
作为全国队列研究的一部分进行纵向数据收集（n=281）。使用潜在变化分数模型分析心理适应结果的变化。为每个结果计算可靠的变化指数，以确定个体的变化模式。将生物心理社会因素作为变化的协变量进行检查。
平均而言，抑郁症状、焦虑症状和一般困扰在入院和出院之间有所减轻，而生活满意度有所提高。根据可靠的变化指数，确定了几种适应模式。根据分析的结果，每种模式的个体比例不同：在抑郁症状（61.57%）和焦虑（66.55%）中，最常见的是无临床相关症状（入院和出院时）的弹性模式；而在困扰（57.32%）中，最常见的是脆弱性模式（两次测量时均有临床相关症状）。在抑郁症状、焦虑症状和困扰方面，分别有 6.41%、4.27%和 7.83%的参与者出现改善模式（统计学上显著下降）。对于生活满意度，有 8.54%的参与者出现改善（统计学上显著增加）。男性、四肢瘫痪、自我效能、乐观和社会支持与心理适应结果的平均变化相关。
平均而言，参与者在所有分析的结果中都有改善。尽管如此，变化仍存在很大的差异。自我效能、社会支持和乐观是住院康复期间促进有利心理适应过程的潜在干预目标。
