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Psychological resources, appraisals, and coping and their relationship to participation in spinal cord injury: a path analysis


Peter, Claudio; Müller, Rachel; Post, Marcel W M; van Leeuwen, Christel M C; Werner, Christina S; Geyh, Szilvia (2014). Psychological resources, appraisals, and coping and their relationship to participation in spinal cord injury: a path analysis. Archives of Physical Medicine and Rehabilitation, 95(9):1662-1671.

Abstract

OBJECTIVE To test the Spinal Cord Injury Adjustment Model and gain a better understanding about whether and how the psychological resources general self-efficacy (SE), purpose in life (PIL), appraisals, and coping influence participation in persons with spinal cord injury (SCI). DESIGN Cross-sectional data collection within the Swiss Spinal Cord Injury Cohort. SETTING Community setting. PARTICIPANTS Persons with SCI (N=516) who are ≥ 16 years old and living in the community in Switzerland. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Participation was measured with the restrictions subscale of the Utrecht Scale for Evaluation of Rehabilitation-Participation, General SE with the General Self-Efficacy Scale, PIL with the Purpose in Life Test-Short Form, appraisals with the Appraisal of Life Events Scale, and coping with the Brief COPE. RESULTS General SE (r=.32) and PIL (r=.23) were associated with less participation restrictions. The initial model yielded a poor model fit. The modified final model had an acceptable fit (χ(2)11=36.2; P<.01; root mean square error of approximation=.067 [90% confidence interval: .045-.09]; comparative fit index=.98). A total of 15% of the variance of participation was explained. In the final model, general SE had a moderate direct effect (β=.24) and mediated effects via threat appraisal and challenge appraisal and humor on participation, indicating a partial mediation effect. The association between PIL and participation was indirect: challenge appraisal and humor acted as mediators. CONCLUSIONS The results only partly support the double-mediating effect as suggested in the SCI adjustment model because both direct and indirect effects on participation were observed. Individuals with higher general SE and PIL perceive less participation restrictions. General SE seems an appropriate target to enhance participation. Longitudinal studies are needed to support our findings.

Abstract

OBJECTIVE To test the Spinal Cord Injury Adjustment Model and gain a better understanding about whether and how the psychological resources general self-efficacy (SE), purpose in life (PIL), appraisals, and coping influence participation in persons with spinal cord injury (SCI). DESIGN Cross-sectional data collection within the Swiss Spinal Cord Injury Cohort. SETTING Community setting. PARTICIPANTS Persons with SCI (N=516) who are ≥ 16 years old and living in the community in Switzerland. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Participation was measured with the restrictions subscale of the Utrecht Scale for Evaluation of Rehabilitation-Participation, General SE with the General Self-Efficacy Scale, PIL with the Purpose in Life Test-Short Form, appraisals with the Appraisal of Life Events Scale, and coping with the Brief COPE. RESULTS General SE (r=.32) and PIL (r=.23) were associated with less participation restrictions. The initial model yielded a poor model fit. The modified final model had an acceptable fit (χ(2)11=36.2; P<.01; root mean square error of approximation=.067 [90% confidence interval: .045-.09]; comparative fit index=.98). A total of 15% of the variance of participation was explained. In the final model, general SE had a moderate direct effect (β=.24) and mediated effects via threat appraisal and challenge appraisal and humor on participation, indicating a partial mediation effect. The association between PIL and participation was indirect: challenge appraisal and humor acted as mediators. CONCLUSIONS The results only partly support the double-mediating effect as suggested in the SCI adjustment model because both direct and indirect effects on participation were observed. Individuals with higher general SE and PIL perceive less participation restrictions. General SE seems an appropriate target to enhance participation. Longitudinal studies are needed to support our findings.

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Contributors:Schubert Martin, Curt Armin
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:September 2014
Deposited On:11 Dec 2014 09:17
Last Modified:14 Feb 2018 22:06
Publisher:Elsevier
ISSN:0003-9993
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.apmr.2014.04.012
PubMed ID:24792142

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