Investigating Dynamics of the Spinal Cord Injury Adjustment Model: Mediation Model Analysis

J. Clin. Med., 2022 · DOI: 10.3390/jcm11154557 · Published: August 4, 2022

Spinal Cord Injury Mental Health Rehabilitation

Simple Explanation

This paper presents a detailed description of the Spinal Cord Injury Adjustment Model (SCIAM), which clarifies how individuals adjust to SCI and contends that adjustment to SCI is a multifactorial process involving non-linear dynamic adaptation over time. Mediation analyses were conducted to test the mediator dynamics proposed by the model. The analyses tested the relationship between two moderators (self-care and secondary health conditions), mediators (two self-efﬁcacy items and appraisal of quality of life or QoL), and positive versus negative vitality/mental health as outcomes. In conclusion, it is important to employ a holistic model such as SCIAM to conceptualise and increase understanding of the process of adjustment following a severe neurological injury such as SCI.

Study Duration

Not specified

Participants

1579 participants with spinal cord injury living in the community in Australia

Evidence Level

Not specified

Key Findings

1
Results showed that higher self-efﬁcacy and perceived QoL was related to greater independence in self-care and reduced negative impacts of secondary health conditions.
2
This study supported the mediation role of self-efﬁcacy and other appraisals such as perceived QoL in enhancing self-care and buffering the negative impact of health challenges.
3
It was concluded that self-efﬁcacy and the appraisal of QoL fully mediated the inﬂuence of self-care activities on positive and negative vitality/mental health.

Research Summary

Spinal cord injury (SCI) is a severe neurological injury that results in damage to multiple bodily systems. SCI rehabilitation requires a signiﬁcant focus on improving adjustment to the injury. The analyses tested the relationship between two moderators (self-care and secondary health conditions), mediators (two self-efﬁcacy items and appraisal of quality of life or QoL), and positive versus negative vitality/mental health as outcomes. In conclusion, it is important to employ a holistic model such as SCIAM to conceptualise and increase understanding of the process of adjustment following a severe neurological injury such as SCI.

Practical Implications

Rehabilitation strategies

Rehabilitation processes should introduce structured assessment of mediator measures like self-efficacy during the inpatient phase.

Self-management strategies

Emphasize personal responsibility and realistic/optimistic thinking within self-management strategies.

Psychosocial guidelines

Structured rehabilitation processes such as the development of psychosocial guidelines, to encourage consistent assessment of measures of mediators.

Study Limitations

1
Data used to conduct the analyses were cross-sectional
2
Database contained no information on coping strategies that participants could employ to manage problems
3
Choice of an outcome variable was inﬂuenced by SCIAM presenting adjustment outcomes as either positive or negative.

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