Article

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 (chi(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 (beta=.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.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS