Abstract
Study design: Cross-sectional.
Objectives: To investigate relationships between coping and mental well-being with clinical relevance to spinal cord lesion (SCL).
Setting: The Gothenburg Spinal Injuries Unit in Sweden.
Methods: The study sample comprised 274 persons. From in-depth interviews, literature reviews, and the transactional theory of stress and coping, items reflecting coping and psychological outcome, respectively were generated. Principal components factor analysis, multi-trait analysis, and structural equation modelling were used.
Results: The coping scale comprised three factors: Acceptance (i.e. revaluation of life values); Fighting spirit (i.e. efforts to behave independently); Social reliance (i.e. a tendency towards dependent behaviour). The outcome scale included the factors: Helplessness (i.e. feeling perplexed, out of control and low self-esteem); Intrusion (i.e. bitterness and brooding); Personal growth (i.e. positive outcomes of life crisis). Acceptance showed a positive relation to Personal growth and was inversely related to both Helplessness and Intrusion. Fighting spirit had a weak negative association to Helplessness and a weak positive association to Personal growth. Social reliance was positively related to Helplessness and Intrusion. Only Social reliance showed any association to neurological status. Those lesioned 1–4 years reported more Helplessness, Intrusion, Social reliance, and less Acceptance than those lesioned ⩾5 years.
Conclusion: Coping is related to psychological outcome in SCL. Our situational coping measure may be a candidate to assess intervention effects.
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Appendix
Appendix
Items from each coping and psychological outcome factor.
SCL-RELATED COPING SCALE
Acceptance
I have been able to see my lesion in perspective.
I think I have accepted my lesion.
Through my lesion I have learned to appreciate new aspects of life that I did not think of before.
What I have lost physically I have gained in so many other ways.
Fighting spirit
I try to make the best of life despite the lesion.
I refuse to let the lesion rule my life.
I always try to get along by myself.
It is important for me to set goals that I can fight to achieve.
I always try to find tricks that might make my situation less difficult.
Social reliance
My lesion has taught me that you are dependent upon others.
Without support from others I would feel completely helpless.
You have to trust that other people are able to help you.
SCL-RELATED PSYCHOLOGICAL OUTCOME SCALE
Helplessness
I often feel at a loss without really knowing what to do.
It often feels like I have no control over my life.
I often feel out of it – that others do not understand my situation.
I often feel less worth than people who are not lesioned.
I often feel anxious about how my lesion might influence my life in the future.
Sometimes I feel like I am ashamed about my lesion.
Intrusion
I will probably never get over feeling bitter that it had to happen to me.
I often ask myself why I was lesioned.
The accident feels like an undeserved punishment.
Personal growth
I probably am more harmonious due to the accident.
I believe the accident has made me more mature.
The lesion has somehow made me more humble.
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Elfström, M., Rydén, A., Kreuter, M. et al. Linkages between coping and psychological outcome in the spinal cord lesioned: development of SCL-related measures. Spinal Cord 40, 23–29 (2002). https://doi.org/10.1038/sj.sc.3101238
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DOI: https://doi.org/10.1038/sj.sc.3101238
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