title: Coping with spinal cord injury: strategies used by adults who sustained their injuries as children or adolescents.
abstract: OBJECTIVE
  To identify the coping strategies used by adults with pediatric-onset spinal cord injuries (SCI) and to determine how these coping strategies were related to demographics, injury-related factors, and adult outcomes.
  
  
  METHODS
  Study Participants were adults who sustained SCI at age 18 years or younger and were interviewed at age 24 years or older. This is part of a large longitudinal study for which there were 864 eligible participants. There were 353 (41%) interviewed, 259 of which were assessed for coping skills. The telephone interview included a questionnaire and several standardized measures (Functional Independence Measure, Craig Handicap Assessment and Reporting Technique, Short-Form 12 measure of health-related quality of life, Satisfaction With Life Scale, Patient Health Questionnaire-9, and the Brief COPE adapted).
  
  
  RESULTS
  Of 259 participants, 62% were male and 58% had tetraplegia. The average age at injury was 14 years (0-18 years) and average age at interview was 30 years (24-42 years). Of 8 coping strategies assessed, 99% of participants used acceptance, 94% used positive reframing, 93% used active coping, 89% used emotional support, 89% used humor, and 74% used religion. The negative coping skills of behavioral disengagement and substance use were used by 28% and 15%, respectively. A hierarchical regression analysis was used to predict higher adult life satisfaction by using the positive coping strategies of seeking emotional support, acceptance, and religion; it was negatively associated with substance use.
  
  
  CONCLUSIONS
  Positive coping strategies tend to be used by a majority of adults with pediatric-onset SCI, and several coping styles are associated with greater life satisfaction.
authors.affiliation: Shriners Hospitals for Children, Chicago, Illinois 60707, USA. cjanderso@comcast.net
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Anderson
authors.forename: Lawrence C
authors.initials: LC
authors.lastname: Vogel
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Chlan
authors.forename: Randal R
authors.initials: RR
authors.lastname: Betz
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D017668:Age of Onset; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012044:Regression Analysis; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000503:physiopathology*; D011795:Surveys and Questionnaires
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