Sense of coherence and psychological outcomes in people with spinal cord injury: appraisals and behavioural responses.
METHODS
Longitudinal, multi-wave design.


OBJECTIVE
To investigate the contribution of sense of coherence (SOC), appraisals, and behavioural responses when predicting psychological outcomes to spinal cord injury (SCI).


METHODS
Patients (N=237) sustaining a SCI aged 17 or above were recruited from specialist spinal injuries centres across six European countries. Measures of SOC, appraisals, coping strategies, and psychological well-being were administered at 6 and 12 weeks post-injury and at a 1 year follow-up.


RESULTS
People scoring high on SOC at 6 weeks post-injury showed significantly better psychological outcomes at 1 year post-injury and SOC showed significant relationships with appraisals at 12 weeks post-injury and coping strategies 1 year post-injury. Significant relationships were found between appraisals at 12 weeks post-injury and psychological outcomes, adaptive coping strategies were significantly related to psychological well-being at 1 year post-injury. Regression analyses found SOC, appraisals, and coping behaviours to explain 61.8% of the variance in psychological quality of life, 66.5% of the variance in depression, and 37.7% of the variance in anxiety at 1 year post-injury.


CONCLUSIONS
This study provides further evidence in support of previous findings which suggest SOC to have a primary role in long-term psychological well-being. The relationship described here - from SOC to the appraisal of injury and subsequent behavioural responses - suggests SOC to be an influential factor in the long-term adjustment of people with SCI.
Kennedy
P
P
Isis Education Centre, Warneford Hospital, University of Oxford, UK. paul.kennedy@hmc.ox.ac.uk
Lude
P
P
Elfström
M L
ML
Smithson
E
E
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003431:Cross-Cultural Comparison; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011379:Prognosis; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D013119:Spinal Cord Injuries / Q000523:psychology* / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D055815:Young Adult