Resilience in the face of coping with a severe physical injury: a study of trajectories of adjustment in a rehabilitation setting.
OBJECTIVE
Despite the popularity of the concept of resilience, little research has been conducted on populations in physical rehabilitation settings. Our purpose was to identify three trajectories of psychological adjustment to an acquired severe physical injury characterized by resilience, recovery, or distress in a longitudinal design.


METHODS
Eighty inpatients with a severe injury at a rehabilitation hospital. The participants had spinal cord injury or multiple traumas.


METHODS
Classification into the three trajectories was based on symptoms of psychological distress (posttraumatic stress disorder, depression, anxiety, and negative affect) and participants' level of positive affect at admission to and discharge from the rehabilitation hospital.


RESULTS
The most common trajectory was the resilience trajectory (54%), followed by the recovery trajectory (25%) and the distress trajectory (21%). The most interesting differences between the trajectories were the result of optimism, affect, social support, and pain. Trait negative and positive affect predicted classification into the trajectories.


CONCLUSIONS
An adaptation pattern characterized by resilience was found to be the most common response to an acquired severe injury, and trait affect predicts the outcome pattern. Interventions based on resilience are discussed.
Quale
Anette Johansen
AJ
Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway. anette.johansen@sunnaas.no
Schanke
Anne-Kristine
AK
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D012917:Social Adjustment; D014947:Wounds and Injuries / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D055815:Young Adult