title: Cognitive appraisals, coping and quality of life outcomes: a multi-centre study of spinal cord injury rehabilitation.
abstract: METHODS
  Longitudinal, multiple wave panel design.
  
  
  OBJECTIVE
  To investigate the degree to which current thinking in terms of early appraisals and coping predicts adjustment and quality of life outcomes after spinal cord injury, and to what degree social and demographic variables are involved.
  
  
  METHODS
  Data were analysed from 266 patients recruited as part of an ongoing study from specialist units in selected British, Swiss, German and Irish spinal centres.
  
  
  METHODS
  Questionnaire booklets were administered as soon as possible after injury onset and after 12 weeks to patients with newly acquired spinal cord injuries. Individuals included had sustained their injury between the ages of 16 and 83.
  
  
  RESULTS
  Significant improvements in outcome measures were found across the data set within the first 12 weeks after spinal cord injury and changes observed in the appraisals and coping strategies employed. Significant differences were found between participating centres on both outcome measures and in the coping and appraisal processes used. Coping and appraisal processes at 6 weeks after injury were found to contribute significantly to the variation in psychological well-being at 12 weeks after injury.
  
  
  CONCLUSIONS
  This study shows the process of adjustment to spinal cord injury to begin in the early stages of rehabilitation, and initial appraisals are important to how an individual will cope with their injury and to their psychological well-being. Support is also given to the importance of psychological factors to functional outcomes.
authors.affiliation: Oxford Doctoral Course in Clinical Psychology, University of Oxford, Oxford, UK. paul.kennedy@hmc.ox.ac.uk
authors.forename: P
authors.initials: P
authors.lastname: Kennedy
authors.forename: P
authors.initials: P
authors.lastname: Lude
authors.forename: M L
authors.initials: ML
authors.lastname: Elfström
authors.forename: E
authors.initials: E
authors.lastname: Smithson
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D004185:Disability Evaluation; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007391:International Cooperation; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D055815:Young Adult