title: Impact of psychological characteristics in self-management in individuals with traumatic spinal cord injury.
abstract: METHODS
  Cross-sectional survey.
  
  
  OBJECTIVE
  To examine the association between psychological characteristics in self-management and probable depression status in individuals with a traumatic spinal cord injury (SCI).
  
  
  METHODS
  Community-dwelling individuals with traumatic SCI living across Canada.
  
  
  METHODS
  Individuals with SCI were recruited by email via the Rick Hansen Institute as well as an outpatient hospital spinal clinic. Data were collected by self-report using an online survey. Standardized questionnaires were embedded within a larger survey and included the Hospital Anxiety and Depression Scale (HADS), the short version of the Patient Activation Measure (PAM), the Moorong Self-Efficacy Scale (MSES) and the Pearlin-Schooler Mastery Scale (PMS).
  
  
  RESULTS
  Individuals with probable depression (n=25) had lower self-efficacy (67.9 vs 94.2, P<0.0001), mastery (18.9 vs 22.9, P<0.0001) and patient activation (60.4 vs 71.6, P<0.0001) as well as higher anxiety (9.0 vs 5.5, P<0.0001), compared with their non-depressed counterparts (n=75). A logistic regression determined that lower self-efficacy and mastery scores as well as less time since injury were associated with depression status (P=0.002; P=0.02 and P=0.02, respectively). Individuals with higher anxiety scores were almost 1.5 times more likely to be depressed, while older age was positively associated with depression status (P=0.016 and P=0.024, respectively).
  
  
  CONCLUSIONS
  Interventions for depression in SCI, including a self-management program, should target factors such as self-efficacy and mastery, which could improve secondary medical complications and overall quality of life.
authors.affiliation: Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
authors.forename: S E P
authors.initials: SE
authors.lastname: Munce
authors.affiliation: Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: S E
authors.initials: SE
authors.lastname: Straus
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: M G
authors.initials: MG
authors.lastname: Fehlings
authors.affiliation: Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Voth
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Nugaeva
authors.affiliation: Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, Toronto, Ontario, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Jang
authors.affiliation: Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: F
authors.initials: F
authors.lastname: Webster
authors.affiliation: Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.|Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.|Department of Physical Therapy, University of Toronto, Toronto, Canada.
authors.forename: S B
authors.initials: SB
authors.lastname: Jaglal
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D013119:Spinal Cord Injuries / Q000150:complications / Q000523:psychology* / Q000628:therapy; D018709:Statistics, Nonparametric