title: Describing functioning and health after spinal cord injury in the light of psychological-personal factors.
abstract: OBJECTIVE
  To describe and explore functioning and health of persons with spinal cord injury from the perspective of psychological-personal factors in the light of the International Classification of Functioning, Disability and Health (ICF) framework.
  
  
  METHODS
  Data from 511 participants regarding feelings, thoughts and beliefs, motives, and patterns of experience and behaviour were analysed. Measurement instruments included the Mental Health Index-5, Positive and Negative Affect Schedule, Hospital Anxiety and Depression Scale, Appraisal of Life Events Scale, 5 items from the World Health Organization Quality of Life Scale, Purpose in Life Test-Short Form, General Self-Efficacy Scale, Big Five Inventory-21, Social Skills Inventory-SF, Brief COPE. The distribution of the selected psychological-personal factors-indicators was examined using descriptive statistics. Differences between SCI subgroups by sex, age, age at injury, time since injury, aetiology and severity of injury were explored using analysis of variance (ANOVA) and F-tests.
  
  
  RESULTS
  Participants who were older and sustained their spinal cord injury more recently experienced more depressed mood, less positive affect, less challenge appraisal, lower life satisfaction, lower purpose in life, and lower self-efficacy. They reported lower social skills, less usage of the coping strategies humour, positive reframing, and acceptance, and more usage of the coping strategies denial and self-distraction. Overall, effect sizes were small.
  
  
  CONCLUSIONS
  Although study participants appeared to be well adjusted to spinal cord injury, those who sustained their injury at an older age and more recently reported more negative experiences. Quantitative description and exploration of the psychological-personal aspects of health will enable hypotheses to be formulated for further research, and suggest a need for tailored interventions for those at risk of less favourable outcomes.
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Szilvia
authors.initials: S
authors.lastname: Geyh
authors.forename: Simon
authors.initials: S
authors.lastname: Kunz
authors.forename: Rachel
authors.initials: R
authors.lastname: Müller
authors.forename: Claudio
authors.initials: C
authors.lastname: Peter
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000209:etiology; D004644:Emotions; D005260:Female; D006801:Humans; D064702:International Classification of Functioning, Disability and Health; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D020377:Self Efficacy; D013119:Spinal Cord Injuries / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult