Psychological hardiness in women with paraplegia.

A revised model of psychological hardiness suggests that transformational coping, positive health behaviors, and activistic social support may be qualitative indicators of hardiness and an expression of the synergistic presence of commitment, control, and challenge. Hardiness indicators correlate with health rather than illness, and have an indirect effect on the stress-illness relationship through health. Stress and illness also correlate with health. A secondary qualitative analysis of the transcripts of eight women with paraplegia revealed three major themes related to spinal cord injury (SCI): physiological aspects of SCI, associated with the traumatic event and its consequences; psychological aspects of SCI, associated with problem-solving, choices, and challenges; and social aspects of SCI, associated with personal and professional relationships.