Tijn van Diemen1, Yvonne Tran2, Janneke M Stolwijk-Swuste3, Ellen H Roels4, Ilse J W van Nes5, Marcel W M Post6. 1. Department of spinal cord injury Rehabilitation, Sint Maartenskliniek, Nijmegen, The Netherlands. Electronic address: t.vandiemen@maartenskliniek.nl. 2. Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia. 3. Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands. 4. University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, The Netherlands. 5. Department of spinal cord injury Rehabilitation, Sint Maartenskliniek, Nijmegen, The Netherlands. 6. Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, The Netherlands.
Abstract
OBJECTIVE: Self-efficacy (SE) is an important determinant for the psychological adjustment of people with spinal cord injury (SCI). However, little is known about the course of SE during inpatient rehabilitation up to one year after discharge. The aim was to determine latent trajectory classes of SE, depressive mood and anxiety in people with SCI and the interrelationships between these trajectories. DESIGN: Longitudinal inception cohort study. SETTING: Eight specialized SCI rehabilitation centers PARTICIPANTS: The 268 participants were mainly men (68.3%), mean age 55.6 years almost half had a traumatic SCI (50.4) and tetraplegia(53.7%), the minority had a motor complete SCI (32.2). INTERVENTION: NA MAIN OUTCOME MEASURES: Self-efficacy was measured using the University of Washington Self-efficacy Scale. Further the Hospital Anxiety and Depression Scale was used to asses distress and perform dual trajectory modeling analyses. RESULTS: Three trajectories of SE, indicating low, middle and high SE, could be distinguished. Furthermore a 2-class trajectory solution for depressive mood and a 4-class solution for anxiety were found to be most suitable. All trajectories were stable over time. Developmental connections between SE and depressive mood and between SE and anxiety were revealed. Especially participants who adjusted well, reporting low scores on depressive mood and anxiety, could be identified by their high SE scores. However, the group of participants with high depressive mood scores and anxiety scores could not always be identified based on their SE trajectory. CONCLUSION: In accordance with our hypotheses, distinct trajectories of SE, depressive mood and anxiety were identified and high probabilities that SE trajectories were interrelated to the trajectories from depressive mood and anxiety were confirmed. Concurrent screening for SE and distress might best detect people at risk for adjustment problems.
OBJECTIVE: Self-efficacy (SE) is an important determinant for the psychological adjustment of people with spinal cord injury (SCI). However, little is known about the course of SE during inpatient rehabilitation up to one year after discharge. The aim was to determine latent trajectory classes of SE, depressive mood and anxiety in people with SCI and the interrelationships between these trajectories. DESIGN: Longitudinal inception cohort study. SETTING: Eight specialized SCI rehabilitation centers PARTICIPANTS: The 268 participants were mainly men (68.3%), mean age 55.6 years almost half had a traumatic SCI (50.4) and tetraplegia(53.7%), the minority had a motor complete SCI (32.2). INTERVENTION: NA MAIN OUTCOME MEASURES: Self-efficacy was measured using the University of Washington Self-efficacy Scale. Further the Hospital Anxiety and Depression Scale was used to asses distress and perform dual trajectory modeling analyses. RESULTS: Three trajectories of SE, indicating low, middle and high SE, could be distinguished. Furthermore a 2-class trajectory solution for depressive mood and a 4-class solution for anxiety were found to be most suitable. All trajectories were stable over time. Developmental connections between SE and depressive mood and between SE and anxiety were revealed. Especially participants who adjusted well, reporting low scores on depressive mood and anxiety, could be identified by their high SE scores. However, the group of participants with high depressive mood scores and anxiety scores could not always be identified based on their SE trajectory. CONCLUSION: In accordance with our hypotheses, distinct trajectories of SE, depressive mood and anxiety were identified and high probabilities that SE trajectories were interrelated to the trajectories from depressive mood and anxiety were confirmed. Concurrent screening for SE and distress might best detect people at risk for adjustment problems.