This study aimed to evaluate the preliminary psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in a community sample of adults living with a spinal cord injury (SCI). A cross-sectional design was used with 963 people living in the community with an SCI. Participants were recruited via three spinal centres in the United Kingdom. They completed the HADS and the Life Satisfaction Questionnaire. Psychometric analyses were conducted for the whole sample, by gender and level of injury. The HADS demonstrated good internal consistency, with promising content validity. Two factors, approximating to anxiety and depression were extracted via factor analysis for the whole sample, by gender and level of injury. In line with existing literature, females scored significantly higher than males on the anxiety subscale. Item 7 ("I can sit at ease and feel relaxed") was found to be a complex item, with a potentially different meaning within this population. This study presents preliminary findings, which support the psychometric integrity of the HADS within an outpatient population with SCI. Items that included potential somatic components revealed a more complex factor loading profile. Recommendations are made to further investigate this measure with amendments to such items, incorporating inpatients and independent measures of anxiety and depression to address validity directly.

Study design: A pilot postal survey. Objective: To examine the levels of sporting/recreational activities, education and employment in people with spinal cord injury (SCI) and to assess if involvement in sport and recreation is associated with higher levels of education and employment. Setting: National Spinal Injuries Centre (NSIC), Stoke Mandeville Hospital, Aylesbury, UK. Methods: Forty-®ve subjects, who met the following criteria: SCI at level C5 or below, wheelchair dependent, aged between 18 and 50 at the time of injury, injured at least 10 years ago, admitted to the NSIC within 6 months of injury and resident in the UK, completed a 26-item postal questionnaire. Results: Among the 45 subjects 47% participated in physical activities (20% in sport; 27% in recreation), 33% were employed (29% full-time) and 18.5% had undergone further education at the time of the survey. Participation in sports as well as employment status decreased after injury (P50.01) usually as a result of poor access to sports and work facilities. Only 4% of investigated SCI patients started to practise physical activity after the accident whilst 42% stopped. Conclusions: Levels of sporting/recreational activities and employment decreased signi®cantly after injury. No signi®cant correlation was found between sport/recreation involvement and education/employment status. Further investigation with a large number of participants that will enable additional analysis of subgroups, such as level of injury and functional independence, is required.

Personal factors, such as general self-efficacy, perception of treatment control and realistic MS timeline perspective, are more salient correlates of self-management in MS than the objective clinical variables, such as the severity, type, and duration of MS.

The aims of this study were to investigate “athletic identity” in people with spinal cord injury (SCI), using the Athletic Identity Measurement Scale (AIMS), to evaluate the psychometric properties of the 7-item version, and to identify reasons for and barriers to sports participation in this population. People with SCI (N = 678), even those competing as athletes, reported lower levels of athletic identity than able-bodied adults and adolescents with physical disabilities. AIMS scores varied according to gender, athlete status, and hours of sports participation per week. No relationship was found between athletic identity and depression, anxiety, or life satisfaction. Exploratory factor analysis did not support the 3-factor structure of the AIMS with this population, although internal consistency was good.

The purpose of this study is to assess satisfaction with life domains in people with spinal cord injuries (SCI) and investigate whether participation in sports and physical recreation is associated with life satisfaction in SCI. 1,748 randomly selected participants with SCI who fulfilled the criteria: SCI at level C5 or below, wheelchair dependent; aged 18-50 at the time of injury; at least 1 year post-injury, were approached to take part in this study. Completed replies were received from 985 individuals with SCI (198 women, 798 men). The measures used included the Sports Participation Questionnaire, the Life Satisfaction Questionnaire and the Hospital Anxiety and Depression Scale. The numbers of hours participating in sports decreased significantly after injury. There was a greater decrease in numbers participating in team sports in comparison to the decrease seen in numbers participating in individual sports. The highest level of satisfaction existed within social domains such as: family life and contacts with friends. The lowest level of satisfaction was found in regard to the participant's sexual life and vocational situation. Higher satisfaction with life in general was demonstrated in respondents with SCI involved in sports or physical recreation compared to those not participating in physical activities.