Illness perception of individuals with spinal cord injury (SCI) during inpatient rehabilitation: a longitudinal study

Abstract

To assess overall illness perception and specific illness representations at admission and discharge of inpatient spinal cord injury (SCI) rehabilitation, and to detect associations between demographic and injury-related variables, and illness perception. SETTING: Seven Dutch SCI-specialised rehabilitation centres. METHODS: Participants aged >18 years with a recent SCI were screened for cognitive and emotional illness representations at admission and discharge with the Brief Illness Perception Questionnaire (B-IPQ). Differences between B-IPQ item scores at admission and discharge were analysed with the Wilcoxon signed-rank test. Differences between B-IPQ total scores were analysed with the paired-samples t-test. Associations between B-IPQ total scores and other variables were tested with bivariable and multivariable regression analyses. RESULTS: B-IPQ results were available for 270 participants at admission (71% male, 59% paraplegia, 83% incomplete) and 119 at discharge (68% male, 50% paraplegia, 78% incomplete). The extent to which people experienced their SCI as a threat was highest for: 'consequences', 'symptom burden' and 'concern' both at admission and discharge. Participants generally experienced less threat at discharge. A more threatening illness perception was significantly associated with older age, complete SCI and a history of cognitive problems at admission. Age and completeness of injury, together, explained 12% of the variance of overall illness perception at admission. CONCLUSIONS: For most individuals, illness perception positively changed during SCI rehabilitation. Measuring illness perception in inpatient rehabilitation could support the identification of specific treatment goals in order to improve adjustment after SCI.

Effect of Training for an Athletic Challenge on Illness Cognition in Individuals with Chronic Disability: A Prospective Cohort Study

“…At discharge there was no association with motor completeness. The findings of Kuiper et al [14] could suggest that those with motor complete SCI experience a stronger decrease of threat compared to those with motor incomplete SCI. Though one would indeed expect individuals with less severe SCI to have lower levels of helplessness than those with more severe injury, the findings in the current study supports research that demonstrates poorer psychological outcomes in individuals with motor incomplete injuries [59].…”

“…However, it is unclear whether the association with motor incompleteness is supported by literature. Kuiper et al [14] showed that motor complete SCI was associated with higher threat at admission. At discharge there was no association with motor completeness.…”

“…One study showed no changes in helplessness, acceptance and perceived benefits from inpatient rehabilitation to 6 months after discharge [13]. However, the other study showed a decrease of experienced illness threat associated with having SCI according to the illness representations at discharge compared to first inpatient rehabilitation admission [14]. In addition, older age and having a complete SCI were associated with higher threat at admission, but not at discharge [14].…”