Relationships among Community Reintegration, Coping Strategies, and Life Satisfaction in a Sample of Persons with Spinal Cord Injury

Abstract

IFE satisfaction is one of the components of subjective quality of life described by Diener, 1 and because tive quality of life as an important outcome of rehabilitation, [2][3][4][5] the study of life satisfaction is a timely endeavor. In a recent article combining scholarship and passion, deLateur 6In this study of 78 people living in the community 1 to 7 years after spinal cord injury, community integration and reported coping strategies were investigated for their association with life satisfaction. Community integration was measured in terms of objective and subjective handicap in social roles. Objective handicap, defined by the Craig Handicap Assessment and Reporting Technique (CHART), and subjective handicap, defined by the Perceived Handicap Questionnaire (PHQ), were hypothesized to show an inverse relationship with life satisfaction, as measured by the Life Satisfaction Index-Z (LSI-Z). It was hypothesized that each measure of handicap would provide unique explanation of variability in life satisfaction. Furthermore, it was hypothesized that differences in participants' use of coping strategies, measured via an abbreviated version of the Ways of Coping Questionnaire (abbrWOC), would be associated with differences in their reported handicap and life satisfaction. Participants' use of coping strategies was hypothesized to provide a unique explanation of their life satisfaction, even when considered together with the two measures of handicap. The study's hypotheses were partially supported. Objective and subjective measures of handicap were correlated with each other and with life satisfaction. However, only perceived handicap provided a unique explanation of life satisfaction in a multivariate context. Two of the eight assessed coping strategies were associated with life satisfaction, but only one, escape-avoidance coping, remained significant when assessed in conjunction with handicap. These results are discussed in relation to a contemporary theory regarding the effects of individual characteristics and handicap on quality of life and directions for future study are discussed.

Associations between psychological factors and quality of life ratings in persons with spinal cord injury: a systematic review

“…In total, 18 of the 77 associations between active problem-focused coping variables and QOL were significant. 21,[29][30][31]33,34,36,37,[42][43][44]58,59 All active problem-focused coping variables showed more nonsignificant than significant relationships, and did not show consistent relationships with QOL outcome measures over time.…”

“…In all, 7 of 13 associations between blaming oneself for one's SCI and QOL were significant. 15,[23][24][25][26][27][28][29][30] Self-blame was associated weakly with higher life satisfaction, 15 lower posttraumatic stress 25 and lower psychological distress. 23 Inconsistently, self-blame was also correlated with greater depression in one study, 26 and with less depression in two other studies.…”

“…In total, 45 out of 78 associations were significant. 30,[33][34][35]37,[42][43][44]49,52,55,[57][58][59] For the coping variables that were longitudinally examined, mental disengagement, behavioral disengagement and alcohol/drug use were related to greater depression and anxiety. [42][43][44] Denial showed an inconsistent relationship to QOL outcomes, correlating positively with greater life satisfaction in a cross-sectional study, 55 and positively with depression and anxiety in several longitudinal studies.…”

Pain following spinal cord injury: the impact on community reintegration

“…20,21 Relationship among pain variables and community reintegration Our results suggest pain impact and pain intensity are both key factors that relate to one's ability to reintegrate to the community, with pain intensity accounting for 25% of the variability, while the addition of the FIM and pain impact accounted for a total of 37% of the variance in RNL scores. This is a worthy finding given that a myriad of factors can potentially influence one's adjustment to the community, including motivation, education, family support, ethnicity and the availability of appropriate resources.…”

“…This is a worthy finding given that a myriad of factors can potentially influence one's adjustment to the community, including motivation, education, family support, ethnicity and the availability of appropriate resources. 20,21 One study that has examined pain and community reintegration reported that individuals with long term SCI (mean length of injury ¼ approx. 7.4 years) who had extreme pain interference reported lower scores on the CHART mobility, social integration, economic selfsufficiency subscales compared to individuals who reported no pain interference.…”