Systematic Review of Psychosocial Interventions for People With Spinal Cord Injury During Inpatient Rehabilitation: Implications for Evidence‐Based Practice

Yan, Li; Bressington, Daniel; Chien, Wai Tong

doi:10.1111/wvn.12238

Cited by 24 publications

(25 citation statements)

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“…However, this review focused on a range of mostly physical interventions, including electrical brain stimulation, exercise, acupuncture, hypnosis, transcutaneous electrical nerve stimulation (TENS) and included only one trial of CBT. Further systematic review evidence has evaluated psychosocial interventions for inpatients with SCI, concluding that more work is required to evidence such interventions for this group [8]. Whilst the efficacy of CBT has been systematically reviewed [9,10], the rapidly growing research interest and evidence surrounding mindfulness-based interventions has not been reviewed systematically, despite the fact that such a review could provide valuable guidance on the future study and application of mindfulness for people with SCI.…”

Section: Introductionmentioning

confidence: 99%

Mindfulness for pain, depression, anxiety, and quality of life in people with spinal cord injury: a systematic review

Hearn

Cross

2020

BMC Neurol

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Background: Populations with reduced sensory and motor function, such as spinal cord injury (SCI) are at increased risk of depression, anxiety, pain, and poorer quality of life (QoL). Mindfulness-Based Interventions (MBIs) have been developed with the aim of improving outcomes for people with SCI. To understand the value of MBIs, a systematic review was conducted pertaining to the use of MBIs, and interventions including elements of mindfulness, with people with SCI. Methods: Databases were reviewed from 1996 to October 2018 (updated January 2020). Eligibility criteria included the assessment of at least one of the common secondary consequences of SCI (i.e. risk of depression, anxiety, pain, and QoL), describe the use of mindfulness training as a component part of an intervention, or as the whole intervention. The Cochrane Collaboration Risk of Bias and The Effective Public Health Practice Project Quality Assessment Tools were utilised for quality appraisals. Two assessors appraised the studies and demonstrated good agreement (Cohen's k = .848, p < .001). Results: Five papers met the inclusion criteria, and demonstrated a range of results of interventions delivered individually, in a group format, in person, and online. Only one study reported significant reductions in pain-related outcomes (with moderate effect sizes), with the remaining studies (n = 4) demonstrating no change. Four studies described reductions in depressive symptoms and three reported reductions in anxiety. Despite the importance of good QoL as a goal for people with SCI, few studies (n = 2) assessed this as an outcome with no improvements reported. Study quality ranged from high to low/weak. Conclusions: The findings in this review provide mixed support for the use of mindfulness to improve outcomes after SCI. In particular, findings indicate that mindfulness may be particularly effective for improving symptoms of depression and anxiety. This review highlights the requirement for more rigorous, high-quality research, particularly larger randomised-controlled trials with long-term follow-up, in this area. The small number of studies included in the present review mean that conclusions drawn are preliminary and thus reflects the paucity of the research in the area to date.

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Section: Introductionmentioning

confidence: 99%

Mindfulness for pain, depression, anxiety, and quality of life in people with spinal cord injury: a systematic review

Hearn

Cross

2020

BMC Neurol

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“…Adaptive coping as a significant predictor of self‐efficacy could be an underlying mechanism for coping‐based interventions in enhancing people’s psychosocial adaptations to SCI. People’s coping abilities post‐SCI or in relation to other chronic disabilities can be enhanced by various psychosocial interventions including emotion management (e.g., relaxation, mindfulness‐based interventions), challenging negative thoughts, and positive behavioral reinforcement (Anson & Ponsford, 2006; Li et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…A few previous studies have investigated self‐efficacy levels in the SCI population (Bhattarai, Jin, Smedema, Cadel, & Baniya, 2021; Craig, Tran, Guest, & Middleton, 2019; van Diemen et al, 2017), and findings indicated lower self‐efficacy levels than those in the general population (Craig et al, 2019; Middleton, Tran, & Craig, 2007). The self‐efficacy scores (as measured using the Moorong Self‐Efficacy Scale [MSES]) of Chinese people with SCI (Li, Bressington & Chien, 2019; self‐efficacy scores ranged from 50 to 60) may also be lower than those seen in SCI patients in other countries (e.g., Australia; Craig et al, 2019; self‐efficacy scores ranged from 60 to 100; Li, Bressington, & Chien, 2017). Chinese people with SCI may face additional challenges and difficulties because the infrastructure and community support systems are less developed than those in developed Western countries (Zhang, 2017).…”

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confidence: 99%

“…With inconsistent and very limited findings, as discussed above, we conducted a cross‐sectional study exploring the predictors of self‐efficacy among Chinese people with SCI during their inpatient rehabilitation. Given the extensive impact of SCI on people’s health, a holistic perspective based on the bio‐psychosocial model has been suggested to be most appropriate to inform the rehabilitation targets or goals (Li et al, 2017). The bio‐psychosocial model of SCI rehabilitation emphasizes the notion that biological or physical function and psychosocial factors are seen as integrative and interrelated in promoting people’s health outcomes (Suls & Rothman, 2004).…”

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confidence: 99%

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Predictors of Self‐Efficacy Among People With Spinal Cord Injury During Inpatient Rehabilitation: A Cross‐Sectional Study

Yan

Chien

Zhu

et al. 2021

J of Nursing Scholarship

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Purpose This study aimed to investigate the predictors of self‐efficacy among Chinese people with spinal cord injury (SCI). Design A cross‐sectional, descriptive, correlational design was adopted. Methods 121 participants were recruited from two rehabilitation hospitals in Shaanxi, China, from August 2016 to June 2017. The Moorong Self‐Efficacy Scale was used to assess participants’ self‐efficacy levels. Participants’ sociodemographic or clinical characteristics, functional independence, coping ability (measured using the Brief Coping Orientations to Problems Experienced Inventory), and social support (measured using the Six‐item Social Support Questionnaire) were assessed as potential predictors of self‐efficacy. A multiple linear regression model was conducted to identify the factors predicting self‐efficacy score. Results The mean age of the participants was 41 (SD 11.9) years and 90% were male. Participants’ mean self‐efficacy score was 53.9 (SD 15.7). Multiple linear regression results indicated that injury type (i.e., paraplegia or tetraplegia; β = 0.290, p < .001) and adaptive coping (β = 0.561, p < .001) were significant predictors, accounting for 62% of the variance in self‐efficacy scores. Conclusions Our findings imply that psychosocial interventions that target enhancing various adaptive coping strategies could have positive effects on self‐efficacy in people with SCI. Clinical Relevance Injury type and adaptive coping ability are two key factors related to patients’ self‐efficacy post‐SCI. Psychosocial interventions that target enhancing various adaptive coping strategies could have positive effects on self‐efficacy in people with SCI.

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“…Outcomes of isolation include high anger and frustration [14,27,28] anxiety and depression [29][30][31] and reduced quality of life [32]. Research demonstrates that infection-isolation results in longer length of overall inpatient stay [33,34] and rehabilitation can be further limited by pragmatic factors, such as restricted access to group-based psychoeducation, a crucial component impacting rehabilitation [35,36]. Thus, strict contact precautions imposed on patients with MRSA can have potentially detrimental physical and psychosocial impacts on health and rehabilitation, compounded by severe stigmatisation and reduced patient autonomy [28,37].…”

Section: Introductionmentioning

confidence: 99%

Psychological outcomes of MRSA isolation in spinal cord injury rehabilitation

Gillett

Duff

Eaton

et al. 2020

Spinal Cord Ser Cases

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Study design Retrospective secondary analysis with a quantitative, matched-pairs design. Patients isolated due to methicillin-Resistant Staphylococcus aureus (MRSA) were matched with controls without MRSA infection admitted to a multi-bedded ward, based on: gender, injury level, injury severity (AIS grade), age at the time of injury and year of admission. Objectives Determine the implications of MRSA-related infection isolation on spinal cord injury patients' anxiety, depression, appraisals of disability, perceived manageability and pain intensity. Hypotheses predicted patients who were isolated due to MRSA during inpatient stay would demonstrate poorer psychological health outcomes at discharge in comparison with non-isolated matched controls. Setting National Spinal Injuries Centre, England, UK. Methods Secondary analyses were conducted on pre-existing data based on patients' first admission for primary rehabilitation. Psychometric scales were used to measure outcome variables. Assessments were repeated at the time of admission and discharge. Results Nonparametric longitudinal analyses using the nparLD package in R were conducted. Relative treatment effects demonstrated that there were no significant differences between groups across all outcome measures. There was a significant effect of time (admission vs discharge) on perceived manageability and pain intensity, indicating improved outcomes at discharge. There was no difference in the overall length of stay between the isolated and non-isolated groups. Conclusions Isolation experienced by rehabilitation inpatients with spinal cord injury with MRSA had no effect on a series of psychological outcomes. Engaging with rehabilitation had a positive impact in reducing pain unpleasantness and increasing perceived manageability of spinal cord injury, irrespective of infection isolation.

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Systematic Review of Psychosocial Interventions for People With Spinal Cord Injury During Inpatient Rehabilitation: Implications for Evidence‐Based Practice

Cited by 24 publications

References 25 publications

Mindfulness for pain, depression, anxiety, and quality of life in people with spinal cord injury: a systematic review

Mindfulness for pain, depression, anxiety, and quality of life in people with spinal cord injury: a systematic review

Predictors of Self‐Efficacy Among People With Spinal Cord Injury During Inpatient Rehabilitation: A Cross‐Sectional Study

Psychological outcomes of MRSA isolation in spinal cord injury rehabilitation

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