ReInventing yourself after SCI: A bridge from rehabilitation to real world
Craig Hospital, Englewood, CO, United states
Objective: For individuals with SCI, self-efficacy beliefs are essential for successful psychosocial adjustment, and are paramount for coping with stressors experienced after discharge from rehabilitation. Self-efficacy has been shown to improve during rehabilitation, but plateaus from three to six months after discharge. New limitations and challenges after leaving rehabilitation can lead to anxiety, depression, and poor satisfaction with life. This study focused on people with SCI who were newly discharged from rehabilitation and was an extension of an earlier randomized controlled trial of a structured group cognitive behavioral approach to enhance self-efficacy beliefs using positive psychology concepts to challenge, reframe, and restructure individuals’ thoughts and beliefs about their capabilities after SCI.
Design/Method: Participants were 46 individuals with SCI who were enrolled within six months post-discharge from inpatient rehabilitation. The primary outcome measure was self-report of SCI-specific self-efficacy, using the Moorong Self-Efficacy Scale (MSES); secondary outcomes included general self-efficacy, satisfaction with life, participation, depression, and anxiety. Measures were collected at baseline and 6, 12, and 18-weeks post-treatment. A mixed model analysis of repeated measures was used to compare scores between the groups and test the time by treatment interaction.
Results: Five of six waves of participants have completed the 18-week study; data collection for the final wave will be complete in January 2018. 24 participants were randomized to receive treatment and 22 were randomized to control. At baseline, groups were equally balanced on demographics and the primary outcome. There was a significant difference at baseline between groups in depression severity scores, although both scored in the mild severity range; there were no differences at baseline between groups for the other secondary outcomes.
Conclusion: Preliminary data from the earlier study have shown a positive effect of the intervention on self-efficacy from baseline to 6 weeks, with a maintenance effect in the long term. Final results of this study will demonstrate whether the intervention is successful in improving self-efficacy and other psychosocial outcomes in people with SCI newly discharged from rehabilitation in both the short and long term.
Support: Craig H Neilsen Foundation #288944
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