Coping strategies and resources as predictors of psychosocial adaptation among people with spinal cord injury.

Abstract

The onset of a spinal cord injury (SCI) is accompanied by a massive amount of stress, on which professionals in the medical field focus attention and care. The subsequent cascade of psychological stressors related to SCI often receives lesser attention. When individuals experience new forms of stress, they typically respond with attempts to cope, which may or may not be adaptive in reducing their stress levels. The twofold purpose of this study was to investigate whether SCI survivors' use of coping resources (i.e., hope, sense of coherence) and coping strategies (e.g., engagement coping, seeking social support) influences their psychosocial adaptation, and whether their use of coping strategies moderates the effect of coping resources, after controlling for the influence of depression and anxiety, on psychosocial adaptation. This cross-sectional study involved a self-report survey of survivors of SCI. Inclusion criteria included: (a) being 18 years of age or older, (b) having received inpatient rehabilitation services following the SCI, and (c) not having traumatic head injury at the time of the SCI onset. The sample consisted of 95 individuals with SCI who received outpatient rehabilitation services at a center in the midsouthern United States. Results indicated that coping resources and coping strategies were significantly associated with psychosocial adaptation. Furthermore, engagement coping explained a significant portion of the variance in psychosocial adaptation both individually and as an interactive variable with the 2 coping resources of sense of coherence and hope. Findings indicate that both coping resources and strategies (especially engagement coping) are reliably linked to adaptation to SCI. The findings further suggest that engagement coping positively influences psychosocial adaptation even when coping resources are mostly absent. Other implications for the field of rehabilitation are briefly outlined.