Paraplegia from spinal cord injury: Self-esteem, loneliness, and life satisfaction

With advances in health care sciences, people with spinal cord injuries can now live to old age. Rehabilitation of the disabled is a dynamic process and should include not only attaining maximum function, but also receiving satisfaction with life in one's environment. Life satisfaction is thought to be the subjective part of quality of life, i.e., the feelings of the persons concerned about their functioning and circumstances. However, these feelings are influenced by self esteem, the positive or negative attitude toward oneself, as well as life satisfaction and the effect of loneliness on self-esteem. Forty community-living adults with paraplegia from spinal cord injury from the metropolitan area of Athens responded to the Rosenberg's Self-Esteem Scale, the Revised UCLA Loneliness Scale, and the Life Satisfaction Index. As expected, statistically significant correlations were obtained among self-esteem, life satisfaction, and loneliness. More specifically, the higher an individual's self-esteem: a) the higher the, life satisfaction and b) the lower the feelings of loneliness experienced. Furthermore, there was a statistically negative relationship between loneliness and life satisfaction. Community mobility, architectural adaptations, and social support, as it is reflected through marital status and frequency of received visits, proved to be important factors in understanding loneliness, self-esteem, and life satisfaction. Implications for rehabilitation of individuals with spinal cord injuries are discussed

Biopsychosocial outcomes in individuals with and without spinal cord injury: a Swiss comparative study

STUDY DESIGN: Multicentre controlled study. OBJECTIVES: To investigate if individuals with and without spinal cord injury (SCI) differ in biopsychosocial variables according to the International Classification of Functioning, Disability and Health (ICF). SETTING: Participants were recruited through three major SCI rehabilitation centres in Switzerland. METHODS: A convenience sample of people with SCI (N=102) and a matched non-SCI sample (N=73) were compared according to secondary conditions, pain, depressive symptoms, participation, social support, self-efficacy, self-esteem, coping and sense of coherence. Difference tests and multivariate logistic regression analyses to predict the likelihood of group membership were calculated. RESULTS: People with SCI reported more health conditions, higher levels of anxiety and depressive symptoms, worse pain and pain interference, lower level of participation and social support, lower self-efficacy, self-esteem and task- and emotion-oriented coping. The two samples did not differ in satisfaction with social support, in use of avoidance-oriented coping and in sense of coherence. Health conditions, pain interference, participation and age were found to be significant predictors of the likelihood of group membership. In the logistic regression models, the number of health conditions, limitations due to health conditions, pain interference, participation, task-oriented coping and age are significant predictors of group membership, accounting for 55% of variation. CONCLUSION: Health conditions, pain interference and participation seemed to be the areas of biopsychosocial functioning that are substantially influenced by SCI. Potential buffering resources seem to be diminished in individuals with SCI. In rehabilitation practice, prevention of secondary conditions, treatment of pain, enhancement of participation and strengthening resources should be addressed

Self-efficacy and self-esteem as predictors of participation in spinal cord injury--an ICF-based study

STUDY DESIGN: A multi-centre cross-sectional study. OBJECTIVE: To examine the relationship of self-efficacy and self-esteem with participation of persons with spinal cord injury (SCI) from a comprehensive bio-psycho-social perspective, based on the conceptual framework of the International Classification of Functioning, Disability and Health (ICF). SETTING: Community-dwelling participants, <5 years post discharge, recruited through three SCI rehabilitation centers in Switzerland. METHODS: Data were collected by means of standardized self-report questionnaires sent to the eligible participants by postal mail. The questionnaires covered the different components of the ICF's bio-psycho-social model, namely health conditions, body functions, participation, environmental and personal factors. Bivariate correlations and multivariate linear regression analyses with participation as the dependent variable have been conducted. RESULTS: In all, 102 persons with SCI answered the survey, response rate 25.9%. Self-esteem (r=0.61) and self-efficacy (r=0.54) correlated highly with participation and were the strongest correlates of participation. They were stronger correlates of participation than symptoms of anxiety, depressive symptoms, pain, health conditions, social support, coping styles or sense of coherence. Participation seemed to be independent of gender, age, level or completeness of injury. Self-efficacy and self-esteem explained together with time since discharge and years of education 48% of the variance in participation adjusting for health condition, depressive symptoms, pain interference and social support. CONCLUSION: Considering self-efficacy and self-esteem within the comprehensive framework of the ICF can contribute to a better understanding of functioning, disability and health in SCI, which in turn may facilitate the development of interventions to support the persons' adjustment and reintegration