Linkages between coping and psychological outcome in the spinal cord lesioned:: development of SCL-related measures

Study design: Cross-sectional. Objectives: To investigate relationships between coping and mental well-being with clinical relevance to spinal cord lesion (SCL). Setting: The Gothenburg Spinal Injuries Unit in Sweden. Methods: The study sample comprised 274 persons. From in-depth interviews, literature reviews, and the transactional theory of stress and coping, items reflecting coping and psychological outcome, respectively were generated. Principal components factor analysis, multi-trait analysis, and structural equation modelling were used. Results: The coping scale comprised three factors: Acceptance (i.e. revaluation of life values), Fighting spirit (i.e. efforts to behave independently); Social reliance (i.e. a tendency towards dependent behaviour). The outcome scale included the factors: Helplessness (i.e. feeling perplexed., out of control and low self-esteem), Intrusion (i.e. bitterness and brooding); Personal growth (i.e. positive outcomes of life crisis). Acceptance showed a positive relation to Personal growth and was inversely related to both Helplessness and Intrusion. Fighting spirit had a weak negative association to Helplessness and a weak positive association to Personal growth. Social reliance was positively related to Helplessness and Intrusion. Only Social reliance showed any association to neurological status. Those lesioned 1-4 years reported more Helplessness, Intrusion, Social reliance, and less Acceptance than those lesioned greater than or equal to 5 years. Conclusion: Coping is related to psychological outcome in SCL. Our situational coping measure may be a candidate to assess intervention effects.