Profiles of psychological adaptation outcomes at discharge from spinal cord injury inpatient rehabilitation

Abstract Objective To evaluate the impact of a newly acquired Spinal Cord Injury by identifying profiles of psychological adaptation outcomes at discharge from inpatient rehabilitation, using several outcome measures in parallel and to examine biopsychosocial factors associated with profile membership. Design Cross-sectional analysis of data from the National Cohort Study (name edited for blind review). Objective To evaluate the impact of a newly acquired Spinal Cord Injury by identifying profiles of psychological adaptation outcomes at discharge from inpatient rehabilitation, using several outcome measures in parallel and to examine biopsychosocial factors associated with profile membership. Setting Inpatient Rehabilitation. Participants 370 individuals 16 years old or older with recently diagnosed SCI, who finished clinical rehabilitation in one of the four major national rehabilitation centers. Interventions Not applicable. Main Outcome Measures Life satisfaction, general distress, and symptoms of depression and anxiety were assessed using a single item from the International SCI Quality of Life Basic Data Set, the Distress Thermometer, and the Hospital Anxiety and Depression Scale respectively. Results Using latent profile analysis, four profiles of psychological adaptation outcomes were identified displaying different levels of impact, ranging from minimal to severe. Regarding covariates associated with profile membership, higher optimism, purpose in life, and self-efficacy indicated a higher probability of having a Minimal impact profile. Additionally, males, individuals with better functional independence, and those with an absence of pain were more likely to show a Minimal impact profile. Conclusion(s) Amongst the participants, 70% showed Minimal or Low impact profiles. Our findings support that individuals can show positive responses across several outcome measures even at an early time after the injury onset (e.g. at discharge from inpatient rehabilitation). Moreover, our results indicate that beyond functional independence, improvement and pain management, a rehabilitation process that strengthens psychological resources might contribute to better adaptation outcomes.