Objective

Self-efficacy (SE) is an important determinant for the psychological adjustment of people with spinal cord injury (SCI). However, little is known about the course of SE during inpatient rehabilitation up to 1 year after discharge. The aim of this study was to determine latent trajectory classes of SE, depressive mood, and anxiety in people with SCI, as well as the interrelationships between these trajectories.

Design

Longitudinal inception cohort study.

Setting

Eight specialized SCI rehabilitation centers.

Participants

The participants (N=268) were mainly men 183 of 268 (68.3%) with a mean age of 55.6 years. Almost half had a traumatic SCI 135 of 268 (50.4%) and tetraplegia (53.7%), and the minority had a motor complete SCI (32.2%).

Interventions

Not applicable.

Main Outcome Measures

SE was measured using the University of Washington Self-Efficacy Scale. In addition, the Hospital Anxiety and Depression Scale was used to asses distress and perform dual trajectory modeling analyses.

Results

Three trajectories of SE, indicating low, middle, and high SE, could be distinguished. Furthermore, a 2-class trajectory solution for depressive mood and a 4-class solution for anxiety were found to be most suitable. All trajectories were stable over time. Developmental connections between SE and depressive mood and between SE and anxiety were revealed. In particular, participants who adjusted well, reporting low scores on depressive mood and anxiety, could be identified by their high SE scores. However, the group of participants with high depressive mood scores and anxiety scores could not always be identified based on their SE trajectory.

Conclusions

In accordance with our hypotheses, distinct trajectories of SE, depressive mood, and anxiety were identified and high probabilities that SE trajectories were interrelated to the trajectories from depressive mood and anxiety were confirmed. Concurrent screening for SE and distress might best detect people at risk for adjustment problems.

中文翻译：

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从入院脊髓损伤康复到出院 1 年的自我效能感、抑郁情绪和焦虑的轨迹

客观的

自我效能感 (SE) 是脊髓损伤 (SCI) 患者心理调整的重要决定因素。然而，在出院后长达 1 年的住院康复期间，对 SE 的过程知之甚少。本研究的目的是确定 SCI 患者的 SE、抑郁情绪和焦虑的潜在轨迹类别，以及这些轨迹之间的相互关系。

设计

纵向初始队列研究。

环境

八个专门的SCI康复中心。

参与者

参与者 (N=268) 主要是 268 人中的 183 人 (68.3%)，平均年龄为 55.6 岁。几乎一半有创伤性 SCI 135 (268) (50.4%) 和四肢瘫痪 (53.7%)，少数有运动性完全性 SCI (32.2%)。

干预措施

不适用。

主要观察指标

SE 是使用华盛顿大学自我效能量表测量的。此外，医院焦虑和抑郁量表用于评估痛苦并进行双轨迹建模分析。

结果

可以区分 SE 的三个轨迹，表示低、中和高 SE。此外，发现抑郁情绪的 2 级轨迹解决方案和焦虑的 4 级解决方案最合适。随着时间的推移，所有的轨迹都是稳定的。揭示了 SE 与抑郁情绪之间以及 SE 与焦虑之间的发展联系。特别是，调整良好的参与者，在抑郁情绪和焦虑方面报告低分，可以通过他们的高 SE 分数来识别。然而，不能总是根据他们的 SE 轨迹确定具有高抑郁情绪分数和焦虑分数的参与者组。

结论

根据我们的假设，确定了 SE、抑郁情绪和焦虑的不同轨迹，并确认了 SE 轨迹与抑郁情绪和焦虑轨迹相互关联的高概率。同时筛查 SE 和痛苦可能最能检测出有适应问题风险的人。