The personal importance of being independent: associations with changes in disability and depressive symptoms.
The personal importance of being independent: associations with changes in disability and depressive symptoms.
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DOI：
10.1037/a0034438
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发表时间：
2014-02
影响因子：
2.7
通讯作者：
Czaja, Sara J.
中科院分区：
文献类型：
--
作者：
Monin, Joan K.;Schulz, Richard;Martire, Lynn M.;Connelly, Dyan;Czaja, Sara J.
这项研究考察了独立中心性(功能独立的个人重要性)在适应脊髓损伤(SCI)患者的功能障碍中的作用。我们评估了残疾的变化如何与抑郁症状的变化相关，独立性中心性和抑郁症状之间的联系，以及独立性中心性在调节残疾变化和抑郁症状变化之间的联系中的作用。使用随机对照试验的数据，我们关注了173名脊髓损伤幸存者，他们完成了独立中心性、残疾(日常生活能力和日常生活需要的工具性活动)和抑郁症状的基线和12个月随访测量。与我们的预测一致，残疾增加与抑郁症状增加有关，在基线时，独立性越高的中心性与更多的抑郁症状有关。与对照的寿命理论一致，具有高度独立性中心性的脊髓损伤幸存者在残疾增加时经历更多的抑郁症状，但当残疾减少时抑郁症状较少。独立性中心性较低的脊髓损伤幸存者较少受到残疾水平变化的影响。具有高度独立性中心性的脊髓损伤患者有更高水平的抑郁症状，并且对功能状态的变化更敏感。考虑到脊髓损伤幸存者的功能状态轨迹，低独立性中心性可能是适应性的，因为它有助于脱离无法实现的目标。
This study examined the role of independence centrality (the personal importance of being functionally independent) in adapting to functional disability in persons with spinal cord injury (SCI). We assessed how changes in disability related to changes in depressive symptoms, the association between independence centrality and depressive symptoms, and the role of independence centrality in moderating the association between changes in disability and changes in depressive symptoms. Using data from a randomized controlled trial we focused on 173 SCI survivors who completed baseline and 12-month follow-up measures of independence centrality, disability (activities of daily living and instrumental activities of daily living needs), and depressive symptoms. Consistent with our predictions, increased disability was related to increased depressive symptoms, and higher independence centrality was associated with more depressive symptoms at baseline. Consistent with the lifespan theory of control, SCI survivors with high independence centrality experienced more depressive symptoms when disability increased but less depressive symptoms when disability decreased. SCI survivors low in independence centrality were less affected by changing levels of disability. Persons with SCI with high in independence centrality have higher levels of depressive symptoms and are more responsive to changes in functional status. Given the functional status trajectories of SCI survivors, having low independence centrality may be adaptive because it facilitates disengagement from unattainable goals.
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影响因子：
5.4
作者：
Heckhausen, Jutta;Wrosch, Carsten;Schulz, Richard
通讯作者：
Schulz, Richard
影响因子：
--
作者：
Irwin, M;Artin, KHH;Oxman, MN
通讯作者：
Oxman, MN
影响因子：
5.9
作者：
JACOBSON, NS;TRUAX, P
通讯作者：
TRUAX, P
影响因子：
3.3
作者：
BOWLBY, J
通讯作者：
BOWLBY, J
影响因子：
4.2
作者：
Martire, LM;Stephens, MAP;Wojno, WC
通讯作者：
Wojno, WC