Impact of psychological characteristics in self-management in individuals with traumatic spinal cord injury.
Impact of psychological characteristics in self-management in individuals with traumatic spinal cord injury.
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DOI：
10.1038/sc.2015.91
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发表时间：
2016-01
期刊：
影响因子：
2.2
通讯作者：
Jaglal SB
中科院分区：
文献类型：
--
作者：
Munce SE;Straus SE;Fehlings MG;Voth J;Nugaeva N;Jang E;Webster F;Jaglal SB
横截面调查。探讨创伤性脊髓损伤（SCI）患者自我管理的心理特征与可能的抑郁状态之间的关系。居住在加拿大各地的创伤性SCI社区居民。SCI患者通过里克汉森研究所的电子邮件以及医院脊柱门诊招募。数据收集自我报告使用在线调查。标准化问卷被嵌入在一个更大的调查中，包括医院焦虑和抑郁量表（HADS），简短版的患者激活测量（PAM），Moorong自我效能量表（MSES）和Pearlin-Schoenstein掌握量表（PMS）。可能患有抑郁症的个体（n=25）自我效能较低（67.9 vs94.2，P<0.0001），掌握（18.9 vs 22.9，P<0.0001）和患者激活与非抑郁对照组（n=75）相比，抑郁组（60.4vs71.6，P <0.0001）焦虑水平（9.0vs5.5，P<0.0001）更高。Logistic回归分析表明，较低的自我效能和掌握分数以及受伤后较短的时间与抑郁状态相关（分别为P=0.002，P=0.02和P=0.02）。焦虑评分较高的个体患抑郁症的可能性几乎是正常人的1.5倍，而年龄较大与抑郁状态呈正相关（分别为P=0.016和P=0.024）。对SCI抑郁症的干预，包括自我管理计划，应该针对自我效能和掌握等因素，这可以改善继发性医疗并发症和整体生活质量。
Cross-sectional survey. To examine the association between psychological characteristics in self-management and probable depression status in individuals with a traumatic spinal cord injury (SCI). Community-dwelling individuals with traumatic SCI living across Canada. Individuals with SCI were recruited by email via the Rick Hansen Institute as well as an outpatient hospital spinal clinic. Data were collected by self-report using an online survey. Standardized questionnaires were embedded within a larger survey and included the Hospital Anxiety and Depression Scale (HADS), the short version of the Patient Activation Measure (PAM), the Moorong Self-Efficacy Scale (MSES) and the Pearlin-Schooler Mastery Scale (PMS). Individuals with probable depression (n=25) had lower self-efficacy (67.9 vs 94.2, P<0.0001), mastery (18.9 vs 22.9, P<0.0001) and patient activation (60.4 vs 71.6, P<0.0001) as well as higher anxiety (9.0 vs 5.5, P<0.0001), compared with their non-depressed counterparts (n=75). A logistic regression determined that lower self-efficacy and mastery scores as well as less time since injury were associated with depression status (P=0.002; P=0.02 and P=0.02, respectively). Individuals with higher anxiety scores were almost 1.5 times more likely to be depressed, while older age was positively associated with depression status (P=0.016 and P=0.024, respectively). Interventions for depression in SCI, including a self-management program, should target factors such as self-efficacy and mastery, which could improve secondary medical complications and overall quality of life.