TY - JOUR
T1 - Relationship of psychology inpatient rehabilitation services and patient characteristics to outcomes following spinal cord injury
T2 - The SCIRehab Project
AU - Heinemann, Allen W.
AU - Wilson, Catherine S.
AU - Huston, Toby
AU - Koval, Jill
AU - Gordon, Samuel
AU - Gassaway, Julie
AU - Kreider, Scott E.D.
AU - Whiteneck, Gale
PY - 2012/11
Y1 - 2012/11
N2 - Context and objective: To evaluate the effects of psychological interventions on rehabilitation outcomes, including residence and functional status at discharge, and residence, school attendance, or employment, and physical, social, occupational, and mobility aspects of participation 1 year after spinal cord injury (SCI). Design: Prospective observational cohort study. Setting: Six inpatient rehabilitation facilities in the United States. Participants: Inpatients with SCI 12 years of age and older. Interventions: Usual rehabilitation care. Outcome measures: Functional Independence Measure at rehabilitation discharge and 1-year injury anniversary; discharge destination and residence at 1-year anniversary; Craig Handicap Assessment and Reporting Technique, Diener Satisfaction with Life Scale, Patient Health Questionnaire, employment or school attendance, rehospitalization, and occurrence of a pressure ulcer at 1-year anniversary. Results: More time in psycho-educational interventions was associated with better function, discharge to home, home residence at 1 year, and the absence of pressure ulcers at 1 year. More psychotherapeutic sessions focusing on processing emotions and/or locus of control were associated with poorer function at discharge and 1 year, less physical independence and community mobility, lower satisfaction with life, and the presence of pressure sores at 1 year. Conclusions: Psychological services are an important component of comprehensive medical rehabilitation and tailored to patient needs and readiness to benefit from rehabilitation. Services focused on remediating deficits tend to be associated with negative outcomes, while services intended to foster adjustment and growth tend to be associated with favorable outcomes. Further research is needed to determine the optimal type and timing of psychological services during inpatient rehabilitation based on individuals' strengths and vulnerabilities. Note: This is the sixth in this third series of SCIRehab articles.
AB - Context and objective: To evaluate the effects of psychological interventions on rehabilitation outcomes, including residence and functional status at discharge, and residence, school attendance, or employment, and physical, social, occupational, and mobility aspects of participation 1 year after spinal cord injury (SCI). Design: Prospective observational cohort study. Setting: Six inpatient rehabilitation facilities in the United States. Participants: Inpatients with SCI 12 years of age and older. Interventions: Usual rehabilitation care. Outcome measures: Functional Independence Measure at rehabilitation discharge and 1-year injury anniversary; discharge destination and residence at 1-year anniversary; Craig Handicap Assessment and Reporting Technique, Diener Satisfaction with Life Scale, Patient Health Questionnaire, employment or school attendance, rehospitalization, and occurrence of a pressure ulcer at 1-year anniversary. Results: More time in psycho-educational interventions was associated with better function, discharge to home, home residence at 1 year, and the absence of pressure ulcers at 1 year. More psychotherapeutic sessions focusing on processing emotions and/or locus of control were associated with poorer function at discharge and 1 year, less physical independence and community mobility, lower satisfaction with life, and the presence of pressure sores at 1 year. Conclusions: Psychological services are an important component of comprehensive medical rehabilitation and tailored to patient needs and readiness to benefit from rehabilitation. Services focused on remediating deficits tend to be associated with negative outcomes, while services intended to foster adjustment and growth tend to be associated with favorable outcomes. Further research is needed to determine the optimal type and timing of psychological services during inpatient rehabilitation based on individuals' strengths and vulnerabilities. Note: This is the sixth in this third series of SCIRehab articles.
KW - Depression
KW - Employment
KW - Functional outcome
KW - Interventions
KW - Paraplegia
KW - Participation
KW - Practice-based evidence
KW - Psychological
KW - Quality of life
KW - Rehabilitation
KW - Rehabilitation psychology
KW - SCI model systems
KW - Spinal cord injuries
KW - Tetraplegia
UR - http://www.scopus.com/inward/record.url?scp=84871502897&partnerID=8YFLogxK
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U2 - 10.1179/2045772312Y.0000000059
DO - 10.1179/2045772312Y.0000000059
M3 - Article
C2 - 23318038
AN - SCOPUS:84871502897
SN - 1079-0268
VL - 35
SP - 578
EP - 592
JO - Journal of Spinal Cord Medicine
JF - Journal of Spinal Cord Medicine
IS - 6
ER -