A study of whether individual and dyadic relations between spirituality and resilience contribute to psychological adjustment among individuals with spinal cord injuries and their family members

Abstract

Objective:

To test a model of spiritual well-being and resilience among individuals with spinal cord injuries and their family members.

Design:

Prospective cross-sectional observational data were analyzed by structural equation modelling.

Setting:

Inpatient and community services at one rehabilitation hospital.

Subjects:

Individual with spinal cord injury (n = 50) and family member (n = 50) dyads.

Interventions:

Standard rehabilitation, both inpatient and community.

Main measure(s):

Functional assessment of chronic illness therapy – spiritual well-being scale – expanded, Connor–Davidson resilience scale, positive and negative affect scale, depression anxiety and stress scale–21, satisfaction with life scale.

Results:

Median time post-injury was 8.95 months (IQR (interquartile range) = 14.15). Individuals with spinal cord injury and family members reported high scores for both spiritual well-being (66.06 ± 14.89; 68.42 ± 13.75) and resilience (76.68 ± 13.88; 76.64 ± 11.75), respectively. Analysis found the model had acceptable fit (e.g. chi-square goodness of fit statistic = 38.789; P = .263). For individuals with spinal cord injury, spiritual well-being was positively associated with resilience which, in turn, was associated with increasing positive affect and satisfaction with life. Among family members, spiritual well-being was positively associated with resilience. Resilience was then associated with lowered levels of depression and mediated the impact of depression on satisfaction with life. Limited evidence was found for mutual dyadic links, with the only significant pathway finding that resilience in the individual with spinal cord injury was associated with increased satisfaction with life among family members.

Conclusion:

Increased spirituality and resilience make a significant contribution (both independently and in combination) to positive psychological outcomes for both individuals with spinal cord injury and their family members.

Keywords

Spinal cord injuries family spirituality resilience a model of adjustment

Get full access to this article

View all access options for this article.

References

White

Driver

Warren

AM.

Resilience and indicators of adjustment during rehabilitation from a spinal cord injury. Rehabil Psychol 2010; 55(1): 23–32.

Wilson

Forchheimer

Heinemann

et al. Assessment of the relationship of spiritual well-being to depression and quality of life for persons with spinal cord injury. Disabil Rehabil 2017; 39(5): 491–496.

Jones

Simpson

Briggs

et al. Does spirituality facilitate adjustment and resilience among individuals and their families after SCI? Disabil Rehabil 2016; 38: 921–935.

Jones

Dorsett

Simpson

et al. Moving forward on the journey: spirituality and family resilience after spinal cord injury. Rehabil Psychol 2018; 63(4): 521–531.

Simpson

Jones

How important is resilience among family members supporting relatives with traumatic brain injury or spinal cord injury?

Clin Rehabil 2013; 27: 367–377.

Elliott

Berry

Richards

et al. Resilience in the initial year of caregiving for a family member with a traumatic spinal cord injury. J Consult Clin Psychol 2014; 82(6): 1072–1086.

Schonherr

Groothoff

Mulder

et al. Participation and satisfaction after spinal cord injury: results of a vocational and leisure outcome study. Spinal Cord 2005; 43(4): 241–248.

Chevalier

Kennedy

Sherlock

Spinal cord injury, coping and psychological adjustment: a literature review. Spinal Cord 2009; 47(11): 778–782.

Middleton

Simpson

De Wolf

et al. Psychological distress, quality of life, and burden in caregivers during community reintegration after spinal cord injury. Arch Phys Med Rehabil 2014; 95(7): 1312–1319.

10.

Charlifue

Botticello

Kolakowsky-Hayner

et al. Family caregivers of individuals with spinal cord injury: exploring the stresses and benefits. Spinal Cord 2016; 54(9): 732–736.

11.

Lefebvre

Levert

MJ.

Sudden and unexpected health situation: from suffering to resilience. Illn Crisis Loss 2006; 14: 337–354.

12.

Canda

Furman

LD.

Spiritual diversity in social work practice: the heart of helping. Cary, NC: Oxford University Press, 2009.

13.

Newman

APA’s resilience initiative. Prof Psychol: Res Pr 2005; 36: 227–229.

14.

Smith

Ortiz

Wiggins

et al. Spirituality, resilience, and positive emotions. In: Miller

(ed.) The Oxford handbook of psychology and spirituality. Oxford: Oxford University Press, 2012, pp.437–454.

15.

Feigin

The relationship between the sense of coherence and adjustment to disability studied in the context of marital interrelations. Marriage Fam Rev 1998; 27: 71–90.

16.

Chan

RC.

How does spinal cord injury affect marital relationship? A story from both sides of the couple. Disabil Rehabil 2000; 22(17): 764–775.

17.

Hui

Elliott

Shewchuk

et al. Communal behaviors and psychological adjustment of family caregivers and persons with spinal cord injury. Rehabil Psychol 2007; 52(1): 113–119.

18.

Windle

Bennett

Noyes

A methodological review of resilience measurement scales. Health Qual Life Outcomes 2011; 9: 8–18.

19.

Connor

Davidson

JR.

Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety 2003; 18(2): 76–82.

20.

Wagnild

Young

HM.

Development and psychometric evaluation of the Resilience Scale. J Nurs Meas 1993; 1: 165–178.

21.

Watson

Clark

The PANAS-X: manual for the Positive and Negative Affect Schedule – expanded form. Iowa City, IA: University of Iowa, 1994.

22.

Brown

Chorpita

Korotitsch

et al. Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples. Behav Res Therapy 1997; 35: 79–89.

23.

Pavot

Diener

Review of the Satisfaction With Life Scale. Psychol Assessment 1993; 2: 164–172.

24.

Dowler

Richards

Putzke

et al. Impact of demographic and medical factors on satisfaction with life after spinal cord injury: a normative study. J Spinal Cord Med 2001; 24(2): 87–91.

25.

Hamilton

Granger

Sherwin

et al. A uniform national data system for medical rehabilitation. In: Fuhrer

(ed.) Rehabilitation outcomes: analysis and measurement. Baltimore, MD: Brooks Publishing, 1987, pp.137–147.

26.

Lovibond

PF.

Manual for the depression anxiety stress scales. 2nd ed. Sydney, NSW, Australia: Psychology Foundation, 1995.

27.

Bredle

Salsman

Debb

et al. Spiritual well-being as a component of health-related quality of life: the functional assessment of chronic illness therapy-spiritual well-being scale (FACIT-Sp). Religions 2011; 2: 77–94.

28.

Arbuckle

JL.

Amos 24.0 users guide. Chicago, IL: IBM SPSS, 2016.

29.

IBM Corporation. IBM SPSS statistics for Windows Version 24.0. Armonk, NY: IBM Corporation, 2016.

30.

Kline

RB.

Principles and practice of structural equation modelling. 2nd ed. New York: Guildford Press, 2005.

31.

Bentler

Chou

CP.

Practical issues in structural equation modeling. Sociol Method Res 1987; 16: 78–117.

32.

Bollen

KA.

Overall fit in covariance structure models: two types of sample size effects. Psychol Bull 1990; 107: 256–259.

33.

Iacobucci

Structural equations modeling: fit indices, sample size, and advanced topics. J Consum Psychol 2010; 20: 90–98.

34.

Handbook of univariate and multivariate data analysis with IBM SPSS. 2nd ed. Boca Raton, FL: Chapman & Hall/CRC Press, 2014.

35.

Hooper

Coughlan

Mullen

MR.

Structural equation modelling: guidelines for determining model fit. Electron J Bus Res Method 2008; 6: 53–60.

36.

Richardson

GE.

The metatheory of resilience and resiliency. J Clin Psychol 2002; 58(3): 307–321.

37.

Baker

Barker

Sampson

et al. Caregiver outcomes and interventions: a systematic scoping review of the traumatic brain injury and spinal cord injury literature. Clin Rehabil 2017; 31(1): 45–60.

38.

Lyubomirsky

King

Diener

The benefits of frequent positive affect: does happiness lead to success?

Psychol Bull 2005; 131(6): 803–855.

39.

Cohn

Fredrickson

Brown

et al. Happiness unpacked: positive emotions increase life satisfaction by building resilience. Emotion 2009; 9(3): 361–368.

40.

Diener

Emmons

Larsen

et al. The satisfaction with life scale. J Pers Assess 1985; 49: 71–75.

41.

Corrigan

Kolakowsky-Hayner

Wright

et al. The satisfaction with life scale. J Head Trauma Rehabil 2013; 28: 489–491.

42.

Jones

Pryor

Care-Unger

et al. Spirituality and its relationship with positive adjustment following traumatic brain injury: a scoping review. Brain Inj 2018; 32(13–14): 1612–1622.

43.

Anderson

Daher

Simpson

GK.

A predictive model of resilience among family caregivers supporting relatives with traumatic brain injury (TBI) in Australia: a structural equation modelling approach. Abstracts of the International Brain Injury, Association World Congress on Brain Injury. Brain Inj 2017; 31: 815–816.

44.

Jones

Dorsett

Briggs

et al. The role of spirituality in spinal cord injury (SCI) rehabilitation: exploring health professional perspectives. Spinal Cord Ser Cases 2018; 4: 54.

45.

Meredith

Murray

Wilson

et al. Can spirituality be taught to health care professionals? J Relig Health 2012; 51(3): 879–889.