ABSTRACT
Background: The consequences of spinal cord injury (SCI) can place significant demands on an individual's coping mechanisms. Interventions to promote psychological adjustment and coping are often included in inpatient rehabilitation programs; however, following discharge, many individuals with SCI do not receive ongoing counseling or education about psychological adjustment to disability. Effective postacute treatment models are needed to help individuals with SCI build skills that help them adapt to the stresses associated with a chronic physical disability, alleviate the consequences of anxiety and depression, and enhance subjective well-being. Objectives: To describe the protocol for a randomized clinical trial (RCT) of a 6-week intervention designed to improve psychosocial outcomes after SCI. Methods: To test efficacy and replicability of the intervention, we designed a three-arm, multisite RCT with assessments conducted at six time points. Our primary hypothesis is that participants in the Group arm will report greater improvements in psychosocial outcomes than participants who complete the intervention individually via video (Individual arm) or those who do not receive the intervention (Control arm). We also hypothesize that participants in the Group arm will maintain greater improvements in psychosocial outcomes longer than those in the individual or control arms. Conclusion: Results of the RCT will be presented and published to professionals and consumers, and intervention training and materials will be made available upon request.
Subject(s)
Spinal Cord Injuries , Humans , Adaptation, Psychological , Patient Discharge , Randomized Controlled Trials as TopicABSTRACT
Research Objectives To examine psychometric properties of a COVID-19 Impact Scale among individuals with disabilities. Design Cross-sectional analysis. Setting Web-based survey. Participants A sample of 418 individuals with multiple sclerosis (62.68%), traumatic brain injury (n=15.07%), and spinal cord injury (22.25%) completed a survey about experiences during the COVID-19 pandemic. The sample was 71.01% female. Ages ranged from 21-84 (M=52.00, SD=11.56). Interventions Not Applicable. Main Outcome Measures COVID-19: Impact of the Pandemic and Health Related Quality of Life (Penedo, Cohen, Bower, & Antoni, 2020). Analysis was restricted to the Psychosocial and Practical Experiences portion of the questionnaire, which yields a Total Measure Score representing overall impact of the pandemic and has three subscales (Distress, Disruption, and Resiliency). Results Principal components analysis of Rasch residuals demonstrated lack of unidimensionality for the overall Total Measure Score. Therefore, subscales were analyzed separately, each showing satisfactory internal consistency (Cronbach's alpha>0.80). The person separation index was 2.48 for Distress, 2.00 for Disruption, and 1.88 for Resiliency. Infit mean square values and corrected item-total correlations were satisfactory for all items on the Distress subscale. However, two items on Disruption and two on Resiliency had corrected item-total correlations < 0.30 and/or infit mean square values>1.30. Conclusions The three subscales on the COVID-19 impact scale had good internal consistency reliability and could differentiate the sample into at least two levels on their respective constructs. Two items referring to pandemic-related practices of health care providers showed poor fit on the Disruption subscale, and items referring to acceptance and the ability to provide others with instrumental social support showed poor fit on the Resiliency subscale. Overall, the study suggests that the instrument provides a reliable indicator of various levels of COVID impact in clinical samples with neurological disabilities. Author(s) Disclosures All authors have no conflicts of interest to declare.