Trajectories of self-efficacy and depressed mood, and their relationship in the first 12 months following spinal cord injury

Publication date: Available online 13 September 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Ashley Craig, Yvonne Tran, Rebecca Guest, James Middleton

Abstract

Objective

To establish self-efficacy and depressive mood trajectories in adults with spinal cord injury (SCI), determine their interrelationship over time, and determine the influence that appraisals and co-morbid physical conditions have on the development of self-efficacy.

Design

A prospective cohort design.

Setting

Inpatient rehabilitation and community settings.

Participants

Eighty-eight adults admitted consecutively into three SCI units (mean age 42.6 years, 70.4% male, 61% paraplegia).

Interventions

Multidisciplinary inpatient SCI rehabilitation.

Main outcome measures

The Moorong Self-Efficacy Scale and Hospital Anxiety and Depression Scale were used to model self-efficacy and depressive mood trajectories. Appraisals were assessed by The Appraisals of Disability Scale and frequency/type of secondary conditions using the Secondary Conditions Scale.

Analysis

Growth mixture modelling was used to determine trajectories. Dual trajectory probability analysis was used to determine concurrent changes in self-efficacy and depressive mood. Linear mixed modelling incorporating repeated measures determined the contribution of appraisals and physical complications to self-efficacy trajectories.

Results

Modelling identified four trajectories of self-efficacy and depressive mood. The majority (around 60%) of the sample was estimated to have moderate to high self-efficacy and low levels of depressive mood. Dual trajectory analysis revealed that robust self-efficacy was strongly connected to low depressive mood over time while low self-efficacy was strongly linked to clinically elevated depressive mood. Low self-efficacy was related to higher severity of secondary conditions and negative appraisals.

Conclusions

Findings highlight the importance of self-efficacy, not only as a strategic clinical measure for assessing adjustment following SCI, but they also raise implications for improving SCI rehabilitation.

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