Factors influencing acceptance of disability in individuals with spinal cord injury in Neiva, Colombia, South America.

PURPOSE: The aim of the present study was to determine the level of acceptance of disability as measured by the Acceptance of Disability Scale (ADS) within a sample of individuals with spinal cord injury (SCI) from Neiva, Colombia and to examine the influence of sociodemographic variables, injury characteristics, and level of depression on ADS score. METHODS: The ADS was administered to 40 adults with SCI from Nieva, Colombia who were recruited from an organization that connects individuals with disabilities to resources. Most (92.5%) participants were men, with a mean age of 34.75 years and approximately 12 years since injury. Fifty-five percent of subjects were diagnosed with paraplegia and the remainder with tetraplegia. Descriptive, linear model and multiple regression analyses were used to describe the relationship between the independent and dependent variables. RESULTS: The mean total ADS score of this sample was 171.5, indicating overall low disability acceptance. After controlling for level of depression and time since injury, gender was significantly related to ADS score such that women reported higher acceptance of disability. After controlling for gender and time since injury, level of depression was significantly related to ADS score. CONCLUSION: Acceptance of disability is a serious problem in this group of SCI survivors in Neiva, Colombia, especially among women and individuals with higher levels of depression. Because acceptance of disability is likely a problem for many individuals living with disability in the developing world, future researchers should investigate what interventions (e.g. counseling, pharmacological intervention, social service programs) can be implemented to improve acceptance of disability in this population.

Family needs and psychosocial functioning of caregivers of individuals with spinal cord injury from Colombia, South America.

OBJECTIVE: 1) To determine the most frequent needs in a group of family caregivers of individuals with spinal cord injury in Neiva Colombia; 2) to describe caregivers' psychosocial functioning; and 3) to examine the relationship between caregiver needs and caregiver psychosocial functioning. DESIGN: Cross-sectional. PARTICIPANTS/METHODS: 37 caregivers completed a caregiver needs questionnaire composed of 27 questions (1-5 scale) and 9 sub-scales (emotional, information, economic, community, and household support, respite, physical health, sleep, and psychological health). The Patient Health Questionnaire (PHQ-9) was used to measure caregiver depression, the Zarit Burden Interview (ZBI) measured stress, the Interpersonal Support Evaluation List Short Version (ISEL-12) measured social support, and the Satisfaction With Life Scale (SWLS) was used to assess satisfaction with life. RESULTS: Information, economic, emotional, community support, and respite needs were most frequently reported among this group of Colombian caregivers. Forty-three percent of the family caregivers reported some level of depression, 68% reported being overwhelmed by their caretaking responsibilities, and 43% reported dissatisfaction with their lives. Information, emotional, economic, physical, sleep, and psychological needs were positively correlated with depression and burden. Those with more household, physical, sleep, economic, and psychological needs had less satisfaction with life and social support. Caregivers with more community and respite needs had less social support, while those with more emotional needs had less satisfaction with life. Caregivers with more respite needs had more burden and those with more household needs had more depression. CONCLUSION: Approximately half of the sample reports some level of burden, depression, or being dissatisfied with life. Psychosocial functioning was related to various family needs. Further longitudinal research is needed to determine whether caregivers with more needs report worse psychosocial functioning or if those with worse psychosocial functioning report more needs.