Pain and quality of life in persons with spinal cord injury: Mediating effects of mindfulness, self-efficacy, social support, and functional independence.

OBJECTIVE: To identify mediating roles of mindfulness, self-efficacy, social support, and functional independence in the relationship between pain and quality of life (QOL) in persons with spinal cord injury (SCI). METHODS: A cross-sectional descriptive study was conducted using a sample of 272 persons with SCI living in the United States. The participants completed self-report standardized questionnaires on a Qualtrics survey. A parallel mediation analysis adjusting for covariates was performed to test the hypotheses. RESULTS: Findings showed significant direct effects of pain on functional independence, self-efficacy, mindfulness, and social support. Self-efficacy, mindfulness, and social support had significant direct effects on QOL. In the mediation analysis, mindfulness, self-efficacy, and social support significantly mediated the relationship between pain and QOL, controlling for other variables in the model. CONCLUSIONS: This study adds to the extant literature by providing evidence that mindfulness, self-efficacy, and social support not only directly contribute to QOL but are likely to mitigate the negative effect of pain on QOL in persons with SCI. Identifying these potential factors that can assuage the adverse effects of pain on QOL is a first step toward active intervention to facilitate the adjustment of persons with SCI.

Mindfulness-Based Self-Care for Forensic Nurses: A Professional Lifestyle Approach.

ABSTRACT: Forensic nurses providing care to patients who are victims or offenders of abuse, trauma, or violence often face enormous challenges in their daily practice, leading to emotional stress, vicarious traumatization, and burnout, and potentially reducing the quality of patient care. Embracing mindfulness as an ongoing method of self-care can have an array of benefits for forensic nurses to prevent burnout and improve their well-being and quality of patient care. Existing literature supports the benefits of mindfulness-based interventions, as self-care practices, in improving many positive health outcomes among nurses working in a variety of healthcare settings. Mindfulness qualities, such as open awareness, attention to detail, nonjudgment, emotional regulation, compassion, and empathy, can contribute to forensic nurses' well-being and the quality of patient care. Mindfulness is a way of living; thus, formal and informal mindful self-care tools integrated into daily nursing practice can result in better outcomes and work satisfaction among nurses. This article discusses the potential benefits of mindfulness and practical ways to integrate mindfulness tools into forensic nursing practice. Incorporating mindful self-care practices should be a goal for consideration for the contemporary forensic nursing profession at large. Further intervention research is recommended to identify the mechanism of how mindfulness can benefit forensic nurses practicing in highly challenging work environments.

The role of mindfulness in quality of life of persons with spinal cord injury: a cross-sectional study.

BACKGROUND: Quality of life is considered the most overarching psychosocial adaptation outcome following the rehabilitation of persons with spinal cord injury. Literature suggests that the quality of life of persons with spinal cord injury is determined by many personal and psychological factors, including mindfulness. This study aimed to identify the direct and indirect effect of mindfulness on the quality of life of persons living with spinal cord injury. METHODS: Participants consisted of 231 members of three spinal cord injury organizations in the United States: United Spinal Association, North American Spinal Cord Injury Consortium, and Paralyzed Veterans of America-Wisconsin Chapter. The participants completed a set of standardized self-report questionnaires in an online Qualtrics survey. A hierarchical regression analysis was performed to identify the contribution of mindfulness to quality of life, controlling for sociodemographic and injury-related factors. A serial mediation analysis was performed to examine the indirect effect of mindfulness on quality of life. RESULTS: In the hierarchical regression analysis, sociodemographic and injury-related factors (i.e., age, gender, race, marital status, education, employment, level and completeness of injury, comorbidities, frequency of hospitalization, pain intensity, and functional limitation) and mindfulness explained 59% variance on quality of life of the participants with spinal cord injury. Mindfulness uniquely contributed to the higher quality of life above and beyond sociodemographic and injury-related variables. In the serial mediation analysis, pain and functional limitation did not significantly mediate the relationship between mindfulness and quality of life. However, the indirect effects of mindfulness on functional limitation and quality of life through pain were significant. CONCLUSION: The findings underscore the vital role of mindfulness in improving the quality of life of persons with spinal cord injury. Implications of these findings for future research and clinical practice are discussed.

Psychosocial factors affecting resilience in Nepalese individuals with earthquake-related spinal cord injury: a cross-sectional study.

BACKGROUND: One of many types of injuries following an earthquake is spinal cord injury (SCI) which is a life-long medically complex injury and high-cost health problem. Despite several negative consequences, some persons with SCI are resilient enough to achieve positive adjustment, greater acceptance, and better quality of life. Since resilience is influenced by several factors and can vary by context, it is beneficial to explore factors that affect the resilience of people who sustained spinal cord injury from the 2015 earthquake in Nepal. METHODS: A descriptive cross-sectional study included 82 participants from the Spinal Injury Rehabilitation Center and communities in Nepal. Participants completed the Demographic and Injury-related Questionnaire, Connor-Davidson Resilience Scale, Multidimensional Scale of Perceived Social Support, Moorong Self-efficacy Scale, Intrinsic Spirituality Scale, and Patient Health Questionnaire-9. Pearson's correlation and point biserial correlation analyses were performed to examine associations between resilience and independent variables. A hierarchical regression analysis was used to identify the influence of certain factors. RESULTS: Findings indicated significant associations between resilience and social support (r = 0.42, p < 0.001), self-efficacy (r = 0.53, p < 0.001), depressive mood (r = - 0.50, p < 0.001) and demographic variables which included sex (r = 0.47, p < 0.001), employment (r = 0.27, p = 0.016), and current living location (r = 0.24, p = 0.029). There was a non-significant association between resilience and spirituality (r = - 0.12, p > 0.05). In hierarchical regression analysis, an overall regression model explained 46% of the variance in resilience. Self-efficacy (ß = 0.28, p = 0.007) and depressive mood (ß = - 0.24, p = 0.016) significantly determined resilience after controlling the effect of demographic variables. Among the demographic factors, being male significantly explained the variance in resilience (ß = 0.31, p = 0.001). CONCLUSIONS: Multiple psychosocial and demographic factors were associated with resilience in people who sustained an earthquake-related SCI. Mental health professionals should demonstrate concern and consider such factors in allocating care in this group. Development of intervention research concerning resilience is recommended to strengthen resilience in order to improve rehabilitation outcomes and enhance reintegration of individuals with SCI into their communities.