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anti- and syn-sesquihomodiamantenes (SDs) were prepared and structurally characterized. anti-SD and parent sesquihomoadamantene were CH-bond functionalized by utilizing a phase-transfer protocol. The density functional theory-computed ionization potentials of unsaturated diamondoid dimers correlate well with the experimental oxidation potentials obtained from cyclic voltammetry. Similar geometries ensue for both the reduced and ionized SD states, whose persistence is supported by the ß-hydrogen's spatial sheltering. This makes SDs promising building blocks for the construction of diamond materials with high stability and carrier mobility.
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PURPOSE: This study aimed at testing the internal consistency and longitudinal measurement invariance of a brief quality of life questionnaire-the spinal cord injury quality of life basic data set (SCI-QoL-BDS)-among individuals with spinal cord injury/disorder undergoing first inpatient rehabilitation. METHODS: Longitudinal data from the Swiss spinal cord injury inception cohort study were used. Participants (n = 218) completed the SCI-QoL-BDS at one and three months post injury and at discharge. The SCI-QoL-BDS consists of three items assessing satisfaction with life as a whole, physical health, and psychological health. Internal consistency was examined at each time point and longitudinal measurement invariance was tested using longitudinal confirmatory factor analysis. RESULTS: Internal consistency coefficients ranged between .82 and .90. The confirmatory factor analysis revealed invariance of the factor structure and of all factor loadings across time. Additionally, all item intercepts except the one of satisfaction with physical health were invariant across time, suggesting partial intercept invariance of the SCI-QoL-BDS. Indeed, a response shift was observed in satisfaction with physical health. This item was evaluated more negatively in the early phase of inpatient rehabilitation, indicating the change of the evolving physical situation after the onset of a spinal cord injury. CONCLUSION: The SCI-QoL-BDS is a consistent and valid measure to assess quality of life among individuals undergoing first spinal cord injury/disorder inpatient rehabilitation. However, we recommend using latent variable frameworks instead of mean scores when examining longitudinal changes in the measure to account for potential response shift.
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Qualidade de Vida , Traumatismos da Medula Espinal , Estudos de Coortes , Humanos , Pacientes Internados , Psicometria , Qualidade de Vida/psicologia , Traumatismos da Medula Espinal/psicologiaRESUMO
STUDY DESIGN: This study is a cross-sectional analysis using data from the Swiss Spinal Cord Injury Cohort Study. OBJECTIVES: To examine internal consistency and convergent validity of the International Spinal Cord Injury Quality of Life Basic Data Set (QoL-BDS) at discharge from first inpatient rehabilitation. SETTING: The study was performed at four rehabilitation centers in Switzerland. METHODS: Participants were Swiss residents aged over 16 years newly diagnosed with traumatic or non-traumatic spinal cord injury (SCI). Measures included the QoL-BDS, World Health Organization Quality of Life (WHOQOL) items, Hospital Anxiety and Depression Scale (HADS), and Spinal Cord Independence Measure III (SCIM). RESULTS: A total of 495 participants were included. In all, 57% had a traumatic SCI, 71.1% a motor complete SCI, and 33.3% had tetraplegia. Mean age was 53 (SD = 16.4) years and 68% were male. No floor or ceiling effects were found. Inter-correlations were strong (0.73-0.80) and Cronbach's alpha was good (0.88). QoL-BDS mean scores were 6.4 (SD = 2.2) for life satisfaction, 5.8 (SD = 2.4) for physical health, 6.9 (SD = 2.4) for psychological health, and 6.4 (SD = 2.1) for total QoL. Correlations with reference measures were strongest for QoL-BDS total and WHOQOL general quality of life (r = 0.67), QoL-BDS physical health and WHOQOL health and daily activities (r = 0.64 and 0.53), and QoL-BDS psychological health and HADS depression and anxiety (r = -0.64 and -0.69). SCIM correlated weakly with all QoL-BDS items. CONCLUSIONS: The QoL-BDS revealed no floor or ceiling effects and demonstrated good internal consistency and convergent validity in individuals with SCI assessed at discharge from first rehabilitation. This study supports the clinical routine use of the QoL-BDS.
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Qualidade de Vida , Traumatismos da Medula Espinal , Idoso , Estudos de Coortes , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Psicometria , Qualidade de Vida/psicologia , Reprodutibilidade dos Testes , Traumatismos da Medula Espinal/reabilitaçãoRESUMO
STUDY DESIGN: Comparative study of survey self-report data. OBJECTIVES: To compare individuals living with spinal cord injury (SCI) in Switzerland to the general population in terms of mental health, quality of life, self-efficacy, and social support. SETTING: Community, Switzerland. METHODS: Data from the 2017 community survey of the Swiss Spinal Cord Injury Cohort Study were compared to data from two matched (1:3 nearest neighbor propensity score) general population surveys collected in the same year. Measures of mental health (mental health index, psychological distress item, vitality scale, and energy item), quality of life (WHOQOL-BREF item), self-efficacy (General Self-Efficacy Scale item), and social support (items of relationship satisfaction, living alone, and marital status) were compared across datasets using regression adjusted for non-response correction weights. The analyses were then replicated in subgroups defined by sociodemographic, lesion-related, and secondary health issues factors. RESULTS: Individuals with SCI had significantly higher psychological distress and poorer mental health, vitality, energy, and quality of life than the general population, with medium to large effect sizes (Cohen's d: 0.35-1.08). They also had lower self-efficacy and relationship satisfaction, lived more frequently alone, and were more frequently single. Individuals with less severe secondary health issues reported mental health and quality of life more similar to the general population than those reporting more severe issues. CONCLUSIONS: This study highlights a significant long-term impact of SCI on well-being and psychosocial resources, underlining the need for ongoing biopsychosocial care beyond inpatient rehabilitation.
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Qualidade de Vida , Traumatismos da Medula Espinal , Estudos de Coortes , Estudos Transversais , Humanos , Saúde Mental , Autoeficácia , Apoio Social , Traumatismos da Medula Espinal/epidemiologia , Inquéritos e Questionários , Suíça/epidemiologiaRESUMO
STUDY DESIGN: Cross-sectional. OBJECTIVE: To investigate the associations of a set of psychosocial resources with pain and pain-related factors in individuals with spinal cord injury (SCI) and chronic pain. SETTING: Community, Switzerland. METHODS: Data from 1,064 individuals with chronic pain who participated in the second community survey of the Swiss Spinal Cord Injury Cohort Study (Survey 2017) were analyzed. Multiple linear regression modeling was performed to test the hypotheses that higher levels of psychosocial resources (self-efficacy, self-esteem, purpose in life, optimism, hope, social support, sense of belonging) are negatively associated with pain intensity, pain interference and depressive symptoms. RESULTS: Higher self-esteem, optimism and hope were related to less pain interference and all psychosocial resources under study were negatively associated with depressive symptoms in final models. However, neither of the psychosocial resources was related to pain intensity when models were adjusted for pain interference and depressive symptoms. CONCLUSIONS: These findings strengthen the evidence that psychosocial resources can have an impact on pain interference and depressive symptoms as pain-related factors, and support the notion that psychosocial resources might be promising targets for pain interventions in individuals with SCI.
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Dor Crônica , Traumatismos da Medula Espinal , Dor Crônica/epidemiologia , Dor Crônica/etiologia , Estudos de Coortes , Estudos Transversais , Humanos , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/epidemiologia , Inquéritos e Questionários , Suíça/epidemiologiaRESUMO
Non-aqueous organic redox flow batteries (RFB) utilizing verdazyl radicals are increasingly explored as energy storage technology. Verdazyl cations in RFBs with acidic aqueous electrolytes, however, have not been investigated yet. To advance the application in aqueous RFBs it is crucial to examine the interaction with the utilized membranes. Herein, the interactions between the 1,3,5-triphenylverdazyl cation and commercial Nafion 211 and self-casted polybenzimidazole (PBI) membranes are systematically investigated to improve the performance in RFBs. The impact of polymer backbones is studied by using mPBI and OPBI as well as different pre-treatments with KOH and H3PO4. Nafion 211 shows substantial absorption of the 1,3,5-triphenylverdazylium cation resulting in loss of conductivity. In contrast, mPBI and OPBI are chemically stable against the verdazylium cation without noticeable absorption. Pre-treatment with KOH leads to a significant increase in ionic conductivity as well as low absorption and permeation of the verdazylium cation. Symmetrical RFB cell tests on lab-scale highlight the beneficial impact of PBI membranes in terms of capacity retention and I-V curves over Nafion 211. With only 2 %â d-1 capacity fading 1,3,5-triphenylverdazyl cations in acidic electrolytes with low-cost PBI based membranes exhibit a higher cycling stability compared to state-of-the-art batteries using verdazyl derivatives in non-aqueous electrolytes.
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Flow batteries are one option for future, low-cost stationary energy storage. We present a perspective overview of the potential cost of organic active materials for aqueous flow batteries based on a comprehensive mathematical model. The battery capital costs for 38 different organic active materials, as well as the state-of-the-art vanadium system are elucidated. We reveal that only a small number of organic molecules would result in costs close to the vanadium reference system. We identify the most promising candidate as the phenazine 3,3'-(phenazine-1,6-diylbis(azanediyl))dipropionic acid) [1,6-DPAP], suggesting costs even below that of the vanadium reference. Additional cost-saving potential can be expected by mass production of these active materials; major benefits lie in the reduced electrolyte costs as well as power costs, although plant maintenance is a major challenge when applying organic materials. Moreover, this work is designed to be expandable. The developed calculation tool (ReFlowLab) accompanying this publication is open for updates with new data.
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OBJECTIVE: This study examined longitudinal changes in post-traumatic stress symptoms (PTSS) in individuals newly diagnosed with spinal cord injury (SCI) and tested various psychosocial and injury-related characteristics as predictors for interindividual differences in symptom courses. DESIGN: Longitudinal data from the larger Swiss Spinal Cord Injury Cohort Study were used. The sample consisted of 269 patients (70.6% male; Mage = 53.21) admitted for inpatient rehabilitation to SCI rehabilitation centers. MAIN OUTCOME MEASURE: PTSS were measured at one and six months after injury using the Impact of Event Scale-6. RESULTS: Latent change score modelling revealed no average change in PTSS in the sample, but significant variability in the individual symptom courses. Reliable change index analyses suggest that among individuals with an initial PTSS severity of clinical concern (n = 65), only 27.7% showed clinically significant decreases over time. Predictors explained 34% of the variance in PTSS change. Loss appraisals (ß = .30, p < .001) and cause of injury (ß = .16, p = .018) emerged as unique predictors. CONCLUSION: Clinically elevated PTSS one month after SCI typically remain across the following months highlighting the need for early screening and intervention. Low loss appraisals were related to decreases in symptom severity and might therefore be a suitable intervention target for reducing PTSS after SCI.
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Traumatismos da Medula Espinal , Transtornos de Estresse Pós-Traumáticos , Estudos de Coortes , Feminino , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologiaRESUMO
OBJECTIVES: To determine average changes and individuals' patterns of change in depressive symptoms, anxiety symptoms, general distress, and life satisfaction between admission to spinal cord injury inpatient rehabilitation and discharge; and to identify factors associated with change. METHOD: Longitudinal data collection as part of a national cohort study (N = 281). Changes in the psychological adaptation outcomes were analyzed using latent change score models. Reliable change indexes were calculated for each outcome to identify individuals' patterns of change. Biopsychosocial factors were examined as covariates of change. RESULTS: On average, depressive symptoms, anxiety symptoms, and general distress decreased between admission and discharge, while life satisfaction increased. According to the reliable change indexes, several adaptation patterns were identified. The proportion of individuals following each pattern varied depending on the analyzed outcome: resilience (absence of clinically relevant symptoms at admission and discharge) was the most common for symptoms of depression (61.57%) and anxiety (66.55%), whereas vulnerability (clinically relevant symptoms at both measurement times) was the most common for distress (57.32%). Improvement patterns (statistically significant decreases) were identified for 6.41%, 4.27%, and 7.83% of participants in depressive symptoms, anxiety symptoms and distress, respectively. For life satisfaction, improvement (statistically significant increases) was found for 8.54%. Male sex, tetraplegia, self-efficacy, optimism, and social support were associated with average changes in the psychological adaptation outcomes. CONCLUSIONS: On average, participants showed improvement in all analyzed outcomes. Still, there is substantial variability in change. Self-efficacy, social support, and optimism are potential intervention targets during inpatient rehabilitation to promote a favorable psychological adaptation process. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Reabilitação Neurológica , Traumatismos da Medula Espinal , Adaptação Psicológica , Estudos de Coortes , Humanos , Pacientes Internados , MasculinoRESUMO
OBJECTIVE: To test the spinal cord injury adjustment model (SCIAM) by examining whether primary appraisals (threat or loss) and coping strategies (approach-oriented and denial) sequentially mediate the impact of functional independence, psychological resources, and social support on depressive and anxiety symptoms among individuals with spinal cord injury during inpatient rehabilitation. METHOD: Path analyses of longitudinal data from a Swiss inception cohort study (N = 207). Models were implemented separately for depressive and anxiety symptoms. RESULTS: The initial models based on the SCIAM yielded poor fit and were respecified. Different from the SCIAM's assumptions, psychological resources and threat appraisal showed direct effects on depressive symptoms (ß = -.28, SE = .07, p < .001 and ß = .33, SE = .07, p < .001, respectively), while social support and threat appraisal showed direct effects on anxiety symptoms (ß = -.23, SE = .06, p < .001 and ß = .42, SE = .06, p < .001, respectively). Primary appraisals and coping strategies partially mediated the effects of psychological resources on depressive symptoms and fully mediated their effect on anxiety symptoms. However, this did not only happen via the SCIAM's sequential double mediation, since indirect effects were also observed via threat appraisal only. The final models explained 40 and 30% of the variance of depressive and anxiety symptoms, respectively. CONCLUSIONS: The findings only partially supported the SCIAM's sequential double mediation mechanism. Psychological resources, social support, and primary appraisals can have direct effects on psychological adaptation outcomes and may be suitable intervention targets during inpatient rehabilitation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Reabilitação Neurológica , Traumatismos da Medula Espinal , Adaptação Psicológica , Estudos de Coortes , Humanos , Apoio SocialRESUMO
OBJECTIVES: To provide a methodological reference paper for the inception cohort of the Swiss Spinal Cord Injury Cohort Study (SwiSCI), by detailing its methodological features and reporting on participant characteristics, response rates and non-response bias. DESIGN: Prospective cohort study starting in 2013 in all 4 specialized rehabilitation centres in Switzerland. SUBJECTS: Included are 655 newly diagnosed first rehabilitation patients aged ≥16 years with traumatic or non-traumatic spinal cord injury (TSCI, NTSCI). METHODS: Descriptive statistics were used to depict participant characteristics and to compare characteristics of responders and non-responders. Logistic regressions were conducted to estimate non-response bias. RESULTS: The sample consisted of 69% males, with mean age 53.5 years, 57.9% TSCI, 60.7% paraplegia and 78.8% incomplete SCI. Males and younger persons more often sustained TSCI and more severe SCI, resulting in longer duration of rehabilitation. Complete lesions were more prevalent in TSCI compared to NTSCI. The response rate was 47.5% and study participation was less likely in females, older persons, persons with lower functional independence and those with NTSCI. CONCLUSION: SwiSCI inception cohort data enable the estimation of epidemiological figures of SCI in Switzerland, and prognostic and trajectory modelling of outcomes after SCI to guide policy, service provision and clinical practice.
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Traumatismos da Medula Espinal/reabilitação , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , SuíçaRESUMO
Electrolyte chemistry is critical for any energy-storage device. Low-cost and sustainable rechargeable batteries based on organic redox-active materials are of great interest to tackle resource and performance limitations of current batteries with metal-based active materials. Organic active materials can be used not only as solid electrodes in the classic lithium-ion battery (LIB) setup, but also as redox fluids in redox-flow batteries (RFBs). Accordingly, they have suitability for mobile and stationary applications, respectively. Herein, different types of electrolytes, recent advances for designing better performing electrolytes, and remaining scientific challenges are discussed and summarized. Due to different configurations and requirements between LIBs and RFBs, the similarities and differences for choosing suitable electrolytes are discussed. Both general and specific strategies for promoting the utilization of organic active materials are covered.
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PURPOSE: Individuals with spinal cord injury (SCI) may experience both positive (posttraumatic growth, PTG) and negative (posttraumatic depreciation, PTD) psychological changes following the injury. PTG and PTD were assessed using the 10-item short form of the Posttraumatic Growth Inventory (PTGI-SF) and 10 matched negatively worded items for PTD (selected from the PTGI-42) within the Swiss Spinal Cord Injury Cohort Study (SwiSCI). This item selection is henceforth called PTG/D-SF. The objective of this study was to test the metric properties of the PTG/D-SF to determine the best strategy to derive reliable sum scores and to test the validity of several different structural conceptualizations. METHOD: Using cross-sectional data (N = 278), a series of unidimensional and multidimensional Rasch analyses of the PTG/D-SF (N = 20) were performed. Rasch analyses were conducted separately for the items or by domains to investigate dimensionality, monotonicity, item and model fit, and local item dependency of the instrument. RESULTS: The separate PTG and PTD items or their domains can be summated to form a unidimensional scale. Aggregation into domains improved the score distribution and increased the scope of the instruments. The reliability of the sum score for PTG was good (Person Separation: 0.81); the one for PTD was admissible (Person Separation: 0.77). CONCLUSION: PTG and PTD should be understood as distinct constructs rather than two ends of a continuum. Findings support the use of a PTG total score and to some degree the PTD total score. Future work could adapt the PTD items to improve the performance of the scale. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Crescimento Psicológico Pós-Traumático , Traumatismos da Medula Espinal/psicologia , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: This study examined whether retrospective reports of posttraumatic growth (PTG) and depreciation (PTD) of individuals recently diagnosed with a spinal cord injury (SCI) coincide with prospectively measured changes in the conceptually close domains of general self-efficacy (SE) and purpose in life (PIL). The study also tested whether PTG/D and changes in SE and PIL independently predict psychological adjustment to the injury (depressive symptoms, anxiety, life satisfaction). METHOD: Adopting a longitudinal design, a sample of 206 newly injured patients admitted to one of the four Swiss SCI rehabilitation centers was analyzed. SE and PIL were assessed one month after injury diagnosis and at rehabilitation discharge, PTG/D and the adjustment indicators only at discharge. Structural equation modeling was used to calculate latent change scores for SE and PIL, to correlate these scores to PTG/D scores, and to regress the adjustment indicators on both of them. RESULTS: PTG/D scores were weakly (rmax = .20, p = .033) correlated to changes in SE and PIL. In the multivariate analyses, positive changes in SE and PIL and PTG scores were all associated with better adjustment (e.g., fewer depressive symptoms). In contrast, PTD scores were related to lower adjustment. CONCLUSIONS: These results suggest that PTG/D in the initial time after a potentially traumatic medical event seem to be illusory to some degree, as indicated by their weak association with "actual" (i.e., longitudinally measured) changes. Nevertheless, both, PTG/D and actual changes, need to be considered by researchers and clinicians, as they seem to be independently related to psychological adjustment. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Ansiedade/psicologia , Depressão/psicologia , Crescimento Psicológico Pós-Traumático , Traumatismos da Medula Espinal/psicologia , Depreciação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
PURPOSE: In the current study, we aimed to examine two possible explanations for why higher levels of posttraumatic growth (PTG) were repeatedly found to be predicted by both approach- and avoidance-oriented coping, focusing on individuals recently diagnosed with a spinal cord injury (SCI). First, negative changes (posttraumatic depreciation, PTD) may moderate the association between PTG and the two types of coping, indicating that PTG reflects avoidance of PTD for some individuals, but a constructive view on posttraumatic life changes for others. Second, it may be that a flexible use of different types of coping strategies (coping flexibility) enables the experience of PTG. METHOD: We examined a sample of 122 patients admitted to one of the four Swiss SCI rehabilitation centers in a longitudinal study. Hierarchical multiple regression analyses were conducted to test the two competing explanations. RESULTS: Both approach- (ß = .30, p = .001) and avoidance-oriented coping (ß = .23, p = .011) measured 3 months after SCI diagnosis predicted higher PTG levels at discharge from clinical rehabilitation. PTD did not moderate the relationship between approach- (ß = .03, p = .743) and avoidance-oriented coping (ß = -.04, p = .656) and PTG. However, coping flexibility (ß = .23, p = .012) predicted higher PTG levels. CONCLUSION: These results suggest that a flexible use of different coping strategies (potentially, according to situational demands) may explain findings that PTG was predicted by both approach- and avoidance-oriented coping. (PsycINFO Database Record
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Adaptação Psicológica , Crescimento Psicológico Pós-Traumático , Traumatismos da Medula Espinal/psicologia , Traumatismos da Medula Espinal/reabilitação , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , SuíçaRESUMO
OBJECTIVE: Findings on the relationship of posttraumatic growth (PTG) with adjustment to potentially traumatic events are inconsistent, whereupon posttraumatic depreciation (PTD) has been suggested as a possible moderator. The objective of this study is to investigate the associations between PTG and PTD on one side and life satisfaction and indicators of mental and physical health on the other side in individuals with spinal cord injury (SCI). The primary study aim is to test whether PTD moderates the relationships of PTG and different adjustment indicators. METHOD: A total of 141 patients administered to one of the four Swiss SCI rehabilitation centers completed questionnaires assessing PTG and PTD and different indicators of mental and physical health as well as life satisfaction at discharge from first rehabilitation. Correlational and regression methods were used to examine the research question. RESULTS: PTG and PTD were significantly positively correlated (rs = .47). PTD was significantly associated with lower mental and physical health and lower life satisfaction, with small to large effect sizes. PTD moderated the associations of PTG with symptoms of depression and life satisfaction (ß of interaction term = -.18 and .24, respectively). PTG was significantly related to lower levels of symptoms of depression and higher life satisfaction in individuals experiencing moderate to high levels of PTD. In contrast, PTG was not significantly related to these outcomes in individuals with low PTD levels. CONCLUSION: The neglect of PTD in research partially explains mixed findings on the relationship of PTG and adjustment to potentially traumatic events. (PsycINFO Database Record
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Adaptação Psicológica , Satisfação Pessoal , Traumatismos da Medula Espinal/psicologia , Depressão , Feminino , Nível de Saúde , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Análise de Regressão , Traumatismos da Medula Espinal/reabilitação , Estresse Psicológico , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To describe and explore functioning and health of persons with spinal cord injury from the perspective of psychological-personal factors in the light of the International Classification of Functioning, Disability and Health (ICF) framework. METHODS: Data from 511 participants regarding feelings, thoughts and beliefs, motives, and patterns of experience and behaviour were analysed. Measurement instruments included the Mental Health Index-5, Positive and Negative Affect Schedule, Hospital Anxiety and Depression Scale, Appraisal of Life Events Scale, 5 items from the World Health Organization Quality of Life Scale, Purpose in Life Test-Short Form, General Self-Efficacy Scale, Big Five Inventory-21, Social Skills Inventory-SF, Brief COPE. The distribution of the selected psychological-personal factors-indicators was examined using descriptive statistics. Differences between SCI subgroups by sex, age, age at injury, time since injury, aetiology and severity of injury were explored using analysis of variance (ANOVA) and F-tests. RESULTS: Participants who were older and sustained their spinal cord injury more recently experienced more depressed mood, less positive affect, less challenge appraisal, lower life satisfaction, lower purpose in life, and lower self-efficacy. They reported lower social skills, less usage of the coping strategies humour, positive reframing, and acceptance, and more usage of the coping strategies denial and self-distraction. Overall, effect sizes were small. DISCUSSION: Although study participants appeared to be well adjusted to spinal cord injury, those who sustained their injury at an older age and more recently reported more negative experiences. Quantitative description and exploration of the psychological-personal aspects of health will enable hypotheses to be formulated for further research, and suggest a need for tailored interventions for those at risk of less favourable outcomes.