STRUCTURE AND CONCEPTUALIZATION OF ACCEPTANCE: A SPLIT-SAMPLE EXPLORATORY AND CONFIRMATORY FACTOR ANALYSIS APPROACH TO INVESTIGATE THE MULTIDIMENSIONALITY OF ACCEPTANCE OF SPINAL CORD INJURY

Journal of Rehabilitation Medicine, 2021 · DOI: 10.2340/16501977-2876 · Published: September 24, 2021

Simple Explanation

Acceptance is a key part of getting used to life after a spinal cord injury. This study looked at different ways acceptance is defined and measured. It found that acceptance is complex and has four parts: accepting reality, changing values, letting go of control, and engaging in activities. These parts are connected and show different mental processes. This means that researchers and healthcare workers should think about these different parts when they study acceptance and when they talk to patients about it. The study looked at 431 adults with spinal cord injuries. They answered questionnaires about acceptance. The answers showed that acceptance isn't just one thing, but has the four connected parts.

Study Duration

29 Years (1991-2020)

Participants

431 adults with spinal cord injury

Evidence Level

Not specified

Key Findings

1
Acceptance of SCI is a multidimensional construct with 4 sub-dimensions: “Accepting Reality”, “Value Change”, “Letting Go of Control”, and “Behavioural Engagement”.
2
PCA in sub-sample 1 with the remaining 11 items suggested 4 components that corresponded with the 4 dimensions of the hypothesized model.
3
CFA in sub-sample 2 with the same model showed good model fit, lending further support to the multidimensional model of acceptance of SCI.

Research Summary

This study investigated the multidimensionality of acceptance of SCI using a split-sample PCA and CFA approach. A 4-dimensional model of acceptance with the sub-dimensions “Accepting Reality”, “Value Change”, “Letting Go of Control” and “Behavioural Engagement” was hypothesized and tested. The 4-dimensional model, including “Accepting Reality”, “Value Change”, “Letting Go of Control” and “Behavioural Engagement” was suggested by the PCA in sub-sample 1 and showed good model fit in the CFA in sub-sample 2.

Practical Implications

Clinical Practice

Acceptance should be regarded as a multidimensional construct with facets that are distinct but interconnected. These facets may manifest themselves sequentially and have differential importance during the adjustment process and in rehabilitation.

Research

When choosing a measurement scale researchers and healthcare professionals should think carefully about what facets of acceptance are of relevance in what context. It is important to explore how the different facets of acceptance might relate differentially to various adjustment outcomes.

Therapeutic Methods

Targeting the different facets of acceptance will probably require different therapeutic methods and some facets might be more susceptible to intervention than others. Furthermore, their sequential manifestation suggests that some facets might have to be targeted prior to others.

Study Limitations

1
The 4-dimensional model of acceptance was derived from previous theoretical and empirical work, it is not necessarily exhaustive, and future research might include more dimensions.
2
Items 1 and 7 were excluded from the AAQ-M from the analysis because of serious issues in the initial PCA.
3
Only individuals who had consented to be part of the database were invited to participate (n = 686). It is estimated that approximately 3,000 individuals in Denmark live with an SCI

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