USING THE MULTIDIMENSIONAL MODEL OF ACCEPTANCE TO INVESTIGATE HOW DIFFERENT FACETS OF ACCEPTANCE ARE RELATED TO QUALITY OF LIFE FOLLOWING SPINAL CORD INJURY

J Rehabil Med, 2022 · DOI: 10.2340/jrm.v54.1055 · Published: April 20, 2022

Spinal Cord Injury Participation Rehabilitation

Simple Explanation

Acceptance of spinal cord injury refers to psychological processes involved in acknowledging reality, re-evaluating life values, and engaging in meaningful activities despite psychological distress. This study explored the association between acceptance and quality of life using a multifa ceted understanding of acceptance. In sum, acceptance might be an important process to facilitate in rehabilitation following spinal cord injury.

Study Duration

June 2019 to October 2020

Participants

453 adults with spinal cord injury

Evidence Level

Not specified

Key Findings

1
The final regression models explained 46% of global QoL, 47% of psychological QoL and 31% of physical QoL.
2
The 4 facets of acceptance significantly increased the amount of variance explained by 6% for psycholo gical QoL, 8% for physical QoL and 14% for global QoL.
3
The facets “value-change” and “behavioural engagement” made significant contributions to all domains of QoL, while “letting go of control” only contributed to global QoL, and “accepting reality” only contributed to psychological QoL.

Research Summary

This study investigated how the different facets of acceptance were associated with global, psychological, and physical QoL following SCI, and whether they would be significantly associated with QoL even when controlling for the effects of sex, age, time since injury, depression, and anxiety. The findings further indicate that “value-change” and “behavioural engagement” were the strongest and most consistent contributors across all domains of QoL. Acceptance could therefore be an important process to facilitate in SCI rehabilitation, and it might be beneficial to support individuals with SCI in finding new values, interests, and activities, and motivating them to engage in these meaningful new activities even in the presence of distressing in ner experiences.

Practical Implications

Conceptualization of Acceptance

The 4 facets of acceptance were differentially associated with QoL following SCI, highlighting the importance of conceptualizing acceptance as a multidimensional construct.

Clinical Practice

Acceptance can increase QoL without necessarily removing distressing psychological symptoms, helping individuals face reality, change life values, and engage in meaningful activities despite distress.

Rehabilitation Focus

Healthcare professionals should focus on supporting individuals with SCI in finding new values, interests, and activities, and then motivating them to engage in these meaningful new activities even in the presence of negative thoughts, depressive feelings, and anxiety.

Study Limitations

1
Substantial amount of missing data for some of the independent variables.
2
Cross-sectional design, which did not permit any analysis of the temporal order of acceptance, psychological distress, and QoL.
3
The study sample is thus potentially not fully representative of the whole SCI population in Denmark.

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