Implementation and outcomes of psychological screening during spinal cord injury rehabilitation

Anxiety and depression symptoms are more common in people with spinal cord injury than in people without spinal cord injury. Several studies and theoretical models, such as the common-sense model of self-regulation (CSM), suggest that the risk of anxiety and depression symptoms is related to certain psychological factors, such as confidence in one's own ability (self-efficacy), illness perception, passive coping and resilience. Early recognition of these psychological factors is expected to improve physical and psychological health outcomes both during and after rehabilitation. To timely identify possible anxiety and depression symptoms, eight spinal cord injury rehabilitation centers were invited to implement psychological screening in 2018. The main objectives of this thesis were (1) evaluation of the implementation and content of psychological screening and (2) a study of associations between psychological factors and psychological adjustment in spinal cord injury rehabilitants.
The studies published in this dissertation show, among other things, that (a) the questionnaires on disease perceptions and resilience have good psychometric properties in spinal cord injury rehabilitation inpatients and that (b) self-efficacy, illness perception, passive coping and resilience all contribute to a greater or lesser extent to explaining anxiety and depression symptoms. In addition, interviews indicate that psychological screening helps the multidisciplinary rehabilitation treatment team with identifying psychological problems and understanding inpatients' behaviors. When the results on psychological screening are integrated into the multidisciplinary, individual rehabilitation treatment of people with spinal cord injury, it is expected to contribute positively to rehabilitation(outcomes).