ESTIMATING SOCIAL-ADJUSTMENT FOLLOWING SPINAL TRAUMA .1. WHO IS MORE REALISTIC - PATIENT OR SPOUSE - A STATISTICAL JUSTIFICATION

Whilst assessment of functional independence has been accomplished, to a greater extent, following spinal trauma, assessing social adjustmen t remains an area requiring considerable further investigation. Provid ing premorbid estimation of adjustment is an area which presents a num ber of methodological difficulties both in the collection and interpre tational of longitudinal data. Such analyses tend to allow overall est imates of adjustment to be made but which lack individual specificity. Analyses are presented of over 250 individuals, and their closest rel ative's assessment, of social adjustment to their spinal cord injury. Using a modification of an established scale for assessing social adju stment it has been possible to establish the statistical level of agre ement and address the hypothesis of differential perception of the ext ent of adjustment problems by the injured person and their closest rel ative. The study allows for the conclusion that an injured person's pe rception of adjustment is at least as reliable as their closest relati ve, and that there is further evidence to support the essential accura cy of their estimations of premorbid and current levels of adjustment. Both issues are of clinical importance, particularly in relation to a ny medico-legal compensation aspects.