Coping with spinal cord injury: personal and marital adjustment in the Hong Kong Chinese setting

Study design: A cross-sectional retrospective study was carried out with st ructured questionnaires and semi-structured interviews on 66 persons with s pinal cord injury (SCI) and 40 spouses. Objectives: The study aimed to explore the psychosocial adjustment of Hong Kong Chinese couples at the post SCI stage. An important study interest was the impact of care-giving in spouses of persons with SCI. Setting: Three major regional rehabilitation centres and one community reso urce centre in Hong Kong, Methods: A set of psychometric measures tapping different aspects of psycho logical functioning was included. These were locus of control (Levenson's I nternality, Powerful Others, and Chance Scale). perceived social support (P rovision of Social Relationship), coping strategies (Ways of Coping Checkli st), marital adjustment (Dyadic Adjustment Scale), caregiving burden (Careg iver Burden Inventory), depression (Beck Depression Inventory), life satisf action (Satisfaction with Life Situation), and social role adjustment (Katz Adjustment Scale - Relative Form). Results: Persons with SCI with pre-injury marriage were more depressed (P<0 .05) as compared with those with post-injury marriage. However, the two gro ups did not differ in terms of satisfaction with life situation and social role dissatisfaction. The spouses in the preinjury marriage reported a sign ificantly higher score in time-dependent burden than those in the post-inju ry marriage (P<0.05). Care-giving burden was associated with locus of contr ol, social support, and modes of coping (P<0.05). Conclusion: The impact of SCI is a long-lasting effect not limited to the p atients but also extending to their spouses. Findings from the adjustment o utcomes and coping styles of persons with SCI and their spouses indicate th at they are not passive victims. A similar injury may produce different out comes in different individuals. Rehabilitation professionals should thus be alert to both the couple's differing needs and idiosyncrasies in their hel ping process.