Article

OBJECTIVES: (1) To examine the mediating effects of depressive symptoms on the
relations between employment, grief, depression treatment, and participation
enfranchisement after spinal cord injury (SCI); and (2) to examine the moderating
role of demographic and injury characteristics, including sex, race, marital
status, education, and injury level, and completeness on these relations. DESIGN:
Cross-sectional survey as part of the Project to Improve Symptoms and Mood after
SCI (PRISMS). SETTING: Rehabilitation facilities. PARTICIPANTS: Persons with SCI
(N=522; average age, 42 y; 76% men; 64% white; 64% completed at least a high
school education) enrolled from 2007 to 2011. INTERVENTIONS: Not applicable. MAIN
OUTCOME MEASURE: Participation enfranchisement. RESULTS: The final model fit the
data relatively well (comparative fix index=.939; Tucker-Lewis Index=.894; root
mean square error of approximation=.066; 90% confidence interval, .043-.089),
explaining 32% of the variance in participation enfranchisement. Enfranchisement
was positively related to employment and negatively related to depression.
Grieving the loss of a loved one and the use of an antidepressant or
psychotherapy were related to participation enfranchisement; these relations were
mediated by depressive symptoms. Multigroup analyses supported the model's
invariance across sex, marital status, severity of injury, and level of injury.
CONCLUSIONS: Depression appears to mediate the influence of employment, grief,
and depression treatments on participation enfranchisement after SCI. These
relations are applicable regardless of sex, marital status, and injury
completeness and level. These findings highlight efforts to improve the detection
and treatment of depression in SCI rehabilitation programs that may enhance
participation.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS