The Relationship Among Self-perceived Burden,Social Support And Coping Style In Patients With Spinal Cord Injury

BackgroundSpinal cord injury(SCI)is a serious disease which can damage the structure and function of spinal cord due to traumatic or non-traumatic cause.Now there is no medical methods can regenerate the injured spinal cord neurons.Although most of the patients receive active rehabilitation,they are still disabled for a lifetime and have to rely on their caregivers.Patients usually worry about their caregivers,namely self-perceived burden(SPB),which could severely affect quality of life of patients.In recent years,the researches on the self-perceived burden have gradually increased,but there is no cross-sectional report on the self-perceived burden of patients with spinal cord injury.The purpose of this study was to investigate the status of the self-perceived burden of patients with spinal cord injury and to analyze the relationship among self-perceived burden,social support,coping style.Objective1 To analyze the level of self-perceived burden,social support,coping style and influencing factors.2 To analyze the relationship among self-perceived burden,social support and coping style.MethodsRecruiting 150 inpatients from rehabilitation department of the first and second affiliated hospital of Nanjing Medical University into this study.The status of self-perceived burden,social support,coping style and influencing factors was investigated by Self-perceived Burden Scale,Social Support Scale(SSRS),Medical Coping Questionnaire(MCMQ).The multiple linear regression analysis was used to analyze the influencing factors of self-perceived burden,social support and coping style.Pearson correlation analysis was used to analyze the relationship of them.Using coping style as the mediator variable to build a structural equation model to find out the interaction among social support,coping style and self-perceived burden.Results1 The status and influencing factors of self-perceived burden in patients with spinal cord injuryThe mean SPBS score was(33.98±10.76).Variables(including injury severity,familiarity with diease,general familiarity with diease,complication,the parents as main caregivers)entered regression equation of the SPB score.Variables(including injury severity,familiarity with diease,general familiarity with diease,complication,the parents as main caregiver,health status of main caregivers)entered regression equation of physical factor.Variables(including injury severity,familiarity with diease,general familiarity with diease,complication,at their own expense and new rural cooperative medical system)entered regression equation of emotional factor.Variables(including injury severity,familiarity with diease,medical insurance,the parents as main caregivers,health status of main caregiver)entered regression equation of economical factor.2 The Status and influencing factors of social support in patients with spinal cord injuryThe SSRS score ranged from(17?55),mean score was(38.88±8.53),objective support is(9.21±3.72),subjective support is(23.56±5.55),support utilization is(6.14±1.91).Variables(including family month income,familiarity with diease)entered regression equation of SSRS total score;Variables(including family month income,live in county/county level city)entered regression equation of objective support;Variables(including familiarity with diease)entered regression equation of subjective support;Variables(including family month income,parents as main caregivers)entered the equation of support utilization.3 The status and influencing factors of coping style in patients with spinal cord injuryThe coping style score was:confronting(19.11±3.95),evading(15.05±3.02),resignation(10.35±3.12).Multifactor regression analysis showed that the influencing factors of evading is gender.4 Path analysis among social support,coping style and self-perceieved burdenSPB did not correlate with confront and avoidance,positively correlate with resignation,but negatively correlate with social support.Subjective support,support utilization had directly negative effect on SPB,while resignation had directly positive effect on SPB.Resignation played a mediating role between social support and SPB.Conclusions1 Patients with SCI commonly experience self-perceived burden,which was in a moderate level.When patients are incomplete damaged,main caregivers are nursing workers,healthier,there is no complication,medical expenses is guaranteed,patient is familiar with diease,self-perceieved burden is more lighter.2 Patients with spinal cord injury generally received well social support.The higher family month income,more familiar with the diease and spouse as caregiver's role,the better social support.3 Male patients with spinal cord injury were more likely to adopt coping style of resignation.4 Objective support and support utilization directly affect self-perceived burden.The better objective support,support utilization,the lighter self-perceved burden;subjective support indirectly impact self-perceived burden through the resignation of coping style.The worse subjective support,patients more likely adopt resignation and self-perceved burden is more heavier.