An exploration of cognitive appraisals following spinal cord injury

Abstract

This study explored the cognitive appraisals that people make following spinal cord injury (SCI) about their situation and their ability to cope with it. Appraisals are thought to be important in determining individual responses to different events and have been shown to predict psychological well-being following injury. A cross-sectional interview study was used. Ten individuals who had recently started rehabilitation at the National Spinal Injuries Centre following an SCI were interviewed. Eight men and two women with a variety of injury level and completeness participated. Interviews were semi-structured and aimed to elicit participants' appraisals of their experiences and their ability to cope. Interviews were analysed qualitatively using interpretative phenomenological analysis. Four super-ordinate themes emerged from the interviews. These were making sense of a traumatic experience, impact of the SCI, coping and altered view of self and life. The interviews revealed that appraisals following SCI are complex and relate not only to the individual but also to their context, life stage, roles and relationships. The study adds to the theoretical understanding of the appraisal process following SCI. Ideas for further research are generated and clinical implications for improving patient experiences and developing appraisal-focused interventions are considered.

Keywords:

• spinal cord injury
• cognitive appraisals
• psychological adjustment

Acknowledgments

The authors would like to thank the individuals who participated in this study and generously shared their experiences with them. They would also like to thank Dr Guinivere Webster and Dr Myra Cooper for their advice and support and Dr Katrin Scanlan for conducting the auditof the analysis process. The authors are also grateful to an anonymous reviewer for the suggestions.