Predictors of Participation Enfranchisement following Spinal Cord Injury: The Mediating Role of Depression and Moderating Role of Demographic and Injury Characteristics

Short Title:
Predictors of Participation Enfranchisement following Spinal Cord Injury: The Mediating Role of Depression and Moderating Role of Demographic and Injury Characteristics
Model System:
SCI
Reference Type:
Journal Article
Accession No.:
J69087
Journal:
Archives of Physical Medicine and Rehabilitation
Year, Volume, Issue, Page(s):
2014, vol. 1, issue 95, pp 1106-1113
Publication Website:
Abstract:
Study examined the mediating effects of depressive symptoms on the relationships among employment, grief, depression treatment, and participation enfranchisement after spinal cord injury (SCI). It also examined the moderating role of demographic and injury characteristics, including sex, race, marital status, education, and injury level, and completeness on these relationships. Participation enfranchisement reflects the extent to which people view their communities as valuing, respecting, and encouraging their participation. Data were obtained from 522 participants with SCI who were recruited primarily from outpatient clinics and from the SCI Model Systems database. Structural equation modeling was used to test the relationship between participation enfranchisement and other variables by treating the level of depressive symptoms as a mediator, and exploring demographic and injury characteristics as the potential moderators. The final model fit the data relatively well, 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. In this study, depression appears to mediate the influence of employment, grief, and depression treatments on participation enfranchisement after SCI. These findings highlight efforts to improve the detection and treatment of depression in SCI rehabilitation programs that may enhance participation.
Author(s):
Wong A, Heinemann A, Wilson C, Neumann H, Fann J, Tate D, Forchheimer M, Richards J, Bombardier C.
Author Address(es):

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