| Factor |
Influence on adjustment |
| Effective communication |
Effective communication improves patient outcomes by establishing rapport, trust and encouraging disclosure16,17 |
| Institutionalization and dehumanization |
SCI rehabilitation requires very long hospitalization stays, resulting in increased dependency, reduced privacy, confusion, and reduced self-responsibility18 |
| Pre-morbid influences |
Factors operating prior to the onset of the SCI will influence adjustment, such as a tendency to substance abuse, a complex personality profile, or other physical disabilities/ diseases4,19,20 |
| Social, family and sexual influences |
SCI is associated with significant changes to sexual, social and family relationships and has the potential to disrupt functional equilibrium3 |
| Employment and social access |
Financial concerns, home modification requirements, transportation difficulties and reduced rates of employment are challenges to adaptive adjustment11,21 |
| Comorbid and secondary conditions |
Conditions such as traumatic brain injury (TBI), recurrent infections, chronic pain and mental health disorders have the capacity to influence adjustment negatively6,7,11,12,22-24 |
| Coping styles and perceptions |
Attributions (eg. self-efficacy) and coping styles can enhance or become a barrier to adjustment9,13,22,26 |
| Mood states |
Elevated negative mood states will impede adjustment and possibly result in higher risks of attempted suicide4-8,25,27,28 |
