Coping with spinal cord injury: Strategies used by adults who sustained their injuries as children or adolescents

Objective: To identify the coping strategies used by adults with pediatric-onset spinal cord injuries (SCI) and to determine how these coping strategies were related to demographics, injury-related factors, and adult outcomes. Methods: Study Participants were adults who sustained SCI at age 18 years or younger and were interviewed at age 24 years or older. This is part of a large longitudinal study for which there were 864 eligible participants. There were 353 (41%) interviewed, 259 of which were assessed for coping skills. The telephone interview included a questionnaire and several standardized measures (Functional Independence Measure, Craig Handicap Assessment and Reporting Technique, Short-Form 12 measure of health-related quality of life, Satisfaction With Life Scale, Patient Health Questionnaire-9, and the Brief COPE adapted). Results: Of 259 participants, 62% were male and 58% had tetraplegia. The average age at injury was 14 years (0-18 years) and average age at interview was 30 years (24-42 years). Of 8 coping strategies assessed, 99% of participants used acceptance, 94% used positive reframing, 93% used active coping, 89% used emotional support, 89% used humor, and 74% used religion. The negative coping skills of behavioral disengagement and substance use were used by 28% and 15%, respectively. A hierarchical regression analysis was used to predict higher adult life satisfaction by using the positive coping strategies of seeking emotional support, acceptance, and religion; it was negatively associated with substance use. Conclusions: Positive coping strategies tend to be used by a majority of adults with pediatric-onset SCI, and several coping styles are associated with greater life satisfaction.