Systematic Review of Psychosocial Interventions for People With Spinal Cord Injury During Inpatient Rehabilitation: Implications for Evidence‐Based Practice

摘要

ABSTRACT Background The bio‐psychosocial model of spinal cord injury (SCI) highlights that psychosocial care is of equal importance as physical rehabilitation, and should be offered in the earlier stages of inpatient rehabilitation. Aim This systematic review aimed to identify interventional research regarding psychosocial care for people with SCI during inpatient rehabilitation and synthesize the evidence of the effects and characteristics of these studies. Methods A systematic search of relevant literature published between 1985 to July 2016 was conducted with six databases (Scopus, MEDLINE, CINAHL, Science Citation Index Expanded, PsycINFO, and the China Academic Journal Full‐text Database). Reference lists of the identified articles were reviewed to find additional relevant articles. Results A total of four randomized controlled trials and seven non‐randomized controlled trials were included in this review. The interventions focused on specialized types of SCI population with relatively high levels of psychological distress, pain or pressure ulcers. Studies reported some varied or inconsistent improvements in participants’ cognitive appraisal, psychosocial adaptation or mental health but there were no significant effects on their coping ability. Due to the heterogeneity of the studies, findings were synthesized narratively without conducting meta‐analysis. Linking Evidence to Action This review found promising evidence that approaches to psychosocial care for people with SCI can improve their cognitive appraisal and psychosocial adaptation. Significant methodological limitations weakened study findings. Additionally, because studies were conducted in only a few developed countries with subgroups of patients having specific illness characteristics or severity, their generalizability to the wider SCI population is uncertain. Therefore, future research should adopt more robust study designs to test psychosocial interventions for SCI patients with different socio‐cultural backgrounds and psychological adjustment conditions in the early stages of rehabilitation.