Determinants of Resilience in People Who Sustained Spinal Cord Injury From Earthquake in Nepal

Abstract

This cross-sectional study was conducted to identify the level of resilience and determinants of resilience among individuals with 2015 earthquake-related spinal cord injury (SCI) in Nepal. The study included 82 Nepalese with earthquake-related SCI who met the inclusion criteria from the Spinal Injury Rehabilitation Center (SIRC) and 14 communities between December 2016 and February 2017. The Demographic and Injury-related Questionnaire (DIQ), Connor-Davidson Resilience Scale (CD-RISC), Multidimensional Scale of Perceived Social Support (MSPSS), Moorong Self-efficacy Scale (MSES), Intrinsic Spirituality Scale (ISS), and Patient Health Questionnaire-9 (PHQ-9) were used to measure the demographic and injury- related characteristics, resilience, social support, self-efficacy, spirituality, and depressive mood, respectively. The Cronbach's alpha coefficients for the CD-RISC, MSPSS, MSES, ISS, and PHQ-9 were .82, .89, .79, .76, and .88, respectively. The data analysis was done using descriptive statistics, Pearson's correlation, and hierarchical multiple regression. The study findings revealed that 61% (n = 50) of the participants had low level of resilience. The Pearson's correlation demonstrated a significant positive correlation between resilience and social support (r = .42, p < .001) and self-efficacy (r = .53, p< .001). There was a significant negative correlation between resilience and depressive mood (r=-.50, p < .001). In the regression analysis, gender, self-efficacy, and depressive mood emerged as significant predictors which explained 46% of the variance (adjusted R2 = .46, F (6, 75) = 12.57, p < .001) in resilience of the participants. Spirituality did not show a significant contribution to the resilience of those individuals (r = -.12, p > .05). A further longitudinal study related to this issue is needed to identify changes in resilience and determinants over a period of time. In addition, development and implementation of nursing interventions to strengthen resilience among this group is recommended.