Estimating social adjustment following spinal trauma -I: Who is more realistic - Patient or spouse? A statistical justification

Abstract

Whilst assessment of functional independence has been accomplished, to a greater extent, following spinal trauma, assessing social adjustment remains an area requiring considerable further investigation. Providing premorbid estimation of adjustment is an area which presents a number of methodological difficulties both in the collection and interpretational of longitudinal data. Such analyses tend to allow overall estimates of adjustment to be made but which lack individual specificity. Analyses are presented of over 250 individuals, and their closest relative's assessment, of social adjustment to their spinal cord injury. Using a modification of an established scale for assessing social adjustment it has been possible to establish the statistical level of agreement and address the hypothesis of differential perception of the extent of adjustment problems by the injured person and their closest relative. The study allows for the conclusion that an injured person's perception of adjustment is at least as reliable as their closest relative, and that there is further evidence to support the essential accuracy of their estimations of premorbid and current levels of adjustment. Both issues are of clinical importance, particularly in relation to any medico-legal compensation aspects.