Effect of the environment on participation in spinal cord injuries/disorders: The mediating impact of resilience, grief, and self-efficacy.

Locatelli, Sara M.; Etingen, Bella; Miskevics, Scott; LaVela, Sherri L.

doi:10.1037/rep0000153

Cited by 9Spinal Cord Injury ResearchResilience and Mental HealthMedical Practices and Rehabilitation

Effect of the environment on participation in spinal cord injuries/disorders: The mediating impact of resilience, grief, and self-efficacy.

Locatelli, Sara M., Etingen, Bella, Miskevics, Scott, LaVela, Sherri L.·2017·Rehabilitation Psychology

DOI 10.1037/rep0000153

Open this paper in CoChat — free account

Abstract

OBJECTIVE: The objective of the study was to test the hypothesis that the influence of environmental barriers on participation will be fully mediated by psychosocial factors (resilience, grief or loss, and self-efficacy) among individuals with spinal cord injuries and disorders. METHOD: This was a cross-sectional mailed survey with a national sample of veterans with spinal cord injuries and disorders (n = 565), which included measures of demographics, perceived environmental barriers, participation, resilience, grief or loss, and self-efficacy. Data were analyzed using a latent variable path analysis; the model fit was assessed using χ2, normed χ2, root mean square error of approximation (RMSEA; <0.07), Comparative Fit Index (CFI; ≥0.95), and Tucker-Lewis Index (TLI; ≥0.95). RESULTS: Participants were mostly male (93.9%), Caucasian or White (74.2%), and, on average, 62.4 years of age (SD = 10.48). Almost 62% had paraplegia, and 38.3% had a motor or sensory complete injury. The hypothesized model showed excellent fit, χ2(42) = 153.40, normed χ2 = 3.65, RMSEA = 0.07, CFI = 0.96, TLI = 0.95. To assess for full mediation, a direct path was added from environment to participation. This model showed nearly identical fit, χ2(41) = 153.39, normed χ2 = 3.74, RMSEA = 0.07, CFI = 0.96, TLI = 0.95; the path from environment to participation was not significant, unstandardized coefficient = -0.04, p = .92. Examination of indirect effects of the hypothesized model demonstrated that environment significantly influences participation through psychosocial factors, unstandardized coefficient = -4.85, p < .001. Together these results support full mediation. CONCLUSIONS: In conclusion the present study expands upon past research by suggesting that perceived environmental barriers play a role in internal factors, such as resilience and self-efficacy, which in turn influence participation. Interventions to improve environmental barriers may be warranted, but attention must also be paid to resilience, grief or loss, and self-efficacy to increase participation. (PsycINFO Database Record

Integrity signals

Registry

Crossref · 10.1037/rep0000153

Cites

44 of 44 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Introspection during meditation may increase the salience of grief processes active after traumatic injury or chronic illness diagnosis.
“This may be as a result of introspection during meditation: renewing a focus on thoughts and emotions may increase the salience of the grief processes (such as denial, anger, bargaining, depression and acceptance) which are active after traumatic injury or chronic illness diagnosis [19–22].”
From Grieving a disrupted biography: an interpretative phenomenological analysis exploring barriers to the use of mindfulness after neurological injury or impairment (2021) · cites this paper as [22]

Self-efficacy: Toward a unifying theory of behavioral change
Bandura, A. (1977) · Psychological Review · doi:10.1037/0033-295x.84.2.191 · Cited by 43,925 · see citing works
Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification
Hu, L.-T., & Bentler, P. M. (1998) · Psychological Methods · doi:10.1037/1082-989x.3.4.424 · Cited by 12,298 · see citing works
Structural Equation Modelling: Guidelines for Determining Model Fit
Hooper, D., Coughlan, J., & Mullen, M. R. (2008) · Dublin Institute of Technology · doi:10.21427/d7cf7r · Cited by 8,746 · see citing works
Human agency in social cognitive theory.
Bandura, A. (1989) · American Psychologist · doi:10.1037/0003-066x.44.9.1175 · Cited by 8,263 · see citing works
Acceptance and commitment therapy: model, processes and outcomes
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.06.006 · Cited by 6,587 · see citing works
Prolonged grief disorder: psychometric validation of criteria proposed for DSM-V and ICD-11
Prigerson, H. G., Horowitz, M. J., Jacobs, S. C., Parkes, C. M., Aslan, M., Goodkin, K., Raphael, B., Marwit, S. J., Wortman, C., Neimeyer, R. A., et al. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000121 · Cited by 1,863 · see citing works
Resilience in the Face of Potential Trauma
Bonanno, G. A. (2005) · Current Directions in Psychological Science · doi:10.1111/j.0963-7214.2005.00347.x · Cited by 839 · see citing works
A Review and Synthesis of Research Evidence for Self-Efficacy-Enhancing Interventions for Reducing Chronic Disability: Implications for Health Education Practice (Part I)
Marks, R., Allegrante, J. P., & Lorig, K. (2005) · Health Promotion Practice · doi:10.1177/1524839904266790 · Cited by 738 · see citing works
Resilience
Tusaie, K. R., & Dyer, J. G. (2004) · Holistic Nursing Practice · doi:10.1097/00004650-200401000-00002 · Cited by 704 · see citing works
What does participation mean? An insider perspective from people with disabilities
Hammel, J. M., Magasi, S. R., Heinemann, A. W., Whiteneck, G. G., Bogner, J. A., & Rodríguez, E. G. (2008) · Disability and Rehabilitation · doi:10.1080/09638280701625534 · Cited by 646 · see citing works
The efficacy of resiliency training programs: a systematic review and meta analysis of randomized trials
Leppin, A. L., Bora, P. R., Tilburt, J. C., Gionfriddo, M. R., Zeballos-Palacios, C., Dulohery, M. M., Sood, A., Erwin, P. J., Brito, J. P., Boehmer, K. R., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0111420 · Cited by 405 · see citing works
Trajectories of resilience, depression, and anxiety following spinal cord injury.
Bonanno, G. A., Kennedy, P., Galatzer-Levy, I. R., Lude, P., & Elfström, M. L. (2012) · Rehabilitation Psychology · doi:10.1037/a0029256 · Cited by 387 · see citing works
Psychosocial Adaptation to Chronic Illness and Disability: A Primer for Counselors
Livneh, H., & Antonak, R. F. (2005) · Journal of Counseling & Development · doi:10.1002/j.1556-6678.2005.tb00575.x · Cited by 338 · see citing works
Environmental factors and their role in participation and life satisfaction after spinal cord injury11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
Whiteneck, G. G., Meade, M. A., Dijkers, M. P. J. M., Tate, D. G., Bushnik, T. L., & Forchheimer, M. B. (2004) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2004.04.024 · Cited by 335 · see citing works
Quality of life of individuals with spinal cord injury: a review of conceptualization, measurement, and research findings.
Dijkers, M. (2005) · Journal of rehabilitation research and development · doi:10.1682/jrrd.2004.08.0100 · Cited by 323 · see citing works
Quantifying environmental factors: A measure of physical, attitudinal, service, productivity, and policy barriers11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated.
Whiteneck, G. G., Harrison-Felix, C. L., Mellick, D., Brooks, C., Charlifue, S. W., & Gerhart, K. A. (2004) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2003.09.027 · Cited by 297 · see citing works
A longitudinal analysis of emotional impact, coping strategies and post‐traumatic psychological growth following spinal cord injury: A 10‐year review
Pollard, C., & Kennedy, P. (2007) · British Journal of Health Psychology · doi:10.1348/135910707x197046 · Cited by 283 · see citing works
Enhancing the conceptual clarity of the activity and participation components of the International Classification of Functioning, Disability, and Health
Badley, E. M. (2008) · Social Science & Medicine · doi:10.1016/j.socscimed.2008.01.026 · Cited by 257 · see citing works
Examination of a theoretical model of psychological resilience in older age
Windle, G., Markland, D. A., & Woods, B. T. (2008) · Aging & Mental Health · doi:10.1080/13607860802120763 · Cited by 220 · see citing works
The buffering effect of resilience on depression among individuals with spinal cord injury: A structural equation model.
Catalano, D., Chan, F., Wilson, L., Chiu, C.-Y., & Muller, V. R. (2011) · Rehabilitation Psychology · doi:10.1037/a0024571 · Cited by 202 · see citing works
Long-term adjustment and community reintegration following spinal cord injury
Boschen, K. A., Tonack, M. I., & Gargaro, J. (2003) · International Journal of Rehabilitation Research · doi:10.1097/00004356-200309000-00001 · Cited by 173 · see citing works
University of Washington Self-Efficacy Scale: A New Self-Efficacy Scale for People With Disabilities
Amtmann, D., Bamer, A. M., Cook, K. F., Askew, R. L., Noonan, V. K., & Brockway, J. A. (2012) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2012.05.001 · Cited by 136 · see citing works
PERCEPTIONS OF PARTICIPATION AND PREDICTORS OF PERCEIVED PROBLEMS WITH PARTICIPATION IN PERSONS WITH SPINAL CORD INJURY
Larsson-Lund, M., Nordlund, A., Nygård, L., Lexell, J. E., & Bernspång, B. (2005) · Journal of Rehabilitation Medicine · doi:10.1080/16501970410031246 · Cited by 113 · see citing works
Evidence-Based Advocacy: Using Photovoice to Identify Barriers and Facilitators to Community Participation After Spinal Cord Injury
Newman, S. D. (2010) · Rehabilitation Nursing · doi:10.1002/j.2048-7940.2010.tb00031.x · Cited by 104 · see citing works
Participation after Spinal Cord Injury
Noreau, L., Fougeyrollas, P., Post, M. W. M., & Asano, M. (2005) · Neurology Report · doi:10.1097/01.npt.0000282247.15911.dc · Cited by 99 · see citing works
Measuring Enfranchisement: Importance of and Control Over Participation by People With Disabilities
Heinemann, A. W., Magasi, S. R., Bode, R. K., Hammel, J. M., Whiteneck, G. G., Bogner, J. A., & Corrigan, J. D. (2013) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2013.05.017 · Cited by 96 · see citing works
Intersection of Participation and Environmental Factors: A Complex Interactive Process
Noreau, L., & Boschen, K. A. (2010) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2009.10.037 · Cited by 90 · see citing works
Measuring Participation Enfranchisement
Heinemann, A. W., Lai, J., Magasi, S. R., Hammel, J. M., Corrigan, J. D., Bogner, J. A., & Whiteneck, G. G. (2011) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2010.07.220 · Cited by 89 · see citing works
Relationships Between Activities, Participation, Personal Factors, Mental Health, and Life Satisfaction in Persons With Spinal Cord Injury
van Leeuwen, C. M. C., Post, M. W. M., Westers, P., van der Woude, L. H. V., de Groot, S., Sluis, T. A. R., Slootman, H. J., & Lindeman, E. (2011) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2011.07.203 · Cited by 86 · see citing works
Association of Environmental Factors With Levels of Home and Community Participation in an Adult Rehabilitation Cohort
Keysor, J. J., Jette, A. M., Coster, W. J., Bettger, J. P., & Haley, S. M. (2006) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2006.08.347 · Cited by 82 · see citing works
The Relationship Between Quality of Life and Change in Mobility 1 Year Postinjury in Individuals With Spinal Cord Injury
Riggins, M. S., Kankipati, P., Oyster, M. L., Cooper, R. A., & Boninger, M. L. (2011) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2011.02.010 · Cited by 79 · see citing works
Capturing the Psychologic-Personal Perspective in Spinal Cord Injury
Geyh, S., Müller, R., Peter, C., Bickenbach, J., Post, M. W. M., Stucki, G., & Cieza, A. (2011) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0b013e318230fb68 · Cited by 61 · see citing works
The Influence of Spinal Cord Injury on Coping Styles and Self-Perceptions Two Years after the Injury
Craig, A., Hancock, K. M., & Chang, E. M. L. (1994) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048679409075644 · Cited by 60 · see citing works
Psychosocial Implications of Spinal Cord Injury
Gill, M. (1999) · Critical Care Nursing Quarterly · doi:10.1097/00002727-199908000-00002 · Cited by 58 · see citing works
Learned Helplessness and Learned Prevalence
Teodorescu, K., & Erev, I. (2014) · Psychology Science · doi:10.1177/0956797614543022 · Cited by 58 · see citing works
Measuring impact of environmental factors on human functioning and disability: a review of various scientific approaches
Reinhardt, J. D., Miller, J. S., Stucki, G., Sykes, C. R., & Gray, D. B. (2011) · Disability and Rehabilitation · doi:10.3109/09638288.2011.573053 · Cited by 52 · see citing works
Methodology for the development and calibration of the SCI-QOL item banks
Tulsky, D. S., Kisala, P. A., Victorson, D. E., Choi, S. W., Gershon, R. C., Heinemann, A. W., & Cella, D. F. (2015) · Journal of Spinal Cord Medicine · doi:10.1179/2045772315y.0000000034 · Cited by 51 · see citing works
A multi-centre study of the community needs of people with spinal cord injuries: the first 18 months
Kennedy, P., Sherlock, O., McClelland, M., Short, D., Royle, J., & Wilson, C. (2009) · Spinal Cord · doi:10.1038/sc.2009.65 · Cited by 46 · see citing works
Obesity and Inpatient Rehabilitation Outcomes for Patients With a Traumatic Spinal Cord Injury
Stenson, K. W., Deutsch, A. F., Heinemann, A. W., & Chen, D. (2011) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2010.07.235 · Cited by 44 · see citing works
Development and psychometric characteristics of the SCI-QOL Ability to Participate and Satisfaction with Social Roles and Activities item banks and short forms
Heinemann, A. W., Kisala, P. A., Hahn, E. A., & Tulsky, D. S. (2015) · Journal of Spinal Cord Medicine · doi:10.1179/2045772315y.0000000028 · Cited by 33 · see citing works
Distinguishing Grief From Depression During Acute Recovery From Spinal Cord Injury
Klyce, D. W., Bombardier, C. H., Davis, T. J., Hartoonian, N., Hoffman, J. M., Fann, J. R., & Kalpakjian, C. Z. (2015) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2015.02.018 · Cited by 28 · see citing works
The Influence of Self-Efficacy on Mood States in People with Spinal Cord Injury
Craig, A. R., Wijesuriya, N. S., & Tran, Y. (2013) · ISRN Rehabilitation · doi:10.1155/2013/232978 · Cited by 15 · see citing works
Health Care Provider Practices, Barriers, and Facilitators for Weight Management for Individuals with Spinal Cord Injuries and Disorders
Locatelli, S. M., Gerber, B. S., Goldstein, B., Weaver, F. M., & LaVela, S. L. (2014) · Topics in Spinal Cord Injury Rehabilitation · doi:10.1310/sci2004-329 · Cited by 13 · see citing works
Self-citation
Documentation of weight management practices for individuals with spinal cord injuries and disorders
Locatelli, S., & LaVela, S. L. (2016) · Spinal Cord · doi:10.1038/sc.2016.59 · Cited by 10 · see citing works
Self-citation

Flagged first, then by citations

1 of the 45 references couldn’t be matched to a known paper.

Sorted by citations

Resilience After Spinal Cord Injury
McDonald, S. D., Pugh, M., & Mickens, M. (2019) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0000000000001371 · Cited by 22 · see citing works
The relationship between resilience, emotional distress, and community participation outcomes following traumatic brain injury
Vos, L., Poritz, J. M. P., Ngan, E., León‐Novelo, L., & Sherer, M. (2019) · Brain Injury · doi:10.1080/02699052.2019.1658132 · Cited by 24 · see citing works
Perceived influence of intrinsic/extrinsic factors on participation in life activities after spinal cord injury
Cobb, J. E., Leblond, J., Dumont, F. S., & Noreau, L. (2018) · Disability and health journal · doi:10.1016/j.dhjo.2018.03.004 · Cited by 14 · see citing works
Grief and Loss Among Veterans With Spinal Cord Injury: A Qualitative Study
Burkhart, L., Kale, I. O., & LaVela, S. L. (2020) · Rehabilitation Nursing · doi:10.1097/rnj.0000000000000303 · Cited by 7 · see citing works
Self-citation
Grieving a disrupted biography: an interpretative phenomenological analysis exploring barriers to the use of mindfulness after neurological injury or impairment
Finlay, K. A., Hearn, J. H., & Chater, A. (2021) · BMC Psychology · doi:10.1186/s40359-021-00628-0 · Cited by 6 · see citing works
Facilitators to alleviate loneliness and social isolation as identified by individuals with spinal cord injuries and disorders: A qualitative study.
LaVela, S. L., Motl, R. W., Berryman, K., Wirth, M., Bartle, B., Aguina, K., Solanki, P. A., & Bombardier, C. H. (2024) · Rehabilitation Psychology · doi:10.1037/rep0000540 · Cited by 4 · see citing works
Self-citation
Effects of Resilience, Self-Perceived Hearing Difficulty, and Demographic Factors on Psychological Distress in Adults With Hearing Loss
Scoresby, K. J., Klein, K. E., Humphrey, E. L., & Cox, L. (2025) · American Journal of Audiology · doi:10.1044/2025_aja-24-00143 · Cited by 3 · see citing works
Coping with bereavement: The experience of a Filipino who lives life using a wheelchair
Yao, D. P., Bontje, P., Inoue, K., Tanaka, A., & Lacsamana-Manalaysay, J. (2021) · World Federation of Occupational Therapists Bulletin · doi:10.1080/14473828.2020.1868164
Relationship between positive psychological factors and social participation in individuals with spinal cord injury: a prospective cross-sectional study
Kim, O., Jung, S., & Park, G. (2026) · Psychology Health & Medicine · doi:10.1080/13548506.2026.2714466

Environmental barriers and social participation in individuals with spinal cord injury.
Tsai, I.-H., Graves, D. E., Chan, W., Darkoh, C., Lee, M., & Pompeii, L. A. (2017) · Rehabilitation Psychology · doi:10.1037/rep0000117 · Cited by 53 · see citing works
An in-depth understanding of the impact of the environment on participation among people with spinal cord injury
Chang, F., Liu, C.-H., & Hung, H.-P. (2017) · Disability and Rehabilitation · doi:10.1080/09638288.2017.1327991 · Cited by 40 · see citing works
Environmental factors and their role in participation and life satisfaction after spinal cord injury11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
Whiteneck, G. G., Meade, M. A., Dijkers, M. P. J. M., Tate, D. G., Bushnik, T. L., & Forchheimer, M. B. (2004) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2004.04.024 · Cited by 335 · see citing works
A tale of two countries: environmental impacts on social participation after spinal cord injury
Dijkers, M., Yavuzer, G., Ergin, S., Weitzenkamp, D. A., & Whiteneck, G. G. (2002) · Spinal Cord · doi:10.1038/sj.sc.3101310 · Cited by 88 · see citing works
Environmental barriers and participation restrictions in community-dwelling individuals with spinal cord injury in Jiangsu and Sichuan Provinces of China: Results from a cross-sectional survey
Yang, Y., Gong, Z., Reinhardt, J. D., Xu, G., Xu, Z., & Li, J. (2021) · Journal of Spinal Cord Medicine · doi:10.1080/10790268.2021.1935094 · Cited by 9 · see citing works

Authors: Locatelli, S. M., Etingen, B., Miskevics, S., & LaVela, S. L.
Affiliations: United States Department of Veterans Affairs (US)
ORCID: Locatelli, Sara M.
Etingen, Bella
LaVela, Sherri L.
Venue: Rehabilitation Psychology
Publisher: American Psychological Association (APA)
Published: 2017-08
Volume: 62
Issue: 3
Pages: 334-344
ISSN: 0090-5550 (ISSN-L)
1939-1544
DOI: 10.1037/rep0000153
OpenAlex: W2622390854
Cited by: 9
References: 45
Citations by year: 2026: 1 · 2025: 1 · 2024: 1 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 1
FWCI: 0.86
Type: journal article
Language: en
Open access: closed
Locations: Rehabilitation Psychology (publishedVersion)
PubMed (publishedVersion)
Funders: Department of Veterans Affairs Office of Research Development (RRP 13-248)
Topics: Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Keywords: spinal cord injury, spinal cord disorders, participation, environmental barriers, resilience, grief and loss, self-efficacy, veterans, mediation, psychosocial factors, paraplegia, adaptation to disability, quality of life, social participation (health and rehabilitation), physical activity, interpersonal relationships, anxiety, post-traumatic stress
MeSH terms: Cross-Sectional Studies, Environment, Female, Grief, Humans, Male, Middle Aged, Surveys and Questionnaires, Spinal Cord Injuries, United States, Veterans, Self Efficacy, Resilience, Psychological

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Effect of the environment on participation in spinal cord injuries/disorders: The mediating impact of resilience, grief, and self-efficacy.

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks