Structure and conceptualization of acceptance: a split-sample exploratory and confirmatory factor analysis approach to investigate the multidimensionality of acceptance of spinal cord injury

J Rehabil Med. 2021 Oct 7;53(10 (October)):jrm00232. doi: 10.2340/16501977-2876.

Abstract

Objective: To determine the multidimensionality of acceptance of spinal cord injury (SCI).

Participants: Adults with SCI who were admitted to an SCI centre between 1991 and 2020.

Methods: All eligible participants (n=686) were invit-ed to complete a survey via REDCap. A 4-dimensional model was hypothesized, which included "Accepting Reality", "Value Change", "Letting Go of Control" and "Behavioural Engagement". Items from 3 accept-ance scales were selected to collectively reflect these 4 dimensions: (i) Spinal Cord Lesion-related Coping Strategies Questionnaire, (ii) Coping Orientations to Problems Experienced, and (iii) a modified Acceptance and Action Questionnaire. A split-sample principal component analysis (PCA) and confirmatory factor analysis (CFA) approach was used.

Results: Complete data were provided by 431 participants (62.8%). A PCA on sub-sample one suggest-ed a 4-factor model based on eigenvalues ≥ 1, corresponding to the hypothesized model of acceptance. A CFA on sub-sample 2 showed good model fit, adding further support to the model.

Conclusion: These findings suggest that acceptance is a multidimensional construct with 4 facets that represent distinct, but interconnected, psychological processes. This model of acceptance can be used as a framework for future research and clinical practice to deepen our understanding of acceptance processes following severe injuries, such as SCI.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Aged, 80 and over
  • Concept Formation*
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Middle Aged
  • Spinal Cord Injuries / psychology*
  • Spinal Cord Injuries / rehabilitation
  • Surveys and Questionnaires