Real-Time Assessment of Resilience in Individuals with Spinal Cord Injury and Chronic Pain: A Feasibility, Reliability, and Validity Study.

Abstract

Objective: This observational study examined the feasibility, between-person reliability, and convergent and discriminant validity of an Ecological Momentary Assessment (EMA) measure of resilience in individuals with spinal cord injury (SCI) and chronic pain.

Design: Participants completed self-report assessments of resilience twice a day for seven days using 6-item EMA measure adapted from the SCI-QOL Resilience item bank. Data were collected via smartphone.

Setting: General community.

Participants: Individuals with SCI and chronic pain (N=53, 54.7% male, 45.3% female).

Interventions: Not applicable.

Main outcome measures: Besides the 6-item EMA resilience measure, we included the full SCI-QOL Resilience Item Bank, the Connor-Davidson Resilience Scale (CD-RISC), the PROMIS Depression Short Form, the SCI-QOL Anxiety Short Form, the NIH Toolbox Perceived Stress Survey, the SCI-QOL Positive Affect and Well-Being Short Form, and the SCI-QOL Ability to Participate in Social Roles and Activities.

Results: Our results showed that the Resilience EMA measure revealed high feasibility with an overall response rate of 88% and strong between-person reliability (above .90). The measure also demonstrated good convergent validity with related constructs, such as depression, anxiety, and social participation, and good discriminant validity with unrelated factors like age and injury level.

Conclusion: Our findings suggest that the EMA resilience measure is a reliable and valid tool for capturing the dynamic nature of resilience in real time. Our study highlights the importance of the application of a real-time assessment, given that understanding daily functioning and contributes to more person-centered rehabilitation interventions for individuals with SCI and chronic pain.