Patient Reported Resilience During Neurorehabilitation

Research Objectives: Many people with disabilities report a high quality of life in contrast to the expectation of the general public. This has been described as “The Disability Paradox.” Positive psychology has proposed that certain resilient characteristics and beliefs contribute to life satisfaction even in the presence of adversity. Further investigation of patient-reported life satisfaction in this population is needed to identify correlates of quality of life after the onset of neurological disability.

Design: This retrospective study assessed patient responses among the brain injury unit population within an inpatient rehabilitation hospital between 2019-2024. Responses were used to assess correlations of resilient characteristics and beliefs.

Setting: Inpatient rehabilitation hospital

Participants: A total of 102 inpatients participated including 59 (57.8%) males and 43 (42.2%) females. Of the 102 participants, 38 (37.3%) completed at least four years of higher education, while 64 participants (62.7%) completed three years of college or less.

Interventions: Not Applicable

Main Outcome Measures: Assessed correlations of resilient characteristics and beliefs (as measured by The Grit Scale and PROMIS Meaning/Purpose), with patient-reported outcome (as measured by PROMIS Life Satisfaction or PROMIS Fatigue). Responses were evaluated to observe any association between Life Satisfaction, and clinician ratings of disability severity at admission and discharge as measured by the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI).

Results: Analysis of patient-reported data showed Life Satisfaction was strongly correlated to Meaning/Purpose. Additionally, Life Satisfaction and Grit were moderately correlated. Life Satisfaction and Meaning/Purpose were both higher for individuals in patients with a bachelor’s degree or a graduate-level degree.

Patient-reported Life Satisfaction was not associated with clinician-rated disability severity at admission or discharge. Additionally, patient-reported Fatigue was correlated with clinician-rated disability severity at admission, but not at discharge.

Clinician-rated disability severity was lower in participants who had a bachelor’s degree or more than the other participants. Participant’s age was correlated with greater clinician-rated disability severity at discharge.

It was observed that neither Life Satisfaction or disability severity were associated with gender or marital status.

Conclusions: Consistent with previous reports, disability severity was not associated with lower Life Satisfaction. In contrast, resilient characteristics and beliefs were strongly associated with Life Satisfaction. These findings will inform patient and family education after onset of neurological disability. They may also be useful in the design of interventions to improve resilience (e.g., “Learned Optimism.”)

Author(s) Disclosures: The authors have no conflicts of interest to declare nor any financial or non-financial interests to disclose.