Evaluating the transactional theory of coping as a psychosocial adaptation model for Taiwanese with spinal cord injury: A multiple regression analysis.

The purpose of this study was to examine the application of Lazarus and Folkman's (1984) transactional theory of coping as a psychosocial adaptation model for Taiwanese with SCI. To evaluate Lazarus and Folkman's theory, sources of stress, primary appraisals, self-efficacy, coping strategies, and social support were used to predict disability acceptance and life satisfaction of Taiwanese with SCI, using multiple regression. A total of 154 participants were recruited for this study. For the life satisfaction model, the full model accounted for 44% of the variance in life satisfaction. However, only basic activity of daily living (ADL) and social support were found to be significant predictors of life satisfaction. The results indicated that severity of a disability can cause chronic life strain and has a significantly negative effect on life satisfaction. When the disability is severe and overwhelming, the use of positive primary and secondary appraisals does not improve the individual's perception of his or her life satisfaction. Conversely, the effect of social support cannot be mediated by severity and contributes to perceived life satisfaction. The full model for disability acceptance accounted for 47% of the variance, indicating that the association between the transaction theory variables and disability acceptance is relatively robust. Basic ADL, primary appraisal (viewing disability as a challenge), and social support were significant predictors of disability acceptance. The results of the current study indicate that functional limitations (as measured by basic ADL) appears to be a strong stressor and the relationship between functioning and life satisfaction cannot be easily mediated by using cognitive appraisals or coping strategies. This finding is different than studies conducted in the U.S. which generally support the significant effects of primary and secondary appraisals in reducing stress and improving life adjustment. Study results highlights the importance of considering cultural and environmental factors in understanding the stress-coping process of people with SCI in Taiwan.