ADAPTATION AND ITS IMPACT ON VALUATION, AN INVESTIGATION OF ADAPTATION AND CHANGE IN VALUATION IN PATIENTS WITH SPINAL CORD INJURY

Objective: When confronted with changes in health, individuals must adapt. Little research has investigated change in health state valuations due to adaptation. Regarding Spinal Cord Injury (SCI), studies have shown that patients adapt to their new health state over time, but none of these studies has investigated change in valuations. We investigate if experience with SCI leads to a change in valuation of this health state.
Method: Patients were interviewed twice, one month after admission to the rehabilitation centre and about 3 months after this first measurement. Patients were asked to value their “own health” of previous week on a time trade off (TTO), fill in the Barthel Index and rate their overall adjustment on a 10-point “ladder”. Results: Until now, 31 patients took part in the first interview. To date, 26 of these patients were interviewed twice, of whom 22 paraplegia patients and four tetraplegia patients. Patients valued their own health lower during the first interview than during the second interview: TTO M = 0.40 vs. M = 0.60, p < 0.01. To control for the improvement caused by rehabilitation, we added change in Barthel Index score as covariate. After controlling for improvement of physical rehabilitation the previous effect remained (p < 0.05). Patients also rated their adjustment during the first interview lower compared to their rating on the second interview:  M = 5.7 vs. M = 6.5, p = 0.01. A moderate partial correlation between Δ TTO and Δ adjustment, controlled for Δ Barthel Index, was found (r = 0.29, p = 0.08, with Δ as sign for change between interview 2 and interview 1). Conclusion: These preliminary results show that experience with SCI leads to a higher valuation of this health state, of which about 10% seems due to a change in adaptation.