Structure and conceptualization of acceptance: a split-sample exploratory and confirmatory factor analysis approach to investigate the multidimensionality of acceptance of spinal cord injury.
Anders Aaby, Sophie Lykkegaard Ravn, Helge Kasch, Tonny Elmose Andersen
Author Information
Anders Aaby: Department of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark. aaaby@health.sdu.dk.
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.
