Measuring Avoidance in Medical Rehabilitation

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Objective:To establish psychometric properties of the Acceptance and Action Questionnaire (AAQ), a measure of avoidance, in medical rehabilitation populations.Study Design:Cross-sectional and longitudinal.Setting:Three acute, inpatient rehabilitation units.Participants:One hundred thirty-nine adults with spinal cord dysfunction, stroke, amputation, or orthopedic surgery.Measures:AAQ, Hope Scale, Spiritual Well-Being Scale, Positive and Negative Affect Scale, Brief Symptom Inventory, Hopkins Rehabilitation Engagement Rating Scale, Functional Independence Measure, Craig Handicap Assessment and Reporting Technique, Satisfaction with Life Scale.Results:The AAQ has adequate internal consistency (α = .70), is best understood with a two-factor solution, is positively correlated with depression (r = .36, p < .01) and negative affect (r = .41, p < .001), and is negatively correlated with hope (r = –.51, p < .001), positive affect (r = –.33, p < .001), and spiritual well-being (r = –.32, p < .001). Predictive relationships with life satisfaction (β = –.40, p < .001) and level of handicap (β = –.20, p < .014) were found at 3-month follow-up.Conclusions:Findings provide preliminary support that the AAQ is reliable and valid in medical populations and that avoidance plays an important role in rehabilitation outcomes.

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