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Bourke J, Johns J, Martin RA. Unpacking how trust, communication and flow interact to sustain quality relationships between disabled people, family and support workers: a realist qualitative study. Disabil Rehabil 2024:1-11. [PMID: 39129515 DOI: 10.1080/09638288.2024.2390049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 08/01/2024] [Accepted: 08/03/2024] [Indexed: 08/13/2024]
Abstract
PURPOSE Many disabled people require support workers to complete personal care, daily tasks and participate in life roles. Due to the intimate nature of community disability support in domestic environments, understanding what facilitates positive relationships is paramount. We examined the intricate interplay of context and mechanisms that drive positive relationship outcomes for disabled people, their family members and support workers. METHODS A realist-informed, participatory methodology involving three participant groups: disabled people, family members, and disability support workers. RESULTS Sixteen participants participated in two workshops per group (5 disabled people, 5 family members, and 6 disability support workers). All three participant groups prioritised three key generative mechanism processes involved in positive relationship outcomes: (1) having clear communication, (2) building trust, and (3) developing a sense of flow. We describe how each mechanism manifested in a unique way for each group, and also how the activation of each mechanism was influenced by a dynamic resources/tensions balance specific to each group. CONCLUSION We describe the interaction between three mechanism processes involved in triadic relationships between disabled people, family members, and support workers. Attention is now required to explore strategies to negotiate the resource/tension balance particular to each group.
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Affiliation(s)
- John Bourke
- Burwood Academy Trust, Christchurch, New Zealand
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, Australia
- Faculty of Medicine and Health, The Kolling Institute, The University of Sydney, Australia
| | | | - Rachelle A Martin
- Burwood Academy Trust, Christchurch, New Zealand
- Rehabilitation Teaching & Research Unit, Department of Medicine, University of Otago, New Zealand
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Mair L, Moses J. Adaptations to adult attachment and intimacy following spinal cord injury: a systematic review. Disabil Rehabil 2024; 46:1962-1978. [PMID: 37326037 DOI: 10.1080/09638288.2023.2218650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/04/2023] [Accepted: 05/21/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE Experiencing spinal cord injury (SCI) can be life-changing for individuals and their families. Previous reviews have focused on coping and psychological adjustment, sexual function and sexuality, or factors facilitating or impeding interpersonal relationships after SCI. However, there is a very little synthesis of research focusing on changes to adult attachment and emotional intimacy post-SCI. This review aims to examine the mechanisms of change in adult attachment and intimacy in romantic relationships following SCI. MATERIALS AND METHODS Four online databases (Psycinfo, Medline, CINAHL, and Scopus) were searched for qualitative papers concerning romantic relationships, attachments, and intimacy post-SCI. Sixteen of the 692 papers met the inclusion criteria. These were quality assessed and analysed using meta-ethnography. RESULTS Three main themes emerged from the analysis: (a) strengthening and maintaining adult attachment; (b) changes in roles; and (c) changing views of intimacy. CONCLUSION Many couples face significant changes to adult attachment and intimacy following SCI. Systematic ethnographic analysis of their negotiations enabled the identification of underlying relational processes and adaptation strategies associated with changes to inter-dependence, communication, role revision, and re-definition of intimacy. The findings indicate that healthcare providers should assess and respond to challenges faced by couples post-SCI using evidence consistent with adult attachment theory.
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Affiliation(s)
- Luned Mair
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Cardiff, UK
| | - Jenny Moses
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Cardiff, UK
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Pallerla S, Krishnareddy SR, Parthasarathy NB, Navaneetham J, Gupta A. A qualitative study on psycho-social needs of the family caregivers of persons with spinal cord injury. J Family Med Prim Care 2024; 13:1262-1270. [PMID: 38827726 PMCID: PMC11142019 DOI: 10.4103/jfmpc.jfmpc_1349_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 06/04/2024] Open
Abstract
Background Spinal cord injury is a high-cost long-lasting disability and a life-changing experience for family caregivers (FCGs). The current study aimed to explore the psycho-social needs of the FCGs of persons with spinal cord injury (PwSCI). Materials and Methods An exploratory qualitative approach was used, and sixteen FCGs of PwSCI participated in the face-to-face interviews. All the interviews were audio-recorded, and session notes were added to the existing data and later transcribed. Thematic analysis was used to identify the main themes. Results Three main themes have emerged, namely, awareness needs, resource needs, and personal care needs, from the data as a result of the qualitative analysis: The main themes have been categorised into nine sub-themes, such as want to know, alternative ways of contacting, the helpful or conducive environment of arrangements, sources to get money, pension certificate needs, resources for livelihood, resources for continuing the treatment, need my own time, and controlling of feelings. Conclusion The findings of this research aid in designing or developing need-based tailor-made psychosocial interventions for the FCGs of PwSCI in India. Multidisciplinary team professionals involved in managing spinal cord injury and other stakeholders should understand the importance of meeting the mentioned psycho-social needs of FCGs of PwSCI and delivering such tailor-made psycho-social interventions in a timely.
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Affiliation(s)
- Srikanth Pallerla
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Shanivaram Reddy Krishnareddy
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Nirmala Berigai Parthasarathy
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Janardhana Navaneetham
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Anupam Gupta
- Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Lindroos A, Douglas-Smith N. Exploring informal caregivers' well-being during COVID-19 through online discussion forums. Scand J Caring Sci 2024; 38:104-113. [PMID: 37522268 DOI: 10.1111/scs.13199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 06/29/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND COVID-19 has increased pressures on caregivers, disruptions to health services and increased health concerns during COVID-19. Reports have been made on informal carers' increased workload and limited support services during the pandemic. AIMS This study aimed to explore how informal caregivers experienced their well-being during COVID-19 through online discussion forums. MATERIALS AND METHODS A reflexive thematic analysis characterised by theoretical flexibility, organic inductive coding processes and theme development was conducted on online discussion forums. The method highlighted theme reviewing which was done twice to encourage data reflection. The project was conducted on a novel topic which was a new area of research interest. Semantic coding where participants' words were used directly in the interpretation and construction of themes was used. RESULTS In the theme 'Locked in or locked away' caregivers worried about continuing care at home, due to limited freedom and worries of hiring help during a pandemic. Some expressed worries about visitation rights and grief of not being present with a loved one if they would reside in a care home. The theme 'Nothing left to give' suggested that COVID-19 exasperated caregivers' loneliness, social isolation and increased responsibilities and challenges with other roles. Bitterness, resentment and anger were felt towards lack of social support and workload. Theme 'Celebrating a virtual way of life' described how caregivers used online forums when other support services were disrupted. DISCUSSION We discuss the role of informal caregiver that was described as all-encompassing during COVID-19. We highlight the importance of advanced planning for care home transitions and the use of online forums as a form of support. We suggest further exploration into informal caregivers' role balancing. CONCLUSION COVID-19 seemed to affect informal caregivers negatively, but they reframed their situations and sought online support. With COVID-19-related restrictions and increased workload, COVID-19 added an all-or-nothing aspect to care home transition decisions.
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Affiliation(s)
- Anni Lindroos
- Psychology Division, School of Education and Social Sciences, University of the West of Scotland, Paisley, UK
| | - Nicola Douglas-Smith
- Psychology Division, School of Education and Social Sciences, University of the West of Scotland, Paisley, UK
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Montejano-Lozoya R, Alcañiz-Garrán MDM, Ramos-Pichardo JD, Sánchez-Alcón M, García-Sanjuan S, Sanjuán-Quiles Á. Affective Impact on Informal Caregivers over 70 Years of Age: A Qualitative Study. Healthcare (Basel) 2024; 12:329. [PMID: 38338215 PMCID: PMC10855777 DOI: 10.3390/healthcare12030329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/17/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Given today's rapidly ageing society, family members providing informal care to dependent older adults face ever-increasing challenges. The aim of this study was to describe the affective impact on older adults over 70 years of age caring for a dependent older person at home. A qualitative study was designed from a phenomenological perspective. Thirteen in-depth interviews were conducted with caregivers aged 70 or older. A content analysis of the interviews was carried out in five stages. Three themes were identified: "Emotions", "Feelings", and "Looking to the future". Caregivers express negative emotions (sadness, anger, and fear) and feelings of social and emotional isolation, and they feel abandoned by health professionals, family, and friends. In conclusion, prolonged caregiving by older adults has a negative affective impact and creates uncertainty about the future. There is a need to devise social and healthcare policies and actions, creating social support networks to improve their health and emotional wellbeing.
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Affiliation(s)
| | | | | | | | - Sofía García-Sanjuan
- Department of Nursing, University of Alicante, 03690 San Vicente del Raspeig, Spain; (S.G.-S.); (Á.S.-Q.)
| | - Ángela Sanjuán-Quiles
- Department of Nursing, University of Alicante, 03690 San Vicente del Raspeig, Spain; (S.G.-S.); (Á.S.-Q.)
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Moran K, Barclay L, Lannin NA. Experiences of people with non-traumatic spinal cord injuries returning home after inpatient rehabilitation. Disabil Rehabil 2024; 46:362-368. [PMID: 36591728 DOI: 10.1080/09638288.2022.2162611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/21/2022] [Indexed: 01/03/2023]
Abstract
PURPOSE The aim of this study was to explore the experience of people with non-traumatic spinal cord injuries who have recently returned home from inpatient rehabilitation. METHODS Semi-structured interviews were conducted with seven adults with non-traumatic spinal cord injuries who had been discharged from inpatient rehabilitation from an Australian rehabilitation hospital, within the last two years. RESULTS Three themes were identified: the practicalities of coming home; adjusting to "my altered home life"; pursuing recovery. When people felt prepared by their rehabilitation service, and had appropriate support from others, they had a more positive adjustment experience, although not one without challenges. Due to less independence and inability to participate in meaningful life roles, participants experienced a sense of lost or changed identity. Maintaining hope for physical recovery was very important and motivated participants to actively engage in rehabilitation efforts. CONCLUSIONS This study adds to the knowledge regarding the lived experience of people with non-traumatic spinal cord injury transitioning from rehabilitation to home. Facilitators for successful rehabilitation discharge included ensuring community services contacted patients immediately after they left hospital, and providing support for carers. Health care workers can positively influence the adjustment process of people with NTSCI by facilitating re-engagement in meaningful roles.IMPLICATIONS FOR REHABILITATIONThe transition home from inpatient rehabilitation after non-traumatic spinal cord injury (NTSCI) is facilitated by early discharge planning and follow-up from services after discharge.Establishing routines helped participants adjust to their new circumstances.The emotional and practical support of carers is vital for successful adjustment to living in the community with an NTSCI.Health care workers can positively influence the adjustment process of people with NTSCI by facilitating their re-engagement in meaningful roles.
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Affiliation(s)
- Kathryn Moran
- Department of Occupational Therapy, Monash University, Frankston, Vic, Australia
| | - Linda Barclay
- Department of Neuroscience, Monash University, Melbourne, Vic, Australia
| | - Natasha A Lannin
- Department of Neuroscience, Monash University, Melbourne, Vic, Australia
- Occupational Therapy Department, Alfred Health, Melbourne, Vic, Australia
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Barrett OEC, Ho AK, Finlay KA. Sexual function and sexual satisfaction following spinal cord injury: an interpretative phenomenological analysis of partner experiences. Disabil Rehabil 2024; 46:86-95. [PMID: 36576221 DOI: 10.1080/09638288.2022.2159073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 11/25/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE This study explored how partners/spouses of people with Spinal Cord Injury (SCI) experienced intimacy, sexual function, and sexual satisfaction post-SCI. MATERIALS AND METHODS Qualitative, semi-structured interviews were conducted with the partners/spouses of people with SCI living in the community in the United Kingdom. Twelve participants (7 females; 5 males) were recruited using purposive sampling. A nine-item semi-structured interview design was used. Interviews were transcribed verbatim and analysed via Interpretative Phenomenological Analysis (IPA). RESULTS Three superordinate themes were demonstrated: (1) Stolen sex through unpreparedness; (2) Redefining sex; and (3) Compromised commitment. Partners struggled to come to terms with the shock of radically altered post-SCI sexual relationships, questioning how their changed sexual relationship and sexual identity conflicted with caring requirements. To minimise post-SCI relationship changes, some partners engaged in strategies to protect against, distract from and avoid sexual intimacy, whereas others were able to retain adapted pre-injury patterns of intimate behaviour. CONCLUSION Compromised sexual function and satisfaction significantly disrupt relationship dynamics post-SCI, initiate voluntary celibacy, and limit the perceived viability of continued sexual intimacy. Specialist partner-support provisions are urgently needed, recognising that partner support needs are not restricted to the inpatient rehabilitation phase but importantly extend long past discharge into the community.
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Affiliation(s)
- Olivia E C Barrett
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Aileen K Ho
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Katherine A Finlay
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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Pallerla S, Krishnareddy SR, Parthasarathy NB, Navaneetham J, Gupta A. Rehabilitation Professionals' Perspectives on Psychosocial Needs of Family Caregivers of Persons with Spinal Cord Injury: A Qualitative Study from India. Korean J Fam Med 2023; 44:168-176. [PMID: 37225442 DOI: 10.4082/kjfm.22.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/28/2022] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND This study explored the psychosocial needs of family caregivers of persons with spinal cord injuries from the perspective of rehabilitation professionals. METHODS An exploratory qualitative approach was used, and a total of 14 rehabilitation professionals from various backgrounds participated in face-to-face interviews. All interviews were audio recorded, and session notes were added to the existing data and later transcribed. Thematic analysis was used to identify key themes. RESULTS Nine need themes emerged: informational, psychological, personal care, financial, social support, welfare, vocational, telemedicine, and referral. CONCLUSION The findings of this study will aid the design or development of need-based customized psychosocial interventions for family caregivers of persons with spinal cord injuries in India. Multiple stakeholders involved in spinal cord injury management should understand the importance of meeting the needs of family caregivers of persons with spinal cord injuries and the timely delivery of customized psychosocial interventions.
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Affiliation(s)
- Srikanth Pallerla
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | | | | | - Janardhana Navaneetham
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Anupam Gupta
- Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bengaluru, India
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Osborne JB, Rocchi MA, McBride CB, McKay R, Gainforth HL, Upper R, Sweet SN. Couples' experiences with sexuality after spinal cord injury. Disabil Rehabil 2023; 45:664-672. [PMID: 35191794 DOI: 10.1080/09638288.2022.2040611] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE To explore sexuality after spinal cord injury (SCI) from the perspectives of individuals with SCI and their romantic partners. METHODS A sample of 8 Canadian adults with SCI (6 men, 2 women) and their partners participated in this study (N = 16). Semi-structured dyadic and individual interviews were conducted, discussions surrounding sexuality and intimacy were extracted, and a qualitative description of the interview data was performed using thematic analysis. RESULTS Three major themes were identified: the changing definition of sex; emotions; and practical support. Couples' conversations around the changing definition of sex after SCI addressed the taboo topic of sexuality and the importance of communication between couples, peers, and healthcare providers. Emotions included fears of losing intimacy, embarrassment in managing bladder and bowel interference, and acceptance in balancing being a romantic partner and a caregiver. Finally, couples reported challenges accessing practical support including medical interventions and sexual health nurses, but saw value in peer mentorship programs. CONCLUSION Couples explored a changing definition of sex following SCI that was complicated by the taboo nature of discussing sexuality, experienced a range of emotions throughout the recovery process, and had difficulties navigating the healthcare system for appropriate support.IMPLICATIONS FOR REHABILITATIONHealthcare professionals should promote discussion and provide support for sexuality following SCI, but during initial rehabilitation may be too early.Healthcare providers should prepare people with SCI and their partners for the inevitable trial-and-error process involved in sexual rehabilitation.Rehabilitation professionals could direct couples to SCI peer mentorship programs to help normalize the experiences and emotions of sexual rehabilitation.
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Affiliation(s)
- Jake B Osborne
- Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Meredith A Rocchi
- Department of Communication, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Rhyann McKay
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Heather L Gainforth
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Randy Upper
- Lawson Health Research Institute, London, Ontario, Canada
| | - Shane N Sweet
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
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Mohammed RS, Boateng EA, Amponsah AK, Kyei-Dompim J, Laari TT. Experiences of family caregivers of people with spinal cord injury at the neurosurgical units of the Komfo Anokye Teaching Hospital, Ghana. PLoS One 2023; 18:e0284436. [PMID: 37083720 PMCID: PMC10121035 DOI: 10.1371/journal.pone.0284436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 03/30/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Spinal cord injury (SCI) often leaves affected persons with a lifelong demand for care. As a result, the effect of the condition goes beyond the injured person to affect family members and significant others who have to adjust their lives to provide care and support. However, little is known about the experiences of these family caregivers regarding the care of people with SCI in Ghana. Exploring their experiences would enhance the understanding of family caregiving of people with SCI and contribute to policy intervention. METHODS This qualitative descriptive phenomenology study used the purposive sampling method to select 10 family caregivers. Data were collected using a semi-structured interview guide through individual in-depth interviews. Written informed consent was obtained and interviews were audio-recorded and transcribed verbatim. Data were manually analysed following Colaizzi's method of data analysis. RESULTS In all, 4 main themes emerged from the analysis of data (1) becoming a caregiver, (2) roles of the caregiver, (3) the burden of caregiving, and (4) coping strategies. The family caregivers provided vital assistance to their relatives with SCI and experienced physical and financial burdens as a result of the care. Due to the strains involved in the caregiving process, family caregivers adopted various strategies to cope with the situation. CONCLUSION This study has provided evidence of the lived experiences of family caregivers of people with SCI in the Ghanaian context and further supports the findings of previous studies. Measures including training, counselling, and instituting social support services for family caregivers should be considered by the management of healthcare institutions to enhance the experiences of family caregivers.
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Affiliation(s)
- Rumana Saeed Mohammed
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Edward Appiah Boateng
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Abigail Kusi Amponsah
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joana Kyei-Dompim
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Timothy Tienbia Laari
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Presbyterian Primary Health Care (PPHC), Bolgatanga, Ghana
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Frank C, Coulthard J, Lee JEC, Skomorovsky A. A moderated-mediation analysis of pathways in the association between Veterans’ health and their spouse’s relationship satisfaction: The importance of social support. Front Psychol 2022; 13:988814. [PMID: 36405134 PMCID: PMC9666880 DOI: 10.3389/fpsyg.2022.988814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction Military personnel and Veterans are at increased risk of mental and physical health conditions, which can impact their families. Spouses often perform a vital role in caring for service members and Veterans facing illness or injury, which can lead to caregiver burden. In turn, this may contribute to relationship issues. Research suggests that ensuring that spouses are well supported can alleviate some of these negative effects. The current study examined whether social support received by spouses of newly released Veterans buffers the impact of Veterans’ health on caregiver burden, subsequently impacting spouses’ relationship satisfaction. Methods Data were collected as part of the Canadian Armed Forces Transition and Well-being Survey. The sample included N = 595 spouses of Regular Force Veterans who released in 2016 with at least 2 years of service. We examined Veterans’ mental and physical health and spouses’ caregiver burden, social support, and relationship satisfaction. A moderated mediation model was tested using structural equation modeling. Results There was a significant indirect association between Veterans’ health (both physical and mental) and spouses’ relationship satisfaction through caregiver burden. Furthermore, social support moderated the association, as evidenced by a weaker association between Veterans’ health and caregiver burden at low levels (−1SD) of social support compared to high levels (+1SD). Implications Findings suggest additional efforts should be made to ensure sufficient support is provided to spouses, especially when they are caring for a service member or Veteran facing illness or injury, to strengthen their families’ well-being.
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Self-Efficacy and Psychological Well-Being of Family Caregivers of Persons with Spinal Cord Injury. PSYCHOLOGICAL STUDIES 2022. [DOI: 10.1007/s12646-022-00659-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Zanin E, Salizzato S, Aiello EN, Leochico CFD, Rey-Matias RR, Pauletto P, Masiero S, Bazo HAC. The contribution of bio-psycho-social dimensions on sexual satisfaction in people with spinal cord injury and their partners: an explorative study. Spinal Cord Ser Cases 2022; 8:42. [PMID: 35443737 PMCID: PMC9021222 DOI: 10.1038/s41394-022-00507-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 11/09/2022] Open
Abstract
STUDY DESIGN Cross-sectional explorative observational study. TITLE Sexual satisfaction in people with spinal cord injury and their partners: an explorative study. OBJECTIVE To investigate the determinants of sexual satisfaction among individuals with spinal cord injury and relative partners by assuming a bio-psycho-social perspective. SETTING Online survey. METHODS Thirty-eight individuals (22 individuals with SCI and their partners) were provided with an anonymous self-report questionnaire. Bio-psycho-social dimensions were investigated by using the Barthel Modified Index, Beck Depression Inventory-II, Short Form Health Survey (SF-36). Sexual attitudes of participants were assessed via the Multidimensional Sexual Self-Concept Questionnaire (Snell, 1993). RESULTS While no differences were observed between individuals with SCI and their partners, women with SCI were overall more satisfied about their sexual life when compared to men with SCI. Coping strategies promoting self-efficacy and an active role in the sexual issues were predictive of Sexual Satisfaction in the couples of persons with SCI and their partners. No significant contribution was played by physical variables. CONCLUSION A tailored-made approach assessing the needs of both individuals with SCI and partners is a key aspect for effective sexual rehabilitation protocols. According to the needs and features of each couple, health professionals should drive individuals with SCI and partners to cope with their sexuality within a bio-psycho-social framework underlying it.
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Affiliation(s)
- Elia Zanin
- Ospedale Riabilitativo di Alta Specializzazione (ORAS)-ULSS 2 TV, Motta di Livenza, TV, Italy.
| | - Sara Salizzato
- Ospedale Riabilitativo di Alta Specializzazione (ORAS)-ULSS 2 TV, Motta di Livenza, TV, Italy
| | - Edoardo Nicolò Aiello
- PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Carl Froilan D Leochico
- Department of Rehabilitation Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.,Department of Physical Medicine and Rehabilitation, St. Luke's Medical Center, Global City and Quezon City, Philippines
| | - Reynaldo R Rey-Matias
- Department of Rehabilitation Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.,Department of Physical Medicine and Rehabilitation, St. Luke's Medical Center, Global City and Quezon City, Philippines
| | - Paolo Pauletto
- Ospedale Riabilitativo di Alta Specializzazione (ORAS)-ULSS 2 TV, Motta di Livenza, TV, Italy
| | - Stefano Masiero
- Department of Neuroscience-Physical Medicine and Rehabilitation, University of Padova, Medical School, Padova, Italy
| | - Humberto A Cerrel Bazo
- Ospedale Riabilitativo di Alta Specializzazione (ORAS)-ULSS 2 TV, Motta di Livenza, TV, Italy.,Department of Neuroscience-Physical Medicine and Rehabilitation, University of Padova, Medical School, Padova, Italy
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Taylan S, Özkan İ, Küçükakça Çelik G. Experiences of patients and their partners with sexual problems after spinal cord injury: A phenomenological qualitative study. J Spinal Cord Med 2022; 45:245-253. [PMID: 32936686 PMCID: PMC8986248 DOI: 10.1080/10790268.2020.1798136] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Objective: This study aimed to examine the experiences of patients and their partners about their sexual lives after Spinal Cord Injury (SCI).Design: This qualitative study was based on Heidegger's hermeneutic phenomenological approach.Setting: The Physical Medicine and Rehabilitation Outpatient Clinic of a city hospital in the Central Anatolia Region in Turkey.Participants: The study consisted of seven female and six male patients with spinal cord injury and their partners.Outcome measures: The textual analysis was carried out in three stages: (1) a naive reading, (2) a structural analysis, and (3) a comprehensive understanding of the text including a discussion. The sample size was calculated by using the criterion sampling technique.Results: As a result of the in-depth interviews with individuals with SCI about their sexual experiences, five themes were derived: (1) first confrontation with SCI, (2) experienced sexual problems, (3) coping, (4) partners' views on sexual problems, and (5) other people.Conclusion: It was found that the sex life of individuals with SCI was negatively affected, they were left helpless in dealing with their problems, and that some patients had difficulties in coping with this condition.
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Affiliation(s)
- Seçil Taylan
- Kumluca Faculty of Health Sciences, Surgical Nursing Department, Akdeniz University, Kumluca-Antalya, Turkey,Correspondence to: Seçil Taylan, Msc, PhD, Assistant Professor, Kumluca Faculty of Health Sciences, Surgical Nursing Department, Akdeniz University, Temel Eğitim Mah. Kumluca Sağlık Bilimleri Fakültesi, 07350Kumluca-Antalya, Turkey; Telephone:+905303462062; +902428870911. E-mail:
| | - İlknur Özkan
- Kumluca Faculty of Health Sciences, Surgical Nursing Department, Akdeniz University, Kumluca-Antalya, Turkey
| | - Gülden Küçükakça Çelik
- Semra ve Vefa Faculty of Health Sciences, Nursing Department, Hacı Bektaşi Veli University, Nevşehir, Turkey
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15
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Ryerson Espino SL, O’Rourke K, Kelly EH, January AM, Vogel LC. Coping, Social Support, and Caregiver Well-Being With Families Living With SCI: A Mixed Methods Study. Top Spinal Cord Inj Rehabil 2022; 28:78-98. [PMID: 35145337 PMCID: PMC8791416 DOI: 10.46292/sci21-00013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To explore coping, problem solving, social support, and well-being among family caregivers of adults with spinal cord injury (SCI). METHODS This was a mixed methods study (qualitative interviews and standardized surveys) with a diverse sample of 39 adults with SCI and their caregivers from four rehabilitation hospitals in the United States, including one Veterans Affairs (VA) hospital. Cluster analysis was used to explore whether distinct profiles of caregivers could be identified, and it was used in conjunction with qualitative data to explore patterns in well-being. Measures of well-being included leisure time satisfaction, social integration, anxiety, depression, physical health complaints, caregiver burden, and quality of life. RESULTS The importance of individual and extra-individual resources, namely coping and social support, emerged from early qualitative analyses and guided subsequent mixed methods examination of the data. A cluster analysis yielded three caregiver profiles: (1) effective problem solvers with moderate satisfaction with social support, (2) mixed problem solvers with stronger negative orientations and mixed satisfaction with social support, and (3) low endorsers overall. Profiles helped us explore patterns across our data set and efficiently identify differences in caregiver social support, coping, well-being, and unmet needs. CONCLUSION Data echo the need for multimodal interventions aimed at skill development, respite options, and screening, support, information, and referral around mental health and burden. SCI care and rehabilitation programs should consider incorporating strategies for bolstering effective caregiver problem-solving skills, reducing negativity and ambivalence, and enhancing social support.
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Affiliation(s)
| | - Kerry O’Rourke
- Marquette University, Milwaukee, Wisconsin
,Shriners Children’s Chicago, Chicago, Illinois
| | | | - Alicia M. January
- Marquette University, Milwaukee, Wisconsin
,Purdue University Northwest, Hammond, Indiana
| | - Lawrence C. Vogel
- Marquette University, Milwaukee, Wisconsin
,Shriners Children’s Chicago, Chicago, Illinois
,Rush University, Chicago, Illinois
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16
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The Lived Experience of Interdependence: Support Worker Relationships and Implications for Wider Rehabilitation. BRAIN IMPAIR 2021. [DOI: 10.1017/brimp.2021.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Engaging in a meaningful life where one can exercise autonomy has been proposed as a key aim of rehabilitation. Influenced by a neoliberal worldview, this has traditionally been characterised by a pursuit towards individual functional independence in which one completes tasks and activities unassisted. However for many persons, individual functional independence may not be a realistic, prioritised or beneficial goal. Many individuals must learn to work with support workers to exercise choice and control. Such relationships extend beyond a transactional nature and involve many subtle characteristics. In this article, I draw on my lived experience of partnering with support workers to illustrate the complexity of such relationships and how they can enable interdependence to serve as a vehicle to self-determination. I finish with some ideas about what rehabilitation can do to recognise the important role human connections play in facilitating interdependence. Understanding the nature of these relationships is necessary to provide services which value interdependence, supporting people to pursue a meaningful life following impairment.
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17
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Page TA, Gordon S, Balchin R, Tomlinson M. Caregivers' perspectives of the challenges faced with survivors of traumatic brain injury: A scoping review. NeuroRehabilitation 2021; 49:349-362. [PMID: 34308914 DOI: 10.3233/nre-210099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Traumatic Brain Injury (TBI) has wide-ranging neuropsychological, physical, social and financial implications. The impact on caregivers of moderate to severe TBI survivors, particularly in low- and middle-income countries, is under-investigated. AIM Identify and describe the experiences of caregivers' of moderate to severe TBI survivors postdischarge from healthcare facilities. METHODS A scoping review was conducted utilising seven electronic databases. Two reviewers screened articles using eligibly criteria related to setting (postdischarge), caregiving (informal), age of TBI survivors (> 18 years) and injury severity (moderate-severe). Studies published in English between 1999 -2018 were included. RESULTS Fourteen articles met the inclusion criteria. Articles reporting on the same sample were merged during data charting. The final analyses included 11 articles comprised of qualitative, quantitative and mixed-methods studies. Ten themes were identified: psychological distress, social functioning, financial burden, family experiences, coping strategies, access to services, time burdens and physical, cognitive and behavioural difficulties. Characteristics of caregivers and TBI survivors were also reported. CONCLUSION Caregivers of moderate to severe TBI survivors experience challenges in various life domains, and there is limited research concerning caregivers in low- and middle-income countries. Future research should focus on understanding more nuanced experiences across various environments, which may increase comprehensive, flexible and long-term support.
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Affiliation(s)
- Teneille A Page
- Department of Psychology, Faculty of Arts and Social Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sarah Gordon
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Ross Balchin
- University of Cambridge NIHR Global Health Research Group on Neurotrauma.,University of Cape Town (UCT) Neuroscience Institute and the Division of Neurosurgery, Groote Schuur Hospital, Cape Town, South Africa
| | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa.,School of Nursing and Midwifery, Queens University, Belfast, UK
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18
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Johns J, Krogh K, Rodriguez GM, Eng J, Haller E, Heinen M, Laredo R, Longo W, Montero-Colon W, Korsten M. Management of Neurogenic Bowel Dysfunction in Adults after Spinal Cord Injury Suggested citation: Jeffery Johns, Klaus Krogh, Gianna M. Rodriguez, Janice Eng, Emily Haller, Malorie Heinen, Rafferty Laredo, Walter Longo, Wilda Montero-Colon, Mark Korsten. Management of Neurogenic Bowel Dysfunction in Adults after Spinal Cord Injury: Clinical Practice Guideline for Healthcare Providers. Journal of Spinal Cord Med. 2021. Doi:10.1080/10790268.2021.1883385. J Spinal Cord Med 2021; 44:442-510. [PMID: 33905316 PMCID: PMC8115581 DOI: 10.1080/10790268.2021.1883385] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Jeffery Johns
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Klaus Krogh
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Gianna M Rodriguez
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| | - Janice Eng
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Emily Haller
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| | - Malorie Heinen
- University of Kansas Health Care System, Kansas City, Kansas, USA
| | | | - Walter Longo
- Department of Surgery, Division of Gastrointestinal Surgery, Yale University, New Haven, Connecticut, USA
| | | | - Mark Korsten
- Icahn School of Medicine at Mount Sinai, Department of Internal Medicine, Division of Gastroenterology, New York, New York, USA
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19
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Bertschi IC, Meier F, Bodenmann G. Disability as an Interpersonal Experience: A Systematic Review on Dyadic Challenges and Dyadic Coping When One Partner Has a Chronic Physical or Sensory Impairment. Front Psychol 2021; 12:624609. [PMID: 33732189 PMCID: PMC7959177 DOI: 10.3389/fpsyg.2021.624609] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 02/01/2021] [Indexed: 02/03/2023] Open
Abstract
Chronically disabling health impairments affect an increasing number of people worldwide. In close relationships, disability is an interpersonal experience. Psychological distress is thus common in patients as well as their spouses. Dyadic coping can alleviate stress and promote adjustment in couples who face disabling health impairments. Much research has focused on dyadic coping with cancer. However, other health problems such as physical and sensory impairments are also common and may strongly impact couple relationships. In order to promote couples' optimal adjustment to impaired health, the identification of disability-related relationship challenges is required. Furthermore, ways in which dyadic coping with these challenges may benefit couples could inform researchers and practitioners how to support couples in coping with health impairments. Accordingly, the aims of this study were to systematically review dyadic challenges and dyadic coping when one partner has a chronically disabling physical or sensory impairment. Out of 873 articles identified through database searches, 36 studies met inclusion criteria. The disability-related dyadic challenges identified in the review were changed roles and responsibilities within the couple, altered communication, compromised sexual intimacy, and reduced social participation. These challenges were reported to burden both partners and the couple relationship. Dyadic adjustment benefitted from a we-perspective, i.e., when couples viewed the disability as a shared challenge and engaged in conjoint dyadic coping. The results suggest that patient/care recipient and partner/caregiver roles should be de-emphasized and that disability should be recognized as an interpersonal experience.
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Affiliation(s)
- Isabella C. Bertschi
- Clinical Psychology for Children/Adolescents and Couples/Families, Department of Psychology, University of Zurich, Zurich, Switzerland
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20
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Johns J, Krogh K, Rodriguez GM, Eng J, Haller E, Heinen M, Laredo R, Longo W, Montero-Colon W, Wilson C, Korsten M. Management of Neurogenic Bowel Dysfunction in Adults after Spinal Cord Injury: Clinical Practice Guideline for Health Care Providers. Top Spinal Cord Inj Rehabil 2021; 27:75-151. [PMID: 34108835 PMCID: PMC8152174 DOI: 10.46292/sci2702-75] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Jeffery Johns
- Vanderbilt University Medical Center, Nashville, Tennessee USA
| | | | | | - Janice Eng
- University of British Columbia, Vancouver Canada
| | | | - Malorie Heinen
- University of Kansas Health Care System, Kansas City, Kansas USA
| | | | | | | | - Catherine Wilson
- Diplomate, American Board of Professional Psychology (RP) Private Practice, Denver, Colorado
| | - Mark Korsten
- Icahn School of Medicine @ Mt Sinai, New York, New York USA
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21
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Morrison V, Williams K. Gaining Longitudinal Accounts of Carers' Experiences Using IPA and Photograph Elicitation. Front Psychol 2020; 11:521382. [PMID: 33343434 PMCID: PMC7746611 DOI: 10.3389/fpsyg.2020.521382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 08/26/2020] [Indexed: 01/19/2023] Open
Abstract
Fluctuations in positive and negative caregiving experiences remain only partially explained as the significant variability over time of potential predictive factors themselves is understudied. The current study aims to gain considerable insight into caregiving experiences and perceptions over time by using photovoice methodology to support semi-structured interviews. A case study, longitudinal design is taken with three female caregivers who provide detailed insight into their caregivers' experiences over a 12 month period. The interview transcripts were analyzed using IPA- Interpretative Phenomenological Analysis. This innovative combination of methods resulted in the emergence of three related themes which included consuming the role, feeling consumed by the role, and letting go of the role. The idiographic approach taken allowed both within case differences to be examined over time, and also between carer differences to be highlighted. Implications of illness type and its characteristics, and of attachment and relationship quality with the care recipient were seen in terms of how and when the caregivers moved between the themes identified. The use of others' support or respite care is examined vis-a vis caregiver's own beliefs, emotions, relationship attachment and motivations to care. Caregivers self-efficacy beliefs also shifted over time and were influential in caregiver experience as the care recipient condition or needs changed. No previous studies have found that negative caregiving consequences are, in part, under volitional control and yet our data on the underlying reasons for consuming caregiving or allowing themselves to consume, would suggest this may in part be true. This is important because it suggests that interventions to support caregivers should address relational and motivational factors more fully.
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Affiliation(s)
- Val Morrison
- School of Psychology, Bangor University, Bangor, United Kingdom
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22
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Performance of Everyday Occupations and Perceived Health of Spouses of Men With Spinal Cord Injury at Discharge and 6 Months Later. Spine (Phila Pa 1976) 2020; 45:1580-1586. [PMID: 32756276 DOI: 10.1097/brs.0000000000003630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN An exploratory longitudinal study. OBJECTIVES (a) Compare the occupational performance, and life satisfaction of spouses of men with SCI with those of spouses of healthy men, (b) compare the occupational performance, perceived health, and life satisfaction of spouses of men with SCI at discharge from inpatient rehabilitation and 6 months postdischarge; and (c) assess whether the functioning levels of men with SCI and the perceived mental health of the spouse, correlate with her occupational performance. SUMMARY OF BACKGROUND DATA Spouses of men with spinal cord injury (SCI) report having symptoms of depression and anxiety. However, their ability to choose everyday occupations and perform them satisfactorily (occupational performance) was less studied. METHODS Fifteen women spouses of men with SCI and 15 women spouses of healthy men participated. Study measures included four self-report questionnaires and the Occupational Performance History Interview that was analyzed quantitatively and measured occupational performance by three components: occupational identity, competence, and settings. RESULTS Occupational performance and life satisfaction of caregivers were lower than those of spouses of healthy men and did not significantly change over 6 months. However, they had higher scores on physical, mental, and general health 6 months postdischarge than at discharge. Mental health of the spouse correlated with her occupational identity. CONCLUSION It is recommended that rehabilitation intervention focus not only on patients with SCI, but also on their healthy spouses to promote their occupational performance, health, and well-being. LEVEL OF EVIDENCE 3.
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23
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Pullin LH, McKenzie H. Lifetime Active Care: A qualitative study of long-term family carers of people with spinal cord injury in Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1622-1631. [PMID: 32239619 DOI: 10.1111/hsc.12987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 02/11/2020] [Accepted: 03/10/2020] [Indexed: 06/11/2023]
Abstract
This study reports the findings of a qualitative, grounded theory study which explored the experiences of partners and other long-term family carers living with and supporting loved ones with spinal cord injury. The study is exploratory in that little was previously known about the experience of long-term care-giving in this context in Australia. Most research in this area has focused on this experience during the first 5 years postinjury. This study focuses on the experiences of family carers beyond that 5-year period. The study aimed to explore the experience of partners and other long-term family carers of people with spinal cord injury, and illuminate their daily lives, interests, concerns and caring approaches in this context. Data collection included in-depth interviews, a focus group and an on-line, password-protected research blog for participant narrative reflections. Findings revealed that the experience of long-term caring is complex, all-encompassing and lifelong. This experience is conceptualised here as lifetime active care which always involves what we describe as protective, negotiated, surreptitious and strategic caring. These dimensions of caring are interdependent and deeply embedded in the daily, active support provided by long-term carers of people with spinal cord injury. We argue that carers in this context are involved in processes that have, in other contexts, been conceptualised as narrative reconstruction and also that the four dimensions of caring identified involve significant emotion work. The social processes of lifetime active care may shed light on the experiences of family carers in other long-term care contexts.
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Affiliation(s)
- Laynie Hall Pullin
- School of Nursing & Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Heather McKenzie
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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24
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Diviani N, Zanini C, Jaks R, Brach M, Gemperli A, Rubinelli S. Information seeking behavior and perceived health literacy of family caregivers of persons living with a chronic condition. The case of spinal cord injury in Switzerland. PATIENT EDUCATION AND COUNSELING 2020; 103:1531-1537. [PMID: 32098740 DOI: 10.1016/j.pec.2020.02.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/14/2020] [Accepted: 02/15/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To examine the information seeking behavior and health literacy of caregivers of individuals living with spinal cord injury in Switzerland and their impact on the caregiving experience. METHODS Nationwide survey of family caregivers of people with spinal cord injury (N = 717). Caregivers aged 18+ who assisted with activities of daily living were included. Self-reported information seeking behavior, including topics, preferred sources, and health literacy were assessed and analyzed. RESULTS Health professionals were the most trusted source of information. Among information-seekers, higher health literacy levels were shown to be associated with lower subjective caregiver burden and, in turn, with higher caregivers' satisfaction with own health. CONCLUSION Caregivers use information on different topics and coming from different sources. In order for information to improve the caregiving experience, however, caregivers need health literacy skills to make sense of it. PRACTICE IMPLICATIONS Building health literacy is a promising approach to support caregivers in their activities, reduce their subjective burden, and even to improve their health. Interventions should consider involving health professionals, as the most trusted source of information, and address both health-related and more practical issues.
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Affiliation(s)
- Nicola Diviani
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland
| | - Claudia Zanini
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland.
| | - Rebecca Jaks
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland
| | - Mirjam Brach
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland
| | - Armin Gemperli
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland
| | - Sara Rubinelli
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland
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25
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Zanini C, Fiordelli M, Amann J, Brach M, Gemperli A, Rubinelli S. Coping strategies of family caregivers in spinal cord injury: a qualitative study. Disabil Rehabil 2020; 44:243-252. [PMID: 32449426 DOI: 10.1080/09638288.2020.1764638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: To identify the coping strategies used by family caregivers of persons with spinal cord injury (SCI) in Switzerland in order to develop tailored support programs.Materials and methods: Purposive sample of >18 years participants, speaking an official Swiss language fluently, being family caregivers of persons with SCI for at least 4 years, and perceiving either a high or low burden in relation to caregiving. Data were collected through face-to-face semi-structured interviews (N = 22). Thematic analysis was performed.Results: Four main coping strategies were identified: reappraisal, active acceptance, setting limits to the caregiver role, and seeking support. These strategies can be used one at a time or combined, and at different times of a caregiver pathway. Our analysis highlighted that caregivers need skills to implement these strategies (e.g., self-evaluation skills).Conclusions: Caregivers of persons with SCI develop cognitive coping strategies to make sense of the situation and establish a "new normal" and problem-focused coping strategies to deal with their new tasks and role. These strategies do not seem to be typical only of SCI caregivers. Hence, interventions that worked for caregivers in other fields could be adapted. Rehabilitation centers should systematically integrate programs targeted to caregivers into their offerings.IMPLICATIONS FOR REHABILITATIONHealthcare systems need to develop educational and support measures for both persons with a health condition and their caregivers.Caregivers should become long-term partners in rehabilitation and a regular and structured needs assessment should be offered.Interventions that worked for caregivers in other fields can be adapted to support also caregivers in SCI.Educational and support programs dedicated to caregivers should teach not only how to perform caregiving tasks but also how to balance between responding to the care recipient's needs and their own needs.
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Affiliation(s)
- Claudia Zanini
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Maddalena Fiordelli
- Swiss Paraplegic Research, Nottwil, Switzerland.,Institute of Communication and Health, Università della Svizzera italiana, Lugano, Switzerland
| | - Julia Amann
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Technology, Health Ethics and Policy Lab, ETH, Zurich, Switzerland
| | - Mirjam Brach
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Armin Gemperli
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Sara Rubinelli
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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26
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Geard A, Kirkevold M, Løvstad M, Schanke AK. How do family members of individuals with spinal cord and acquired brain injuries make sense of their experiences: A qualitative study of meaning making processes. Health Psychol Open 2020; 7:2055102920913477. [PMID: 32284872 PMCID: PMC7133077 DOI: 10.1177/2055102920913477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This study explores the processes that promote coping with abruptive life
changes, often experienced as life before and after injury. The consept of
meaning making, was used as theoretical framework for analysisthr. Family
members of individuals with spinal cord and acquired brain injury participated
in two focus groups three to twenty years post-injury. Data was analysed using
thematic analyses. Two main themes were identified: drawing upon different
coping strategies and balancing family needs against personal autonomy. Making
sense of an altered situation was by keeping a positive outlook, making
comparisons to worst cases, engagement in activities and making room for own
needs. Thus, the study illistrates that life can continue in a good manner after
adversities, but requires flexibility and adjustments.
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Affiliation(s)
- Anne Geard
- University of Oslo, Norway.,Sunnaas Rehabilitation Hospital, Norway
| | | | - Marianne Løvstad
- University of Oslo, Norway.,Sunnaas Rehabilitation Hospital, Norway
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27
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Jeyathevan G, Cameron JI, Craven BC, Jaglal SB. Identifying Required Skills to Enhance Family Caregiver Competency in Caring for Individuals With Spinal Cord Injury Living in the Community. Top Spinal Cord Inj Rehabil 2019; 25:290-302. [PMID: 31844381 DOI: 10.1310/sci2504-290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: Due to the earlier discharge of individuals with spinal cord injury (SCI), family caregivers are often left with limited time for learning caregiving skills, and they usually feel unprepared to undertake the caregiver role. Objective: Considering the key role of family caregivers in maintaining the overall health and well-being of the individual with SCI, the objective of this study was to determine the breadth of skills needed by family caregivers to enhance their competency in caring for individuals with SCI living in the community. Methods: A qualitative descriptive approach was used with semi-structured interviews. Thematic analysis was used to determine key themes arising from the experiences of individuals with SCI (n= 19) and their family members (n = 15). Results: Twenty-nine SCI family caregiving skills were identified and grouped into six caregiving processes signifying the multiple dimensions of the SCI caregiving role. These include monitoring and managing physical health and secondary health conditions, providing for psychosocial needs, decision making, time management, being flexible, and navigating the health and social services system. Conclusion: The current study demonstrated that development of multiple caregiving skills is crucial to enhance family members' competency in caregiving. These findings should further alert health care professionals that assessment of caregiving skills at regular intervals is necessary to help caregivers achieve mastery in situations where they are facing caregiving difficulties. Future programs need to be designed to include the skills that family caregivers need and use in real-life caregiving situations.
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Affiliation(s)
- Gaya Jeyathevan
- Institute of Health Policy, Management and Evaluation, University of Toronto.,Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
| | - Jill I Cameron
- Toronto Rehabilitation Institute-University Health Network, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - B Catharine Craven
- Institute of Health Policy, Management and Evaluation, University of Toronto.,Toronto Rehabilitation Institute-University Health Network, Toronto, Canada.,Department of Medicine, Division of Physical Medicine & Rehabilitation, University of Toronto, Toronto, Canada
| | - Susan B Jaglal
- Institute of Health Policy, Management and Evaluation, University of Toronto.,Toronto Rehabilitation Institute-University Health Network, Toronto, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Canada
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28
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Jeyathevan G, Cameron JI, Craven BC, Munce SEP, Jaglal SB. Re-building relationships after a spinal cord injury: experiences of family caregivers and care recipients. BMC Neurol 2019; 19:117. [PMID: 31176359 PMCID: PMC6555989 DOI: 10.1186/s12883-019-1347-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 05/31/2019] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Following spinal cord injury (SCI), family members are often called upon to undertake the caregiving role. This change in the nature of the relationship between the individuals with SCI and their families can lead to emotional, psychological, and relationship challenges. There is limited research on how individuals with SCI and their family caregivers adapt to their new lives post-injury, or on which dyadic coping strategies are used to maintain relationships. Thus, the objectives of this study were to obtain an in-depth understanding of 1) the experiences and challenges within a caregiving relationship post-SCI among spouses, as well as parents and adult children; and 2) the coping strategies used by caregivers and care recipients to maintain/rebuild their relationships. METHODS A qualitative descriptive approach with an exploratory design was used. Semi-structured face-to-face and telephone interviews were conducted. Thematic analysis was used to identify key themes arising from individuals with SCI's (n = 19) and their family caregivers' (n = 15) experiences. RESULTS Individuals with SCI and family caregivers spoke in-depth and openly about their experiences and challenges post-injury, with two emerging themes (including subsequent sub-themes). The first theme of deterioration of relationship, which reflects the challenges experienced/factors that contributed to disintegration in a relationship post-injury, included: protective behaviours, asymmetrical dependency, loss of sex and intimacy, and difficulty adapting. The second theme of re-building/maintaining the relationship, which reflects the strategies used by dyads to adjust to the changes within the relationship brought upon by the injury, included: interdependence, shifting commonalities, adding creativity into routine, and creating a new normal. CONCLUSIONS These findings should alert healthcare professionals and peer support groups as to the need for possible education and training (e.g., coping strategies, communication skills training) as well as counseling prior to discharge to assist individuals with SCI and family caregivers with adaptation to a new life post-injury.
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Affiliation(s)
- Gaya Jeyathevan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Neural Engineering and Therapeutics Team, KITE, Toronto Rehab - University Health Network, Toronto, Ontario, Canada
| | - Jill I Cameron
- Neural Engineering and Therapeutics Team, KITE, Toronto Rehab - University Health Network, Toronto, Ontario, Canada.,Department of Occupational Science and Occupational Therapy, Toronto, Ontario, Canada
| | - B Catharine Craven
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Neural Engineering and Therapeutics Team, KITE, Toronto Rehab - University Health Network, Toronto, Ontario, Canada.,Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
| | - Sarah E P Munce
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Neural Engineering and Therapeutics Team, KITE, Toronto Rehab - University Health Network, Toronto, Ontario, Canada.,Department of Occupational Science and Occupational Therapy, Toronto, Ontario, Canada
| | - Susan B Jaglal
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. .,Neural Engineering and Therapeutics Team, KITE, Toronto Rehab - University Health Network, Toronto, Ontario, Canada. .,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
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Jeyathevan G, Catharine Craven B, Cameron JI, Jaglal SB. Facilitators and barriers to supporting individuals with spinal cord injury in the community: experiences of family caregivers and care recipients. Disabil Rehabil 2019; 42:1844-1854. [PMID: 30669882 DOI: 10.1080/09638288.2018.1541102] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Family members make an important contribution to informal and formal care, as well as the overall health and wellbeing of individuals with spinal cord injury. Caregiving often results in negative outcomes which, if not addressed, threaten the sustainability of these critical supports. We sought to explore the perceptions of individuals with spinal cord injury and their family caregivers regarding the facilitators and barriers to undertaking and sustaining the caregiving role in the community.Methods: A qualitative descriptive approach with semi-structured interviews. Thematic analysis was employed to determine key themes arising from individuals with spinal cord injury (n = 19) and their family members' (n = 16) experiences.Results: The following four facilitators to caregiving were identified: access to community support services, positive coping in relationship, social support, and mastery of caregiving roles. Conversely, the following six barriers to caregiving were identified: lack of access to community resources, lack of knowledge about resources and formal training, fragmented continuity of care, negative coping in relationship, role strain, and caregiver injury or illness.Conclusions: The current study demonstrated that positive coping, social support, skills training, access to community services and continuity of care contribute significantly to the sustainability of the spinal cord injury family caregiving role. As such, the development of future caregiver interventions should consider these facilitators.Implications for RehabilitationFamily caregivers make an important contribution to the care processes and overall quality of life of individuals with spinal cord injury post-discharge into the community.The potential negative effects of caregiving could threaten the sustainability of these critical supports.Positive coping, social support, skills training, access to community services, and continuity of care contribute significantly to the sustainability of the spinal cord injury family caregiving role.This study shows the need for better integration of family members during the rehabilitation and discharge process to better prepare them for the caregiving role.
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Affiliation(s)
- Gaya Jeyathevan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - B Catharine Craven
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute, University Health Network Toronto, Canada.,Department of Medicine Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Canada
| | - Jill I Cameron
- Toronto Rehabilitation Institute, University Health Network Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Susan B Jaglal
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute, University Health Network Toronto, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Canada
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Hearn JH, Cotter I, Finlay KA. Efficacy of Internet-Delivered Mindfulness for Improving Depression in Caregivers of People With Spinal Cord Injuries and Chronic Neuropathic Pain: A Randomized Controlled Feasibility Trial. Arch Phys Med Rehabil 2018; 100:17-25. [PMID: 30268806 DOI: 10.1016/j.apmr.2018.08.182] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 08/13/2018] [Accepted: 08/15/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To explore the feasibility and efficacy of web-based mindfulness training for carers of people with spinal cord injury (SCI). DESIGN Randomized controlled feasibility study with 3-month follow-up. SETTING Community setting. PARTICIPANTS Spouses or family caregivers (N=55) of people with SCI and chronic neuropathic pain were recruited via the direct care team and advertisements. Participants were older than 18 years (no upper age limit), with Internet access for the duration of the study. Participants were randomly allocated to an 8-week online mindfulness training intervention (n=28), or to receive 8 weeks of psychoeducational materials on SCI and chronic pain (n=27). INTERVENTIONS An established web-based, mindfulness training course was delivered over 8 weeks. Participants completed 10 minutes of mindfulness practices, twice per day, 6 days per week, totaling 960 minutes. The control group received a weekly e-mail with psychoeducational materials (based on the established elements) on SCI and pain for 8 weeks. MAIN OUTCOME MEASURE Depression severity. RESULTS Mindfulness reduced depression severity more than psychoeducation at T2 (mean difference= -.891; 95% confidence interval,-1.48 to -.30) and T3 (mean difference=-1.96; 95% confidence interval, -2.94 to -.97). Mindfulness training also reduced anxiety at T2 (mean difference=-.888; 95% confidence interval, -1.40 to -.38) and T3 (mean difference=-2.44; 95% confidence interval, -3.20 to -1.69). CONCLUSIONS Results indicate that Internet-delivered mindfulness training offers unique benefits and is viable for caregivers of people with SCI and chronic neuropathic pain. Further work should explore the feasibility of combined education and mindfulness training incorporating both patient and caregiver, for optimum benefit.
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Affiliation(s)
| | - Imogen Cotter
- Department of Clinical Psychology, The National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, United Kingdom
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Tough H, Brinkhof MWG, Siegrist J, Fekete C. The impact of loneliness and relationship quality on life satisfaction: A longitudinal dyadic analysis in persons with physical disabilities and their partners. J Psychosom Res 2018; 110:61-67. [PMID: 29764607 DOI: 10.1016/j.jpsychores.2018.04.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/20/2018] [Accepted: 04/21/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Persons with physical disabilities and their caregiving partners are at an increased risk of experiencing reduced life satisfaction. One potential explanation for this trend may be the potentially harmful effects of loneliness and poor relationship quality which this population often experience. To date, little is known about how the perceptions of loneliness and relationship quality affect life satisfaction in the disability and caregiving setting, furthermore the directionality of effect is not well understood. In this study, we investigate the actor and partner effects, and the reciprocal effects of loneliness and relationship quality on life satisfaction. METHODS The analyses are based on longitudinal dyadic data from a Swiss community survey of persons with spinal cord injury (SCI) and their partners (n = 246). We employed mixed effects modelling to explore standardized (β) and unstandardized (B) actor and partner effects, and used cross-lagged path analysis to explore reciprocal effects. RESULTS Loneliness was more prevalent in persons with SCI than in their caregiving partners. In caregiving partners, we found significant negative actor effects of loneliness (β = -0.20 (-0.31, -0.10)) and positive actor effects of relationship quality (β = 0.15 (0.04, 0.26)) on life satisfaction, and significant partner effects of relationship quality on wellbeing. In persons with SCI, only the negative actor effect of loneliness was significant (β = -0.30 (-0.41, -0.18)). Over time, loneliness demonstrated reciprocal associations with life satisfaction. CONCLUSION The findings of our study highlight the importance of reducing loneliness and strengthening relationship quality to improve life satisfaction in partnerships of persons coping with disability.
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Affiliation(s)
- Hannah Tough
- Swiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
| | - Martin W G Brinkhof
- Swiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Johannes Siegrist
- Faculty of Medicine, University of Düsseldorf, Life-Science-Center, Düsseldorf, Germany
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Bibi S, Rasmussen P, McLiesh P. The lived experience: Nurses' experience of caring for patients with a traumatic spinal cord injury. Int J Orthop Trauma Nurs 2018; 30:31-38. [PMID: 29934253 DOI: 10.1016/j.ijotn.2018.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 02/26/2018] [Accepted: 05/14/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Nurses are involved in delivering care for patients following acute traumatic spinal cord injury throughout the entire care journey. An injury of this type is significant for the individual and their family and can be challenging for nurses delivering care for patients with life changing injuries, especially for nurses new to this setting. There is a lack of research that examines the experience of nurses caring for these patients in the acute setting. METHOD A hermeneutic phenomenological approach was used to understand the experience of nurses caring for patients in the acute setting who had sustained a traumatic spinal injury with associated neurological deficit. Using the phenomenological approach guided by the insight of Gadamer and Max Van Manen, participants with a broad range of experience were recruited and interviewed. The responses were transcribed into a text and subjected to hermeneutic analysis. Burnard's (1991) 14-step process and the hermeneutic approach were used to interpret and understand the phenomenon of interest. CONCLUSION The study highlights the experience and challenges of providing care to these individuals. Although patients had significant physical disabilities and were often dependent physically, the nurses' concerns were directed more towards fulfilling their psychological needs. Nurses identified grieving patients and felt their role was to provide realistic hope to motivate them. They felt an internal tension regarding desensitisation towards their patients, but this was often an internal protective mechanism to deal with the significance of the events surrounding these patients. Nurses new to this setting took time to learn the routines and manage the unique challenges effectively. Caring for these patients gave the nurses the opportunity to understand their patients and their families, and appreciate that both groups will fluctuate in their behavior throughout the acute process, as they adjust to grief and loss.
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Affiliation(s)
- Shareena Bibi
- Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia.
| | - P Rasmussen
- Adelaide Nursing School, University of Adelaide, Australia
| | - P McLiesh
- Adelaide Nursing School, University of Adelaide, Australia
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"That's what you do for people you love": A qualitative study of social support and recovery from a musculoskeletal injury. PLoS One 2018; 13:e0196337. [PMID: 29694438 PMCID: PMC5919019 DOI: 10.1371/journal.pone.0196337] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 04/11/2018] [Indexed: 11/19/2022] Open
Abstract
Background Social support has been identified as a significant factor in facilitating better health outcomes following injury. However, research has primarily focused on the role of social support from the perspective of the person experiencing an injury. Limited research has examined the experiences of the family members and friends of a person with injury. This study aims to explore the perceptions and experiences of social support and recovery following a transport-related musculoskeletal injury (MSI) in a population of injured persons and their family members and friends. Methods This study was conducted using a phenomenological qualitative research design. In-depth semi-structured interviews were conducted with ten persons with MSI, recruited via the Transport Accident Commission (TAC) in Victoria, Australia. Seven family members and friends were also interviewed. The data was analysed using constant comparative method and thematic analysis. Results Several themes were identified including: (1) key sources and types of support received, (2) relationship development and (3) challenges of providing and receiving support. Participants with MSI reported stories about how the social network provided emotional and tangible support. Family members and friends confirmed the supportive acts provided to the participants with MSI. Positive iterative changes in relationships were reported by the participants with MSI. Participants with MSI, their family members and friends described several difficulties including loss of independence, feeling like a burden, and the impact of caring on health and well-being. Conclusions The role of social support is complex given the multitude of people involved in the recovery process. The findings of this study suggest that persons with MSI may benefit from support groups and maintenance of existing support networks. Furthermore, family members and friends engaged in the recovery process may benefit from support in this role.
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Perspectives From Family Caregivers of Persons With Spinal Cord Injury in Hospital Versus Rehabilitation: A Pilot Study. Rehabil Nurs 2018; 44:311-318. [PMID: 29613875 DOI: 10.1097/rnj.0000000000000143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The study aims to assess differences in family preferences for involvement in the ongoing care of a hospitalized family member with spinal cord injury based on whether the patient was hospitalized for initial rehabilitation (Group R) or hospitalized to treat secondary complications (Group C). DESIGN Explorative cross-sectional design. METHOD Family members rated the importance and experience of involvement on five subscales of the Patient Participation in Rehabilitation Questionnaire. Differences among the importance and experience scores between the groups were tested using the Mann-Whitney U test. FINDINGS Group C scored the importance to be involved significantly higher than Group R (M = 3.17 vs. M = 4.04, p =.01). No other significant differences between groups were detected. CONCLUSION Family members of patients hospitalized for secondary complications want greater involvement in care compared to those hospitalized for rehabilitation. CLINICAL RELEVANCE Results indicate the need for tailored interventions using a family-centered approach and ongoing needs assessment.
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Relatives of people with spinal cord injury: a qualitative study of caregivers' metamorphosis. Spinal Cord 2018; 56:548-559. [PMID: 29563575 DOI: 10.1038/s41393-018-0092-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 01/05/2018] [Accepted: 02/01/2018] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Qualitative study. OBJECTIVE To detect the major challenges and needs reported by family member caregivers of people with spinal cord injury (SCI). SETTING Family member caregivers of people with SCI and expert professionals were evaluated. This study was conducted in Spain, and most of the participants attended the National Paraplegics Hospital of Toledo. METHODS We performed 25 semi-structured interviews. The data were analyzed from a phenomenological perspective using the Colaizzi method. RESULTS The metamorphosis of the caregiver is a complex personal and family-related process. Analysis of the adjustment phase of the caregiving role allowed us to describe three stages, patterns, and trends. Five basic needs were identified. CONCLUSIONS People with SCI and their primary caregivers experienced changes in every sphere of their lives. Their most important needs were psychological support, social support, economic resources, information, training throughout the process of suffering, and the creation of informal groups of mutual aid.
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Kang MG, Kim CH, Park E, Huh JW, Yang WJ, Nam TW, Min YS, Jung TD. Effect of Family Caregiving on Depression in the First 3 Months After Spinal Cord Injury. Ann Rehabil Med 2018; 42:130-136. [PMID: 29560333 PMCID: PMC5852216 DOI: 10.5535/arm.2018.42.1.130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 06/02/2017] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate the effect of family caregiving on depression in the first 3 months after spinal cord injury (SCI). Methods A retrospective study was carried out on 76 patients diagnosed with an SCI from January 2013 to December 2016 at the Department of Physical Medicine and Rehabilitation of Kyungpook National University Hospital, Korea. Clinical characteristics including age, gender, level of injury, completeness of the injury, time since injury, caregiver information, etiology, and functional data were collected through a retrospective review of medical records. Depression was assessed using the Beck Depression Inventory (BDI). Patients with 14 or more points were classified as depressed and those with scores of 13 or less as non-depressed group. Results Of the 76 patients, 33 were in the depressed group with an average BDI of 21.27±6.17 and 43 patients included in the non-depressed group with an average BDI of 4.56±4.20. The BDI score of patients cared by unlicensed assistive personnel (UAP) was significantly higher than that of patients cared by their families (p=0.020). Univariate regression analysis showed that motor complete injury (p=0.027), UAP caregiving (p=0.022), and Ambulatory Motor Index (p=0.019) were associated with depression after SCI. Multivariate binary logistic regression analysis showed that motor completeness (p=0.002) and UAP caregiving (p=0.002) were independent risk factors. Conclusion Compared with UAP, family caregivers lowered the prevalence of depression in the first 3 months after SCI.
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Affiliation(s)
- Min-Gu Kang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Chul-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Eunhee Park
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jae-Won Huh
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Won-Jong Yang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Tae-Woo Nam
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Yu-Sun Min
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Tae-Du Jung
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
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Mental health and life satisfaction of individuals with spinal cord injury and their partners 5 years after discharge from first inpatient rehabilitation. Spinal Cord 2018; 56:598-606. [PMID: 29335473 DOI: 10.1038/s41393-017-0053-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/14/2017] [Accepted: 12/17/2017] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES To describe and compare mental health and life satisfaction between individuals with spinal cord injury (SCI) and their partners 5 years after discharge from first inpatient rehabilitation; and to examine if injury severity moderates the association between individuals' with SCI and their partners' mental health and life satisfaction. SETTING Dutch community. METHODS Sixty-five individuals with SCI and their partners completed a self-report questionnaire. Main outcome measures were the mental health subscale of the Short-Form Health Survey and the Life Satisfaction Questionnaire. RESULTS Levels of mental health and life satisfaction of individuals with SCI and partners were similar, with median scores of 76 and 4.8 versus 76 and 4.6, respectively. Moderate to strong correlations between individuals with SCI and their partners were found for the mental health (rS = 0.35) and life satisfaction scores (rS = 0.51). These associations were generally stronger in the subgroup of individuals with less severe SCI. Associations between scores on separate life domains ranged from negligible (0.05) to moderate (0.53). Individuals with SCI and their partners were least satisfied with their 'sexual life'. Compared with their partners, individuals with SCI were significantly more satisfied in the domains 'leisure situation', 'partnership relation' and 'family life', and less satisfied in 'self-care ability'. CONCLUSIONS This study showed similarities but also differences in mental health and life satisfaction between individuals with SCI and their partners. In clinical practice, attention on mental health and life satisfaction should, therefore, focus on different domains for individuals with SCI and partners.
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Geard A, Kirkevold M, Løvstad M, Schanke AK. Exploring narratives of resilience among seven males living with spinal cord injury: a qualitative study. BMC Psychol 2018; 6:1. [PMID: 29301561 PMCID: PMC5755441 DOI: 10.1186/s40359-017-0211-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 12/14/2017] [Indexed: 12/04/2022] Open
Abstract
Background It is a challenge for both individuals and families when an illness or traumatic injury results in a severe spinal cord injury. The on-going physical impairments experienced by persons with spinal cord injury play themselves out over time. Few qualitative studies have explored how health, resilience and wellbeing interplay across time among persons living with the consequences of severe physical injuries. Thus, the aim of this study was to obtain a deeper understanding of how individuals with spinal cord injury reflect upon the efforts, strategies and agency they perform to sustain long term resilience and wellbeing. Methods In this exploratory qualitative study, we conducted a thematic analysis of in-depth interviews with seven men who had lived with spinal cord injury for 2–32 years and who previously had undergone medical rehabilitation. Results The efforts revealed by the participants in normalising life with a spinal cord injury required continued flexibility, persistency and solution-focused adjustment, interpreted as processes documenting resilience. The participants were marshalling personal resources to handle challenges over time. They explained that they succeeded in maintaining health and wellbeing by manoeuvring between different strategies such as being self-protective and flexible as well as staying active and maintaining a positive attitude. Further, support from relational resources were of utmost importance emotionally, socially and when in need of practical assistance. When harnessing relational resources when needed, the participants underlined that balancing dependence and autonomy to remain a part of ordinary life was essential in staying emotionally stable. Conclusions The findings of the present study show similarities to those of previous studies with regard to the participants’ attribution of their resilience and wellbeing to their innate personal abilities and strong connection to their family and friends. In addition, the current participants provide enlightening nuances and depth that expand our understanding of the construct of resilience by highlighting the importance of continuously exerting agency, willpower and strength through rational cognitive strategies to adjust and adapt to chronic and new challenges. Electronic supplementary material The online version of this article (10.1186/s40359-017-0211-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anne Geard
- Sunnaas, Rehabilitation Hospital, Bjørnemyrveien 11, 1450 Nesoddtangen, Nesodden, Norway.
| | - Marit Kirkevold
- Department of Nursing Science, University of Oslo, Postboks 1130 Blindern, 0318, Oslo, Norway
| | - Marianne Løvstad
- Sunnaas, Rehabilitation Hospital, Bjørnemyrveien 11, 1450 Nesoddtangen, Nesodden, Norway
| | - Anne-Kristine Schanke
- Sunnaas, Rehabilitation Hospital, Bjørnemyrveien 11, 1450 Nesoddtangen, Nesodden, Norway
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Munakomi S, Bhattarai B, Cherian I. Prospective observational research on the clinical profile and outcome analysis among a cohort of patients sustaining traumatic cervical spine and cord injury in a peripheral tertiary spine care centre in Nepal. F1000Res 2017; 6:1957. [PMID: 29250317 PMCID: PMC5701450 DOI: 10.12688/f1000research.12911.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2017] [Indexed: 11/20/2022] Open
Abstract
Background: In developing nations like Nepal, spinal cord injury has multispectral consequences for both the patient and their family members. It has the tendency to cripple and handicap the patients, and burn out their caretakers, both physically and mentally. Furthermore, the centralization of health care with only a handful of dedicated rehabilitation centers throughout Nepal further places patients into disarray. This study was carried out as a pilot study to determine the modes of injury, age groups affected, clinical profiles and patterns of injury sustained, as well as the efficacy of managing a subset of patients, who have sustained cervical spine and cord injuries. Methods: This was a prospective cohort study comprising of 163 patients enrolled over a period of three years that were managed in the spine unit of College of Medical Sciences, Bharatpur, Nepal. Results: Road traffic accidents were implicated in 51% of these patients. 65% of them were in the age group of 30-39 years. Traumatic subluxation occurred in 73 patients with maximum involvement of the C4/5 region (28.76%). Good outcome was seen in patients with ASIA ‘C’ and ‘D’ with 55% of patients showed improvement from ‘C’ to ‘D’ and 95% of patients showed improvement from ‘D’ to ‘E’ at 1 year follow up. The overall mortality in the patients undergoing operative interventions was only 1.98%. Conclusions: The prevalence of cervical spine injuries in the outreach area is still significant. The outcome of managing these patients, even in the context of a resource limited setup in a spine unit outside the capital city of a developing nation, can be as equally as effective and efficient compared to the outcome from a well-equipped and dedicated spine unit elsewhere.
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Affiliation(s)
- Sunil Munakomi
- Department of Neurosurgery, College of Medical Sciences, Chitwan, Bharatpur, 44207, Nepal
| | - Binod Bhattarai
- Department of Neurosurgery, College of Medical Sciences, Chitwan, Bharatpur, 44207, Nepal
| | - Iype Cherian
- Department of Neurosurgery, College of Medical Sciences, Chitwan, Bharatpur, 44207, Nepal
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Moreno A, Zidarov D, Raju C, Boruff J, Ahmed S. Integrating the perspectives of individuals with spinal cord injuries, their family caregivers and healthcare professionals from the time of rehabilitation admission to community reintegration: protocol for a scoping study on SCI needs. BMJ Open 2017; 7:e014331. [PMID: 28780539 PMCID: PMC5724190 DOI: 10.1136/bmjopen-2016-014331] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION There is fragmented information about the different needs following a spinal cord injury (SCI). Expressed SCI needs can be met or unmet, they change along the rehabilitation continuum (eg, acute, rehabilitation and reintegration into the community) and can be different for traumatic and non traumatic SCI. The general objective of this scoping study is to evaluate and integrate the needs of individuals with traumatic and non-traumatic SCI, their family caregivers and those reported by rehabilitation professionals from the time of rehabilitation admission to community reintegration. The specific objectives are to: (A) synthesise the needs of individuals with SCI as perceived by themselves, their family caregivers and rehabilitation professionals using two theoretical models, (B) classify needs as met and unmet, (C) explore the evolution of met/unmet needs from the time of rehabilitation admission to community reintegration and (D) provide recommendations to improve SCI care. METHODS AND ANALYSIS: (A) identifying the most frequent met and unmet needs reported by adults with traumatic and non-traumatic SCI, their family caregivers and their rehabilitation professionals from the time of rehabilitation admission to community reintegration; (B) identifying relevant studies with a search in electronic databases; (C) charting the data based on categories refined and adjusted with a stakeholder group; (D) collating, summarising and reporting the results using two analytical frameworks (Maslow's hierarchical model of human needs and the Ferrans et al's model of health-related quality of life) and (E) a stakeholder consultation phase. ETHICS AND DISSEMINATION The results of this scoping study will allow understanding SCI needs from the time of rehabilitation admission to community reintegration from the perspective of different stakeholders. An integrated master report combining the needs of individuals with SCI from the perspectives of different stakeholders from the time of rehabilitation admission to community reintegration will follow the consultation meetings.
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Affiliation(s)
- Alexander Moreno
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Diana Zidarov
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Chandhana Raju
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Jill Boruff
- Schulich Library of Science and Engineering, McGill University, Montreal, Canada
| | - Sara Ahmed
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
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Barclay L, Lentin P, McDonald R, Bourke-Taylor H. Understanding the factors that influence social and community participation as perceived by people with non-traumatic spinal cord injury. Br J Occup Ther 2017. [DOI: 10.1177/0308022617713699] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction The number of people with non-traumatic spinal cord injury is rising in developed countries such as Australia and Great Britain. People with non-traumatic spinal cord have different gender, injury and age-related profiles compared to those with traumatically acquired spinal cord injury; therefore, their lived experience is likely to be different. However, the specific issues and challenges that this group faces have not been well investigated. Method Semi-structured in-depth interviews were conducted with 17 adults with non-traumatic spinal cord injury. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Findings The factors that influenced the social and community participation of people with non-traumatic spinal cord injury were grouped into three broad areas: person factors, factors in the physical and institutional environment, and factors in the social or cultural environment. Conclusion The findings from this study inform the understanding of occupational therapists regarding the social and community participation of people with non-traumatic spinal cord injury and how this can be facilitated. Assisting people with non-traumatic spinal cord injury to participate in meaningful social and community-based activities is important to maximise their quality of life.
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Affiliation(s)
- Linda Barclay
- Lecturer, Department of Occupational Therapy, Monash University, Australia
| | - Primrose Lentin
- Senior Lecturer, Department of Occupational Therapy, Monash University, Australia
| | - Rachael McDonald
- Associate Professor, Department of Health and Medical Sciences, Swinburne University, Australia
| | - Helen Bourke-Taylor
- Associate Professor, Department of Occupational Therapy, Monash University, Australia
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The impact of spinal cord injury on the quality of life of primary family caregivers: a literature review. Spinal Cord 2017; 55:964-978. [DOI: 10.1038/sc.2017.56] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 04/14/2017] [Accepted: 04/16/2017] [Indexed: 11/08/2022]
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Braaf SC, Lennox A, Nunn A, Gabbe BJ. Experiences of hospital readmission and receiving formal carer services following spinal cord injury: a qualitative study to identify needs. Disabil Rehabil 2017; 40:1893-1899. [DOI: 10.1080/09638288.2017.1313910] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sandra C. Braaf
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alyse Lennox
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Andrew Nunn
- Victorian Spinal Cord Service, Austin Hospital, Heidelberg, Victoria, Australia
| | - Belinda J. Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- The Farr Institute, Swansea University Medical School, Swansea University, Singleton Park, Swansea, United Kingdom
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Eglseder K, Demchick B. Sexuality and Spinal Cord Injury: The Lived Experiences of Intimate Partners. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2017. [PMID: 28621221 DOI: 10.1177/1539449217701394] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although sexuality is an integral aspect of the human experience, individuals who sustain a spinal cord injury (SCI) often receive inadequate education to facilitate successful participation in sexual activities. Intimate partners are often not included in discussions related to sexuality during the rehabilitative process. The purpose of this study was to identify the lived experiences of intimate partners of individuals with SCI related to sexuality. Four intimate partners were selected to participate in semistructured interviews related to their lived experiences of sexuality. Participants identified aspects of SCI, extreme discomfort due to self-perceived sexual norms, and a lack of education as contributors to unsuccessful participation in sexual activity. Coupled sexual activity is a complex phenomenon which includes factors that influence both the injured individuals as well as their intimate partners. To provide effective interventions in addressing sexuality, practitioners should consider the entire issue, the couple.
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Oyesanya T. The experience of patients with ABI and their families during the hospital stay: A systematic review of qualitative literature. Brain Inj 2017; 31:151-173. [PMID: 28055226 DOI: 10.1080/02699052.2016.1225987] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Patients with acquired brain injury (ABI) and their families have unique experiences and needs during the hospital stay; yet, limited literature exists on this topic. The purpose of this systematic review was to compile and synthesize literature on the experience of patients with ABI and their families during the hospital stay. METHODS A systematic review of qualitative studies was conducted by searching for studies from seven databases. Content analysis was used to analyse and synthesize studies' findings separately for the patient and family experience. RESULTS The initial search provided 2871 records. Ultimately, 11 studies relevant to the research question were included in this review. No studies were excluded based on critical quality appraisal. Findings on the patient experience showed patients had negative perceptions of the rehabilitation environment and a perceived need for information. Findings on the family experience included difficulty adjusting after the patient's injury, a desire to be involved in the patient's care, mixed feelings about staff support and a high perceived need for information. CONCLUSIONS Findings provide awareness for healthcare providers on the multifaceted experiences of patients with ABI and their families during the hospital stay, strategies to make care more patient- and family-centred and directions for future research.
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46
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Family caregivers of individuals with spinal cord injury: exploring the stresses and benefits. Spinal Cord 2016; 54:732-6. [PMID: 27001130 DOI: 10.1038/sc.2016.25] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 01/27/2016] [Accepted: 01/31/2016] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Cross-sectional, focus group. OBJECTIVES To explore positive and negative issues reported by family caregivers of people with spinal cord injury (SCI) to develop a relevant and valid tool to assess caregiver distress and benefit for this unique population. METHODS Seventy-three family caregivers of people with SCI participated in 16 focus groups. We audio-recorded all focus group discussions and transcribed the recordings verbatim. Qualitative analysis of the transcripts was performed to identify major themes and subthemes relating to family caregiving activities. RESULTS Positive themes were disproportionately limited in comparison with negative themes. Positives included changes in self-awareness, enhanced family cohesiveness and feeling appreciated. Negative themes included physical and emotional strain, dissatisfaction with hired carers and strain on family relationships. Health-related themes included fatigue and lack of sleep. Caregivers identified sources of strength that helped them manage stresses including faith and support from friends and co-workers. CONCLUSION The numerous themes help lay the groundwork to develop a valid and reliable assessment tool to assist health-care providers in treatment planning and the provision of long-term assistance to people with SCI by enhancing areas of strengths and addressing factors that contribute to burden and distress for family caregivers.
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Stevens LF, Lehan T, Durán MAS, Plaza SLO, Arango-Lasprilla JC. Pilot Study of a Newly Developed Intervention for Families Facing Serious Injury. Top Spinal Cord Inj Rehabil 2016; 22:49-59. [PMID: 29398893 DOI: 10.1310/sci2201-49] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: There is a need to develop interventions that address the entire family after spinal cord injury (SCI), especially in Latin America, where rehabilitation resources are limited and little is known about family adjustment to SCI. Objective: To evaluate the short-term (post-intervention) and longer term (6-month) effectiveness of the newly developed, 8-session manualized family intervention for individuals with SCI and their family members compared to a control group. Methods: In this clinical demonstration project, longitudinal self-report data were collected from 8 individuals with SCI and their family members in Colombia, South America. The 8 families were randomly assigned to either the SCI intervention group or the waitlist control group. The intervention group included 10 individuals from 4 different families, with a mean age of 41.40 years (SD = 14.18). The control group was composed of 13 individuals from 4 different families with a mean age of 44.38 years (SD = 14.76). All participants completed Spanish versions of instruments that assessed depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), burden (Zarit Burden Interview), and perceived problem-solving skills (Problem-Solving Inventory). Results: Results provide preliminary evidence that symptoms of depression, anxiety, and burden as well as problem-solving appraisals improved significantly for individuals who participated in the intervention, whereas no change in symptoms was observed among those in the waitlist control group. Conclusions: Findings suggest that this newly developed intervention for families facing SCI can be beneficial; however, this pilot study represents only the first step in the examination of the efficacy and effectiveness of this intervention.
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Affiliation(s)
- Lillian Flores Stevens
- Hunter Holmes McGuire Department of Veterans Affairs Medical Center, Richmond, Virginia.,Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Tara Lehan
- Office of Assessment and Institutional Research, Northcentral University, Prescott Valley, Arizona
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Eifert EK, Adams R, Dudley W, Perko M. Family Caregiver Identity: A Literature Review. AMERICAN JOURNAL OF HEALTH EDUCATION 2015. [DOI: 10.1080/19325037.2015.1099482] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Coleman JA, Harper LA, Perrin PB, Olabarrieta Landa L, Leonor Olivera S, Libardo Perdomo J, Anselmo Arango J, Carlos Arango-Lasprilla J. Mind and body: Mental health and health related quality of life in SCI caregivers from Neiva, Colombia. NeuroRehabilitation 2015; 36:223-32. [DOI: 10.3233/nre-151210] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jennifer A. Coleman
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Leia A. Harper
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Paul B. Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | | | | | | | - Jose Anselmo Arango
- Department of Psychology, Universidad Cooperativa de Colombia, Neiva, Colombia
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Conti A, Garrino L, Montanari P, Dimonte V. Informal caregivers' needs on discharge from the spinal cord unit: analysis of perceptions and lived experiences. Disabil Rehabil 2015; 38:159-67. [DOI: 10.3109/09638288.2015.1031287] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Alessio Conti
- City Hospital Health and Science of the City of Turin, Turin, Italy,
| | - Lorenza Garrino
- Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy, and
| | | | - Valerio Dimonte
- Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy, and
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