Subjective Well-Being Among People with Spinal Cord Injuries

The purpose of this study was to explore the joint contributions of demographic variables, perceived health, self-efficacy beliefs, and perceived social support to subjective well-being (SWB) in people with spinal cord injuries (SCI). One hundred twenty-seven individuals with SCI participated in the study. The results indicated that general self-efficacy, perceived social support, perceived health, and age at injury accounted for a substantial variance in SWB of the participants. Income was correlated with SWB, but it did not contribute to the prediction of SWB when the influences of general self-efficacy, perceived social support, perceived health, and age at injury were statistically controlled. Gender, ethnicity, and educational level were not significantly correlated with SWB. Implications of the results for rehabilitation counseling practice and research are discussed.

Living with a spinal cord injury: a grounded theory approach

AIMS

This paper reports a study which examined patients' experiences of suffering a spinal cord injury.

BACKGROUND

Spinal cord injury has major bio-psycho-social and spiritual implications for patients. However, very limited research exists regarding the experience of patients with spinal cord injury in Taiwan or other countries worldwide.

METHOD

Grounded theory was used to explore the psychosocial implications for patients of spinal cord injury.

DATA COLLECTION AND ANALYSIS

Data were collected from October 2002 - March 2003 through tape-recorded, semi-structured interviews and complete observation of a group discussion focusing on patients with tetraplegia, in a rehabilitation hospital in Taiwan. The number of patients with spinal cord injury interviewed for this study was 15, involving 18 interviews. Data collection and analysis occurred concurrently.

RESULTS

The findings resulted in the core category 'living with a spinal cord injury' and identify the experiences of suffering a spinal cord injury. Three stages were identified as the individual experience, including four categories: stage 1 A catastrophic life event, stage 2 Confront challenges and stage 3 Moving forward or Withdraw from society.

CONCLUSIONS

This study shows that patients suffering a spinal cord injury have to find their own way and learn to live with their disability. Patients who did better in living with spinal cord injury point could move forward, otherwise, they may withdraw from society.

RELEVANCE TO CLINICAL PRACTICE

Health professionals need to recognize patients' experiences, perceptions and needs, to provide better nursing care.

An examination of depression through the lens of spinal cord injury. Comparative prevalence rates and severity in women and men

PURPOSE

This study describes the prevalence of probable major depressive disorder (MDD) as well as other depressive disorders (ODD) and severity of depressive symptoms in a national sample of women with spinal cord injury (SCI) and compares them with a case-matched sample of men with SCI.

METHODS

A sample of 585 women was drawn and case-matched with men from the SCI Model System National SCI Database according to level/completeness of injury, follow-up year, and age. The outcome measure of depression was the Patient Health Questionnaire.

MAIN FINDINGS

Prevalence rates for women were 7.9% for probable MDD and 9.7% for ODD; rates for men were 9.9% and 10.3%, respectively. Logistic regression revealed that women who were divorced or at year 1 follow-up had a higher odds of having probable MDD (odds ratio [OR], 3.4 and 2.9, respectively). Employed women and men had significantly lower odds of probable MDD (OR, 0.274 and 0.358, respectively). Statistically significant differences were not found in gender comparisons for either probable MDD or symptom severity, which also were not associated with injury characteristics.

CONCLUSION

The most significant, and unexpected, research finding is the absence of gender differences in probable MDD and symptom severity. Results challenge notions that depression will necessarily follow SCI; that injury characteristics determine the development and severity of depression; and that women experience a greater burden of depression than men. The main clinical implication is that depression screening and referral should be a routine feature of health care for women living with SCI, as well as for their male counterparts. Furthermore, nearly one fourth of women and men reported experiencing some or greater difficulty in daily life and relationships in the absence of probable depressive disorder, warranting monitoring of subsyndromal depression as well.