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Austin PD, Siddall PJ, Lovell MR. Posttraumatic growth in palliative care settings: A scoping review of prevalence, characteristics and interventions. Palliat Med 2024; 38:200-212. [PMID: 38229018 DOI: 10.1177/02692163231222773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND Posttraumatic growth refers to positive psychological change following trauma. However, there is a need to better understand the experience of posttraumatic growth in the palliative care setting as well as the availability and efficacy of interventions that target this phenomenon. AIMS To provide a review of the prevalence, characteristics and interventions involving posttraumatic growth in adults receiving palliative care and to collate recommendations for future development and utilisation of interventions promoting posttraumatic growth. DESIGN We performed a systematic scoping review of studies investigating posttraumatic growth in palliative care settings using the Arksey and O'Malley six-step scoping review criteria. We used the PRISMA guidelines for scoping reviews. DATA SOURCES Articles in all languages available on Ovid Medline [1946-2022], Embase [1947-2022], APA PsycINFO [1947-2022] and CINAHL [1981-2022] in November 2022. RESULTS Of 2167 articles located, 17 were included for review. These reported that most people report low to moderate levels of posttraumatic growth with a decline towards end-of-life as distress and symptom burden increase. Associations include a relationship between posttraumatic growth, acceptance and greater quality-of-life. A limited number of interventions have been evaluated and found to foster posttraumatic growth and promote significant psychological growth. CONCLUSION Posttraumatic growth is an emerging concept in palliative care where although the number of studies is small, early indications suggest that interventions fostering posttraumatic growth may contribute to improvements in psychological wellbeing in people receiving palliative care.
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Affiliation(s)
- Philip D Austin
- Department of Palliative Care, HammondCare, Greenwich Hospital, Sydney, NSW, Australia
| | - Philip J Siddall
- Department of Pain Management, HammondCare, Greenwich Hospital, Sydney, NSW, Australia
- Sydney Medical School-Northern, University of Sydney, Sydney, NSW, Australia
| | - Melanie R Lovell
- Department of Palliative Care, HammondCare, Greenwich Hospital, Sydney, NSW, Australia
- Sydney Medical School-Northern, University of Sydney, Sydney, NSW, Australia
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2
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Clifton S, Bray E, Dong S, McCabe R, Siddall P. Co-design of an intervention exploring meaning and purpose after spinal cord injury. Disabil Rehabil 2024:1-10. [PMID: 38258447 DOI: 10.1080/09638288.2023.2300655] [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: 07/11/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024]
Abstract
PURPOSE Rebuilding a strong sense of meaning and purpose following trauma is a vital contributor to post-traumatic growth and adapting well to a spinal cord injury. This project aimed to develop an intervention that used the concept of post-traumatic growth to foster a stronger sense of meaning and purpose in people with a spinal cord injury. METHODS Using participatory action research methodology, the intervention was designed in an iterative process with health professionals and people with lived experience of spinal cord injury. We developed a ten-week online group program and delivered two pilot programs to 13 participants. We used their feedback to further refine the program before finalisation. RESULTS A participatory action research approach resulted in a positive intervention well received by participants and consumer organisations. Feedback suggests the intervention shows promise for improvements in functional and psychosocial outcomes and has long-term viability. CONCLUSIONS The project successfully developed and delivered a novel program that uses the concept of post-traumatic growth to foster a stronger sense of meaning and purpose. Further implementation of the program with larger numbers will allow for evaluation of the program's effectiveness.
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Affiliation(s)
- Shane Clifton
- Centre for Disability Research and Policy, Faculty of Health Sciences, The University of Sydney, Camperdown, Australia
| | - Emily Bray
- Spinal Cord Injuries Australia, Sydney, Australia
| | - Skye Dong
- Melanoma Institute Australia, Wollstonecraft, Australia
| | | | - Philip Siddall
- Hammondcare, Sydney, Australia
- Sydney Medical School-Northern, The University of Sydney, Camperdown, Australia
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3
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Angel S. Ten years of living with an injured spinal cord: A qualitative longitudinal study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100100. [PMID: 38745602 PMCID: PMC11080325 DOI: 10.1016/j.ijnsa.2022.100100] [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: 04/11/2022] [Revised: 09/19/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
Purpose Rehabilitation and recovery following spinal cord injury often implies a fundamentally changed life. The aim of this study was to explore the process of living with spinal cord injury for 10 years to identify which factors were most decisive for living a fulfilled life. Materials and methods The present study was a 10-year longitudinal qualitative study based on Ricoeur's hermeneutic-phenomenological approach to explore and interpret people's experiences of life during the first 10 years after they had suffered a spinal cord injury. Interviews were conducted with 10 people during the first year and then again after two, five and 10 years. Results The process over 10 years showed that a satisfying life can be led despite limitations caused by the damaged spine by balancing possibilities and the life wished for. Reduced body function did not have to hinder people from living a satisfying life. Bodily issues can move into the background when new skills and routines are developed. This enabled backgrounding body conditions, letting other matters foreground. Thus, life can be experienced as good and can resemble the lives of other people of the same age, though strains and struggles were an integrated part of every activity. However, the new normal was disturbed when bodily conditions could not be kept stable or worsened due to illness, often related to the damaged spine. If this challenged the new way of living, the body foregrounded and became the primary focus for effort and attention, and the process of balancing possibilities and the life wished for had to be repeated. Conclusions Life 10 years after spinal cord injury can be experienced as good despite limitations, partly resembling life lived by other same-aged people. Having stable bodily conditions allowed other matters to foreground. This was important to the process of reconciling oneself to the situation and balancing possibilities and the life wished for.
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Affiliation(s)
- Sanne Angel
- Corresponding author at: Sanne Angel, Associated Professor, Research unit of nursing and healthcare, Department of Public Health. Aarhus University. Bartolins Alle 2, 8000 Aarhus C. Denmark.
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4
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Wasilewski MB, Rios J, Simpson R, Hitzig SL, Gotlib Conn L, MacKay C, Mayo AL, Robinson LR. Peer support for traumatic injury survivors: a scoping review. Disabil Rehabil 2022:1-34. [PMID: 35680385 DOI: 10.1080/09638288.2022.2083702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Peers are uniquely able to draw on their lived experiences to support trauma survivors' recovery. By understanding the functions and outcomes of peer support and the factors that impact implementation, evidence can be mobilized to enhance its application and uptake into standard practice. As such, we aimed to review the literature on peer support for trauma survivors to: examine the role of peer support in recovery; describe the nature and extent of peer support; Examine the influence of peer support on health and well-being; and identify the barriers and facilitators to developing and implementing peer support. METHODS Scoping review methodology as outlined by Arksey and O'Malley. RESULTS Ninety-three articles were reviewed. Peer support was highlighted as an important component of care for trauma survivors and provided hope and guidance for the future post-injury. Most peer support programs were offered in the community and provided one-on-one support from peer mentors using various modalities. Interventions were successful when they involved knowledgeable peer mentors and maintained participant engagement. Prior negative experiences and stigma/privacy concerns deterred trauma survivors from participating. CONCLUSIONS Peer support fulfills several functions throughout trauma survivors' recovery that may not otherwise be met within existing health care systems. Implications for rehabilitationBy understanding the functions and outcomes and the factors that impact implementation of peer support, evidence can be mobilized to enhance its application and uptake into standard practice.Peers provide trauma survivors with socioemotional support as well as assistance in daily management and life navigation post-injury.Peer support provided hope and guidance for the future after injury and improved self-efficacy amongst trauma survivors.Peer support programs are most likely to be successful when they involve knowledgeable peer mentors, are flexibly delivered, align with organizations' values and priorities, and have adequate resources and funding to support their implementation.
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Affiliation(s)
- Marina B Wasilewski
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Jorge Rios
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Robert Simpson
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Sander L Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Lesley Gotlib Conn
- Tory Trauma Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Crystal MacKay
- West Park Healthcare Centre, Toronto, Ontario, Canada.,Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Amanda L Mayo
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Physical Medicine and Rehabilitation, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lawrence R Robinson
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Physical Medicine and Rehabilitation, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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5
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Amsters D, Kendall M, Schuurs S, Kuipers P. Influences on Participation in Life After Spinal Cord Injury: Qualitative Inquiry Reveals Interaction of Context and Moderators. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:898143. [PMID: 36188957 PMCID: PMC9397943 DOI: 10.3389/fresc.2022.898143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022]
Abstract
BackgroundGreater understanding of the influences on participation in life after spinal cord injury (SCI) can inform rehabilitation theory and practice. Careful qualitative inquiry can reveal subjective meanings associated with the relevant experiences, strategies, and perceptions of those with lived experience of SCI. A search of literature, followed by a thematic synthesis of qualitative studies, was undertaken to bring together these insights in a meaningful way.MethodsThe research question guiding the literature review and synthesis was, What do people with SCI perceive to be the influences on their participation in life? Three critical databases were searched for qualitative studies examining influences on participation in life after SCI. Peer-reviewed studies published after 2006, involving adults with SCI living in countries with advanced economies, were included. Data were extracted from 24 articles and subjected to three-level thematic synthesis—the coding of primary data from the studies, the development of descriptive themes based on an organization of those codes, and the generation of analytical themes.ResultsThe synthesis yielded five analytical themes, supported by 17 descriptive themes. The analytical themes were (1) external contextual influences, (2) personal physical context, (3) personal psychological context, (4) potential moderators of participation outcomes, and (5) temporal dimensions of participating in life after SCI.InterpretationThese themes highlight the complex interactions that shape participation from the perspective of people with SCI. Closer examination of the potential moderators may provide insights into effective rehabilitation interventions.ConclusionsSynthesis of qualitative inquiry provides valuable insights into the perceptions of influences on participation in life from the point of view of people with SCI. The findings of this synthesis are instructive for rehabilitation theory and practice. It can complement what we learn from using the ICF to understand participation.
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Affiliation(s)
- Delena Amsters
- Spinal Outreach Team, Queensland Spinal Cord Injuries Service, Metro South Health, Brisbane, QLD, Australia
- The Hopkins Centre, Menzies Health Institute, Griffith University, Brisbane, QLD, Australia
- *Correspondence: Delena Amsters
| | - Melissa Kendall
- The Hopkins Centre, Menzies Health Institute, Griffith University, Brisbane, QLD, Australia
- Transitional Rehabilitation Program, Queensland Spinal Cord Injuries Service, Metro South Health, Brisbane, QLD, Australia
| | - Sarita Schuurs
- Spinal Outreach Team, Queensland Spinal Cord Injuries Service, Metro South Health, Brisbane, QLD, Australia
- The Hopkins Centre, Menzies Health Institute, Griffith University, Brisbane, QLD, Australia
| | - Pim Kuipers
- Central Queensland Centre for Rural and Remote Health, James Cook University, Emerald, QLD, Australia
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6
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Rocchi MA, Shi Z, Shaw RB, McBride CB, Sweet SN. Identifying the outcomes of participating in peer mentorship for adults living with spinal cord injury: a qualitative meta-synthesis. Psychol Health 2021; 37:523-544. [PMID: 33754920 DOI: 10.1080/08870446.2021.1890729] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Peer mentorship is a flagship program utilized by Canadian community-based spinal cord injury (SCI) organizations. Through connecting trained SCI peer mentors with fellow adults with SCI, these programs help adults adapt and thrive following their injury. The objective of this meta-synthesis was to work with SCI community organizations and to identify outcomes of participating in community- or rehabilitation-based peer mentorship programs using an integrated knowledge translation approach. DESIGN A meta-synthesis of 21 qualitative peer-reviewed studies and 66 community documents was conducted. MAIN OUTCOME MEASURES A total of 87 outcomes of peer mentorship were identified. RESULTS The outcomes of peer mentorship were grouped according to six higher-order themes: 1) Independence: enhanced self-sufficiency; 2) Personal growth: positive psychological changes; 3) Activities and participation: greater participation in activities and events; 4) Adaptation: adapting to life with disability; 5) Knowledge: obtaining new information, resources, and opportunities; and 6) Connection: developing and maintaining social relationship. CONCLUSION The positive nature of the identified outcomes suggests that participating in peer mentorship can promote improved health and quality of life for adults with SCI. Furthermore, the integrated knowledge translation approach helped identify outcomes that were previously not examined within SCI peer mentorship research, thus providing important insight for future research.
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Affiliation(s)
- Meredith A Rocchi
- Department of Communication, University of Ottawa, Ottawa, Canada.,Department of Kinesiology and Physical Education, McGill University, Montreal, Canada.,Centre for Interdisciplinary Rehabilitation Research in Metropolitan Montreal, Montreal, Canada
| | - Zhiyang Shi
- Department of Kinesiology and Physical Education, McGill University, Montreal, Canada.,Centre for Interdisciplinary Rehabilitation Research in Metropolitan Montreal, Montreal, Canada
| | - Robert B Shaw
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada
| | | | - Shane N Sweet
- Department of Kinesiology and Physical Education, McGill University, Montreal, Canada.,Centre for Interdisciplinary Rehabilitation Research in Metropolitan Montreal, Montreal, Canada
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7
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Byra S. Associations between post-traumatic growth and wisdom in people with long-term paraplegia - the role of disability appraisals and participation. Disabil Rehabil 2021; 44:3510-3517. [PMID: 33417504 DOI: 10.1080/09638288.2020.1867903] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The number of people with long-term spinal cord injury (SCI) is growing but our knowledge about their successful functioning is still limited. The goal of this study was to investigate the correlations between posttraumatic growth (PTG) and wisdom in people with long-term paraplegia, exploring the mediating effect of disability appraisals, and participation/autonomy (P/A). METHODS One-hundred and sixty-six persons with paraplegia completed a set of questionnaires, which included: The three-dimensional Wisdom Scale; The Post-traumatic Growth Inventory; Appraisals of Disability Primary and Secondary Scale; Impact on Participation and Autonomy Questionnaire. Mediation was tested using bootstrapping and a multiple mediation model with two mediators. RESULTS Positive and significant correlations between PTG, disability appraisals (as determined resilience), P/A, and wisdom were found. PTG is associated with wisdom when disability appraisals and P/A are mediators. Higher PTG was related to higher determined resilience and smaller restrictions in participation, both of which were associated with higher wisdom. CONCLUSIONS The relationship between PTG and wisdom is complex and indirect in people with long-term paraplegia. The mediating variables of disability appraisals and P/A explained the variance in PTG, with P/A playing a more significant role. Findings suggest that long-term SCI may correlate with experiencing high levels of PTG and wisdom, and more positive disability appraisals.Implications for rehabilitationPTG is associated with life wisdom in people with long-term SCI, with a significant contribution of disability appraisal and P/A.Therapists can increase these people's awareness about the possibility of experiencing PTG and maintaining positive changes, despite long-term SCI.Therapists can support people with long-term SCI in maintaining or extending the possibilities of participation and autonomous decision-making about their daily activities, which in consequence may be important for increasing their life wisdom.
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Affiliation(s)
- Stanisława Byra
- Faculty of Education and Psychology, Institute of Pedagogy, Maria Curie-Skłodowska University, Lublin, Poland
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8
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Kee KM, Mohamad NZ, Koh PPW, Yeo JPT, Ng YS, Kam JC, Asano M. Return to work after spinal cord injury: a Singaporean pilot community-based rehabilitation program. Spinal Cord 2020; 58:1096-1103. [PMID: 32273565 DOI: 10.1038/s41393-020-0459-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/20/2020] [Accepted: 03/20/2020] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Retrospective analysis of data collected as part of a pilot program. OBJECTIVES The primary objective of our study was to document the return-to-work rate of individuals with SCI who participated in a community-based interdisciplinary vocational rehabilitation program. The secondary objectives were to assess changes in their levels of community integration and functional independence. SETTING A community-based rehabilitation center in Singapore. METHODS Participants were individuals with SCI between 21 and 55 years. They identified return to work as a rehabilitation goal, and were certified fit to undergo rehabilitation by their physicians. Primary outcome was the return-to-work rate at discharge from the program. Secondary outcomes were community integration and functional independence, measured by the Community Integration Questionnaire (CIQ) and the Spinal Cord Independence Measure III (SCIM-III), respectively. We summarized participants' clinical and socio-demographic characteristics descriptively, and used inferential statistics to compare pre- and postprogram scores for secondary outcome measures. RESULTS Thirty-nine participants were included for this study. Thirty-two completed the program, of which 84% (n = 27) reported returning to work. Participants who completed the program had mean change in total CIQ and SCIM-III scores of 7 (95% CI, 5-8) and 11 (95% CI, 7-15), respectively. There were differences (p < 0.05) between pre- and postprogram scores for both secondary outcome measures. CONCLUSIONS Our findings suggest that our vocational rehabilitation program facilitated participants with SCI in Singapore to return to work and was beneficial to enhance their levels of community integration and functional independence. Future interventional studies are recommended to estimate the efficacy of such programs.
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Affiliation(s)
- Kalya M Kee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
| | - Nizar Z Mohamad
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
| | | | - Joanna P T Yeo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
| | - Yee Sien Ng
- Department of Rehabilitation Medicine, Singapore General Hospital, Singapore, Singapore
| | | | - Miho Asano
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore. .,National University Health System, Singapore, Singapore.
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9
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Gupta S, Jaiswal A, Norman K, DePaul V. Heterogeneity and Its Impact on Rehabilitation Outcomes and Interventions for Community Reintegration in People With Spinal Cord Injuries: An Integrative Review. Top Spinal Cord Inj Rehabil 2019; 25:164-185. [PMID: 31068748 DOI: 10.1310/sci2502-164] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Various injury characteristics such as cause, level, severity, and time since injury divide individuals with spinal cord injury (SCI) into many subgroups. The heterogeneity among individuals' injuries and personal characteristics has significant implications for SCI rehabilitation practice, specifically directed toward community reintegration, which is a key goal of rehabilitation interventions for people with disabilities. Purpose: This study aims to summarize the evidence on attributes that make the SCI population heterogeneous, the impact of these attributes on community reintegration, and the implications of heterogeneity for rehabilitation interventions directed toward optimizing community reintegration. Methods: We used an integrative review approach to conduct this study. MEDLINE, PubMed, CINAHL, EMBASE, Google Scholar, and PsycINFO were searched from inception until May 2017. Out of 670 articles retrieved, 49 provided evidence on the impact of various attributes that make SCI heterogeneous on rehabilitation outcomes related to community reintegration. Results: An array of injury-related, personal, social, and environmental factors are associated with various rehabilitation outcomes that affect community reintegration of people with SCI. There is level 1 evidence that social support, self-efficacy, and self-esteem facilitate community reintegration among people with SCI while there is level 5 evidence that presence of psychological or medical complications decreases it. There is lack of clarity on the impact of injury-related factors on community reintegration. Conclusion: This integrative review found that social support and individuals' self-efficacy can improve community reintegration of people with SCI. However, evidence regarding the impact of injury characteristics on community reintegration is still underdeveloped. Approaches directed at community reintegration should involve components of psychosocial, physical, and vocational rehabilitation while considering personal and societal aspects of an individual's life.
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Affiliation(s)
- Shikha Gupta
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Atul Jaiswal
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Kathleen Norman
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Vincent DePaul
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
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10
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Papavassiliou-Alexiou I, Fotiadou M. People with acquired physical disabilities in Greece in recession: How do they cope with issues of vocational (re-)integration? JOURNAL OF VOCATIONAL REHABILITATION 2019. [DOI: 10.3233/jvr-180998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Maria Fotiadou
- Department of Educational and Social Policy, University of Macedonia, Thessaloniki, Greece
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11
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LaVela SL, Etingen B, Miskevics S, Heinemann AW. What determines low satisfaction with life in individuals with spinal cord injury? J Spinal Cord Med 2019; 42:236-244. [PMID: 29733775 PMCID: PMC6419684 DOI: 10.1080/10790268.2018.1466480] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE To examine variables associated with satisfaction with life (SWL) in individuals with a spinal cord injury (SCI). DESIGN Cross-sectional, national survey to assess SWL, demographic and injury characteristics, health care utilization, chronic conditions (obesity, diabetes, heart problems, lung problems, hypertension, high cholesterol), symptoms (poor sleep, pain, depression), social support, grief/loss, and independence. SETTING/PARTICIPANTS Community-dwelling Veterans with SCI. Outcome Measures/Analyses: Bivariate analyses were conducted to assess differences in demographics, injury characteristics, chronic conditions, symptoms, social support, grief/loss, and independence in individuals who reported low SWL (≤20) vs. average/high SWL (21-35). Multivariate logistic regression assessed factors independently associated with low SWL. RESULTS 896 Veterans with SCI (62%) responded. Average age was 62 years, the majority were male (94%), Caucasian (77%), and had paraplegia (61%). Odds of low SWL were 2.4 times greater for individuals experiencing pain (OR = 2.43, CI95: 1.47-4.02, P = 0.0005). Odds of low SWL were increased for individuals reporting greater grief/loss due to their SCI (OR = 1.14, CI95: 1.10-1.18, P < 0.0001). Lesser odds of low SWL were seen for individuals reporting greater emotional social support (OR = 0.97, CI95: 0.96-0.99, P < 0.0001) and independence (OR = 0.94, CI95: 0.90-0.97, P < 0.0001). CONCLUSIONS Pain and feelings of grief/loss due to injury were associated with low SWL. Self-perceived independence and good social support were associated with better SWL. Along with addressing pain and facilitating independence and social support, these findings suggest that interventions to improve SWL should focus on helping individuals deal with grief/loss due to injury.
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Affiliation(s)
- Sherri L. LaVela
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital, Hines, Illinois, USA,Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA,Correspondence to: Sherri L. LaVela, PhD, MPH, MBA, Department of Veterans Affairs, Edward Hines, Jr. VA Hospital (151-H, Building 1, Office D-312), 5th Avenue & Roosevelt Road, Hines, IL60141, USA; Ph: (708) 202-5895, (708) 202-2499.
| | - Bella Etingen
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital, Hines, Illinois, USA
| | - Scott Miskevics
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital, Hines, Illinois, USA
| | - Allen W. Heinemann
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA,Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Illinois, USA
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12
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Byra S. Basic hope and posttraumatic growth in people with traumatic paraplegia- the mediating effect of acceptance of disability. Spinal Cord 2018; 57:301-307. [PMID: 30374064 DOI: 10.1038/s41393-018-0215-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 09/14/2018] [Accepted: 09/17/2018] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES Investigating the correlations between basic hope, acceptance of disability, and posttraumatic growth (PTG) in people with traumatic paraplegia, exploring the mediating effect of acceptance of disability. SETTING Community-dwelling people with traumatic paraplegia in Poland. METHODS Data were obtained from 281 individuals with paraplegia. The set of questionnaires included: The Posttraumatic Growth Inventory (PTGI); Basic Hope Inventory (BHI); and The Multidimensional Acceptance of Loss Scale. Four dimensions of disability acceptance were measured: subordinating physique relative to other values, enlarging the scope of values, transforming comparative-status values into asset values, and containing the effects of disability. Mediation was tested with the Baron and Kenny's approach. RESULTS A positive and statistically significant correlation between basic hope, acceptance of disability, and posttraumatic growth was found. Using a hierarchical regression analysis, a mediating effect of acceptance of disability was found for explaining the relationship between basic hope and posttraumatic growth in people with paraplegia. Only two dimensions of disability acceptance, subordinating physique relative to other values and transforming comparative-status values into asset values, were found to play a mediating role. CONCLUSION Beliefs about the world and the transformation of values that constitute acceptance of disability are important for explaining PTG in people with paraplegia. Correlations between these variables are complex. The correlation between basic hope and posttraumatic growth in individuals with paraplegia may be understood better by taking into account the mediating role of acceptance of disability.
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Affiliation(s)
- Stanisława Byra
- Faculty of Education and Psychology, Institute of Pedagogy, Maria Curie-Skłodowska University, Lublin, Poland, Narutowicza 12, 20-004, Lublin, Poland.
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13
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Renwick R, Yoshida K, Eacrett E, Rose N. Meaning of Staring and the Starer-Staree Relationship Related to Men Living With Acquired Spinal Cord Injuries. Am J Mens Health 2018; 12:283-291. [PMID: 26873341 PMCID: PMC5818106 DOI: 10.1177/1557988316632297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
When in public places, many individuals with physical disabilities experience staring. Although staring is typically seen as uncomplicated and something to be "ignored," it has consequences for the person being stared and the staree. Few studies have focused on staring experienced by men following spinal cord injury (SCI). Accordingly, this study explored how adult men with SCI give meaning to the staring from others, the consequences for them, and their responses to the staring and to the starer. Principles of modified grounded theory methods were used to conduct a secondary analysis of interview data for 30 male participants from a larger study of community-dwelling individuals with SCI. Themes revealed through analysis related to context-dependent meanings of staring, negative consequences of staring for some men, and positive opportunities for self-growth and interaction with the public. These findings contribute to a more complex understanding of staring and the relationship between the starer and staree in various social circumstances which can support people living with differences in their public interactions, and improve their quality of life.
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The meaning of work after spinal cord injury: a scoping review. Spinal Cord 2017; 56:92-105. [PMID: 29057988 DOI: 10.1038/s41393-017-0006-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 08/21/2017] [Accepted: 08/21/2017] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Scoping review. OBJECTIVES To explore the meaning of work after spinal cord injury (SCI) in existing literature. METHODS Arksey and O'Malley's widely used methodological framework for scoping reviews was used to guide this review. Studies involving adults with SCI, conducted using qualitative methods, and published in peer reviewed literature were identified based on key terms and searches in three databases (CINAHL, MEDLINE, PsycINFO). Further search steps included checking citations in identified articles and citation tracking for other relevant articles and reviews. Reported qualitative data were then thematically analysed to generate themes. RESULTS Twelve studies were included. Three themes were identified across these studies that describe the meanings of work after spinal cord injury: re-developing a sense of self, re-establishing place in the community and regaining economic self-sufficiency. CONCLUSIONS The varied meanings of work after SCI identified in this review may be used in rehabilitation programs to explore ideas about work, the types of work they wish to pursue, and the ways in which work may be meaningful for people with SCI, so as to identify individually and contextually relevant work. Taking account of meaning in ICF based models of work participation could enhance patient-centred approaches in SCI rehabilitation.
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Bjørnshave Noe B, Bjerrum M, Angel S. The influence of clarification and threats on life situation: patients' experiences 1 year after TSCI. Spinal Cord Ser Cases 2017; 3:17006. [PMID: 28435741 DOI: 10.1038/scsandc.2017.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 12/22/2016] [Accepted: 01/10/2017] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The study was conducted at the Spinal Cord Injury Centre of Western Denmark (VCR). The aim of the study was to explore patients' experiences following traumatic spinal cord injury and to identify characteristics of positive versus negative life situation 1 year post discharge from hospital rehabilitation. This was a qualitative study conducted using inductive content analysis. CASE PRESENTATION In this qualitative study seven patients were interviewed one year after discharge from initial rehabilitation at the VCR. The interviews were analysed using inductive content analysis. DISCUSSION We found that two categories condensed the patients' experiences of their life situation 1 year post discharge: 'clarification in relation to overall life situation' and 'threat to core competences'. The transversal analysis across the derived categories identified different combinations of clarification and threats to core competences explaining the patients' experiences: high degree of clarification combined with low degree of threat to core competences was indicative of positive life situation. Also, positive life situation was seen when a high degree of clarification compensated for high degree of threats on core competencies. In contrast, an overall stressful and negative life situation was influenced by poor clarification combined with a high degree of threat to core competences. However, when core competences can be transformed into new skills, threats were manageable. This study revealed that clarification related to overall life situation in combination with threat to core competences may explain traumatic spinal cord injury patients' overall life situation 1 year post discharge. An appropriate balance characterises a positive life situation. There might be a need to pay attention to patients who are challenged by low degree of clarification and high degree of threats on core competencies 1 year post discharge as this may influence the life situation negatively.
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Affiliation(s)
- Bodil Bjørnshave Noe
- Section of Nursing, Institute of Public Health, Health, Aarhus University, Aarhus, Denmark
| | - Merete Bjerrum
- Section of Nursing, Institute of Public Health, Health, Aarhus University, Aarhus, Denmark
| | - Sanne Angel
- Section of Nursing, Institute of Public Health, Health, Aarhus University, Aarhus, Denmark
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Littooij E, Leget CJW, Stolwijk-Swüste JM, Doodeman S, Widdershoven GAM, Dekker J. The importance of ‘global meaning’ for people rehabilitating from spinal cord injury. Spinal Cord 2016; 54:1047-1052. [DOI: 10.1038/sc.2016.48] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Revised: 02/24/2016] [Accepted: 02/28/2016] [Indexed: 11/10/2022]
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Littooij E, Widdershoven GA, Stolwijk-Swüste JM, Doodeman S, Leget CJ, Dekker J. Global meaning in people with spinal cord injury: Content and changes. J Spinal Cord Med 2016; 39:197-205. [PMID: 25615571 PMCID: PMC5072500 DOI: 10.1179/2045772314y.0000000290] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND After spinal cord injury (SCI), people are confronted with abrupt discontinuity in almost all areas of life, leading to questions on how to live a meaningful life again. Global meaning refers to basic ideas and goals that guide people in giving meaning to their lives, in specific situations. Little is known about global meaning relating to SCI and whether global meaning changes after SCI. PURPOSE The purpose of this study was twofold: (i) to explore the content of global meaning of people with SCI, and (ii) to explore whether or not global meaning changes after SCI. METHODS In-depth semi-structured interviews were conducted with 16 people with SCI. Interviews were analyzed according to the method of grounded theory. RESULTS (i) Five aspects of global meaning were found: core values, relationships, worldview, identity and inner posture. (ii) Overall, little change in the content of global meaning was found after SCI; specific aspects of global meaning were foregrounded after SCI. CONCLUSION Five aspects of global meaning were found in people with SCI. Global meaning seems hardly subject to change.
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Affiliation(s)
- Elsbeth Littooij
- Amsterdam Rehabilitation Research Center, Reade, The Netherlands,Correspondence to: Elsbeth Littooij, Amsterdam Rehabilitation Research Center
- Reade, PO Box 58271, 1040 HG Amsterdam, The Netherlands.
| | - Guy A.M. Widdershoven
- Department of Medical Humanities, VU University Medical Center, Amsterdam, The Netherlands,EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | | | - Suzan Doodeman
- Amsterdam Rehabilitation Research Center, Reade, The Netherlands
| | - Carlo J.W. Leget
- Department of Care and Welfare, University of Humanistic Studies, Utrecht, The Netherlands
| | - Joost Dekker
- EMGO Institute for Health and Care Research, Amsterdam, The Netherlands,Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands,Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
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18
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Wang Y, Wang H, Wang Z, Xie H, Shi J, Zhao X. The process of posttraumatic growth in individuals with traumatic spinal cord injury in Mainland China: An interpretative phenomenological analysis. J Health Psychol 2015; 22:637-649. [PMID: 26466850 DOI: 10.1177/1359105315610812] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aims to explore the process of posttraumatic growth for individuals who have sustained a traumatic spinal cord injury. Semi-structured interviews were conducted with 12 participants with spinal cord injury from the local community. Interviews were recorded on audiotape and transcribed verbatim. Transcripts were analyzed using interpretative phenomenological analysis. Three superordinate themes emerged: struggling in hopelessness, disentangling from disability, facing challenge, and achieving positive growth. Our findings reveal how individuals with spinal cord injury overcome their disability to achieve personal growth, and can contribute to clinicians' understanding of psychological responses to spinal cord injury while promoting physical and psychological recovery in these individuals.
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Affiliation(s)
- Yanbo Wang
- 1 School of Medicine, Tongji University, China
| | | | | | - Haixia Xie
- 3 Shanghai Sunshine Rehabilitation Center, China
| | - Jingyu Shi
- 1 School of Medicine, Tongji University, China
| | - Xudong Zhao
- 1 School of Medicine, Tongji University, China
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19
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Büssing A. Spirituality/Religiosity as a Resource for Coping in Soldiers: A Summary Report. Med Acupunct 2015. [DOI: 10.1089/acu.2014.1062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Arndt Büssing
- Professorship Quality of Life, Spirituality and Coping, Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Germany
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20
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Yoshida KK, Self HM, Renwick RM, Forma LL, King AJ, Fell LA. A value-based practice model of rehabilitation: consumers’ recommendations in action. Disabil Rehabil 2014; 37:1825-33. [DOI: 10.3109/09638288.2014.981301] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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21
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Lundström U, Lilja M, Gray D, Isaksson G. Experiences of participation in everyday occupations among persons aging with a tetraplegia. Disabil Rehabil 2014; 37:951-7. [DOI: 10.3109/09638288.2014.948139] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Salbach NM, O'Brien K, Evans C, Yoshida K. Dissemination of student research in a canadian master of science in physical therapy programme. Physiother Can 2014; 65:154-7. [PMID: 24403678 DOI: 10.3138/ptc.2012-18] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the extent of presentation and publication, as well as time to publication, of student research completed as a component of a Master of Science in Physical Therapy (MScPT) degree at a Canadian university. METHOD The authors conducted a retrospective cross-sectional study of MScPT research projects completed between 2003 and 2009, each undertaken by a group of MScPT students who carried out protocol development, ethics submission, data collection, analysis, and manuscript and poster preparation under the supervision of research advisors. Research advisors were e-mailed a request for citations of presentations and publications. RESULTS Advisors from 102 of 113 research projects completed from 2003 through 2009 provided information, for a response rate of 90.3%. Of the 102 groups, 53.9% disseminated findings through publication or presentation, 33.3% presented at one or more conferences, and 30.4% published at least one peer-reviewed journal article. Median time to publication was 21 months. Almost half the journal articles (47%) were published in Physiotherapy Canada. CONCLUSIONS MScPT student research groups are disseminating their findings through publication or presentation at a moderate rate. Investigation of factors influencing dissemination is needed to develop strategies to facilitate knowledge transfer.
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Affiliation(s)
- Nancy M Salbach
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto
| | - Kelly O'Brien
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto
| | - Cathy Evans
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto
| | - Karen Yoshida
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto
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Mutch K, Methley A, Moore P, Jacob A. Life on hold: the experience of living with neuromyelitis optica. Disabil Rehabil 2013; 36:1100-7. [PMID: 24028351 DOI: 10.3109/09638288.2013.833301] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE Neuromyelitis optica (NMO) is a rare autoimmune condition characterised by acute relapses of optic neuritis and extensive transverse myelitis. The aim of this qualitative study was to develop an improved understanding of the experiences of people living with NMO. METHOD Fifteen participants completed a semi-structured interview and data were interpreted using a constant comparative method. Participants were recruited from the Northern UK NMO Service. RESULTS Five major themes were identified: diagnosis and treatment, symptoms, adjustment, identity and support. CONCLUSION Results suggest NMO is a difficult condition to live with due to the unpredictability of relapses and accrued disability of visual or spinal symptoms occurring with each relapse. Poor vision, reduced mobility, bladder dysfunction and pain affected participants' independence and experience of living with NMO. Participants reported that during relapse and recovery they would "put their life on hold". They identified the importance of periods of stability to enable them to adjust to their condition and therefore aim for "normality" of life that they believed was comparable to their peers. Implications for Rehabilitation Disability due to NMO has a major impact on an individual's life, abilities and identity. Timely treatment of relapse is essential to reduce or prevent disability. Health care professionals need to coordinate care locally and nationally. Multi-disciplinary work is vital to promote adjustment, coping strategies and support for people living with NMO.
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Affiliation(s)
- Kerry Mutch
- Neuromyelitis Optica Service, Department of Neurology, Walton Centre Foundation Trust , Liverpool , UK
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Kennedy P, Lude P, Elfström ML, Cox A. Perceptions of gain following spinal cord injury: a qualitative analysis. Top Spinal Cord Inj Rehabil 2013; 19:202-10. [PMID: 23960704 DOI: 10.1310/sci1903-202] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Significant research has focused on psychological difficulties following spinal cord injury (SCI), and there is a small prevalence of individuals who experience distress after injury. However, the converse is that many adjust well to injury and rate their quality of life highly. Despite this, there has been a comparative dearth of research investigating positive psychological outcomes after SCI, perceived by individuals living with this disability. OBJECTIVE To explore individuals' perceptions of gain following the experience of SCI. METHODS Participants, who had sustained an SCI between the ages 16 and 83, responded to an open-ended written question: "What do you think you have gained from the experience of spinal cord injury?" This was administered at 4 time points post injury: 6 weeks, 12 weeks, 1 year, and 2 years. RESULTS Participants' responses were analyzed qualitatively using the framework of thematic analysis. Thirteen themes were identified: relationships, appreciation of relationships, perspective and appreciation of life, new goals or priorities, understanding of SCI or disability, appreciation of health or health care, changed personality, opportunity or challenge, knowledge of SCI or body, newly acquired skills, spirituality, acceptance, and nothing. Descriptive statistics were incorporated in the presentation of the data. CONCLUSIONS This study provides evidence that a broad range of positive as well as negative psychological outcomes are possible following SCI. More research is needed to better understand the process through which these outcomes arise and to inform how such outcomes may be communicated to persons experiencing this type of injury.
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Affiliation(s)
- P Kennedy
- Oxford Doctoral Course in Clinical Psychology, University of Oxford , UK ; Department of Clinical Psychology, National Spinal Injuries Centre, Stoke Mandeville Hospital , Aylesbury, Buckinghamshire , UK
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Dibb B, Ellis-Hill C, Donovan-Hall M, Burridge J, Rushton D. Exploring positive adjustment in people with spinal cord injury. J Health Psychol 2013; 19:1043-54. [DOI: 10.1177/1359105313483158] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study explored adjustment in people with spinal cord injury; data from four focus groups are presented. Thematic analysis revealed four themes, managing goals and expectations, comparison with others, feeling useful and acceptance, showing participants positively engaged in life, positively interpreted social comparison information and set realistic goals and expectations. These positive strategies show support for adjustment theories, such as the Cognitive Adaptation Theory, the Control Process Theory and Response Shift Theory. These results also provide insight into the adjustment process of a person with spinal cord injury and may be useful in tailoring support during rehabilitation.
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