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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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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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Shackleton C, Swartz L, Skowno P, Evans R, West S, Albertus Y, Derman W, Bantjes J. A qualitative study of the perceived benefits of participating in a spinal cord rehabilitation intervention in a low-middle income country. Disabil Rehabil 2023:1-7. [PMID: 37789608 DOI: 10.1080/09638288.2023.2265816] [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: 04/27/2022] [Accepted: 09/15/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE Improving quality of life (QoL) is a major goal of rehabilitation following spinal cord injury (SCI). However, people with disabilities in resource constrained contexts have limited access to rehabilitation and poorer health outcomes, including QoL. There is a paucity of qualitative research on the experiences of persons with SCI involved in rehabilitation programmes in low-middle income countries. This study aimed to assess participants' perceptions of the benefits of a 24-week SCI rehabilitation programme delivered as part of a pilot randomized controlled trial (RCT) in South Africa. MATERIALS AND METHODS Sixteen participants, with chronic motor-incomplete tetraplegia, were enrolled in a two-arm pilot RCT involving robotic locomotor training, a novel technology, and standard activity-based training (Pan African Clinical Trial Registry (PACTR201608001647143)). Data were collected via in-depth interviews and analysed using thematic analysis. RESULTS Participants described several improvements in QoL, including enhanced functional independence; reduced secondary complications; and improved psychosocial and emotional well-being. CONCLUSIONS The holistic approach to rehabilitation calls for the involvement of individuals' views about what matters to them to inform clinical practice and to highlight the role that physical activity and the perceived successes play in shaping the lived experiences after SCI. TRIAL REGISTRATION Pan African Clinical Trial Registry (PACTR201608001647143), registration date (21st May 2016), study start date (30th Nov 2016)https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1647.
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Affiliation(s)
- Claire Shackleton
- Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Leslie Swartz
- Department of Psychology, Stellenbosch University, Western Cape, South Africa
| | - Philippa Skowno
- Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Robert Evans
- Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Sacha West
- Department of Sport Management, Cape Peninsula University of Technology, Cape Town, Western Cape, South Africa
| | - Yumna Albertus
- Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Wayne Derman
- Faculty of Medicine and Health Sciences, Institute of Sport and Exercise Medicine, Stellenbosch University, Cape Town, Western Cape, South Africa
- IOC Research Center, Cape Town, South Africa
| | - Jason Bantjes
- Mental Health, Alcohol, Substance Use and Tobacco (MAST) Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Simpson B, Villeneuve M, Clifton S. Exploring well-being services from the perspective of people with SCI: A scoping review of qualitative research. Int J Qual Stud Health Well-being 2021; 16:1986922. [PMID: 34694982 PMCID: PMC8547844 DOI: 10.1080/17482631.2021.1986922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Objective Well-being after spinal cord injury is affected by a range of factors, many of which are within the influence of rehabilitation services. Although improving well-being is a key aim of rehabilitation, the literature does not provide a clear path to service providers who seek to improve well-being. This study aimed to inform service design by identifying the experience and perspective of people with SCI about interventions targeting their well-being. Method The scoping review of qualitative literature used thematic analysis to identify and categorize themes related to service activities, valued aspects, limitations and perceived outcomes. Results Thirty-eight studies were selected, related to a range of service types. Most studies did not adopt a well-being conceptual framework to design and evaluate the services. People with SCI particularly valued being treated with dignity, positive expectations, increased autonomy and peer support. Improvements to well-being were reported, including many years post-SCI. However, people with SCI reported limited opportunities to engage in such services. Conclusions Rehabilitation services can improve well-being across the lifetime of people with SCI, but gaps in service provision are reported. The review identified valued aspects of services that may inform service design, including staff approach and positive expectations, having own skills and worth valued, peer support and interaction, autonomy in valued occupations, and long-term opportunities for gains.
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Affiliation(s)
- Bronwyn Simpson
- Occupational Therapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | | | - Shane Clifton
- Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, Australia; Centre for Disability Research, The University of Sydney, Sydney, Australia
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Simpson B, Villeneuve M, Clifton S. The experience and perspective of people with spinal cord injury about well-being interventions: a systematic review of qualitative studies. Disabil Rehabil 2020; 44:3349-3363. [PMID: 33377801 DOI: 10.1080/09638288.2020.1864668] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Promoting well-being is a key aim of rehabilitation. The intentional design of interventions to address well-being requires an understanding of the factors that affect this complex phenomenon. A growing body of qualitative literature has identified determinants that people with SCI report affect their well-being. It is unclear whether or how rehabilitation interventions can influence these well-being determinants. This study sought to explore the experience and perspective of people with SCI about interventions that target their well-being. METHOD Systematic search of seven databases. Deductive analysis to categorize findings related to well-being determinants, and further inductive coding to identify sub-themes, relationships and additional findings. RESULTS Twenty studies were selected, involving a wide range of interventions. Each intervention influenced a number of well-being determinants, which were inter-related. People with SCI reported improvements in both subjective and psychological well-being. However, well-being was not always well defined in the studies and people with SCI reported lack of priority for, and opportunity to engage in, well-being interventions in the current rehabilitation system. CONCLUSIONS Rehabilitation interventions can influence well-being determinants. These determinants form a useful framework for the intentional design of well-being interventions, which should be informed by a broad understanding of well-being.IMPLICATIONS FOR REHABILITATIONWell-being can be influenced by rehabilitation interventions, and a more explicit focus on well-being in intervention design and evaluation is recommended.Conceptual frameworks used to define and measure well-being should adopt a broad understanding of well-being.Well-being interventions should address the determinants identified by people with SCI (engaging in occupation, responsibility, values and perspectives, self-worth, self-continuity, relationships and the environment).People with SCI want a greater priority placed on well-being interventions, and more opportunities to engage in these interventions, especially in the community.
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Affiliation(s)
- Bronwyn Simpson
- Occupational Therapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | | | - Shane Clifton
- Centre for Disability Research, The University of Sydney, Sydney, Australia.,Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, Sydney, Australia
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Rocca CH, Moseson H, Gould H, Foster DG, Kimport K. Emotions over five years after denial of abortion in the United States: Contextualizing the effects of abortion denial on women's health and lives. Soc Sci Med 2020; 269:113567. [PMID: 33309441 DOI: 10.1016/j.socscimed.2020.113567] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/04/2020] [Accepted: 11/26/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Turnaway Study was the first to follow women denied abortions because of state law or facility policy over five years. The study has found negative effects on women's socioeconomic status, physical health, and on their children's wellbeing. However, women did not suffer lasting mental health consequences, prompting questions about the effects of denial on women's emotions. METHODS In this mixed methods study, we used quantitative and qualitative interview data from the Turnaway Study to offer insight into these findings. We surveyed 161 women who were denied abortions at 30 facilities across the United States between 2008 and 2010 one week after the abortion denial and semiannually over five years. Mixed-effects regression analyses examined emotions about having been denied the abortion over time. To contextualize the quantitative findings, we draw on in-depth qualitative interviews with 15 participants, conducted in 2014-2015, for their accounts of their emotions and feelings over time. RESULTS Survey participants reported both negative and positive emotions about the abortion denial one week after. Emotions became significantly less negative and more positive over their pregnancy and after childbirth. In multivariable models, lower social support, more difficulty deciding to seek abortion, and placing the baby for adoption were associated with reporting more negative emotions. Interviews revealed how, for some, belief in antiabortion narratives contributed to initial positive emotions. Subsequent positive life events and bonding with the child also led to positive retrospective evaluations of the denial. CONCLUSIONS Findings of emergent positive emotions about having been denied an abortion suggest that individuals are able to cope emotionally with an abortion denial, although evidence that policies leading to abortion denial cause significant health and socioeconomic harms remains.
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Affiliation(s)
- Corinne H Rocca
- University of California, San Francisco, School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, Advancing New Standards in Reproductive Health (ANSIRH), 1330 Broadway, Suite 1100, Oakland, CA, 94612, USA.
| | - Heidi Moseson
- Ibis Reproductive Health, 1736 Franklin Street, Suite 600, Oakland, CA, 94612, USA.
| | - Heather Gould
- University of California, San Francisco, School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, Advancing New Standards in Reproductive Health (ANSIRH), 1330 Broadway, Suite 1100, Oakland, CA, 94612, USA.
| | - Diana G Foster
- University of California, San Francisco, School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, Advancing New Standards in Reproductive Health (ANSIRH), 1330 Broadway, Suite 1100, Oakland, CA, 94612, USA.
| | - Katrina Kimport
- University of California, San Francisco, School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, Advancing New Standards in Reproductive Health (ANSIRH), 1330 Broadway, Suite 1100, Oakland, CA, 94612, USA.
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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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Torregrosa-Ruiz M, Tomás-Miguel JM. Diferencias de sexo en el uso de estrategias de afrontamiento en personas con lesión medular. AQUICHAN 2017. [DOI: 10.5294/aqui.2017.17.4.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objetivo: profundizar en la experiencia de afrontamiento en personas con lesión medular (LM), teniendo en cuenta tanto el afron- tamiento actual como el afrontamiento durante momentos iniciales tras sufrir la LM. Materiales y métodos: estudio transversal de encuesta. Participaron 127 personas con LM de larga evolución, 95 hombres y 32 mujeres. Los datos fueron recogidos por medio de un cuestionario online con información sociodemográfica y el Cuestionario de Afrontamiento del Estrés (CAE). Se han realizado análisis descriptivos, pruebas t de Student y análisis multivariados de la varianza (Manovas) Resultados: las comparaciones intrasujetos muestran que la estrategia de focalización en solución de problemas se usa más en el afrontamiento actual. La autofocalización negativa es más utilizada en el afrontamiento pasado, en los momentos iniciales tras sufrir la LM. Los resultados de los Manovas muestran que no existen diferencias en función del sexo en el afrontamiento rememorado ni en el actual. Los Anova de seguimiento para el afrontamiento actual evidencian que las mujeres utilizan más las estrategias de búsqueda de apoyo social y expresión emocional abierta. Conclusiones: no hay diferencias de sexo en el uso de las estrategias de afrontamiento en la LM. Se sugiere seguir investigando cómo el género puede actuar en este proceso.
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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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Ferdiana A, Post MWM, King N, Bültmann U, van der Klink JJL. Meaning and components of quality of life among individuals with spinal cord injury in Yogyakarta Province, Indonesia. Disabil Rehabil 2017; 40:1183-1191. [PMID: 28271725 DOI: 10.1080/09638288.2017.1294204] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Knowledge on the meaning of quality of life in individuals with spinal cord injury in developing countries is limited. This study aims to explore the meaning and components of quality of life for individuals with spinal cord injury in a rural area in Indonesia. METHOD Data were obtained through semi-structured interviews with 12 individuals with paraplegia (8 males, 4 females) aged 24-67 years. Thematic analysis was used to identify themes that constitute meaning and components of quality of life. RESULTS Quality of life was not an easily understood concept, while "life satisfaction" and "happiness" were. Life satisfaction was associated with a person's feeling when achieving goals or dreams and related to fulfillment of needs. Thirteen components of life satisfaction were identified and categorized into five domains as follows: (1) participation: earning income and work, being useful to others, community participation, and having skills and knowledge, (2) social support: social support, social relationship, (3) relationship with God: injury is God's will, praying, (4) independence: being independent, mobility and accessibility, and health, and (5) psychological resources: accepting the condition, maintaining goals and motivation. CONCLUSIONS Social, cultural and religious influences were prominent in the perception of life satisfaction. The measurement of quality of life for individuals with spinal cord injury in Indonesia needs to consider locally perceived meaning and components of quality of life. Implications for Rehabilitation Financial, social and health needs of individuals with spinal cord injury in Indonesia must be immediately addressed. To increase financial independence, rehabilitation professionals should equip individuals with spinal cord injury with adequate self-employment skills. Sociocultural and religious aspects should be considered in the measurement of quality of life.
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Affiliation(s)
- Astri Ferdiana
- a Community and Occupational Medicine, Department of Health Sciences , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands.,b Department of Public Health, Faculty of Medicine , University of Mataram , Mataram , Indonesia
| | - Marcel W M Post
- c Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat , Utrecht , The Netherlands.,d Department of Rehabilitation Medicine , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Nigel King
- e School of Human and Health Sciences, University of Huddersfield , Huddersfield , UK
| | - Ute Bültmann
- a Community and Occupational Medicine, Department of Health Sciences , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Jac J L van der Klink
- f Tranzo , School of Social and Behavioral Sciences, Tilburg University , Tilburg , The Netherlands
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Factors Which Facilitate or Impede Interpersonal Interactions and Relationships after Spinal Cord Injury: A Scoping Review with Suggestions for Rehabilitation. Rehabil Res Pract 2017; 2016:9373786. [PMID: 28127471 PMCID: PMC5227179 DOI: 10.1155/2016/9373786] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/20/2016] [Accepted: 11/16/2016] [Indexed: 11/22/2022] Open
Abstract
Interpersonal interactions and relationships can influence an individual's perceptions of health and quality of life in the presence of disability. In the case of people with spinal cord injury (SCI), positive interpersonal interactions and relationships have been shown to contribute to resilience and adaptability. Understanding factors which facilitate or impede the development and maintenance of relationships after SCI may form the basis for proactive relationship support for people with SCI. To gain a broad insight into these factors, a scoping review was undertaken. Databases were searched for English language studies published between 2000 and 2015 that informed the review question. Sixty-two (62) studies were identified. Thematic analysis was conducted on data extracted from the studies and 51 factors which may facilitate relationships and 38 factors which may impede relationships after SCI were noted. The majority of factors could be categorized as environmental or personal according to the domains of the International Classification of Functioning, Disability, and Health (ICF). The facilitating factors included partner and social support, reciprocity in relationships, and presenting oneself positively. Impeding factors included physical environmental barriers, real and perceived social biases, and poor self-image. Factors identified may inform the provision of supportive, holistic rehabilitation for people with SCI.
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Callaway L, Barclay L, McDonald R, Farnworth L, Casey J. Secondary health conditions experienced by people with spinal cord injury within community living: implications for a National Disability Insurance Scheme. Aust Occup Ther J 2016; 62:246-54. [PMID: 26256853 DOI: 10.1111/1440-1630.12206] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Australia's National Disability Insurance Scheme (NDIS) provides supports for individuals, delivered through a personalised participant planning process, to influence choice and goal attainment. AIM This study aimed to use both quantitative and qualitative methods to examine the impact of secondary health conditions on the experiences of people with spinal cord injury (SCI) who have returned to community living, in the context of Australia's National Disability Strategy and recently launched NDIS. Exploration of lived experience of health conditions following SCI utilising this mixed methods approach may offer important insights for effective planning within an NDIS. METHODS A cross-sectional survey using the Spinal Cord Injury Secondary Conditions Scale (SCISCS), demographic questionnaire and in-depth interview was undertaken with 33 people with SCI living in the community. Demographic and SCISCS data were reported using descriptive statistics. Interviews were audio-taped, transcribed and analysed thematically. RESULTS Participants were on average 58.5 years of age and 20 years post-injury. Five key themes emerged relating to (i) spasm and pain; (ii) sexual dysfunction; (iii) pressure areas; (iv) fatigue; and (v) the impact of secondary health conditions on life role participation and choice of supports and equipment. CONCLUSION Secondary health conditions can significantly impact occupational participation following SCI. Appropriate intervention, including customised equipment and direct support, if delivered as part of an effective NDIS, may prevent or reduce the severity of these conditions and offer the potential to influence health and participation outcomes of people who have returned to community living.
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Affiliation(s)
- Libby Callaway
- Occupational Therapy Department, Monash University, Frankston, Victoria, Australia
| | - Linda Barclay
- Occupational Therapy Department, Monash University, Frankston, Victoria, Australia
| | - Rachael McDonald
- Occupational Therapy Department, Monash University, Frankston, Victoria, Australia
| | - Louise Farnworth
- Occupational Therapy Department, Monash University, Frankston, Victoria, Australia
| | - Jackie Casey
- Occupational Therapy Department, University of Ulster, Antrim, UK
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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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15
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Byra S. Posttraumatic growth in people with traumatic long-term spinal cord injury: predictive role of basic hope and coping. Spinal Cord 2015; 54:478-82. [PMID: 26643986 DOI: 10.1038/sc.2015.177] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 08/11/2015] [Accepted: 09/04/2015] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Participants with spinal cord injury (SCI) sustained at least 15 years before the study completed questionnaires measuring posttraumatic growth (PTG), basic hope and coping strategies. OBJECTIVES To determine contribution of basic hope and coping strategies to accounting for PTG variability in participants with traumatic long-term SCI. SETTING Polish rehabilitation centres, foundations and associations implementing social inclusion and professional activation programmes. Participants were enrolled based on their medical history by trained rehabilitation specialists and psychologists. METHODS The set of questionnaires included the following: The Post-traumatic Growth Inventory; The Coping Orientations to Problems Experienced (COPE); and Basic Hope Inventory. RESULTS A study of 169 individuals with paraplegia in the range of PTG showed the highest degree of positive changes in appreciation of life (AL) and the lowest in self-perception. Regression analysis showed that coping strategies such as religion (REL), focus on the problem, humour, alcohol/drug use ideation and basic hope jointly account for 60% of variance of PTG. The highest contribution to accounting for this variability had REL. Also, it was found that coping strategies and basic hope allow to predict variance of individual growth aspects. Age at trauma exposure positively correlated with changes in AL and spiritual change. No significant relationship between growth and age of participants was confirmed. CONCLUSION PTG occurring in people with long-term traumatic SCI is primarily manifested in increased AL. Specific coping strategies and basic hope have a significant role in fostering positive changes.
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Affiliation(s)
- S Byra
- Faculty of Pedagogy and Psychology, Institute of Pedagogy, Maria Curie-Skłodowska University, Lublin, Poland
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16
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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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17
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Jones K, Simpson GK, Briggs L, Dorsett P. Does spirituality facilitate adjustment and resilience among individuals and families after SCI? Disabil Rehabil 2015; 38:921-35. [DOI: 10.3109/09638288.2015.1066884] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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18
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Lude P, Kennedy P, Elfström ML, Ballert CS. Quality of life in and after spinal cord injury rehabilitation: a longitudinal multicenter study. Top Spinal Cord Inj Rehabil 2014; 20:197-207. [PMID: 25484566 DOI: 10.1310/sci2003-197] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To investigate the changes in quality of life (QOL) in persons with spinal cord injury (SCI) and their close persons during the first 2 years post injury. METHOD Longitudinal multiple sample multiple wave panel design. Data included 292 patients recruited from Austrian British German Irish and Swiss specialist SCI rehabilitation centers and 55 of their close persons. Questionnaire booklets were administered at 6 weeks 12 weeks 1 year and 2 years after injury to both samples. RESULTS Study 1 investigated the WHOQOL-BREF domains in individuals with SCI and found differences mostly in the physical domain indicating that QOL increases for persons with SCI from onset. An effect of the culture was observed in the psychological and environmental domains with higher QOL scores in the German-speaking sample. Study 2 compared individuals with SCI to their close persons and found differences in the physical environmental and social domains over time. The scores on the psychological dimension did not significantly differ between the persons with SCI and their close persons over time. CONCLUSION QOL measured by the WHOQOL-BREF shows that QOL changes during rehabilitation and after discharge. Apart from the physical dimension the persons with SCI and their close persons seem to experience a similar change in QOL. Further longitudinal research is suggested to clarify the mutual adjustment process of people with SCI and their close persons and to explore cultural differences in QOL between English-and German-speaking countries.
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Affiliation(s)
- P Lude
- Swiss Paraplegic Research , Nottwil , Switzerland ; Swiss Paraplegic Centre , Nottwil , Switzerland ; School of Applied Psychology, Zurich University of Applied Sciences , Zurich , Switzerland ; Private Practice , Bad Zurzach , Switzerland
| | - P Kennedy
- Isis Education Centre, Warneford Hospital, University of Oxford , UK ; Department of Clinical Psychology, The National Spinal Injuries Centre, Stoke Mandeville Hospital , Aylesbury, Buckinghamshire , UK
| | - M L Elfström
- Department of Psychology, School of Health, Care and Social Welfare, Mälardalen University , Eskilstuna/Västerås , Sweden
| | - C S Ballert
- Swiss Paraplegic Research , Nottwil , Switzerland
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