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Nuechterlein A, Feng L, Yehia A, Illes J. Strengths, gaps, and future directions on the landscape of ethics-related research for spinal cord injury. Spinal Cord 2023; 61:477-482. [PMID: 37072509 PMCID: PMC10495258 DOI: 10.1038/s41393-023-00897-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/24/2023] [Accepted: 03/30/2023] [Indexed: 04/20/2023]
Abstract
Spinal cord injury (SCI) affects between 250,000-500,000 people globally each year. While the medical aspects of SCI have received considerable attention in the academic literature, discourse pertaining to its ethical implications is more limited. The experience of SCI is shaped by intersecting demographic and identity factors such as gender, race, and culture that necessitate an intersectional and value-based approach to ethics-related research that is properly situated in context. Given this background, we conducted a content analysis of academic studies exploring the perspectives and priorities of individuals with SCI published in peer-reviewed journals in the decade between 2012-2021. Terms pertaining to SCI and ethics were combined in a search of two major publication databases. We documented overall publication patterns, recruitment and research methods, reporting of demographic variables, and ethics-related discourse. Seventy (70) papers met inclusion criteria and were categorized by their major foci. Findings reveal a gap in reporting of participant demographics, particularly with respect to race and ethnicity, geographic background, and household income. We discuss these person-centered themes and gaps that must be closed in the reporting and supporting of SCI research.
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Affiliation(s)
- Anna Nuechterlein
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, 2211 Wesbrook Mall, Koerner S124, Vancouver, BC, V6T 2B5, Canada
| | - Lydia Feng
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, 2211 Wesbrook Mall, Koerner S124, Vancouver, BC, V6T 2B5, Canada
| | - Alaa Yehia
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, 2211 Wesbrook Mall, Koerner S124, Vancouver, BC, V6T 2B5, Canada
| | - Judy Illes
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, 2211 Wesbrook Mall, Koerner S124, Vancouver, BC, V6T 2B5, Canada.
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Matérne M, Simpson G, Jarl G, Appelros P, Arvidsson-Lindvall M. Contribution of participation and resilience to quality of life among persons living with stroke in Sweden: a qualitative study. Int J Qual Stud Health Well-being 2022; 17:2119676. [PMID: 36062839 PMCID: PMC9467624 DOI: 10.1080/17482631.2022.2119676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2022] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Resilience contributes to positive adaptation after many health conditions, but little is known about its contribution to long-term recovery after stroke. This study investigated the lived experience of resilience and participation and their relationship to quality of life after stroke in Sweden. MATERIAL AND METHOD Semi-structured telephone interviews were conducted with 19 informants (10 male, 9 female), aged from 44-89 years and between 1 and 19 years post-stroke. Stroke severity ranged from mild (n = 8), moderate (n = 9) to severe (n = 2). Interviews were analysed using content analysis. RESULTS The analysis resulted in an overarching theme; Life with stroke has been adapted to but not accepted, built on five subthemes: 1) Adapting and adjusting life, 2) Meaningful values in life, 3) Inner resources, 4) Support and treatment from social relations, and 5) Support and treatment from external resources. CONCLUSION Participants described a tension between adapting and accepting life after stroke. Resilience was a useful framework, highlighting the contribution of inner, social and societal resources to recovery and quality of life, both directly and as enhanced through increased participation. Important factors for adaptation are meaningful values in life, individual strategies for adaptation and support from both social relationship and the society.
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Affiliation(s)
- Marie Matérne
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Grahame Simpson
- John Walsh Centre of Rehabilitation Research, University of Sydney, Sydney, Australia
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Gustav Jarl
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Peter Appelros
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Mialinn Arvidsson-Lindvall
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Hauser DR, Tripathi NS, Smith MN, Williams CL, Lefebvre BM, Ly A, Higgins MK. The Impact of Chronic Conditions on Leisure Participation among Community-Dwelling Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2022.2056672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Daniella R. Hauser
- Department of Occupational Therapy, Wingate University, Wingate, NC, USA
| | - Neha S. Tripathi
- Department of Occupational Therapy, Wingate University, Wingate, NC, USA
| | - Melanie N. Smith
- Department of Occupational Therapy, Wingate University, Wingate, NC, USA
| | | | - Brooke M. Lefebvre
- Department of Occupational Therapy, Wingate University, Wingate, NC, USA
| | - Alyssa Ly
- Department of Occupational Therapy, Wingate University, Wingate, NC, USA
| | - Melia K. Higgins
- Department of Occupational Therapy, Wingate University, Wingate, NC, USA
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Lee B. A serial mediation model of gratitude on life satisfaction in people with multiple sclerosis: The intermediary role of perceived stress and mental health symptoms. Mult Scler Relat Disord 2021; 58:103421. [DOI: 10.1016/j.msard.2021.103421] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 11/07/2021] [Accepted: 11/20/2021] [Indexed: 01/07/2023]
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Upenieks L, Ford-Robertson J. Give Thanks in All Circumstances? Gratitude Toward God and Health in Later Life after Major Life Stressors. Res Aging 2021; 44:392-404. [PMID: 34365849 DOI: 10.1177/01640275211033914] [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
Gratitude is foundational to well-being throughout the life course, and an emerging body of work suggests that older adults may be more inclined to attribute gratitude to a non-human target (God). Drawing on life course theory and Erikson's lifespan development framework, we use data from a national sample of Christian older adults from the United States (N = 1,005) to examine whether gratitude toward God buffers the noxious health effects of the death of a loved one or personal illness. Results suggest that gratitude toward God tends to predict better age-comparative and global self-rated physical health in the aftermath of stress, a moderation effect which is partially mediated by stronger beliefs in God-mediated control (that God is a collaborative partner in dealing with problems). We conclude by proposing some interventions for clinicians and counselors centered around gratitude and religiosity that may assist older adults in coping with major life stressors.
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Affiliation(s)
- Laura Upenieks
- Department of Sociology, Baylor University, Waco, TX, USA
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6
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Tsang J, Schnitker SA, Emmons RA, Hill PC. Feeling the intangible: antecedents of gratitude toward intangible benefactors. THE JOURNAL OF POSITIVE PSYCHOLOGY 2021. [DOI: 10.1080/17439760.2021.1952480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- JoAnn Tsang
- Department of Psychology and Neuroscience, Baylor University Waco United States
| | - Sarah A. Schnitker
- Department of Psychology and Neuroscience, Baylor University Waco United States
| | - Robert A. Emmons
- Department of Psychology, University of California, Davis, United States
| | - Peter C. Hill
- Rosemead School of Psychology, Biola University La Mirada United States
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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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Day G, Robert G, Rafferty AM. Gratitude in Health Care: A Meta-narrative Review. QUALITATIVE HEALTH RESEARCH 2020; 30:2303-2315. [PMID: 32924863 PMCID: PMC7649920 DOI: 10.1177/1049732320951145] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Research into gratitude as a significant sociological and psychological phenomenon has proliferated in the past two decades. However, there is little consensus on how it should be conceptualized or investigated empirically. We present a meta-narrative review that focuses on gratitude in health care, with an emphasis on research exploring interpersonal experiences in the context of care provision. Six meta-narratives from literatures across the humanities, sciences, and medicine are identified, contextualized, and discussed: gratitude as social capital; gifts; care ethics; benefits of gratitude; gratitude and staff well-being; and gratitude as an indicator of quality of care. Meta-narrative review was a valuable framework for making sense of theoretical antecedents and findings in this developing area of research. We conclude that greater attention needs to be given to what constitutes "evidence" in gratitude research and call for qualitative studies to better understand and shape the role and implications of gratitude in health care.
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Affiliation(s)
- Giskin Day
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom
- School of Medicine, Imperial College London, London, United Kingdom
- Giskin Day, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, James Clerk Maxwell Building, 27 Waterloo Road, London SE1 8WA, UK.
| | - Glenn Robert
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom
| | - Anne Marie Rafferty
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom
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Jones KF, Pryor J, Care-Unger C, Simpson G. "Spirituality is everybody's business": an exploration of the impact of spiritual care training upon the perceptions and practice of rehabilitation professionals. Disabil Rehabil 2020; 44:1409-1418. [PMID: 32976734 DOI: 10.1080/09638288.2020.1820586] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE This study explored the impact of a brief spiritual care training program upon the perceptions and self-reported practice of rehabilitation professionals working in traumatic injury. METHODOLOGY AND METHODS A qualitative study. Semi-structured interviews were held with staff from a rehabilitation hospital in Sydney, Australia, between six and eight weeks after participation in spiritual care training. A thematic analysis was conducted. RESULTS Of the 41 rehabilitation professionals who attended the training (1 h online, 1.5 h face to face), 16 agreed to be interviewed. The majority worked in spinal cord injury and were female. Half reported holding a Christian affiliation. One overarching theme and six sub-themes were identified from the qualitative data. The overarching theme was "spirituality is everybody's business". The six sub-themes were: (i) increased awareness of the nature of spirituality, (ii) realisation of the importance of spirituality to clients, (iii) a desire to keep spirituality on the radar, (iv) identifying barriers to providing spiritual care (v) incorporating spirituality into practice, and, (vi) recognising spirituality as personally meaningful. CONCLUSIONS A brief spiritual care training program can impact positively upon perceptions and practice of rehabilitation professionals. Ongoing training is needed to ensure that staff retain what was learnt. IMPLICATIONS FOR REHABILITATION Brief spiritual care training can impact positively upon rehabilitation professionals' perceptions of spirituality and lead to practice change in the delivery of spiritual care across many clinical disciplines. The stories of patients and family members are powerful staff education tools in spiritual care training. Client spirituality is an under recognised resource that staff can draw upon in supporting and enhancing the rehabilitation process.
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Affiliation(s)
- Kate Fiona Jones
- Royal Rehab, Sydney, Australia.,School of Human Services and Social Work, Griffith University, Brisbane, Australia.,Institute for Ethics and Society, University of Notre Dame, Sydney, Australia
| | - Julie Pryor
- Royal Rehab, Sydney, Australia.,Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, Australia
| | | | - Grahame Simpson
- School of Human Services and Social Work, Griffith University, Brisbane, Australia.,Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
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Maurer MM, Daukantaitė D. Revisiting the Organismic Valuing Process Theory of Personal Growth: A Theoretical Review of Rogers and Its Connection to Positive Psychology. Front Psychol 2020; 11:1706. [PMID: 32793057 PMCID: PMC7385226 DOI: 10.3389/fpsyg.2020.01706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 06/22/2020] [Indexed: 12/18/2022] Open
Abstract
Humanistic and positive psychology have had a contentious past. Initially, positive psychology researchers have distanced themselves from humanistic psychology, proceeding to build an array of differentiated constructs relevant to an empirical study of well-being. Twenty years on, it is now generally acknowledged that humanistic psychology is the theoretical predecessor of positive psychology in terms of holistic growth theories. In this theoretical review, we aim to show how Carl Rogers’ organismic valuing process (OVP) theory can serve as a holistic framework for individual positive psychological research findings and theories and how positive psychology, in turn, provides empirical support for this meta-theoretical framework. An important motivation for considering personal growth as a process that integrates various aspects of well-being is theoretical integration, which can help us better understand how well-being develops in individuals across the lifespan. Some theoretical and practical implications of incorporating OVP theory into well-being research are also suggested.
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Affiliation(s)
- Mia M Maurer
- Department of Psychology, Lund University, Lund, Sweden
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11
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Kim E, Bae S. Gratitude Moderates the Mediating Effect of Deliberate Rumination on the Relationship Between Intrusive Rumination and Post-traumatic Growth. Front Psychol 2019; 10:2665. [PMID: 31849774 PMCID: PMC6901784 DOI: 10.3389/fpsyg.2019.02665] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 11/12/2019] [Indexed: 11/13/2022] Open
Abstract
PURPOSE This study examines the moderating effect of gratitude on the mediating effect of deliberate rumination on the relationship between intrusive rumination and post-traumatic growth (PTG). METHODS We used self-report questionnaires to collect data from 450 18-68-year-old participants (Mage = 39.73, SD = 13.73) residing in major cities and regions across South Korea. Data that were collected from 411 participants were subjected to analysis. Version 25 of SPSS (Statistical Package for Social Science) and PROCESS macro were used to analyze mediation, moderation, and moderated mediation effects. RESULTS Deliberate rumination mediated the relationship between intrusive rumination and PTG. Gratitude moderated the effect of deliberate rumination on PTG. Finally, gratitude moderated the mediating effect of deliberate rumination on the relationship between intrusive rumination and PTG. CONCLUSION Deliberate rumination and gratitude facilitate PTG for traumatized adults. In particular, gratitude reinforces the effect of deliberate rumination on PTG.
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Affiliation(s)
- Eunseung Kim
- Department of Psychology, Dankook University, Cheonan, South Korea
| | - Sungman Bae
- Department of Psychology and Psychotherapy, College of Health Sciences, Dankook University, Cheonan, South Korea
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Bezmez D, Shakespeare T, Yardimci S. Family role in in-patient rehabilitation: the cases of England and Turkey. Disabil Rehabil 2019; 43:559-567. [PMID: 31257955 DOI: 10.1080/09638288.2019.1632941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE This article explores the differences between experiences of family role in in-patient rehabilitation in Turkey and England. BACKGROUND The literature predominantly assumes family presence in rehabilitation as positive, because it draws upon Western cases, where care is delivered fully by professionals, and patients may feel isolated during hospital stays. Analyses of other contexts provide a more nuanced view. METHOD This qualitative research included in-depth interviews (Turkey: 42, England: 18) with people with disabilities (n = 39), their families (n = 8) and hospital staff (n = 13); hospital ethnography (Turkey), focus groups (England: 3 groups involving 4 doctors, 5 nurses, 6 therapists), and participant-observation (England: 5 families). Thematic analysis highlights experiences of family involvement across different contexts. RESULTS Families are differently integrated in rehabilitation in England and Turkey. In England, where family presence is regulated and relatively limited, people with disabilities feel more isolated and see family as a major form of support. In Turkey, where family presence is unregulated and intense, they enjoy family as an agent of intra-hospital socialising, but find it disabling when it implies a loss of privacy and individuality. CONCLUSION Family involvement in rehabilitation should support social interaction but allow people with disabilities to remain independent.Implications for rehabilitationFamily involvement in rehabilitation can be both enabling and disabling.Existing literature draws upon rehabilitation practices, where family presence is limited and perceived as positive. An analysis of cases, where families are integral to the health care system (e.g., Turkey), can provide a nuanced view of family integration, which can be both enabling and disabling.Rehabilitation processes and health professionals need to integrate families in ways that will enrich social interaction, but still allow people with disabilities to retain their independence.
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Affiliation(s)
- Dikmen Bezmez
- Sociology Department, Koç University, Istanbul, Turkey
| | | | - Sibel Yardimci
- Sociology Department, Mimar Sinan University of Fine Arts, Istanbul, Turkey
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Longitudinal associations between gratitude and depression 1 year later among adult cystic fibrosis patients. J Behav Med 2019; 43:596-604. [PMID: 31254218 DOI: 10.1007/s10865-019-00071-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 06/14/2019] [Indexed: 01/27/2023]
Abstract
Individuals with cystic fibrosis (CF) are confronted by a range of difficult physical and psychosocial sequelae. Gratitude has drawn growing attention as a psychosocial resource, but it has yet to be examined among adults with CF. The current investigation evaluated longitudinal associations between trait gratitude and subsequent outcomes from depression screening 12 months later, adjusting for disease severity (FEV1% predicted) and other significant clinical or demographic covariates. Participants were 69 adult CF patients recruited from a regional adult treatment center. They completed a validated measure of gratitude (Gratitude Questionnaire-6) at baseline and a screening measure of depression (Hospital Anxiety and Depression Scale) at 12-month follow-up. In a logistic regression analysis controlling for disease severity, higher levels of baseline gratitude were associated with reduced likelihood of depression caseness at 12 months (OR .83, 95% CI .73-.91, p = .001). Gratitude remained predictive after adjusting for other psychosocial resource variables (i.e., perceived social support and positive reframing coping). Findings offer an initial indication of the potential salutary role of dispositional gratitude in an understudied clinical population.
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Haque OS, Lenfest Y, Peteet JR. From disability to human flourishing: how fourth wave psychotherapies can help to reimagine rehabilitation and medicine as a whole. Disabil Rehabil 2019; 42:1511-1517. [DOI: 10.1080/09638288.2019.1602674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Omar Sultan Haque
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Yusuf Lenfest
- Department of Divinity, Harvard University, Cambridge, MA, USA
| | - John R. Peteet
- Department of Psychiatry, Brigham And Women’s Hospital, Harvard Medical School, Boston, MA, USA
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Bibi S, Rasmussen P, McLiesh P. The lived experience: Nurses' experience of caring for patients with a traumatic spinal cord injury. Int J Orthop Trauma Nurs 2018; 30:31-38. [PMID: 29934253 DOI: 10.1016/j.ijotn.2018.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 02/26/2018] [Accepted: 05/14/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Nurses are involved in delivering care for patients following acute traumatic spinal cord injury throughout the entire care journey. An injury of this type is significant for the individual and their family and can be challenging for nurses delivering care for patients with life changing injuries, especially for nurses new to this setting. There is a lack of research that examines the experience of nurses caring for these patients in the acute setting. METHOD A hermeneutic phenomenological approach was used to understand the experience of nurses caring for patients in the acute setting who had sustained a traumatic spinal injury with associated neurological deficit. Using the phenomenological approach guided by the insight of Gadamer and Max Van Manen, participants with a broad range of experience were recruited and interviewed. The responses were transcribed into a text and subjected to hermeneutic analysis. Burnard's (1991) 14-step process and the hermeneutic approach were used to interpret and understand the phenomenon of interest. CONCLUSION The study highlights the experience and challenges of providing care to these individuals. Although patients had significant physical disabilities and were often dependent physically, the nurses' concerns were directed more towards fulfilling their psychological needs. Nurses identified grieving patients and felt their role was to provide realistic hope to motivate them. They felt an internal tension regarding desensitisation towards their patients, but this was often an internal protective mechanism to deal with the significance of the events surrounding these patients. Nurses new to this setting took time to learn the routines and manage the unique challenges effectively. Caring for these patients gave the nurses the opportunity to understand their patients and their families, and appreciate that both groups will fluctuate in their behavior throughout the acute process, as they adjust to grief and loss.
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Affiliation(s)
- Shareena Bibi
- Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia.
| | - P Rasmussen
- Adelaide Nursing School, University of Adelaide, Australia
| | - P McLiesh
- Adelaide Nursing School, University of Adelaide, Australia
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Schwartz CE, Stucky B, Rivers CS, Noonan VK, Finkelstein JA. Quality of Life and Adaptation in People With Spinal Cord Injury: Response Shift Effects From 1 to 5 Years Postinjury. Arch Phys Med Rehabil 2018; 99:1599-1608.e1. [PMID: 29481771 DOI: 10.1016/j.apmr.2018.01.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 01/24/2018] [Accepted: 01/26/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate response shift effects in spinal cord injury (SCI) over 5 years postinjury. DESIGN Prospective cohort study observed at 1, 2, and 5 years post-SCI. SETTING Specialized SCI centers. PARTICIPANTS Sample included 1125, 760, and 219 participants at 1, 2, and 5 years post-SCI (N = 2104). The study sample was 79% men; 39% were motor/sensory complete (mean age, 44.6±18.3y). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Patient-reported outcomes included the Medical Outcomes Study 36-Item Short-Form Health Survey version 2 and the Life Satisfaction-11 Questionnaire. Participant latent variable scores were adjusted for (1) potential attrition bias and (2) propensity scores reflecting risk of worse outcomes. The Oort structural equation modeling approach for detecting and accounting for response shift effects was used to test the hypothesis that people with SCI would undergo response shifts over follow-up. RESULTS The study data comprised the time after FIM scores, an objective measure of motor and cognitive function, had improved and stabilized. Three latent variables (Physical, Mental, and Symptoms) were modeled over time. The response shift model indicated uniform recalibration and reconceptualization response shift effects over time. When adjusted for these response shift effects, Physical showed small true change improvements at 2- and 5-year follow-up, despite FIM stability. CONCLUSIONS We detected recalibration and reconceptualization response shift effects in 1- to 5-year follow-up of people with SCI. Despite stable motor and cognitive function, people with SCI are adapting to their condition. This adaptation reflects a progressive disconnection between symptoms and physical or mental health, and a real improvement in the Physical latent variable.
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Affiliation(s)
- Carolyn E Schwartz
- DeltaQuest Foundation Inc, Concord, MA; Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA.
| | | | | | | | - Joel A Finkelstein
- Division of Orthopaedics, Sunnybrook Health Sciences Center and the University of Toronto, Toronto, ON, Canada
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Leppma M, Mnatsakanova A, Sarkisian K, Scott O, Adjeroh L, Andrew ME, Violanti JM, McCanlies EC. Stressful life events and posttraumatic growth among police officers: A cross-sectional study. Stress Health 2018; 34:175-186. [PMID: 28703379 PMCID: PMC6314019 DOI: 10.1002/smi.2772] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 06/05/2017] [Accepted: 06/10/2017] [Indexed: 01/07/2023]
Abstract
Police officers often continue to face numerous threats and stressors in the aftermath of a disaster. To date, posttraumatic growth (PTG) has been studied primarily in the context of significant trauma; thus, it is not known whether stressful life events are associated with PTG. This study investigated the development of PTG among 113 police officers working in the New Orleans area following Hurricane Katrina. Hierarchical regression was used to evaluate if gratitude, social support, and satisfaction with life moderated the relationship between stressful life events (as measured by the total life stress score) and PTG, after adjustment for age, sex, race, level of involvement in Hurricane Katrina, and alcohol intake. Results indicate that stressful life events are independently associated with PTG. Gratitude, satisfaction with life, and social support were seen to moderate this relationship; as stressful life events increased so too did PTG-particularly among officers with higher levels of gratitude (B = 0.002, p ≤ .05), satisfaction with life (B = 0.002, p ≤ .05), and social support (B = 0.001, p ≤ .05). These findings suggest that promoting satisfaction with life, interpersonal support, and gratitude may be beneficial to those who are regularly at risk of trauma exposure.
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Affiliation(s)
| | - Anna Mnatsakanova
- National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | | | | | - Leonie Adjeroh
- National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Michael E. Andrew
- National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | | | - Erin C. McCanlies
- National Institute for Occupational Safety and Health, Morgantown, WV, USA
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Xin DQ, Hu ZM, Huo HJ, Yang XJ, Han D, Xing WH, Zhao Y, Qiu QH. Schisandrin B attenuates the inflammatory response, oxidative stress and apoptosis induced by traumatic spinal cord injury via inhibition of p53 signaling in adult rats. Mol Med Rep 2017; 16:533-538. [PMID: 28560444 PMCID: PMC5482126 DOI: 10.3892/mmr.2017.6622] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 02/20/2017] [Indexed: 12/14/2022] Open
Abstract
Schisandrin B is an active monomer of the Chinese magnolia vine (Schisandra chinensis) that can reduce transaminase activity in liver cells, inhibit lipid peroxidation, enhance antioxidant status, has protective effects in the liver and has antitumor effects. The present study investigated the potential protective effects of schisandrin B on the p53 signaling pathway in attenuating the inflammatory response, oxidative stress and apoptosis induced by traumatic spinal cord injury (TSCI) in adult rats. Behavioral examination, inclined plate test and spinal cord water content were used to evaluate the protective effect of schisandrin B in TSCI rats. The expression levels of superoxide dismutase (SOD), malondialdehyde (MDA), nuclear factor (NF)-κB subunit p65 and tumor necrosis factor (TNF)-α were examined using ELISA kits. Western blot analysis was performed to analyze the protein expression of caspase-3 and phosphorylated (p)-p53 in TSCI rats. In the present study, schisandrin B improved behavioral examination results and the maximum angle of inclined plate test, and inhibited spinal cord water content in rats with TSCI. Notably, schisandrin B reduced the activation of traumatic injury-associated pathways, including SOD, MDA, NF-κB p65 and TNF-α, in TSCI rats. In addition, schisandrin B suppressed the TSCI-induced expression of caspase-3 and p-p53 in TSCI rats. These results indicated that schisandrin B may attenuate the inflammatory response, oxidative stress and apoptosis in TSCI rats by inhibiting the p53 signaling pathway in adult rats.
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Affiliation(s)
- D Q Xin
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Z M Hu
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - H J Huo
- Department of Spinal Surgery, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010030, P.R. China
| | - X J Yang
- Department of Spinal Surgery, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010030, P.R. China
| | - D Han
- Department of Cardiovascular Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010059, P.R. China
| | - W H Xing
- Department of Spinal Surgery, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010030, P.R. China
| | - Y Zhao
- Department of Spinal Surgery, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010030, P.R. China
| | - Q H Qiu
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
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19
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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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Ogilvie R, Foster K, McCloughen A, Curtis K. The injury trajectory for young people 16-24 years in the six months following injury: A mixed methods study. Injury 2016; 47:1966-74. [PMID: 27282687 DOI: 10.1016/j.injury.2016.04.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 04/13/2016] [Accepted: 04/22/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Adolescents and young people are the population at greatest risk of injury and therefore injury-related mortality and morbidity. Inquiry into the injury trajectory of young people is needed to identify this group's specific needs for healthcare. This paper reports the integration of quantitative and qualitative findings from a sequential explanatory mixed methods study examining young people aged 16-24 years' experience and trajectory of traumatic physical injury in the initial six months. The aim of integration was to address the question: In what ways are injured young peoples' experiences and self-management during the initial six months of the injury trajectory impacted by their injury, family support, and provision of healthcare? METHODS Key findings from epidemiological datasets on young person injuries from hospital and coronial databases (Phase 1) were combined with key findings from qualitative interviews with 12 injured young people and 10 family members (Phase 2). RESULTS The integration of findings from Phase 1 and Phase 2 resulted in three new findings; [1] (Alfred Health, 2014). A young person's perception of the severity of their injury, as well as the amount of time spent in hospital, impacts substantially on the way in which they experience injury, and this is managed differently between genders; [2] (Newnam et al., 2014). Admission to an Intensive care unit, including the intensity and duration of care, is the primary influence on how a family will provide support to the young person in the inpatient period; and [3] (Lyons et al., 2010). Young people's perception and understanding of their recovery from injury is in contrast with how healthcare systems are structured to provide rehabilitation and recovery care. CONCLUSION The injury trajectory and recovery process of young people in the six months following injury have been have conceptualised. These trajectories of recovery can inform the development of anticipatory guidance frameworks for clinicians and guide the provision of and planning for clinical services for injured young people.
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Affiliation(s)
- Rebekah Ogilvie
- Shock Trauma Service at the Canberra Hospital, Building 6, Level 1, The Canberra Hospital, Yamba Drive, Garran ACT 2605, T-6244 2793, Sydney Nursing School, University of Sydney, Australia.
| | - Kim Foster
- Disciplines of Nursing & Midwifery, University of Canberra, Australia
| | | | - Kate Curtis
- Sydney Nursing School, University of Sydney, Trauma Coordinator, St. George Hospital, Sydney, Australia
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Löfvenmark I, Norrbrink C, Nilsson Wikmar L, Löfgren M. 'The moment I leave my home - there will be massive challenges': experiences of living with a spinal cord injury in Botswana. Disabil Rehabil 2015; 38:1483-92. [PMID: 26694314 DOI: 10.3109/09638288.2015.1106596] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND When suffering a spinal cord injury (SCI), the patient and family face numerous challenges regardless of socio-economic level. The stigmatisation of persons with disabilities has been reported, however, reports from Southern Africa are largely lacking. PURPOSE To explore the experiences of living with a traumatic SCI in Botswana concerning perceived attitudes, obstacles and challenges. METHOD A qualitative approach with semi-structured interviews was conducted. Thirteen community-dwelling persons who have lived with an SCI for at least two years participated. RESULTS A theoretical model was formed that illustrate the associations between the core category, Self, and the categories Relationships and Society. The model illustrates that personal resources, including a strong identity and a positive attitude, are crucial to the experience of inclusion in the community. A supportive family, a source of income, and faith were strong facilitators, while inaccessibility and devaluing attitudes were barriers. Having a disability led to increased risk of poverty and social exclusion. CONCLUSION This study emphasised the importance of personal resources, family support, and improved accessibility to facilitate inclusion in the society. Informants requested legislation to advocate for the rights of persons with disabilities to be respected, with the aim of moving towards an equal accessible society. Implications for Rehabilitation Reclaiming or restructuring one's identity after a SCI is crucial for the person's ability to move on and develop beneficial coping strategies. Support from family and friends, staff and peer support are crucial parts in that process. Spirituality, values, needs and coping strategies vary profoundly among persons sustaining disabling injuries. In striving to optimise care, rehabilitation staff needs to be attentive to the personal resources and preferences to be able to individualise care, encounter, and facilitate transition back to the community. Family members play a crucial part in rehabilitation. It is essential for the patients' well-being and care that they get explicit descriptions of the patient's abilities. Living in a well-adapted home will facilitate well-being, independence, and return to work. Rehabilitation staff needs to focus their efforts on making this successful prior to discharge from hospital.
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Affiliation(s)
- Inka Löfvenmark
- a Department of Neurobiology, Care Sciences and Society , NVS, Division of Physiotherapy, Karolinska Institutet , Huddinge , Sweden ;,b Spinalis , Rehab Station Stockholm , Solna , Sweden
| | - Cecilia Norrbrink
- a Department of Neurobiology, Care Sciences and Society , NVS, Division of Physiotherapy, Karolinska Institutet , Huddinge , Sweden ;,c Department of Clinical Sciences , Karolinska Institutet Danderyd Hospital (KI DS) , Stockholm , Sweden
| | - Lena Nilsson Wikmar
- a Department of Neurobiology, Care Sciences and Society , NVS, Division of Physiotherapy, Karolinska Institutet , Huddinge , Sweden
| | - Monika Löfgren
- c Department of Clinical Sciences , Karolinska Institutet Danderyd Hospital (KI DS) , Stockholm , Sweden
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22
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Family members' experience of providing support for young people with traumatic physical injury during the acute hospital phase of care: A qualitative study. Injury 2015; 46:1834-40. [PMID: 25817164 DOI: 10.1016/j.injury.2015.03.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 02/02/2015] [Accepted: 03/07/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE The aim of this study was to explore how family members perceive and support young people with traumatic physical injury during the acute phase of hospital care. METHODS This study forms part of the qualitative explanatory follow-up phase of a mixed methods study. The paper reports on family members' experiences of providing support to young people 16-24 years admitted with major traumatic injury to an Australian Level 1 Trauma Centre. Semi-structured in-depth interviews with family members were conducted and transcribed verbatim. Data were managed using NVivo software, and thematically analysed. FINDINGS Family support was determined by how family members perceived the injury. Driven by a need to protect the injured young person, family members sought to control potential emotional impacts of injury, creating a buffer between the young person and other people including healthcare professionals. Family members safeguarded the psychological well-being of the young person, in an attempt to facilitate their transition back to independence. CONCLUSION This study identifies iterative changes in family relationships and emotional and practical support provided by family members during the initial injury trajectory, extending understandings of the broader burden of injury. Key elements of family stress theory offer a useful framework for the development of anticipatory guidance for clinicians that are responsive to the emotional needs of patients and families, supporting the need for a family-centred care approach to managing major traumatic injury in young people.
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Noreau L, Noonan VK, Cobb J, Leblond J, Dumont FS. Spinal Cord Injury Community Survey: Understanding the Needs of Canadians with SCI. Top Spinal Cord Inj Rehabil 2014; 20:265-76. [PMID: 25477740 PMCID: PMC4252127 DOI: 10.1310/sci2004-265] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND There is a lack of literature regarding service needs of people with SCI living in the community. Better assessment of expressed and met and unmet needs would help in the development of effective service delivery. OBJECTIVE From a national SCI Community Survey in Canada, the aim was to identify the most critical service needs of people living in the community at least 1 year post discharge from rehabilitation and the support they received to meet their needs. METHOD Data were collected mainly through a secure Web site and encompassed demographics, personal and household income, an SCI severity measure, and an SCI community needs measure containing information on 13 SCI-related needs. RESULTS A total of 1,549 persons with SCI (traumatic lesion, n = 1,137; nontraumatic lesion, n = 412) across Canada completed the survey. Most critical needs for community integration were expressed by a substantial proportion of survey participants, but significantly more expressed and met needs were reported by persons with a traumatic than a nontraumatic lesion. Personal and environmental characteristics influenced the probability of expressing and meeting needs (eg, severity of injury and household income). Help and support to meet expressed needs were received from government agencies, community organizations, and friends or family. CONCLUSION Better assessment of expressed and met or unmet needs for services remains a challenge but will serve as a tool to optimize service delivery in the community. Environmental barriers to services, particularly the process of getting needs met and associated costs, remain an issue that requires a reconsideration of some aspects of access to services.
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Affiliation(s)
- Luc Noreau
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and Université Laval, Quebec City, Canada
| | - Vanessa K. Noonan
- Rick Hansen Institute, Vancouver, Canada
- Division of Spine, Department of Orthopedics, University of British Columbia, Vancouver, Canada
| | - John Cobb
- Rick Hansen Institute, Vancouver, Canada
- Vancouver General Hospital, Vancouver, Canada
| | - Jean Leblond
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and Université Laval, Quebec City, Canada
| | - Frédéric S. Dumont
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and Université Laval, Quebec City, Canada
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24
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Gendreau A, de la Sablonnière R. The cognitive process of identity reconstruction after the onset of a neurological disability. Disabil Rehabil 2013; 36:1608-17. [PMID: 24286233 DOI: 10.3109/09638288.2013.859749] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Rehabilitation professionals and researchers underscore the impact of an acquired disability on identity. However, the cognitive process by which identity is transformed is understudied. The present study aims to explore the cognitive process by which personal identity is reconstructed following disability onset. METHODS A template organizing style of interpretation was used to perform a qualitative analysis based on the Cognitive-Developmental Model of Social Identity Integration (CDMSII) using interview data from 10 participants with traumatic brain injury or traumatic spinal cord injury. RESULTS As suggested by the CDMSII, following the accident, participants initially tend to emphasize distinctions between their pre- and post-injury conditions. Eventually, individuals are able to create cognitive connections between pre-injury self-knowledge and how they understand their new condition. Finally, in the last stage of the identity integration process, the various identity components are recognized as part of the self. Organizing data based on the three stages of this theory was found to resonate with participants and aided the comprehension of how every stage in the identity reconstruction process is intertwined with the need for continuity through life. CONCLUSIONS The CDMSII offers a useful heuristic for understanding long-term identity reconstruction and the present research emphasizes the importance of a sense of continuity following disability onset.
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Affiliation(s)
- Anne Gendreau
- Department of Psychology, Université du Québec à Montréal , Montréal, QC , Canada and
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