The influence of social support on the rehabilitation of women with spinal cord injury: experiences recounted by occupational therapists

Intra- and interpersonal agency: Resuming occupational participation among persons with spinal cord injury after discharge from in-patient rehabilitation

Background: This research aim was to understand and describe how changes occur in occupational participation among persons with spinal cord injury (SCI) following discharge from a rehabilitation center in Bangladesh.Materials and methods: Using a selected ethnographical research design, nineteen participants were selected following a purposive sampling technique, then interviewed and observed on three occasions. Data analysis consisted of an iterative approach combining thematic narrative and narrative slopes analyses.Results: Eight themes determined the transitional progress, regression and stability, in which, three of the eight themes characterized the ascending slopes, namely developing affirmative attitudes, adapting the occupational environments and working on identities. Three themes characterized the descending slopes, which were reducing confidence created difficulties, becoming bored in daily life, and declining health reduced social connections. The final two themes characterized periods of stability, namely, maintaining daily life through skills and helplessness to participate in occupations.Conclusions and significance: Each of participants' transitions unfolded in unique, complex patterns. The processes directions of the transitions were understood as waning and waxing of agency. This agency could be individual, and shared with or dedicated by others, when participants and other persons combined their skills or when participants were supported by others.

Beyond the Diagnosis: Lived Experiences of Persons with Spinal Cord Injury in a Selected Town in Ghana

Background

Although several studies have been conducted on the lived experiences of persons with spinal cord injury (SCI) in high income countries, there is no published data on such experiences in Ghana. The purpose of this study was to explore the lived experiences of persons with SCI in the Tamale Metropolis of the Northern Region of Ghana.

Material and Methods

A qualitative descriptive design involving thirteen participants was conducted at the Tamale Metropolis-Ghana. A purposive sampling technique was used to recruit participants, using the Neurosurgical Unit of the Tamale Teaching Hospital as an outlet for recruitment of the sample. Data was gathered mainly through face-to-face in-depth interviews. The data was analyzed concurrently with data collection, using thematic content analysis. Ethical approval was obtained for the study from the Noguchi Memorial Institute for Medical Research and the research unit of the Tamale Teaching Hospital.

Results

The three main themes that emerged from the data during analysis were “physical effects,” “psychological effects,” and “social issues.” Conclusion. The findings from the study suggest that SCI is a life threatening condition and that persons with SCI grapple with a myriad of physical symptoms that range from chronic pain and paralysis of lower and/or upper limbs, to bladder and bowel incontinence. These physical symptoms have significant psychological and social effects on the functioning of the affected persons.

[Occupational therapy and community integration of adults with neurological conditions: A scoping review]

BACKGROUND.

Although community integration (CI) is the ultimate goal of rehabilitation, it is rarely achieved in clinical settings.

PURPOSE.

The purpose of this study was to (a) synthesize the state of occupational therapy knowledge related to CI for people with neurological issues and to (b) illustrate how CI is conceptualized within the literature.

METHOD.

A scoping review was completed using two reviewers, resulting in the selection of 47 articles pertaining to four study populations. Themes common across all client populations were identified through content analysis, and an iterative synthesis was used to analyse the evolution of knowledge.

FINDINGS.

The selected articles covered craniocerebral trauma ( n = 21, 9 experimental categories [EXP]), medullar injuries ( n = 11, 4 EXP), cerebrovascular injuries ( n = 9, 4 EXP), and multiple sclerosis ( n = 4, 1 EXP). CI was used interchangeably with the term social participation. Fifty-one percent of the articles defined CI solely as part of a measurement tool, and 10% did not provide a definition of CI. The physical dimension of CI had been studied more frequently than the social and psychological dimensions.

IMPLICATIONS.

Innovative practices should work to enable community inclusion and full citizenship to support the long-term enablement.

Diferencias de sexo en el uso de estrategias de afrontamiento en personas con lesión medular

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.

Patients With Brain Tumors: Who Receives Postacute Occupational Therapy Services?

Data on the utilization of occupational therapy among patients with brain tumors have been limited to those with malignant tumors and small samples of patients outside North America in specialized palliative care settings. We built on this research by examining the characteristics of patients with brain tumors who received postacute occupational therapy services in Ontario, Canada, using health care administrative data. Between fiscal years 2004-2005 and 2008-2009, 3,199 patients with brain tumors received occupational therapy services in the home care setting after hospital discharge; 12.4% had benign brain tumors, 78.2% had malignant brain tumors, and 9.4% had unspecified brain tumors. However, patients with benign brain tumors were older (mean age=63.3 yr), and a higher percentage were female (65.2%). More than 90% of patients received in-home occupational therapy services. Additional research is needed to examine the significance of these differences and to identify factors that influence access to occupational therapy services in the home care setting.