This study was conducted in subjects who became paraplegic or quadreplegic after accidental traumatic injury to the spinal cord. The aim was to determine the effect of different personal factors and of environment on their quality of life. Data obtained from the patients in the different questionnaires completed during interviews were analysed to determine the Linear Structural Relationships. The results demonstrated a direct significant impact of three quality of life variables: a) the amount of caring expressed in the behaviour and attitudes of the individual's family during his childhood and infancy, b) the current level of self-estime and c) self-involvement and personal activities (for example in studies or employment). Other relationships between the different study factors also appeared and contributed to an explanation of the subject's life style after the accidental trauma to the spinal cord.
Despite education and changes in public policy, trauma-related injuries continue to exact an unacceptably high morbidity and mortality, particularly among young people. Most injuries are preventable and can often be attributed to poor choices.
A mixed methods study involving 262 high school students was conducted to study the effect on knowledge and risk assessment after a day-long injury prevention program, and to develop a theoretic framework to better understand attitudes and beliefs that underlie commonly seen behaviors among young people.
Knowledge about injury increased after participation in the program, but was not durable over time. Risk perception and capacity to discern safer options improved after the program and persisted for up to 30 days. A qualitative analysis revealed seven themes that reflect a sense of invincibility and a belief that fate is more important than choice in determining the outcomes of a situation.
Effective injury prevention programs should include risk perception training that is informed by the attitudes and beliefs of the recipients.
This paper presents narratives that focus on experiences of hope, told by 10 participants three to four years after suffering spinal cord injury. Experiences of hope are understood as vital, essential and dynamic aspects of human life and human health. This is the first study addressing patients' experiences of hope three to four years following spinal cord injury. This study has a descriptive, longitudinal design, and is part of a larger study on patients' experiences of hope three to four years following spinal cord injury (Lohne, 2001, 2006, 2008a, 2008b; Lohne & Severinsson, 2004a, 2004b, 2005, 2006). Data were collected at three points in time by personal interviews. A phenomenological approach inspired by Ricoeur (1976) was used to extract the meaningful content of the patients' experiences. Findings revealed three main themes: Life-related hopes (I), Body-related hopes (II), and Creative and expanding hopes (III). Results indicated that three to four years following injury, participants were focusing on life more than on hope due to improvements and adaptation to a new life.
This investigation determined the themes that represented quality of life for persons with a spinal cord injury. Fifteen people (6 females, 9 males; 7 persons with quadriplegia, 8 with paraplegia) participated in this study, which used naturalistic inquiry methodologies. Results showed that quality of life for this population, regardless of severity of impairment, consisted of nine themes: (a) physical function and independence, (b) accessibility, (c) emotional well-being, (d) stigma, (e) spontaneity, (f) relationships and social function, (g) occupation, (h) finances, and (i) physical well-being. The themes of life quality were similar for quadriplegics and paraplegics; however, physical function and independence and physical well-being affected the quality of life of persons with a quadriplegic injury to a greater extent. These findings may provide health professionals with information necessary to assist in the development of programs to enhance quality of life.
The purpose of this article is to describe a new educational practice that demonstrates new teaching strategies used to help nursing students better integrate a family systems approach in their clinical practice. This narration emerges from a qualitative study aiming to include the components of teaching practice, facilitating a change in family care approach toward a practice that considers the "person-family" as a unit of care. The methodological course of this qualitative research is guided by interrelationship of action research and introspective analysis globally supported by systemic constructivist perspectives towards the construction of an educational practice for teaching the family systems approach in nursing science, and the development of new knowledge concerning this practice. This article presents one of the six narratives from an educational situation. A partial description of the results demonstrates that the professor-researcher being present in a different manner creates and uses innovative strategies in her teaching, such as narratives, self dialogue and dramatization which helped nursing bachelor students in transforming their thoughts towards acting in a systemic way towards the family.
Athletes with a spinal cord injury (SCI) appear to have relatively modest energy requirements despite demanding training regimes. Virtually nothing is known about the factors which influence the energy intake of those with a SCI including food related attitudes and behaviours. Using a cross-sectional observational design, three aspects of eating attitudes were measured using the Three-Factor Eating Questionnaire (TFEQ) along with six days of self-reported dietary intake and anthropometrics. Between March 2007 and May 2009, a total of 32 Canadian athletes with a SCI (n=24 men, n=8 women) completed the study. The TFEQ scales showed a cognitive dietary restraint score of 10.8±4.7, disinhibition score of 2.8±1.8 and hunger score of 3.1±2.2. When the group was split into high and low restraint groups using a median of 11.5, no differences were detected in any of the absolute parameters of reported dietary intake although the higher restraint group had protein intakes account for a greater proportion of total energy. Those with higher restraint scores also had a relatively higher disinhibition score. While the cognitive dietary restraint scores for the women were similar to other able-bodied populations, the scores for men were higher than population norms from other studies. The scores for disinhibition and hunger were lower than reported ranges from able-bodied subjects. These athletes may be actively monitoring or limiting dietary intake to avoid the high prevalence of obesity associated with a SCI or perhaps to maintain an ideal body composition for their sport performance.
The ThinkFirst Canada Smart Hockey program is an educational injury prevention video that teaches the mechanisms, consequences, and prevention of brain and spinal cord injury in ice hockey. This study evaluates knowledge transfer and behavioural outcomes in 11-12 year old hockey players who viewed the video.
Randomized controlled design.
Greater Toronto Minor Hockey League, Toronto Ontario.
Minor, competitive 11-12 year old male ice hockey players and hockey team coaches.
The Smart Hockey video was shown to experimental teams at mid-season. An interview was conducted with coaches to understand reasons to accept or refuse the injury prevention video.
A test of concussion knowledge was administered before, immediately after, and three months after exposure to the video. The incidence of aggressive penalties was measured before and after viewing the video.
The number of causes and mechanisms of concussion named by players increased from 1.13 to 2.47 and from 0.67 to 1.22 respectively. This effect was maintained at three months. There was no significant change in control teams. There was no significant change in total penalties after video exposure; however, specific body checking related penalties were significantly reduced in the experimental group.
This study showed some improvements in knowledge and behaviours after a single viewing of a video; however, these findings require confirmation with a larger sample to understand the sociobehavioural aspects of sport that determine the effectiveness and acceptance of injury prevention interventions.
Cites: JAMA. 1999 Dec 22-29;282(24):2328-3210612320
Ensuring the physical activity (PA) guidelines for people with spinal cord injury (SCI) are effectively disseminated is important for promoting PA. Few studies have investigated knowledge mobilization (KM) initiatives that aim to disseminate PA guidelines. Diffusion research suggests that using interpersonal communication channels may increase the adoption of guidelines.
The aim of the present study was to examine the reach and effectiveness of an event-based KM initiative that used interpersonal communication to disseminate the guidelines to people with SCI. The KM initiative consisted of 12 separate events attended by a total of 104 people with SCI (age = 53 ± 18.9 years; 31% female).
Questionnaires assessing attendees' adoption of the guidelines in accordance with Rogers' innovation-decision process were completed before (Time 1), directly after (Time 2) and 1 month following an event (Time 3).
Findings indicate that in total the events reached 5% of SCI Ontario clients. RM-ANOVAs and Related-Samples McNemar Tests indicated that initial adoption of the guidelines was high but in general was not maintained. Specifically, at Time 2, attendees' knowledge of the guidelines, attitudes toward the guidelines, self-efficacy and intentions to meet the guidelines increased from Time 1 (ps
The aim of this paper was to explore the patients' experiences of hope during the first months following acute spinal cord injury. This qualitative study has a descriptive and explorative design. Data were collected by personal interviews (N = 10) at a rehabilitation centre in Norway. A phenomenological-hermeneutic approach inspired by Ricoeur was used to extract the meaning content of the patients' experiences. The findings revealed one main interpretation; the awakening of hope, expressed by two themes: hope and despair, and uncertainty. Awakening hopes, even sometimes silent hopes, constituted a contextual background in the immediate aftermath of spinal cord injury.
BACKGROUND: According to the general literature on hope, individuals who are hopeful live more positive lives than those who experience hopelessness. Hope has been defined as a positive orientation toward future improvements, and is associated with health and well-being. AIM: This paper reports a study that explored patients' experiences of hope following spinal cord injury. METHOD: Data were collected by personal interviews (n = 10) at a rehabilitation institution in Norway. A phenomenological-hermeneutic approach was used to extract the meaningful content of patients' experiences. The analysis was performed as a spiral process that included a reading to gain a sense of the whole, followed by identification of meaningful parts and a comprehensive and understandable interpretation of the whole. FINDINGS: Two themes emerged: 'images of the past and future', and 'balancing between inner emotional dichotomies' that were, mainly, related to experiences of courage/uncertainty and patience/restlessness. DISCUSSION: All participants experienced hope. The substance of hope--being able to walk again and hoping for recovery--was a universal experience among participants and was comprehended in terms of positive expectations. The process of hope involved continuous 'ups and downs'. Patients were in need of skilled nursing care to enable and foster hope during the first months following acute spinal cord injury. CONCLUSION: In conclusion, patients hoped for recovery and every improvement stimulated hope. The process of hope was future-oriented, characterized by dichotomies. Nurses need the skills to foster hope and enable recently injured patients to look beyond the immediate situation and direct their energies appropriately.