Graduation date: 1994

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

No description available.

Thesis (Ph.D)--Biomedical Engineering, Georgia Institute of Technology, 2009. / Committee Co-Chair: Shawn Hochman; Committee Co-Chair: Stephen P. DeWeerth; Committee Member: Lena Ting; Committee Member: Robert J. Butera; Committee Member: Robert Lee; Committee Member: Vivian K. Mushahwar. Part of the SMARTech Electronic Thesis and Dissertation Collection.

Thesis (MScPhysio)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Background Traumatic spinal cord injury (SCI) remains one of the most serious and devastating injuries often resulting in permanent disability and with life changing implications for the individual and his/her family. Successful reintegration into community life and employment after SCI is considered important goals of rehabilitation as this has been positively associated with quality of life, self esteem and life satisfaction. The International Classification of Functioning, Disability and Health (ICF) allows researchers to identify the impact of environmental factors on functioning and disability. Minimal research, particularly in South Africa, has been done on the impact of the environment on persons living with various health conditions and specifically spinal cord injury. Objectives The main purpose of this study was to describe and compare the level of participation of persons with traumatic SCI at two time points (discharge and six months after discharge) from the inpatient rehabilitation setting and to identify the environmental barriers experienced. Methods A prospective, descriptive study was conducted using consecutive sampling. All patients with traumatic SCI that were discharged from September 1, 2008 from the Western Cape Rehabilitation Centre (WCRC) who were eligible for this study were included. Two questionnaires (one based on the ICF and one purposely-developed) and the International Standards for the Classification of SCI (ISCSCI) were used. Data were analyzed with the statistical software package STATISTICA. Results A person sustaining a traumatic SCI in the Cape Metropolitan area of the Western Cape Province is most likely to be a male, young (20 to 29 years), of the Black or Coloured race and living in the Cape Flats suburbs. More than half of the subjects had a grade eight to ten level of education which together with the lack of employers’ responsibilities towards part-time workers might explain the low percentage (11%) of employment at six months after discharge from the WCRC. Complete paraplegia, occurring mainly in the thoracic cord, was the most common neurological disability found in this study. The most common secondary condition was pain followed by spasticity limiting function. The low incidence of pressure sores and urinary tract infections found in this study contradicts findings of previous studies.The majority of the subjects were discharged to the same house they were living in at the time of their injury. However, due to various architectural barriers, some of them were not able to function independently in their homes. Inaccessibility of public transport, the lack of recreational and sport facilities, lack of social support structures in the community and inadequate financial resources were the main environmental barriers experienced by these individuals. Conclusion The main finding of this study was the low employment rate and the difficulty experienced with reintegration at community level after SCI. The results of this study confirm the significant contribution of environmental factors in participation, especially those of transport and education in return to work. Fourteen years after the publication of the Integrated National Disability Strategy (INDS) White Paper (1997), legislative strategies to ensure that people with disabilities have equal access to social and economic opportunities remain lacking. / AFRIKAANSE OPSOMMING: Agtergrond Traumatiese spinaalkoordbesering (SKB) lei dikwels tot permanente verlamming en dit het lewensveranderende implikasies vir die individu en sy/haar familie. Suksesvolle herintegrasie in die gemeenskap en werkverrigting na SKB is belangrike doelstellings vir rehabilitasie omdat dit positief met lewenskwaliteit, selfrespek en lewens-bevrediging geassosieer word. Die Internasionale Klassifisering van Funksionering, Gestremdheid en Gesondheid (IKF) bied aan navorsers die geleentheid om die impak van omgewingsfaktore op funksionering en gestremdheid te identifiseer. Daar is veral in Suid-Afrika beperkte navorsing oor die impak van die omgewing op mense met verskillende gesondheidstoestande, spesifiek SKB. Doel Die hoofdoel van hierdie studie was om die vlak van deelname van mense met traumatiese SKB op twee verskillende tye te beskryf en te vergelyk, onmiddellik na hulle uit die rehabilitasiesentrum ontslaan is, en ses maande later. Die studie het ook ten doel gehad om die omgewingsfaktore te identifiseer wat deelname negatief beïnvloed. Metode Daar is van ’n beskrywende studie gebruik gemaak. Alle pasiënte met traumatiese SKB wat vanaf 1 September 2008 vanaf die Wes-Kaapse Rehabilitasiesentrum (WKRS) ontslaan is en wat voldoen het aan die insluitingskriteria is ingesluit. Twee vraelyste is gebruik om data in te samel – een is op die IKF gebaseer en een is spesifiek vir die studie ontwikkel. Daar is ook van die Internasionale Standaarde vir die Klassifisering van SKB (ISKSKB) gebruik gemaak om data in te samel. Data is met behulp van STATISTICA, ’n statistiese sagteware pakket, geanaliseer. Resultate Iemand wat ’n traumatiese SKB in die Kaapse metropolitaanse gebied van die Wes-Kaap provinsie opdoen, is mees waarskynlik ’n jong man (20 tot 29 jaar) van die Swart of Kleurling ras wat woonagtig in die voorstede op die Kaapse Vlakte is. Meer as die helfte van die deelnemers in die studie het slegs ’n opvoedingsvlak van graad agt tot tien. Hierdie aspek, tesame met die gebrek aan werkgewers se verantwoordelikheid teenoor deeltydse werknemers is dalk die rede waarom slegs 11% van die deelnemers ses maande na hulle uit die WKRS ontslaan is, werksaam was. Volledige paraplegie, hoofsaaklik as gevolg van ’n besering van die torakale spinaalkoord, was die algemeenste neurologiese besering wat in hierdie studie gevind is. Die algemeenste sekondêre komplikasie wat voorgekom het, was pyn gevolg deur spastisiteit. Die lae voorkoms van druksere en urienweginfeksies in dié studie is in teenstelling met bevindings van vorige studies. Die meeste deelnemers is ontslaan na dieselfde huis waar hulle voor die besering gewoon het, maar as gevolg van verskeie argitektoniese hindernisse, kon sommige van hulle nie onafhanklik binne hulle wonings funksioneer nie. Die ontoeganklikheid van openbare vervoer, die gebrek aan ontspannings- en sportfasiliteite, die gebrek aan sosiale ondersteuningsnetwerke in die gemeenskap en onvoldoende finansiële hulpbronne was die algemeenste omgewingshindernisse wat deur die deelnemers ondervind is. Samevatting Die belangrikste bevinding van dié studie was dat slegs ’n klein persentasie van die deelnemers ses maande na hul ontslaan is, werksaam was en dat herintegrasie in die gemeenskap na ’n SKB baie moeilik is. Die resultate van die studie bevestig die belangrike rol wat omgewingsfaktore by deelname speel, veral die faktore wat te make het met vervoer en die opvoedingsvlak wanneer daar na ’n werk teruggekeer word. Veertien jaar na die publikasie van die Geïntegreerde Nasionale Gestremdheidstrategie in 1997, is wetgewende strategieë om gelyke toegang tot sosiale en ekonomiese geleenthede vir persone met gestremdhede te verseker, steeds gebrekkig.

No description available.

The present study examined the effects of physical disability in fathers on the development and adjustment of their children. There is little empirically based information about the influence of physical characteristics of parents on children, but speculative articles have described many deleterious effects of being raised by a physically handicapped parent. These hypothesized relations between parental disability and child adjustment were tested. Two groups of adult children selected through the Veterans Administration Spinal Cord Injury system were studied: (a) Disabled Parent (DP)--17 male and 28 female children, mean age 21.6, who were raised by a spinal cord injured father from a mean age of 1.31, and (b) Comparison (C)--15 male and 21 female children, mean age 23.8, with nondisabled fathers. The two groups were matched on father's age, education level, state of residence, and disposable family income. Children had lived with both parents until age 15, and their fathers were veterans. Subjects completed a battery of tests: the Minnesota Multiphasic Personality Inventory (MMPI), Sixteen Personality Factor Questionnaire (16PF), Bem Sex Role Inventory, Body-Cathexis scale, Parent-Child Relations Questionnaire II (PCR), and Buck-Hohmann questionnaire (designed specifically for this study). The results did not support any of the hypothesized relations between parental disability status and child adjustment. DP and C children scored within the normal range on the MMPI and 16PF. The only significant difference which emerged was that DP children tended to be more cautious in emotional expression than did C subjects. The DP and C groups did not differ in body image or sex role orientation. On the Rokeach Value Survey, DP children ranked national security, a world at peace, clean, obedient, and responsible higher than did C children. C children valued being logical more than DP children. As perceived by the children, DP and C fathers did not differ significantly in the degree to which they were loving or rejecting, casual or demanding (PCR). On the Buck-Hohmann questionnaire, there was no evidence that disabled fathers excluded themselves from discipline and childrearing aspects of parenthood or that disabled fathers lose control over their children. DP children were found to hold significantly more positive attitudes toward their fathers than were C children. There were no effects on children's health patterns or interpersonal relations as a function of the father's disability status. DP children expressed more interest and participation in athletics than did C children. It was concluded that parental disability does not pose a severe threat to child adjustment. Children with spinal cord injured fathers appeared to be well-adjusted, emotionally stable persons who highly regarded their fathers. Limitations of the study and implications for rehabilitation programs, adoption and court custody decisions, and future research were discussed.

Spinal cord injury (SCI) is an acute and devastating event that results in significant and permanent life changes for the individuals who are injured, as well as their families and friends. Depression has received more attention from clinicians and researchers than any other psychological issue among persons with SCI. Measurement of depression in this population has a variety of methodological issues, including inconsistent assessments used (self-report versus clinical interviews), varying definitions of depression, inclusion and exclusion of physical symptoms in the assessment process, and use of measures that do not represent DSM-IV criteria for major depressive disorder. The primary goal of this study was to evaluate the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR) and provide descriptive analyses of this measure with persons with SCI. Results showed that somatic symptoms were more frequently endorsed than psychological symptoms in this population. Additionally, scores on the QIDS-SR were significantly associated with a depression diagnosis in the patient's medical chart. However, QIDS-SR scores were not found to be correlated inversely with quality of life scores as predicted. The QIDS-SR was shown to have good internal consistency and convergent validity with patients with SCI. However, it failed to demonstrate construct validity. The QIDS-SR has the potential to be a valid measure with this population and further analysis of the psychometric properties with patients with SCI is warranted.

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy