Census estimates in 2010 indicated that 6,3 percent South Africans aged 5 years and older are currently classified as disabled in five of the nine provinces in the country. The national figure for 2005 was 5 percent, with the figure for females (6,5 percent) slightly higher than that for males (6,1percent). Spinal cord injured persons and their significant others experience a range of emotions which affect their relationships with themselves, others and their environment. To deal with the life-changing consequences of the injury and regain control, these persons not only require a variety of coping strategies but rediscovery of resilience is inevitable if the experience of personal purpose and meaningful existence is ever to be regained. In the Nelson Mandela Bay Municipal area, Port Elizabeth, South Africa – the geographical area in which this research study was undertaken - persons with spinal cord injuries have many challenges to face due to the shortcomings the existing resource for health care delivery in the post-discharge phase. The research objectives identified for the study were, firstly, to explore and describe the lived experiences of persons with spinal cord injuries; secondly, to explore and describe the lived experiences of the significant others of persons with spinal cord injuries; and thirdly, to develop a strategy to guide the professional nurse and the health care team in facilitating the health care of persons with spinal cord injuries. The study was a qualitative, exploratory, descriptive, and contextual method of inquiry. The data obtained was used to formulate the strategy with its three sub-strategies to guide professional nurses and the health care team to facilitate renewed resilience and the re-establishment of meaning for persons with spinal cord injuries. Although the experiences of the significant others were explored in order to thicken the description of the experiences of persons with spinal cord injuries, the strategy developed was limited to the persons with spinal cord injuries. Although it is well documented that there are significant physical needs, the themes that emerged from the current research mostly related to psychological and social aspects. In acknowledging the human being as unitary multi-dimensional being, the researcher in his discussions and quest to address the issue of renewed resilience in spinal cord injured persons towards finding purpose and re-establishing meaning in their lives, focused on their psychological, spiritual and social health. The outcome of the study is a strategy constructed to facilitate renewed resilience, and three sub-strategies ‘addressing experienced emotions’, ‘facilitating meaningful relationships’ and ‘facilitating effective coping’. The strategy has as purpose the empowering of spinal injured persons in their efforts to re-establish meaning by serving as a tool to guide professional nurses and members of the health care team in their facilitating of renewed resilience in persons with spinal cord injury. It is envisaged that the co-ordination of the strategy will take place from the health care delivery facility nearest to the spinal cord injured individual concerned. In order for persons with spinal cord injuries to become accountable members of society, all levels and aspects of care aimed at physical, psychological, spiritual and social well-being need to be holistically addressed. The front-line role of the professional nurse is vital as the professional nurse acts as the co-ordinator for the health care team in ensuring that persons with spinal cord injuries receive quality and holistic care in order to deal meaningfully with the life-altering consequences of a spinal cord injury. Through this study, valuable insight was gained with regard to experiences of both persons with spinal cord injuries and that of their significant others. Recommendations were made for nursing practice, nursing education and nursing research.

M.A. / Spinal cord trauma resulting in paraplegia or quadriplegia is one of the most devastating injuries. A frequent complication of spinal cord injury is intractible pain. It compounds a host of personal and social consequences: disruption of personal roles, dysfunctional marital and family relationships, unemployment, financial hardship, depression, anxiety, lowered self-esteem and hopelessness. There is an abundance of research on pain in general, but a dearth of literature on chronic pain in the spinal cord injured population - especially in the South African context. This study examined the psychosocial impact of pain on spinal cord injured patients in a hospital setting. Specifically, it addressed six core research questions, concerned with the physiological components of pain, and the social, affective and rehabilitation consequences of pain for spinal cord injured patients. The effects of etiology and level of lesion, age, gender and culture on the general pain experience were investigated. The purpose of this study was to accurately describe the phenomenon of pain as experienced by spinal cord injured (SCI) patients. The evidence showed that pain was a serious problem for SCI patients. A variety of physical and social modifiers of the pain experience were identified, as were several important temporal features of pain. SCI patients reported high frequencies of social, affective (depression, low selfesteem, suicidal responses and partner relationship problems), and rehabilitation consequences. The etiology of spinal cord injury was found to be related to pain intensity, while the level of the lesion was not associated with pain intensity or frequency. Some effect was found for age, however, gender did not contribute to the variance of any of the dependent variables. The culture of SCI patients plays an important role in both pain perception and the psychosocial and rehabilitation consequences of chronic pain. The results suggest that pain in SCI patients, as in other pain populations, needs to be recognized as a complex, multidimensional phenomena. Successful treatment requires an understanding of the SCI patient's emotional and psychological, as well as his physical requirements. The role of pain assessment is fundamental to any pain management programme.

No description available.

This investigation was conducted to determine the effectiveness of Personal Achievement Skills (PAS), a structured group psychotherapy approach, on the productivity, social functioning, self-esteem, locus of control, and life satisfaction of individuals with traumatic spinal cord injury. Subjects for the study were recruited through disability advocacy organizations, state disability service agencies, and local colleges, universities, and rehabilitation centers. The research design utilized was a randomized, pretest, posttest control group design with 15 experimental and 14 control group subjects. A behavioral Activity Questionnaire was specially designed for the study to assess productivity. It included activities such as employment, educational pursuits, social and community involvement, volunteer work, and family responsibilities. Other measures included: (a) the Affiliative Tendency Scale, (b) the Rosenberg Self-Esteem Scale, (c) the Nowicki-Strickland Locus of Control Scale, and (d) the Life Satisfaction Index. The results of the investigation indicated that PAS group participants, in comparison to the control group, improved significantly on the self-esteem measure. No such improvement was found on the other measures in the study. With regard to the self-esteem finding, male subjects responded more favorably to the PAS approach than female subjects. The issues and concerns of using the PAS approach with individuals with physical limitations were discussed along with recommendations and modifications for future research. / Graduation date: 1992

No description available.

Thesis (Ph. D.)--Drexel University, 2005. / Includes abstract and vita. Includes bibliographical references (leaves 91-101).

Advances in health care science are enabling greater numbers of spinal cord injured persons to live to old age. As these persons grow older, there may be additional problems in coping due to stressors such as decreasing health and income and loss of significant others. The purpose of this study was to determine those factors that contribute to the well-being of middle-aged and elderly community-residing spinal cord injured persons. One hundred spinal cord injured persons ranging in age from 40 to 73 were interviewed. Extensive data were collected in order to investigate the relationship among social support, types of social comparisons made, perceived control, health status and psychological well-being and life satisfaction. In general, respondents reported a degree of well-being that was slightly lower than that reported in studies of nondisabled populations on the same measures of psychological well-being, life satisfaction, and depression. Pearson correlations and multiple linear regressions showed that persons reporting high levels of well-being made favorable social comparisons, reported high levels of perceived control over their lives, had high levels of social support, and judged their health status to be good. They also viewed their disability more favorably and tended to have higher incomes, more education, to be employed, and to be more religious than those indicating lower levels of well-being. The severity of the spinal cord injury was not correlated highly with subjective well-being, although there was a tendency for persons with greater disabilities to report lower levels of well-being. Persons who were younger and who incurred their disability at a younger age also tended to report higher levels of well-being. A model of well-being is proposed. This model suggests that social support fosters the perception of control and the making of favorable social comparisons which, in turn, foster a sense of well-being and satisfaction with life. This model provides direction for future research and has valuable implications for clinical application.

No description available.

This study aims to explore, and to a certain extent to clarify, what it means psychologically to experience Traumatic spinal cord injury (TSCI) in a South African spinal unit. The target time chosen for analysis is the acute medical period. The study presents a review of the literature on psychological adjustment to TSCI and then proceeds to introduce and extensively articulate the hermeneutic approach and methodology. Subsequently, an interpretive research strategy is presented for the purpose of studying the acute phase of TSCI. The data for the study was obtained by means of three dialogical interviews which were tape recorded, transcribed and analyzed with~n a cyclical framework consisting of three interdependent levels. The interpretive procedure is modeled upon the 'reading guide' developed by Brown, Tappan, Gilligan, Miller and Argyris (1989). The analysis follows a course from the individual psychological descriptions of the experience to the generation of a general, nomothetic narrative account of the acute phase. The findings are then discussed in relation to the existing literature and evaluated on the basis of the goals of the study. The study highlights the value of some of the 'stage' ways of thinking about SCI adjustment, while simultaneously stressing the need for placing adjustment within a more personalized, and individually meaningful context. Significant differences between the psycho-physical experiences of patients in the categories of complete and -incomplete SCI were found, which suggests that a sharper distinction be made in the literature between these two groups, in order to account for the marked variations in their experiences.-- The study also contains a number of shortcomings, such as a lack of understanding about certain historical and contextual factors which may have mediated the experiences of the trauma for the individuals concerned. These shortcomings and some suggestions fro their resolution are then discussed. The study concludes with an evaluation of the research strategy and methodology and also offers some suggestions for future research.

published_or_final_version / Psychiatry / Master / Master of Philosophy