Psychosocial Problems Faced by Persons with Spinal Cord Injury: A Rehabilitation Hospital Based Qualitative Study

Abstract

Spinal cord injury (SCI) is a major trauma that impacts many aspects of a person’s life. The experience of a life altering incident, acute hospital care and prolonged hospitalization for rehabilitation creates a severe disruption to a spinal cord injured person’s life. The purpose of this study was to describe psychosocial problems faced by persons with SCI. A qualitative study was conducted among persons with SCI, undergoing rehabilitation at the Rheumatology and Rehabilitation Hospitals, Ragama and Digana Sri Lanka. Ten participants were selected purposively to represent both males and females, with cervical, thoracic or lumbar levels of injuries due to traumatic and non-traumatic causes as well as from different socioeconomic backgrounds. In-depth interviews were conducted after informed consent using an interview guide with probes. Interviews were audio taped and transcribed verbatim. Qualitative content analysis was conducted. Ethical approval for this study was obtained from the Ethics Review Committee, Faculty of Medicine, University of Kelaniya. The following themes were identified in the content analysis: Physical dependency, financial difficulty, burden on the family, uncontrollable sensations, uncertainty of marital relationships and lack of concern from associates. Physical dependency was perceived in relation to their limited mobility. They perceived financial difficulties in relation to their inability to return to work. They felt that they would hitherto be a burden on their families financially. Uncontrollable sensations were due to spasticity and frequent spasms. Fears and doubts about “partner satisfaction’ in their marriage due to their physical disabilities was expressed. They also expressed concern about the insensitive over reaction from relatives and friends that made them miserable angry. The findings reinforce the needs of persons with SCI. Care teams should endeavor to address them in e rehabilitation process. The role of the social services too should be strengthened to complement the medical role in ensuring psychosocial wellbeing.