International survey responses from an interdisciplinary cohort of spinal cord injury clinicians assessing professional burnout and meaning in work.

Study design: While clinicians who care for patients with spinal cord injury may experience heightened levels of workplace stress related to secondary trauma, little is known about the characteristics of burnout and potential protective factors among interdisciplinary professionals who care for this distinct clinical population. An online survey of self-reported burnout symptoms and meaning in work was conducted to assess the prevalence of burnout and characteristics of meaning in work among spinal cord injury professionals. Objectives: To assess symptoms of professional burnout and meaning in work among a broad-ranging cohort of spinal cord injury clinicians and researchers. Setting: A group of international spinal cord injury professionals. Methods: An online survey was developed using commonly assessed metrics of burnout and meaning in work based upon prior literature. Results: A majority of survey respondents reported feeling exhaustion (60.1%), while fewer reported feelings of burnout (41.1%) or work-life imbalance (31.9%). Many respondents found support in personal relationship from friends and family and reported using various strategies to deal with work stress, including exercise, meditation, and engaging in personally meaningful activities outside of work. Conclusions: Exhaustion is a prevalent issue for many spinal cord injury professionals and burnout appears to be a significant issue for a subset of responders, yet despite potential workplace stressors, spinal cord injury professionals reported high meaningfulness of work, positive impact from colleagues, and satisfaction with intellectual stimulation at work.

Sexual concerns after Spinal Cord Injury: An update on management.

BACKGROUND: Spinal Cord Injury (SCI) causes neurological impairment with resultant neurogenic sexual dysfunction which can compound preexisting psychological and medical sexual concerns. Understanding these concerns is important in managing the lifelong needs of persons with SCIs. OBJECTIVES: To provide an overview of the impact of SCI on sexuality along with a framework for treatment of sexual concerns. To briefly review male infertility and its treatments and pregnancy in females after SCI. METHODS: Interdisciplinary literature review and synthesis of information. RESULTS: The average age at SCI is increased, thus persons with SCIs may have preexisting sexual concerns. Sexual activity and satisfaction are decreased after SCI. Psychogenic sexual arousal is related to remaining sensation in the T11-L2 dermatomes. Orgasm occurs in approximately 50% of persons with SCIs with all injuries except subjects with complete lower motor neuron (LMN) injuries affecting the lowest sacral segments A structured approach to treatment including assessing preinjury function, determining the impact of injury, education, assessing and treating iatrogenic sexual dysfunction and treatment of concomitant problems is recommended. Basic and advanced methods to improve sexual arousal and orgasm are discussed and treatment of anejaculation and issues associated with pregnancy and SCI are reviewed. CONCLUSIONS: Sexual satisfaction is impaired after SCI; however, education and new therapies can improve responsiveness. Future research is warranted to improve sexual function and fertility potential in persons with SCIs.