Hope, coping and psychosocial adjustment after spinal cord injury.

INTRODUCTION: The study was a prospective, longitudinal design. The purpose was to explore the role of hope in the coping and psychosocial adjustment process following a spinal cord injury. The study was conducted at Spinal cord injury rehabilitation units in Queensland, Australia and Christchurch, New Zealand. MATERIALS AND METHODS: This was a longitudinal study conducted in two SCI rehabilitation centres, one in Australia and one in New Zealand. A total of 47 participants with newly acquired traumatic SCI were administered a survey consisting of the Adult Hope Scale; the Moorong Self-Efficacy Scale; the Centre for Epidemiology Studies-Depression Scale (CES-D); Life Satisfaction, Self-Rated Adjustment and Life Problems Subscales of the Life Situation Questionnaire and selected subscales from the Spinal Cord Lesion-related Coping Strategies Questionnaire (SCL-CSQ) and the COPE scales at 6 weeks post injury and 3 months post discharge. RESULTS: Hope levels and coping strategies remained consistent over time. Hope levels significantly and positively correlated with life satisfaction and self-reported adjustment, and negatively correlated with life problems. Hope levels also positively correlated with positive coping styles, including positive reappraisal, planning, acceptance and fighting spirit. Finally, hope levels negatively correlated with the negative coping strategies behavioural disengagement and social reliance. DISCUSSION: Hope and coping styles are likely to be determined by personality traits. The findings suggest that hope enhancing interventions should be explored as a means of improving outcomes for people with SCI.

Traumatic and non-traumatic spinal cord impairment in New Zealand: incidence and characteristics of people admitted to spinal units.

This paper estimates the incidence (all ages) of spinal cord neurological impairment (SCI; traumatic and non-traumatic) in New Zealand and describes pre-SCI characteristics and early post-SCI outcomes for participants (16-64 years) in this longitudinal study. Demographic and clinical data on all people admitted to New Zealand's two spinal units (mid-2007 to mid-2009) were included for the estimate of incidence. Participants in this longitudinal study were asked at first interview about pre-SCI socio-demographic, health and behavioural characteristics, and about post-SCI symptoms, general health status (EQ-5D) and disability (WHODAS 12-item). Age-adjusted incidence rates (95% CI) for European, Maori, Pacific and 'Other' ethnicities were 29 (24-34), 46 (30-64), 70 (40-100) and 16 (9-22) per million, respectively. Interviews with 118 (73%) participants (16-64 years), occurred 6.5 months post-SCI. Most reported bother with symptoms, and problems with health status and disability. Compared with Europeans, the incidence of SCI is high among Maori and particularly high among Pacific people. Six months after SCI, proximate to discharge from the spinal units, considerable symptomatic, general health and disability burden was borne by people with SCI.

Knowledge of autonomic dysreflexia in the emergency department.

OBJECTIVES: To determine the level of knowledge that medical staff in the emergency department and spinal unit have of autonomic dysreflexia, its causes, symptoms, treatment and complications; and to educate the participating staff about autonomic dysreflexia. METHOD: The study design was a prospective questionnaire, which was completed by 91 staff in the spinal unit and emergency department in Christchurch, who then undertook a teaching session on autonomic dysreflexia. RESULTS: 29 of 70 staff in emergency department could not answer any questions. The average mark out of 29 was 2 for the emergency department and 12 for the spinal unit. Only 16 staff in the emergency department had had teaching on autonomic dysreflexia previously. CONCLUSION: Due to the potentially serious complications of autonomic dysreflexia, staff require teaching on autonomic dysreflexia accompanied by permanent reminders in the form of posters.