The meaning of hope for individuals with spinal cord injury in Brazil

Toward a person-centered ethics framework for autonomy in spinal cord injury research and rehabilitation

In this paper, we explore how the concepts of autonomy and autonomous choice are understood in the context of spinal cord injury in the academic literature, both in reporting on research results and more broadly on outcomes and quality of life. We find inconsistent, framework-absent portrayals of autonomy as well as an absence of discourse that draws upon ethical constructs and theory. In response, we advance a person-centered framework for spinal cord injury research that combines both lived experience and a disability ethics approach to fill this gap.

Dance for Parkinson, multifaceted experiences of persons living with Parkinson's Disease

BACKGROUND

Dance classes for people with Parkinson's Disease (PD) are offered worldwide; however, further studies are needed to explore patients' experiences of how dance affects well-being.

PURPOSE

To explore how Dance for Parkinson (Dance for PD) is experienced, and how it contributes to the well-being and health of participants in Sweden.

METHODS

This qualitative study collected data from four focus groups. Participants were asked how dance classes impacted their well-being, and their ability to perform activities of daily life. The focus groups were recorded and transcribed. Data were analysed using content analysis, meaning units were coded, and codes were coalesced into categories from which themes were abstracted.

RESULTS

Dance for PD provided a multifaceted experience related to social relationships, aesthetic context, feelings of wellbeing and the physical experience of dancing. The main theme contained four sub-themes: Connectedness, Pleasure and glamour, Well-being in mind and body and Customized movements.

CONCLUSION

The present study highlights that health and well-being are improved by Dance for PD. It is an enjoyable activity that meets the specific needs of persons living with the consequences of PD and should therefore be promoted by occupational therapists.

Efficacy of Urethral Sphincter Botulinum Toxin A Injection in Patients with Spinal Cord Injury with Dysuria: A Retrospective Cohort Study

Spinal cord injury (SCI) often leads to neurogenic lower urinary tract dysfunction, causing dysuria and affecting patients' well-being. This study aimed to evaluate the efficacy of a urethral sphincter botulinum toxin A (BoNT-A) injection in patients with SCI and dysuria. This was a retrospective study including 118 patients with SCI who underwent a urethral BoNT-A injection following a standardized protocol for refractory voiding dysfunction. The protocol involved injecting BoNT-A into the urethral sphincter under cystoscopic guidance. Patient demographics, bladder condition parameters, and treatment outcomes were analyzed. Logistic regression and receiver operating characteristic curve analyses were performed to identify predictors of treatment success. Of the 118 patients, 71 (60.1%) showed satisfactory treatment outcomes after the injection. Post-injection status, bladder management, and injection frequency varied significantly among patients with satisfactory and unsatisfactory treatment outcomes. Age, bladder compliance, intravesical pressure, and bladder contractility were indicators of satisfactory outcomes. The first sensation of bladder filling of ≤263 mL, intravesical pressure of ≤28, and bladder contractility index of ≥14 were highly correlated with satisfactory outcomes. A urethral sphincter BoNT-A injection shows promise in managing dysuria in patients with SCI. Understanding bladder condition parameters and patient demographics helps optimize patient selection for this intervention. Further studies are needed to validate these findings and refine treatment protocols.

Exploring the Experience of Living with Pain after Spinal Cord Injury: A Qualitative Study

A spinal cord injury is a life-changing experience that results in functional limitations and an increased risk of secondary health conditions. People with spinal cord injury identify pain as the most devastating health problem following their injury that not only affects their social life but their mental well-being as well. This study is aimed at exploring the lived experience of living with pain by community-dwelling manual wheelchair users with spinal cord injuries. An explorative qualitative design was used to explore their experiences. In-depth interviews were recorded and transcribed, and the data were analysed using inductive thematic content analysis in the MAXQDA v2020. Fifteen manual wheelchair users with paraplegia participated in this study, and four themes were identified from their experience of living with pain: pain constantly lurks, pain is worse than the direct consequences of the SCI, pain is restrictive, and life continues despite the pain. Categories and subcategories included the participants being one with the pain; pain interfering with sleep; feelings of anger, isolation, and suicidal ideation; and uncertainties about what the future holds living with pain. Living with pain after SCI is a challenging feat, and effective management of pain is necessary to improve not only functioning and mobility but also mental health and life satisfaction.

The Effect of Spiritual Well-being on Hope in Immobile Patients Suffering From Paralysis Due to Spinal Cord Injuries

This study aimed to determine the effect of spiritual well-being on hope in immobile patients suffering from paralysis due to spinal cord injuries. The sample size of this cross-sectional study was determined to be 100 immobile patients suffering from paralysis due to spinal cord injuries via power analysis. "Descriptive Characteristics Form," "Spiritual Well-being Scale," and "Dispositional Hope Scales" were used to collect the data. It was determined that participants' spiritual well-being scores were 22.25 ± 9.62 and their hope scores were 29.53 ± 9.83. There was a weak but positive correlation between the total scores on the hope scale and the spiritual well-being scale (p = 0.001, r = 0.477). Among immobile patients suffering from paralysis due to spinal cord injury, spiritual well-being levels accounted for 22% of the variance in hope levels (p = 0.001, R² = 0.22). This study showed that as patients' spiritual well-being levels increased, their hope levels also increased.

Restored Life of Elite Athletes after Spinal Cord Injury

Spinal cord injury (SCI) affects every aspect of human life: medical, psychological, social, material. People with SCI face a variety of secondary conditions (e.g., chronic pain, urinary tract infections, cognitive impairment) that place a significant emotional burden, resulting in an increased risk of depression and reduced quality of life. The purpose of this study was to better understand the coping strategies and to identify factors that promote or hinder the successful adjustment of elite athletes after SCI. Individual semi-structured interviews were conducted with eight top athletes after spinal cord injury. The interviews were recorded, transcribed, and then thematically analyzed using MAXQDA software. Thematic analysis identified the following categories: coping, athletic identity, and adjustment. The results of the study indicate that loss of functional ability does not cause loss of athlete identity. Elite athletes live a life consistent with this identity, attempting to maintain it despite the loss of physical fitness. Involvement in sports provides meaning and is a positive factor in the process of disability acceptance, which is essential in the process of adjustment to injury and also provides group belonging.