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Background: People with a recent spinal cord injury (SCI) often follow intensive rehabilitation. Learning appropriate self-care, deal with their impairments and prevent secondary health conditions (SHCs), is highly important during rehabilitation. To date it is not clear how self-care skills are taught to people with SCI. The objective of this study was to understand how people with SCI experienced the learning of appropriate self-care skills during inpatient rehabilitation, including the role of the rehabilitation team. Methods: Individual semi-structured interviews were conducted with 15 people with SCI, recently discharged from initial inpatient rehabilitation. Interviews were audio-taped, transcribed and analyzed thematically. Results: Two main themes and seven sub-themes were identified. Participants stated that the contribution of the rehabilitation team to learning self-care, including prevention of SHCs, was mostly made by optimizing opportunities to learn through experience. For preventing SHCs, education and lessons learned from the professionals during therapy and the formal educational program, was experienced as especially important. Further, the motivational attitude of the professionals which participants found stimulating and was based on respect, combined with their positive contribution as one team, were seen as essentials elements for learning appropriate self-care. However participants did not recognize the contribution of the nursing staff as part of their rehabilitation, although it was seen as very important. An important aspect of the participants' own contribution was challenging oneself to learn self-care. This was done in different ways by the participants. Further, their own mental adjustment was considered important in the learning process. The gaining of confidence was by most participants seen as personal characteristic, although they also recognized the importance of the team effort and the experiences they underwent. Conclusions: Learning appropriate self-care was mostly done through experience, by challenging themselves, and making use of the opportunities given by the members of the rehabilitation team. The same strategies used by the rehabilitation team to teach people with SCI to perform appropriate self-care, were also helpful for the participants to gain confidence. Explicit attention for self-care training as an important goal in SCI rehabilitation may strengthen the nursing staff's role and stimulate interdisciplinary working. [ABSTRACT FROM AUTHOR]

Design: Retrospective cohort study., Objective: Determine the course of burden and psychological distress of significant others (SOs) during initial spinal cord injury (SCI) rehabilitation and to predict the caregiver's burden at discharge with characteristics of SOs and persons with SCI (PSCIs) at the start of rehabilitation., Setting: Rehabilitation center Sint Maartenskliniek, Nijmegen, The Netherlands., Methods: All PSCIs admitted for initial rehabilitation between October 2020 and December 2022 were included. One of their SOs were asked to complete a set of screening questionnaires, collected in our routine context of care., Results: A total of 181 PSCIs (62% male, average age 60 years, 80% incomplete SCI, 60% paraplegia and 32 days after injury) and 158 SOs (40% male, average age 57 years) were screened at admission, and 145 and 93 at discharge, respectively. For SOs, the average caregiver's burden and feelings of depression and anxiety did not change during admission. The caregiver's burden score at discharge was best predicted by the burden score at admission, explaining 20% (P < 0.001) of the variance. An additional 13% (P = 0.02) of the variance was explained by other SO and PSCI variables gathered in this study., Conclusion: The caregiver's burden in this group of SOs during rehabilitation, was higher than that of a representative group in the chronic phase. On both assessments, around 20% scored above the cutoff. Scores of psychological distress are comparable to former studies. Standard screening of SOs during initial SCI rehabilitation is important to help the interdisciplinary team identify SOs at risk, and target their treatment during inpatient rehabilitation., (© 2024. The Author(s), under exclusive licence to International Spinal Cord Society.)

Background: People with recently acquired spinal cord injury (SCI) experience changes in physical, social and psychological aspects of their lives. In the last decades, attention has grown for aspects of self-management and self-efficacy in SCI research. However, we still do not know what the self-management and self-efficacy outcomes of first rehabilitation are and whether utilizing these skills may prevent secondary health conditions (SHCs) and increase participation and psychological adjustment early after SCI., Objective: To describe the course and determinants of self-management and self-efficacy during and after first SCI rehabilitation; and to determine theory-based associations between self-management and self-efficacy with SHCs, participation and psychological adjustment., Methods: Multicenter prospective longitudinal cohort study. All people with a newly acquired SCI admitted to one of the 8 specialized SCI rehabilitation centers in the Netherlands will be considered for inclusion in this study. Main assessments will take place during the first and last week of admission and 3, 6 and 12 months after discharge. The target sample is 250 participants. The primary outcomes are self-management (knowledge and execution of self-care) and self-efficacy (confidence in the ability to manage the consequences of SCI and of self-care). Secondary outcome measures are SHCs, participation and psychological adjustment to SCI., Results: The first results with the complete set of data are expected in June 2019., Conclusions: This protocol describes the SELF-SCI cohort study investigating self-management and self-efficacy of initial inpatient SCI rehabilitation. Second, associations will be investigated with SHCs, participation and psychological adjustment early after onset of SCI, until 1 year after discharge. The results will be used to test theories about motivation to perform health-promoting behaviors and adjustment to SCI., (©Tijn van Diemen, Eline WM Scholten, Ilse JW van Nes, SELF-SCI Group, Jan HB Geertzen, Marcel WM Post. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 26.02.2018.)

Objective: To investigate the correlation of higher-order coping strategies of tenacious goal pursuit and flexible goal adjustment with adjustment after rehabilitation in spinal cord injury., Design: Cross-sectional correlational study., Subjects/patients: All 397 eligible patients entered for spinal cord rehabilitation between 1999 and 2009 were contacted and 130 (33%) agreed to complete a self-report questionnaire., Methods: Partial correlations were computed between tenacious goal pursuit and flexible goal adjustment and affective and cognitive psychological adjustment. Demographics, spinal cord injury related variables, social support and coping were used as control variables., Results: After controlling for relevant demographic, medical and social support indices, partial correlations between tenacious goal pursuit and indices of adaptation were not significant. Significant partial correlations were observed between flexible goal adjustment and each of the indices of adjustment (r = -0.33, -0.42, 0.51, -0.38, respectively, for depression, anxiety, acceptance, and helplessness) after controlling for all relevant variables in the model. Flexible goal adjustment explained significant additional proportions of variance for each of the adjustment indices (7%, 11%, 18%, and 7%, respectively)., Conclusion: Flexible goal adjustment, but not tenacious goal pursuit, is associated with psychological adjustment in spinal cord injury. Further research is needed to understand the mechanisms of flexible goal adjustment. Interventions targeting flexible goal adjustment might be of benefit for the patient.