The Mayo Clinic reports that a spinal cord injury often causes loss of movement and sensation below the injured area, resulting in permanent disability. Hsiao-Yu Chen endeavored to define the emotional stages in response to a spinal cord injury. The resulting paper "Living with a Spinal Cord Injury" published in 2008 in "Journal of Clinical Nursing" defined three main emotional stages.
Catastrophic Life Event
The first stage begins with the patient justifiably viewing the spinal cord injury as a devastating event. He experiences feelings of grief, low self-esteem, negative body image and fear of the future and its unpredictability. Many patients experience job loss, resulting in financial insecurity. The spinal cord injury propels the patient's entire family into crisis. For patients with a more severe injury, such as those paralyzed from the chest down, thoughts of suicide are prevalent. In the "Journal of Clinical Nursing," Chen notes that family support and support from health care professionals is critical for helping the patient to overcome suicidal feelings.
Confront Challenges
The "Journal of Clinical Nursing" article points out that this stage usually occurs while the patient is still receiving care in a hospital. She must develop strategies to join the world as a person with a disability. Chen notes this stage has five sub-challenges. First, the patient needs to learn to reintegrate herself, to feel secure with her disabled body through rehabilitation. Second, challenges on the patient's psychological well-being exist. Third, she may feel challenges to her spirituality. Joining support groups and meeting others who face the same challenges can help. Fourth, the ability to take part sexually is a topic many patients are concerned about but embarrassed to discuss. Health care providers should initiate this conversation if the patient is reticent. Fifth, the challenge of planning for the future and future support presents itself. Financial constraints may force the patient back into the home before she feels ready, and the thought of being alone or going out alone may cause feelings of panic. Sharing information and setting up support options with health care professionals, friends, support groups and family is vital during this stage.
Move Forward or Withdraw from Society
Moving forward is the ability to lead as full and independent a life as possible. The "Journal of Clinical Nursing" article points out that length of time since injury, the severity of the injury and support systems are all important factors. It is easier for patients with paralyzed legs to move forward than for those paralyzed from the neck down. Chen defines moving forward by two sub-categories: triumph over tragedy and having courage. Patients must feel a sense of triumph and the courage to choose and follow alternate ways of living. Many patients consider returning to some form of work, even with care attendants, critical for regaining a sense of triumph. Patients unable to do this withdraw from society, which further impairs the ability to cope with the spinal cord injury. Chen states that support systems including family, friends, community and health care professionals are the key to moving forward.
