Experiences of communication changes following spinal cord injury: a qualitative analysis.

Abstract:

:Purpose: Voice and communication changes can occur following cervical spinal cord injury due to dysfunction of the respiratory and phonatory subsystems. Few studies have explored the "lived experience" of communication changes post cervical spinal cord injury. Furthermore, the impacts of these changes on community activity/participation and requirements for psychosocial adjustment have not been well-elucidated. The current study explored the experience of communication changes in non-ventilated individuals following cervical spinal cord injury, using a biopsychosocial framework.Materials and Methods: Semi-structured interviews were conducted with 14 community-dwelling non-ventilated individuals with cervical spinal cord injury. Thematic analysis was undertaken using an inductive approach. Themes were subsequently coded against domains of the World Health Organization International Classification of Functioning Disability and Health model, using established linking rules.Results: Four main themes were identified: (1) how communication has changed; (2) difficulties getting the message across, (3) the multifactorial impact of communication changes on everyday life; and (4) strategies/support to adjust to communication changes. Communication changes had multifaceted effects on participants' functioning, and were represented equally across the Body Functions (12 codes), Activities/Participation (12 codes), and Environmental Factors (11 codes) domains of the model.Conclusions: Individuals with cervical spinal cord injury perceive and experience meaningful changes on communication function post-injury, with salient impacts to daily-living and social participation.IMPLICATIONS FOR REHABILITATIONAs a result of communication changes post-injury, individuals with cervical spinal cord injury experience several challenges across a variety of domains in daily lifeThe current study highlights the benefit of using a biopsychosocial framework, such as The International Classification of Functioning, Disability and Health (ICF), to consider the complex and diverse impact of communication changes on the functioning of individuals with cervical spinal cord injury, as well as the influence of environmental factors, on rehabilitation planningThe current data demonstrates the need for increased involvement of speech-language pathologists as core members of the multidisciplinary team, and for acute awareness by all health professionals of the potential impact of communication changes on rehabilitation and psychosocial adjustment in individuals with cervical spinal cord injury.

journal_name

Disabil Rehabil

authors

Wall LR,Nund RL,Ward EC,Cornwell PL,Amsters DI

doi

10.1080/09638288.2018.1557264

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

2271-2278

issue

16

eissn

0963-8288

issn

1464-5165

journal_volume

42

pub_type

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