Centre for Functioning and Health Research, Metro South Hospital & Health Service, Brisbane, Australia.
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
Disabil Rehabil. 2020 Aug;42(16):2271-2278. doi: 10.1080/09638288.2018.1557264. Epub 2019 Jan 29.
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. 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. 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. 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.
由于呼吸和发声子系统的功能障碍，颈椎脊髓损伤后可能会出现语音和交流变化。很少有研究探讨颈椎脊髓损伤后交流变化的“生活体验”。此外，这些变化对社区活动/参与以及心理社会调整的要求的影响还没有得到很好的阐明。本研究使用生物心理社会框架探讨了非通气的颈椎脊髓损伤患者的交流变化体验。对 14 名居住在社区的非通气颈椎脊髓损伤患者进行了半结构化访谈。采用归纳法进行主题分析。随后，根据世界卫生组织国际功能、残疾和健康分类的领域，使用既定的链接规则，对主题进行编码。确定了四个主要主题：（1）沟通方式的变化；（2）传达信息的困难；（3）沟通变化对日常生活的多方面影响；（4）适应沟通变化的策略/支持。沟通变化对参与者的功能有多种影响，在模型的身体功能（12 个代码）、活动/参与（12 个代码）和环境因素（11 个代码）领域中表现均衡。颈椎脊髓损伤患者在受伤后感知和体验到沟通功能的显著变化，对日常生活和社会参与有明显影响。
由于受伤后的沟通变化，颈椎脊髓损伤患者在日常生活的多个领域都面临着各种挑战。
本研究强调了使用生物心理社会框架（如国际功能、残疾和健康分类（ICF））的好处，以考虑沟通变化对颈椎脊髓损伤患者功能的复杂和多样化影响，以及环境因素对康复计划的影响。
目前的数据表明，需要增加言语语言病理学家作为多学科团队的核心成员的参与，并需要所有卫生专业人员意识到沟通变化对颈椎脊髓损伤患者康复和心理社会调整的潜在影响。
