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“与破碎的身体共存”:一项关于脊髓损伤后对身体变化认知的定性研究。

"Living with a fragmented body": a qualitative study on perceptions about body changes after a spinal cord injury.

机构信息

Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, Spain.

National Paraplegic Hospital, Castilla-La Mancha Health Service, Toledo, Spain.

出版信息

Spinal Cord. 2021 Aug;59(8):855-864. doi: 10.1038/s41393-021-00634-4. Epub 2021 Jun 2.

Abstract

STUDY DESIGN

A qualitative study analyzed using Grounded Theory.

OBJECTIVES

To explore perceived bodily changes in people with acquired spinal cord injury of both genders and with different levels of injury.

SETTING

The National Paraplegic Hospital in Toledo, Spain, a national reference center for the treatment of spinal cord injury.

METHODS

A qualitative study designed and analyzed from the perspective of Grounded Theory. Semi-structured interviews were conducted in a triangulated sample of 32 people with acquired spinal cord injury. The analysis was based on the constant comparative method and an open, axial, and selective coding process.

RESULTS

The perceptions regarding bodily changes in people with spinal cord injury were grouped into two broad categories: changes in body schema (a fragmented body, a blurred body, body as a burden, non-muscular body, the wheelchair as an extension of the body, and body normalization) and increased bodily awareness (an uncontrollable body and retraining the body). The amount of time since the injury, positive life behaviors and attitudes, youth, male gender, and having flexible beliefs, values, and habits were considered facilitators for coping with body changes after a spinal cord injury.

CONCLUSIONS

Suffering a spinal cord injury implies a new body schema and a change in body awareness. When healthcare professionals are aware of the changes affecting the body after a spinal cord injury, they display more favorable attitudes and are more involved in promoting the patients' adaptation to their new body schema.

摘要

研究设计

采用扎根理论进行的定性研究。

目的

探索两性和不同损伤程度的获得性脊髓损伤患者对身体变化的感知。

设置

西班牙托莱多国家截瘫医院,是脊髓损伤治疗的国家参考中心。

方法

从扎根理论的角度设计和分析定性研究。对 32 名获得性脊髓损伤患者进行了三角样本的半结构化访谈。分析基于恒定比较法和开放、轴向和选择性编码过程。

结果

脊髓损伤患者对身体变化的感知分为两大类:身体图式的变化(碎片化的身体、模糊的身体、身体作为负担、非肌肉的身体、轮椅作为身体的延伸、身体正常化)和身体意识的增强(不可控的身体和重新训练身体)。受伤时间、积极的生活行为和态度、年轻、男性性别、灵活的信仰、价值观和习惯被认为是应对脊髓损伤后身体变化的促进因素。

结论

脊髓损伤意味着新的身体图式和身体意识的改变。当医护人员意识到脊髓损伤后对身体的影响时,他们会表现出更有利的态度,并更积极地促进患者适应新的身体图式。

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