Ernst F A
Am J Phys Med. 1987 Feb;66(1):12-5.
Theoretical approaches to the understanding of psychological adjustment in spinal cord injury have recently experienced a re-examination which seriously questions the traditional "stage theory" of adjustment. Despite limited empirical validation at best, the stage theory has not only enjoyed an unchallenged popularity amongst rehabilitation professionals but often has been imposed upon new SCI patients as a necessary criterion for hospital discharge. Experienced professionals have also been shown to exaggerate the distress of their SCI patients and these misperceptions tend to progressively worsen with length of clinical experience. The present study replicated and extended this tendency amongst research personnel and their SCI subjects. Staff members tended to over-estimate depression, anxiety, and social discomfort while under-estimating the optimism of their SCI subjects. Recommendations are made for the use of a questionnaire to measure their distress. Also, suggestions are made regarding the potential clinical utility of assessing the contrasting perceptions of distress by SCI patients and significant people in their rehabilitation and social environments.
最近，用于理解脊髓损伤心理调适的理论方法经历了重新审视，这对传统的调适“阶段理论”提出了严重质疑。尽管该阶段理论充其量只有有限的实证验证，但它不仅在康复专业人员中一直广受欢迎且毫无争议，还常常被强加给新的脊髓损伤患者，作为出院的必要标准。研究还表明，经验丰富的专业人员会夸大脊髓损伤患者的痛苦，而这些误解往往会随着临床经验的增加而逐渐恶化。本研究在研究人员及其脊髓损伤受试者中重复并扩展了这种趋势。工作人员往往高估抑郁、焦虑和社交不适，而低估脊髓损伤受试者的乐观情绪。建议使用问卷来测量他们的痛苦。此外，还就评估脊髓损伤患者与其康复及社会环境中的重要人物对痛苦的不同认知的潜在临床效用提出了建议。
