Women with spinal cord injury and the impact of aging

Abstract

Objectives: The objectives of this study were to describe what women with longstanding spinal cord injury (SCI) feel they are experiencing as they age, how they are coping and what they require in order to ensure their continued social and economic participation in society. Study design, methods and setting: A naturalistic approach was taken, incorporating three focus groups (n=10) and key informant interviews (n=19) of women with SCI ranging in age from 31 to 70 years and living in rural and urban communities in Ontario, Canada. Results: The women feel isolated and sense many of their key concerns are ignored or dismissed by health care and service providers. The common physical changes and concerns were gynecological/sexual and bowel and bladder issues. Socio-emotional changes with age included impact of their age-related changes on important relationships and re-evaluation of personal priorities. They articulated worries including declining health, increasing dependency and ®nancial stresses. Additional resources they need to age successfully include improved environmental accessibility, assistive devices, more¯exible and responsive attendant and household support, access to recreation and ®tness opportunities and peer and psychological support. Conclusions: Many of the issues raised by the women were consistent with the authors' previous examination of aging in men with SCI and women with disabilities. The most striking dierence was their profound sense of isolation and perceptions that health care and service providers were unprepared or unwilling to address the unique issues they face as women living and now aging with SCI. Sponsorship: This research was funded by the Ontario Neurotrauma Foundation.

Sexual issues in a sample of women with spinal cord injury

“…The majority of women in our sample classified the information they received as insufficient or nonexistent Many of the published studies on the subject with women with SCI do not address the sexual aspect of this condition, 1,6,7,12,23 which highlights the fact that those professionals who provide care and/or rehabilitation for women with these lesions are usually not involved in the important process of sexual readaptation. It is our belief that it is more difficult to adapt without help, and consequently we are in favor of a structured plan of information and integration of women with SCI in their new sexual lives.…”

Fatigue and spinal cord injury: a qualitative analysis

“…19,20 Moreover, the work of living with pain is compounded by sleep disturbances that result in fatigue, 20 and fatigue is associated with sleep disturbance, depression and pain. 5,8 More research is required before directions of causality can be stated with any confidence.…”

“…From their clinical experience the review's authors noted that cognitive complaints (attention, concentration and memory) accompany 'chronic fatigue' in SCI, yet contended that prevention depends on fighting physical deconditioning. This overlooks the identified linkages between overuse and fatigue 1,4,8 and sidesteps the reality that fatigue is not activityspecific (and thus related to specific muscle weakness). 10 Chart review at the GF Strong Rehabilitation Centre in Vancouver, British Columbia (BC) found that 57% of outpatients with SCI of greater than 1-year duration reported fatigue of sufficient severity to interfere with function.…”

Quality of life among people with high spinal cord injury living in the community

“…The present study identified the importance of being able to contribute to otherspartners, assistants, families, friends and communities -in reciprocal relationships that foster perceptions of value and competence, connecting and belonging, a finding supported by other researchers. 1,32,33,73,[77][78][79][80][81][82][83][84][85] The important role that special people had played in encouraging autonomy, affirming value and worth and facilitating engagement in meaningful occupations suggests that the rehabilitation process would benefit from the conscious and deliberate inclusion of friends and families. If relationships with special people provide opportunities for reciprocity and for engaging in meaningful occupations following discharge it makes little sense to exclude these people from the rehabilitation process.…”