A Clinical Perspective on the Need for Psychosocial Care Guidelines in Spinal Cord Injury Rehabilitation

Abstract

Objective: Spinal cord injury (SCI) is a catastrophic physical injury presenting substantial obstacles to adjustment in the long-term, often being associated with additional challenges, including traumatic brain injury, frequent hospitalization, substance abuse, co-morbid psychiatric conditions, chronic pain and fatigue, social discrimination and poor employment prospects. Methods: In an effort to improve rehabilitation and outcomes for people with SCI in the state of NSW, Australia, psychosocial guidelines have been developed to provide direction for enhanced service delivery, staff training and care processes. A major goal was to ensure persons with SCI would receive comprehensive psychosocial care, arguably leading to improved quality of life and functionality in daily living. It is believed that implementation of psychosocial recommendations into care settings will improve decision-making concerning assessment, treatment, referral and living arrangements by rehabilitation health professionals (such as physicians, psychologists, social workers, occupational and physical therapists, rehabilitation counselors and nurses). A secondary goal was to provide guidelines that would promote improved understanding of the psychosocial needs of people with SCI in legislators, policy-makers and other stakeholders within the health and social care environments. Conclusion: This paper provides details of the developed guidelines, discussing implications for their application in rehabilitation practice within the hospital inpatient setting, as well as the significance for research directions into psychosocial aspects of SCI rehabilitation.