Abstract
BackgroundSecondary health conditions (SHCs) such as pain, pressure sores, sexual problems, bowel and bladder problems are prevalent throughout the lifespan of people with spinal cord injury (SCI). Studies have reported that SHCs decrease life expectancy and increase health care costs. Studies on the lived experience of SHCs are, however, limited.ObjectivesTo explore the experiences of SHCs amongst people with SCI in a public rehabilitation hospital in South Africa.MethodFace-to-face semi-structured interviews were conducted with people with SCI from August 2018 to July 2019. All interviews were transcribed verbatim and analysed using a content analysis approach.ResultsSeventeen people with SCI were interviewed. Participants experienced a range of SHCs. The most common experienced SHC was pain (94%). The main theme that emerged from the analysis was ‘the impact of secondary health conditions on health and well-being’. The categories linked to the impact were SHCs co-occurrence and how SHCs limit function, restrict participation, affect mental health and disrupt lives.ConclusionWe found that SHCs were enormously impactful on our participants’ lives and health, as illustrated by their stories of fear, embarrassment and shame. Understanding people with SCI experiences of SHCs can enhance communication between people with SCI and health professionals and may help develop prevention strategies.Clinical implicationsTo enhance patient-centred care, health professionals are encouraged to actively listen to patients’ experiences of illness and the impact on health and wellbeing.
Highlights
Secondary health conditions (SHCs) such as pain, pressure sores, sexual problems, bowel and bladder problems are prevalent throughout the lifespan of people with spinal cord injury (SCI)
Across the lifespan, people with Spinal cord injury (SCI) are at risk of developing secondary health conditions (SHCs), which lead to poor health (Mittmann, Hitzig & Craven 2014) and quality of life (Mashola & Mothabeng 2019)
The different SHCs that may develop after SCI include pain, pressure sores, spasms, postural hypotension, pneumonia, bowel and bladder problems, mental health problems and sexual problems (Brinkhof et al 2016; Jensen et al 2013)
Summary
Secondary health conditions (SHCs) such as pain, pressure sores, sexual problems, bowel and bladder problems are prevalent throughout the lifespan of people with spinal cord injury (SCI). Health is a complex phenomenon that extends beyond dysfunction or impairments It is a by-product of the interaction between the affected bodily structures and systems, and ability to function and participate in life within a specific context (World Health Organization 2013). Across the lifespan, people with SCI are at risk of developing secondary health conditions (SHCs), which lead to poor health (Mittmann, Hitzig & Craven 2014) and quality of life (Mashola & Mothabeng 2019). The different SHCs that may develop after SCI include pain (neuropathic and musculoskeletal), pressure sores, spasms, postural hypotension, pneumonia, bowel and bladder problems, mental health problems and sexual problems (Brinkhof et al 2016; Jensen et al 2013). The reported SHCs prevalence in South Africa during the acute hospital phase was estimated at 50% (Joseph & Wikmar 2016), which is markedly lower than that reported in Sweden http://www.sajp.co.za
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