SCI Nursing Volume 24, Number 3

Editorial: Coming to Terms With Tetraplegia

Deanna Persaud, MSN, RN

Neologism––A word, term, or phrase which has been recently created (“coined”) often to apply to new concepts, to synthesize pre-existing concepts, or to make older terminology sound more contemporary. (Wikipedia, 2007)


In the early 1990s, the International Standards for Neurological and Functional Classification of Spinal Cord Injury (ISCSCI) proclaimed that the term “tetraplegia” was the preferred term over “quadriplegia” for describing a spinal cord injury (SCI) resulting in “the loss of motor and or sensory function in the cervical segment of the spinal cord.” (Maynard, et al, 1997). Historically, the term “tetraplegia” has been widely used in Europe, while “quadriplegia” appears to be more popular in the United States. A review of the literature revealed that the rationale for the change stemmed from the fact that the term tetraplegia was more etymologically correct. “Quadra” is a Latin root; “tetra” and “plegia” are both Greek roots (languagehat, 2007). To avoid mixing our “roots,” tetraplegia was deemed appropriate. The bottom line is both terms mean exactly the same thing. Read the rest of this entry »

President’s Message: Believe

Cathy Parsa MA, RN

Last December I sent each board member a holiday card and placed a silver metal bookmark with attractive letters that spelled b-e-l-i-e-v-e inside. It caught my attention while waiting to check out at the local bookstore. I knew immediately that this was the simple message I wanted to send as we approached the New Year with so much on our plates. Optimism, my modus operandi up to that point, would take us far, but we all needed to believe deep down that we could make AASCIN work––not like before, but better in every way than it had ever been. At least that had been my intent when I sent it. I regret that I never asked anyone what they thought about it at the time. Did they get it or was the message too subtle? Read the rest of this entry »

Feature Article: ThinkFirst For Teens Injury Prevention Program: Evidence-Based Practice––Are We Making a Difference?

Deborah Boy Gerhardstein,RN, BSN, MA

Abstract
A pre-test, post-test study was used to evaluate outcomes of implementing the ThinkFirst For Teens program to students at three Chicago suburban high schools. Results showed an increase in knowledge related to potential for injury and the importance of safety belt use, bicycle helmet use, avoiding violence, driving sober and generally making safe choices. An increase in coinciding stated safe behavior choices was also seen. Sixty-seven percent of students stated they were most influenced to make safe choices by hearing from someone who had been injured, while 26% were influenced by facts on injury prevention and 7% were influenced by the potential for being ticketed. A qualitative posttest was administered three months later that determined lasting positive impact. Read the rest of this entry »

Feature Article: Chronic Pain After Spinal Cord Injury: An Overview of Treatment Options

Angela Starkweather PhD, ACNP, CCRN, CNRN

Abstract
It is estimated that two out of every three spinal cord injured persons experience some kind of pain syndrome, with many inflicted chronically. Pain can have enormous consequences on the psychological, social, and physical realms of rehabilitation and resocialization. Various mechanisms involved in chronic pain syndromes have led to a vast array of therapies; medical, surgical and behavioral. Not all of the traditional therapies used in other types of neuropathic pain, however, translate to successful outcomes in the spinal cord injury (SCI) population. SCI nurses are in a unique position to help advocate, educate, and collaborate with other clinicians and persons with SCI to improve care and outcomes for persons with SCI-related pain syndromes. The following article will review the impact of identified pain syndromes after SCI, provide an overview of the pathophysiology and mechanisms involved, review available therapies, and discuss recent research geared toward improving outcomes. Read the rest of this entry »

Feature Article: Quality of Life in Spinal Cord Injury Patients with Pressure Ulcers

Sarah Lyons, MS, RN, and Matthew Sorenson, PhD, RN

Abstract
Pressure ulcers can have a major impact on quality of life for those with spinal cord injury. The purpose of this mixed methods study was to describe subject perceptions related to the presence of a pressure ulcer and compare quality of life scores among SCI individuals with a pressure ulcer with those without a pressure ulcer. All subjects (N = 36) had a Grade 3 or 4 pressure ulcer, with at least one year between occurrence of injury and study participation. Data were collected through online surveys using a standardized quality of life instrument and four open-ended questions which addressed pressure ulcer perceptions. Quantitative findings found significant reductions in quality of life for SCI patients with a pressure ulcer as compared to SCI patients without such an ulcer. Qualitative findings reflected negative emotionality, loss of independence, and social isolation. These findings highlight the need for aggressive skin maintenance programs in individuals with SCI, and demonstrate a potential need for psychosocial support and counseling. Read the rest of this entry »

Leadership Circle: Finding The Leader Within

Barb Lawrie, MSN, RN, CRN

Several months ago I was asked as a member of the American Association of Spinal Cord Injury Nurses Board of Directors and a nurse leader to write an article for the SCI Nursing on the topic of nursing leadership. At the time, a deadline of August 1st seemed like such a long way away. Now, here I am pondering nursing leadership and our future as SCI nurses on a hot August weekend, days after my deadline! Read the rest of this entry »

Innovation Station: Meeting the Needs of Adolescents in a Spinal Cord Injury Rehabilitation Program

Christy Stackhouse, RN, CRRN

A spinal cord injury is perhaps one of the most devastating injuries a person can sustain. It is considered a catastrophic event and one’s life is changed forever. Major adaptations need to be made to activities of daily living and one’s life is irrevocably changed in a way that is difficult for able persons to imagine. These injuries are particularly devastating to adolescents for whom body image is vitally important. Not only do they have to deal with never walking again, they lose control of bowel and bladder and they may also have to face the fact that they may in a wheelchair for the rest of their lives. Read the rest of this entry »

Pediatric Perspectives: Adulthood: Life after Pediatric-Onset Spinal Cord Injury

Lisa Merenda, MSN, RN, CRRN, CCRC

Introduction
Successful transition to adulthood is a goal for any child or adolescent, with or without a disability. Preparation for adulthood is more complex for children with spinal cord injury (SCI) than it is for their peers. Pediatric patients will be followed by the health care team for many years before reaching adulthood. A goal of rehabilitation and habilitation for children and adolescents with SCI is to help ensure that they are prepared in every way for adult life, including having the same employment opportunities as the general population. Discussing transition to adulthood with patients and families at the time of injury is only the first step for health care professionals. There have been numerous reports on the outcomes of individuals with adult-onset SCI. Participation, functional independence, and decreased medical complications have been found to have an impact on health-related quality of life and life satisfaction of adult-onset SCI (Dijkers, 1999; Dijkers, 1997; Pierce, Richards, Gordon, & Tate, 1999). Until recently, however, there have been few comprehensive studies of the adult outcomes of pediatric-onset SCI patients. Read the rest of this entry »

Research Corner: Toward Understanding and Using Statistical Power Analysis

Karyn Holm, PhD, RN, FAAN,

Statistical power analysis, known simply as “power analysis,” is used to determine how many subjects will be needed when investigators plan to use parametric statistics to determine significant relationships and/or differences. Power analysis is now an expectation in the design of quantitative nursing studies, making it increasingly clear that investigators who intend to propose, secure funding for, conduct, and publish quantitative nursing research must understand and use power analysis. Read the rest of this entry »