Spinal cord injury is a life transforming condition that is thought to have an impact on the entire family of the affected individual. The needs and psychological outcomes of siblings of children with spinal cord injury (SCI) have not been researched. The current study focuses on the experiences of children living with a brother or sister with SCI. Eight participants (4 male, 4 female) aged between 7 and 18 years were interviewed using a semi-structured interview, concentrating on their unique experiences and understandings of having a brother or sister with SCI. The qualitative method of Interpretative Phenomenological Analysis (IPA) was used to analyze the data and three main themes were identified: "Life interrupted", "What about me?" and "My safety net". Results are discussed in relation to attachment and coping and adjustment theories. The discussion also highlights the clinical implications for siblings and parents of children affected by SCI, and for professionals who work within pediatric SCI settings.
Background/Objective: Spinal cord injury (SCI) is a devastating event with lasting implications for children and families. The rehabilitation of children and adolescents with SCI must be developmentally based, and goal-planning programs must respond to their changing needs as they grow. The Child Needs Assessment Checklist (ChNAC) and goal-planning program provides a developmentally sensitive way to assess and address young people's needs within the context of their family and community. This preliminary study investigated the utility of the ChNAC in planning rehabilitation goals and evaluating outcomes for young people.Methods: A retrospective review of scores on the ChNAC was conducted to assess the effectiveness of the goal-planning program in addressing pediatric patients' rehabilitation needs. The sample comprised 33 young people for whom both baseline and outcome ChNACs had been completed.
Results:Comparison of goals achieved on baseline and outcome ChNACs by median percentage score showed improvements in 9 of 10 areas. Differences in scores were compared across demographic groups.
Conclusions:The ChNAC is a practical tool for planning young people's rehabilitation after SCI and assessing rehabilitation outcome. This study is a preliminary demonstration of the pediatric goal-planning program's effectiveness in achieving positive rehabilitation outcomes. Future research should replicate these results with larger samples and include detailed studies of the ChNAC's reliability and validity.J Spinal Cord Med. 2007;30:S140-S145
Little work is carried out with child relatives by acquired brain injury rehabilitation staff, influenced by several factors. A priority in addressing this is to provide staff training.
Although the literature documents the considerable problems acquired brain injury causes for the survivor's family and close relationships, and the corresponding significantly inflated rate of separation and divorce, few papers offer practical solutions. The objective of this paper is to respond to this gap in the literature by presenting some of the problems raised for the rehabilitation team when a family separates, and some suggestions for ways in which these problems could be overcome. The literature is reviewed briefly, followed by reflections and suggestions which are based on this review and on clinical experience. The discussion indicates that there are a number of practical dilemmas raised for the rehabilitation team when a family already involved in the rehabilitation process starts to break up. Some specific suggestions for addressing these issues are made; further research is needed to evaluate their effectiveness.
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