The biopsychosocial model and spinal cord injury

Abstract

Objective: To highlight the importance of taking the psychological, social and biological aspects into consideration when dealing with somatic complaints of spinal cord injured patients. Setting: Supra-regional Spinal Injury Unit in the UK. Study design: Case study series. Material and methods: The somatic complaints of four patients with spinal cord injury were assessed and their relationship to psychological and social issues were correlated. Two patients su ered unexplained pain, another excessive spasm uncontrolled with intrathecal Baclofen pump and the fourth with several pressure sores, constipation and other physical problems. The impact of psychosocial issues on the somatic complaints were analysed. Results: In all four patients the resolution of their psychosocial issues resulted in signi®cant gains vis-aÁ-vis their somatic complaints. Conclusion: Psychological and social issues of spinal injury patients could have a serious impact on the resolution of somatic complaints. It is important to take these into consideration in their treatment. Spinal Cord (2001) 39, 644 ± 649

Individualised and health-related quality of life of persons with spinal cord injury

“…In particular, the interplay among psychosocial variables and physical functioning might be playing a key role. 6 There is evidence suggesting that coping strategies act as a potential mediator, together with social participation and support, between the physical consequences of SCI and the psychological adjustment. 7,8 However, the results of studies investigating the role of coping in shaping psychological adjustment and QoL are not always in agreement.…”

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

“…The Guide incorporates a number of models [29][30][31][32][33][34][35][36][37] that have the capacity to improve the psychosocial rehabilitation of people with SCI. In particular, the clinical recommendations were influenced by the premises of the Biopsychosocial Model [29], acknowledging that people with SCI, in addition to the physical challenges, have experienced psychological and social changes requiring substantial adjustment.…”

“…The Guide incorporates a number of models [29][30][31][32][33][34][35][36][37] that have the capacity to improve the psychosocial rehabilitation of people with SCI. In particular, the clinical recommendations were influenced by the premises of the Biopsychosocial Model [29], acknowledging that people with SCI, in addition to the physical challenges, have experienced psychological and social changes requiring substantial adjustment. The Guide also recognized the value of other models in shaping SCI psychosocial rehabilitation, such as the Stress Appraisal Model [36], which suggests that adjustment and coping depend upon a person's stress and health status, believed to be a product of how people perceive their ability to cope with life stressors, and the Transtheoretical Readiness to Change Model [37], proposing that the ability to change depends upon the person's psychological readiness to change.…”

“…self-efficacy) and coping styles can enhance or become a barrier to adjustment [9,13,22,26] Mood states Elevated negative mood states will impede adjustment and possibly result in higher risks of attempted suicide [4][5][6][7][8]25,27,28] The Biopsychosocial Model should guide SCI rehabilitation, as it integrates biological, psychological and social dimensions of physical and mental health outcomes, and it has been successfully applied previously to SCI care [29,30].…”

“…This is the case in Australia, if not in many SCI units worldwide. Psychosocial management is certainly required when specific problems are examined, for instance, high occurrence of psychological morbidity [18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Rates of depression are estimated to range between 20 to 40% of the adult SCI population, almost 10 times the rates of depressive mood in the able-bodied [4,8,28].…”