تبیین عوامل مؤثر بر پذیرش و سازگاری با ضایعه نخاعی: یک مطالعه کیفی

Objective Spinal cord injury is one of traumatic events that has considerable impact on the quality of life of the injured patients. Not all people react similarly in facing unpleasant event in life. This reaction cold be affected by different factors. Some people after the traumatic event are unable to do normal functions for several years and show some chronic dysfunctions, while others try hard for months, reach some level of adaptation, and show a model of recovery and improvement after tolerating some suffering. Individuals after spinal cord injury tend to adapt and cope with their injuries. However, there are differences in the level of compatibility and coping with injury and some remain vulnerable to some psychological problems. This incompatibility, in addition to the experience of emotional distress can affect other functional areas such as physical health and increase the risk of secondary complications. The purpose of this study was to explore factors affecting the acceptance and adaptation with spinal cord injury based on the experiences of these patients. Materials & Methods This qualitative study was conducted using content analysis method. Content analysis is a qualitative method to associate data with the main subject and its final product is the concepts and categories of the study subject. The study participants comprised 23 patients with spinal cord injury in Tehran City, Iran, that were selected purposefully, with a maximum variation in age, levels of education and experiences and roles in life. The inclusion criteria were spinal cord injury, over 18 years old, at least one year passed from the time of injury , and their desire for sharing their experiences on the study subject. Purposive sampling was continued to reach the saturation point in every concept so that more new information could not be found about these concepts. The study data were collected through in depth semi-structured interviews during 2016, and were analyzed using content analysis. Results The results of the data analysis were led to the extraction of the facilitators and obstacles of acceptance and adaptation in patients with spinal injuries. Facilitators were classified in eight main categories, including the correct support, communication with peers, social participation, spiritual belief, positive attitude, motivators, access to facilities and contextual factors. The obstacles were classified also in two general categories or concepts. Category of social and cultural incorrect beliefs with subcategories such as, pity, negative feedback of relatives, and insufficient knowledge about correct support. The second category comprised structural and contextual obstacles, including subcategories of health-related problems, urban handicap, financial problems, inefficiency of supporting organizations, and unawareness of disabled people. Conclusion The results obtained from the experiences of patients with spinal cord injury showed that a collection of individual factors, environmental and social factors can affect the process of acceptance and adjustment with injury, and take the role of facilitator or inhibitor during the process of acceptance and adapting with the lesion. Identifying these factors that have been achieved with regard to social context and real experiences of people from exposure to spinal cord injury, can have effective application in designing psychological rehabilitation programs for these people and their families. By promoting the individual and environmental facilitator factors, the process of accepting and coping with injury can be facilitated. In addition delays in acceptance and compatibility and negative psychological side effects can also be prevented by reducing the impact of inhibitory factors.