Abstract
Study design:
Matched patient/staff study.
Objectives:
To investigate spinal cord lesion (SCL) rehabilitation staff perceptions of SCL patient problems, coping efforts, and well-being, and to compare these evaluations with patient self-reports of the same aspects.
Settings:
Spinal Unit, Sahlgrenska University Hospital, Göteborg, Sweden.
Methods:
In all, 29 persons with SCL and 24 members of the caring staff participated. Each patient was matched to a staff person actually involved in his or her care. The participants completed a study-specific questionnaire containing 45 SCL-related problems covering six problem areas: somatic symptoms, functional limitations, role problems, family-related problems, psychosocial problems, and emotional problems. Coping activities were assessed by a self-report 47-item questionnaire covering eight aspects of coping: self-trust, problem focusing, acceptance, fatalism, resignation, protest, minimization, and social trust. The patients were instructed to respond to the items included in the questionnaires according to their situation during the last week, while staff members were instructed to reply as ‘they thought that their matched patient would answer’.
Results:
Moderate but statistically significant correlations were demonstrated between patient and staff ratings of most investigated problem areas. However, the staff systematically overestimated patients' emotional as well as family problems, and tended to underestimate patients' reported coping ability and mental health. Staff were most accurate in assessing patients' physical symptoms, functional limitations, and role problems, but less accurate in their perception of less visible symptoms.
Conclusion:
Relatively high agreement between patients and staff concerning patients' problems and states is possible to obtain in a caring setting. This may be more related to the quality of caring in the studied unit than to the study methodology used. Small units with high staff density and a long stay and/or prolonged contact with the patients probably facilitate communication with and knowledge about the patients. Interventions aimed at increasing staff awareness of patients' coping efforts may further improve staff ability to understand and support patients in their adaptation process.
Sponsorship:
The Foundation of Rehabilitation Research (FRF), The Vårdal Foundation, Sweden.
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References
Sprangers MAG, Aaronson NK . The role of health care providers and significant others in evaluation of the quality of life of patients with chronic disease: A review. J Clin Epidemiol 1992; 45: 743–760.
Lampic C, Sjödén P-O . Patient and staff perceptions of cancer patients' psychological concerns and needs. Acta Oncologica 2000; 39: 9–22.
Farrell G . How accurately do nurses perceive patients' needs? A comparison of general and psychiatric settings. J Adv Nurs 1991; 16: 1062–1070.
Holmes S, Eburn E . Patients' and nurses' perception of symptom distress in cancer. J Adv Nurs 1989; 14: 840–846.
Jennings B, Muhlenkamp A . Systematic misperception: oncology patients' self-reported affective states and their care-givers' perceptions. Cancer Nurs 1981; 4: 485–489.
Bodenhamer E, Achterberg-Lawis J, Kevorkian G, Belanus A, Cofer J . Staff and patient perceptions of the psychosocial concerns of spinal cord injured persons. Am J Phys Med 1983; 62: 182–193.
Ernst F . Contrasting perceptions of distress by research personnel and their spinal cord injured subjects. Am J Phys Med 1987; 66: 12–15.
Johnston M . Recognition of patients' worries by nurses and by other patients. Br J Clin Psychol 1982; 21: 255–261.
Davies A, Peters M . Stresses of hospitalisation in the elderly: nurses' and patients' perceptions. J Adv Nurs 1983; 8: 99–105.
Caplan B . Staff and patient perception of patient mood. Rehabil Psychol 1983; 28: 67–77.
Cushman L, Dijkers M . Depressed mood in spinal cord injured patients: staff perceptions and patient realities. Arch Phys Med Rehabil 1990; 71: 191–196.
Trieschmann RB . Spinal cord injuries. Psychological, Social and Vocational Rehabilitation. Demos Publ: New York 1988.
Gerhart KA, Koziol-McLain J, Lowenstein SR, Whiteneck GG . Quality of life following spinal cord injury: knowledge and attitudes of emergency care providers. Ann Emerg Med 1994; 23: 807–812.
Gerhart KA . Quality of life: the danger of differing perceptions. Top Spinal Cord Inj Rehabil 1997; 2: 78–84.
Sprangers MAG, Schwartz CE . Integrating response shift into health-related quality of life research: a theoretical model. Soc Sci Med 1999; 48: 1507–1515.
Merluzzi TV, Sanche MAM . Perceptions of coping behaviours by persons with cancer and health care providers. Psycho-Oncology 1997; 6: 197–203.
Albrecht GL, Devlieger PJ . The disability paradox: high quality of life against all odds. Soc Sci Med 1999; 42: 977–988.
Folkman S, Moskowitz JT . Positive affect and the other side of coping. Am Psychol 2000; 55: 647–654.
Salander P, Bergenheim T, Henriksson R . The creation of protection and hope in patients with malignant brain tumours. Soc Sci Med 1996; 42: 985–986.
Brink E, Persson LO, Karlsson BW . Psychometric evaluation of a coping questionnaire in a sample of patients with myocardial infarction. (Submitted).
Ray C, Lindop J, Gibson S . The concept of coping. Psychol Med 1982; 12: 385–395.
Taylor SE . Adjustment to threatening events: a theory of cognitive adaptation. Am Psychol 1983; 17: 87–99.
Wright BA . Physical Disability – A Psychosocial Approach. Harper & Row Publisher: New York 1983.
Stensman R . Severely mobility-disabled people assess the quality of their lives. Scan J Rehabil Med 1985; 17: 87–99.
Lazarus R . Coping theory and research: past, present, and future. Psychosom Med 1993; 55: 234–247.
Elfström ML, Rydén A, Kreuter M, Persson LO, Sullivan M . Linkages between coping and psychological outcome in the spinal cord lesioned: development of SCL-related measures. Spinal Cord 2002; 40: 23–29.
Gustafsson M, Persson LO, Amilon A . A qualitative study of coping strategies in the early stage of acute traumatic hand injury. J Clin Nurs 2002; 11: 594–602.
Ware JE, Snow KK, Kosinski M, Gandek B . SF-36 Health Survey Manual and Interpretation Guide. New England Center: Bosten, MA 1993.
Sullivan M, Karlsson J, Ware JE . SF-36 Hälsoenkät: Svensk manual och tolkningsguide (Swedish Manual and Interpretation Guide) Health Care Research Unit, Medical Faculty, Gothenburg University and Sahlgrenska University Hospital, Gothenburg: Sweden 1994 (in Swedish).
SPSS Base 10.0. Applications Guide. SPSS Inc.: Chicago 1999.
SPSS for Windows. Version 10.0.5. SPSS Inc.: Chicago 1999.
Westgren N, Levi R . Quality of life and traumatic spinal cord injury. Arch Phys Med Rehabil 1998; 79: 1433–1439.
Elfström ML, Rydén M, Kreuter M, Taft C, Sullivan M . Effects of coping strategies on quality of life in the spinal cord lesioned person. J Rehab Med (in press).
El Masri WS, Short DJ . Current concepts: spinal injuries and rehabilitation. Curr Opin Neurol 1997; 10: 484–492.
Dembo T, Leviton G, Wright B . Adjustment to misfortune – a problem of social–psychological rehabilitation. In: Dembo T (ed). Artificial Limbs. Prosthetics Research Board, National Academy of Sciences-National Research Council: Washington 1956 pp. 4–62.
Ditunno JF, Young W, Donovan WH, Creasy G . The international standards booklet of neurological and functional classification of spinal cord injury. Paraplegia 1994; 32: 70–80.
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Siösteen, A., Kreuter, M., Lampic, C. et al. Patient–staff agreement in the perception of spinal cord lesioned patients' problems, emotional well-being, and coping pattern. Spinal Cord 43, 179–186 (2005). https://doi.org/10.1038/sj.sc.3101693
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DOI: https://doi.org/10.1038/sj.sc.3101693
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