Abstract
Study design
A qualitative study analyzed using Grounded Theory.
Objectives
To explore perceived bodily changes in people with acquired spinal cord injury of both genders and with different levels of injury.
Setting
The National Paraplegic Hospital in Toledo, Spain, a national reference center for the treatment of spinal cord injury.
Methods
A qualitative study designed and analyzed from the perspective of Grounded Theory. Semi-structured interviews were conducted in a triangulated sample of 32 people with acquired spinal cord injury. The analysis was based on the constant comparative method and an open, axial, and selective coding process.
Results
The perceptions regarding bodily changes in people with spinal cord injury were grouped into two broad categories: changes in body schema (a fragmented body, a blurred body, body as a burden, non-muscular body, the wheelchair as an extension of the body, and body normalization) and increased bodily awareness (an uncontrollable body and retraining the body). The amount of time since the injury, positive life behaviors and attitudes, youth, male gender, and having flexible beliefs, values, and habits were considered facilitators for coping with body changes after a spinal cord injury.
Conclusions
Suffering a spinal cord injury implies a new body schema and a change in body awareness. When healthcare professionals are aware of the changes affecting the body after a spinal cord injury, they display more favorable attitudes and are more involved in promoting the patients’ adaptation to their new body schema.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
Data availability
The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
Staas WE, Formal ChS, Freedman MK, Fried GW, Schmitd Read ME. Spinal cord injury and spinal cord injury medicine. En: Esclarín de Ruz A.(ed) Lesión medular. Enfoque multidisciplinario: Madrid. Médica Panamericana; 2009. p. 6.
OMS Lesiones medulares. Who.int. 2013. Available from: https://www.who.int/es/news-room/fact-sheets/detail/spinal-cord-injury.
García-Reneses JA, Martínez Moreno M, Moraleda Pérez S Rehabilitación de la lesión medular. En: S.L. Mirand Mayordomo (ed). Madrid. Rehabilitación Médica; 2004. p. 307–18.
Pérez K, Novoa AM, Santamariña-Rubio E, Narvaez Y, Arrufat V. Incidence trends of traumatic spinal cord injury and traumatic brain injury in Spain, 2000-9. Accid Anal Prev. 2013;46:37–44.
Sheldon AP, Renwick R, Yoshida KK. Exploring body image and self-concept of men with acquired spinal cord injuries. Am J Mens Health. 2011;5:306–17.
Muñoz Langa J, Forner Cordero A, Gisbert Grifo M, Delgado Calvo M. Valoración del daño corporal en la lesión medular: diferencias entre tetrapléjicos y parapléjicos. Rehabilón. 2004;38:51–8.
Alcedo-Rodríguez ÁM, Aguado-Díaz AL, García-Carenas L, Arias-Martínez B. Relación entre variables clínicas y psicológicas en mujeres con lesión medular. Univ Psychol. 2010;9:715–28.
Moreno-Ferguson ME, Amaya Rey MC. Cuerpo y corporalidad en la paraplejia: significado de los cambios*. Av Enferm 2012;XXX (1):82–94.
Taleporos G, McCabe MP. Body image and physical disability-personal perspectives. Soc Sci Med. 2002;54:971–80.
Bassett RL, Martin Ginis KA. More than looking good: impact on quality of life moderates the relationship between functional body image and physical activity in men with SCI. Spinal Cord. 2009;47:252–6.
García L. “ La perspectiva de género en el proceso de adaptación a la lesión medular” Universidad de Oviedo. Departamento de Psicología. Vol. 33. 2006. pág: 225–34.
Bailey KA, Gammage KL, Van Ingen C, Ditor DS. Managing the stigma: exploring body image experiences and self-presentation among people with spinal cord injury. Health Psycholy Open 2016;3:1–10. (1)
Duarte DM, Torres YM, Moreno Ferguson ME. Cuerpo y corporalidad en adolescentes y adultos jóvenes con lesión traumática de la médula espinal. Investigación y Educación en Enfermería. 2016;34:84–93.
Bailey KA, Gammage KL, Van Ingen C, Ditor DS. “My body was my temple”: a narrative revealing body image experiences following treatment of a spinal cord injury. Disabil Rehabilitation. 2017;39:1886–92.
Costa VPS, Melo MRA, Garanhani ML, Fujisawa DS. Representaciones sociales de la silla de ruedas para la persona con lesión de la médula espinal. Revista Latino-Am. Enfermagen. 2010;18:7–8.
Bassett RL, Martin Ginis KA, Buchholz AC. A pilot study examining correlates of body image among women living with SCI. Spinal cord. 2009;47:496–8.
Kaiser S, Kennedy P. An exploration of cognitive appraisals following spinal cord injury. Psychol Health Med. 2011;16:708–18.
Bailey KA, Gammage KL, Van Ingen C DD. “It’s all about acceptance”: A qualitative study exploring a model of positive body image for people with spinal cord injury. Body Image. 2015;15:24–34.
Ide-Okochi A, Tadaka E, Fujimura K. The meaning of self-care in persons with cervical spinal cord injury in Japan: a qualitative study. BMC Neurol. 2013;4:13. 115
Isaksson G, Prellwitz M. One woman’s story about her everyday life after a spinal cord injury. Disabil Rehabil. 2010;32:1376–86.
Glaser, B Strauss A. The discovery of grounded theory. Chicago: Aldine Pre.; 1967.
Baumbusch J. Semi-structured interviewing in practice-close research. J Spec Pediatr Nurs. 2010;15:255.
Green, J, Thorogood N. Qualitative methods for health research. London: SAGE Publications London; 2004
Strauss AL, Corbin JM. Basic of qualitative research. techniques and procedures for developing grounded theory. London, UK: SAGE Publications; 1998.
Vall J, Batista-Braga VA, Almeida PC. Central neuropathic pain and its relation to the quality of life of a person with a traumatic spinal cord injury. Rev Neurol. 2006;42:525–9.
Monteagudo XR, Larraz JA. El paciente experto en personas con trastorno mental grave. El grupo de iguales como factor de recuperación. Informaciones psiquiátricas. Publicación científica los Cent la Congregación Hermanas Hospitalarias del Sagrado Corazón Jesús. 2016;225:39–46.
Molina Escribano F,Castaño Moreno E, Massó Orozco J. Experiencia educativa con un paciente experto. Rev Clin Med Fam. 2008;2:1–3.
Author information
Authors and Affiliations
Contributions
MVF was responsible for designing the research protocol and interviews. BRM and MVF performed the data analysis and wrote the manuscript. Both authors approved the final version of the manuscript and the scientific article.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no competing interests.
Ethics
This study was conducted in accordance with the ethical principles of the Declaration of Helsinki. Interview data were anonymized, and all participants signed the informed consent after receiving an understandable and comprehensive explanation of the study aim and procedures. In addition, this study was approved by the Clinical Research Ethics Committee of the National Paraplegic Hospital and by the Medical Management of the center.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Vázquez-Fariñas, M., Rodríguez-Martin, B. “Living with a fragmented body”: a qualitative study on perceptions about body changes after a spinal cord injury. Spinal Cord 59, 855–864 (2021). https://doi.org/10.1038/s41393-021-00634-4
Received:
Revised:
Accepted:
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1038/s41393-021-00634-4
This article is cited by
-
Biopsychosocial challenges of spinal cord injury survivors in Bangladesh: a qualitative investigation
BMC Public Health (2025)
-
Mental Health and Spinal Cord Injury: Clinical Considerations for Rehabilitation Providers
Current Physical Medicine and Rehabilitation Reports (2022)
-
A response to “Living with a fragmented body”: a qualitative study on perceptions about body changes after a spinal cord injury
Spinal Cord (2021)
