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Managing Health Following SCI: Making translations between theory, research and clinical practice

Guihan M, Ehde DE, Meade M. Managing Health Following SCI: Making translations between theory, research and clinical practice. Paper presented at: Academy of Spinal Cord Injury Professionals Annual Meeting; 2010 Sep 23; Las Vegas, NV.


When living with Spinal Cord Injury (SCI), health impacts what someone can do and how much energy they have to do it. While there is currently no cure for SCI, there are ways to manage the condition to optimize functioning. One key is to prevent secondary conditions, such as pressure sores, chronic pain, bowel problems, and others, that can decrease independence, increase health care costs and result in more hospital stays. This symposium will present three programs, and three different approaches, to improve health and minimize secondary conditions through the development of self-management skills. Theoretical frameworks, research evidence and translation into clinical practice will be discussed with regard to each program Program 1: Pressure ulcer (PrU) prevalence and recurrence is high in persons with SCI and better strategies for preventing breakdown are needed. Our study drew from existing literature on empirically-based behavior change methods for chronic conditions in the general patient population (e.g., smoking, poor diet, risky drinking; adherence to medical treatment and health promotion studies) and clinical practice guidelines to identify behaviors and behavior change strategies to develop an intervention that is currently being tested in a large multi-center efficacy trial in veterans at risk of developing PrUs. Program 2: Chronic pain is a serious and often under-treated problem for many persons with SCI. Self-management interventions such as CBT have been demonstrated to be helpful for chronic pain problems. However, a number of barriers interfere with SCI individuals' abilities to access them. Telephone-delivered interventions have been shown to be effective treatments in other health conditions but have not been studied in persons with pain secondary to SCI. This presentation will describe a telephone delivered pain self-management intervention for SCI that is currently being tested in a randomized controlled trial. Program 3: Health care providers play a key role in facilitating health and self-management skills of individuals with SCI. Characteristics, competencies and behaviors of providers can serve as either barriers or supports for the individual with SCI and their family. This presentation will discuss an evidence-based and client-centered approach for health care providers, which includes examination of personal expectations and assumptions, optimizing the patient-provider relationship and developing a treatment agenda / plan.

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