Spasticity experience domains in persons with spinal cord injury.
OBJECTIVE
To understand the everyday life experiences of persons who have spasticity associated with spinal cord injury (SCI).


METHODS
Applied ethnographic design.


METHODS
Patients' homes and rehabilitation clinics.


METHODS
Twenty-four people with SCI who experience spasticity.


METHODS
Not applicable.


METHODS
Domains identified through qualitative analysis of in-depth open-ended interviews.


RESULTS
Domain analysis revealed 7 domains: physical, activity, emotional, economic, interpersonal, management, and cognitive. Descriptive subcategories within each domain were identified. Patients personalized the meaning of spasticity and expressed their understandings of the condition in ways that may not be consistent with clinical definitions. Some patients suggested that being able to control spasticity was preferable to total suppression.


CONCLUSIONS
Spasticity-related interventions need to be aimed at what matters most to the patient. It is critical for clinicians to understand patients' experiences to make accurate assessments, effectively evaluate treatment interventions, and select appropriate management strategies. When providers reconfigure patients' descriptions to fit neatly with a biomedical understanding of spasticity without carefully assessing the descriptions in terms of what matters most to patients, a potential risk for misappropriating interventions may arise.
Mahoney
Jane S
JS
School of Nursing, University of Texas Health Science Center, and Menninger Clinic, Houston, TX 77080, USA. jmahoney@menninger.edu
Engebretson
Joan C
JC
Cook
Karon F
KF
Hart
Karen A
KA
Robinson-Whelen
Susan
S
Sherwood
Arthur M
AM
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D017281:Cost of Illness; D004644:Emotions; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000523:psychology* / Q000628:therapy; D010146:Pain / Q000209:etiology; D059408:Pain Management; D012648:Self Care; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000523:psychology* / Q000628:therapy