title: Perspectives on strategies and challenges in the conversation about stem cells for spinal cord injury.
abstract: METHODS
  Qualitative study.
  
  
  OBJECTIVE
  To examine how trusted communication between individuals with spinal cord injury (ISCIs) and physicians who care for ISCIs is affected by the discussion of advances in stem cell research and interventions locally and abroad.
  
  
  METHODS
  Canada and the United States (US).
  
  
  METHODS
  Semi-structured interviews with ISCIs and physicians. A thematic analysis approach was applied to more than 12 h of data to derive prominent themes and describe relationships between them.
  
  
  RESULTS
  A convergence of factors involving transparency impact trusted communication between ISCIs and physicians about stem cells and spinal cord injury (SCI). ISCIs expressed that trusted communication is strengthened when physicians exhibit caring, attentive and positive attitudes that are underpinned by domain-specific knowledge and scholarship. Perceived reluctance to communicate or lack of knowledge poses significant challenges. Physicians also emphasised the importance of transparency for trusted communication but expressed that the still limited clinical reality of treatment choices for SCI and the pressures imposed by external resources are significant stressors that complicate the communication landscape. Both groups cited the range and variable quality of information sources, and the difficulty associated with navigating them, as priorities for action that would remediate these tensions.
  
  
  CONCLUSIONS
  (1) Epistemic transparency should be privileged over silence. (2) A new generation of innovations in research and clinical trial dissemination about stem cells for SCI is needed to remedy the perceived inadequacies of existing information content and accessibility.
authors.affiliation: National Core for Neuroethics, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: K J
authors.initials: KJ
authors.lastname: Jacob
authors.affiliation: Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: B K
authors.initials: BK
authors.lastname: Kwon
authors.affiliation: National Core for Neuroethics, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Lo
authors.affiliation: Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Snyder
authors.affiliation: National Core for Neuroethics, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Illes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D036301:Qualitative Research; D017678:Sex Distribution; D013119:Spinal Cord Injuries / Q000523:psychology*; D013234:Stem Cells; D014481:United States; D055815:Young Adult