| Abstrakt: |
Background: Traumatic spinal cord injury (TSCI) is a sudden forceful damage to the spinal nerves resulting in temporary or permanent paralysis. Those who survive face lifelong risk of secondary complications and subsequently poor health, physical dependence, and early death. Few outcome studies are published for rural low-income areas and data are scarce on the causes and experiences of those who survive a SCI longer-term. Objectives: To examine the outcomes of individuals with TSCI and describe how those who survived longer-term in rural Tanzania cope with their injury. Methodology: Individuals who sustained a TSCI and were admitted to KCMC were recruited over one year. The causes, severity and location of injury, and hospital discharge outcomes were obtained by patient-observation, ward rounds, patient, and records. Purposive sampling identified individuals who lived with TSCI longer than 5 years for participation in in-depth qualitative interviews. Qualitative data were transcribed, translated, and coded using a modified grounded theory approach to identify categories of coping. Quantitative data were analyzed descriptively using SPSS. Results: Eighty-seven individuals with TSCI admitted to the hospital were enrolled (79.3% male). Injuries were predominantly from falls (66.6% and mostly from trees) and road traffic accidents (29.9%), with 56.3% affecting the cervical spine, and 42.5% were complete injuries (most severe). Thirteen individuals died after being admitted; among those discharged home, 39.1% were wheelchair dependent, 23.0% used a walking aid, and 20.7% walked independently. Ten individuals (70% males) who survived 7-28 years after injury described internal coping resources (e.g., secured in God, social and problem-solving skills) and external (reliable family, community support and material possessions) and dependence on these resources facilitated acceptance. Conclusions and recommendations: Addressing falls would reduce TSCI incidents in this region. Rehabilitation services ought to facilitate identification and utilization of the available coping resources. [ABSTRACT FROM AUTHOR] |
