Invited grand rounds article - Up close but not too personal: Establishing appropriate boundaries with individuals following spinal cord injury

摘要

The incidence of traumatic spinal cord injury (SCI) is estimated to occur in the United States at a rate of approximately 40 cases per million [1]. Spinal cord injury disease (SCID) (i.e., tumors, infections, inflammatory) is not as common, but presents with similar physical and functional consequences. A comprehensive inpatient and outpatient rehabilitation program to address the medical and nursing needs as well as the functional and psychological changes is considered the best approach to help individuals with SCI/D achieve the highest level of independence possible and improve quality of life. However, this is often complicated by the demands to carry out bodily functions in an entirely new way while simultaneously coping with the reality of a sudden and often unexpected change. Individuals with SCI/D usually navigate a lengthy course from initial entry via emergent/crisis care, to acute care to inpatient rehabilitation and outpatient rehabilitation. As a result, they now may interact with health care professionals from a wide variety of disciplines, all of whom have different roles and relationships with the individual with SCI/D as they move through the continuum of care.