Rehabilitation after spinal cord injury and the influence of the professional's support (or lack thereof)

Aim and objectives. To investigate how spinal cord injured patients struggle with their rehabilitation and how they feel that the professionals influence this process. Background. Rehabilitation after a spinal cord injury is a long and arduous process during which the patient needs much support. Some patients lack adequate support from the professionals. This makes it pertinent to investigate the processes patients go through to get on with their lives and the influence professionals have. Design. A phenomenological-hermeneutic study with a narrative approach using Ricoeur's theory. Method. A purposeful and consecutive sample of 12 newly injured, adult Danish-speaking patients previously living a normal life were observed 7-12 times and interviewed six or seven times over two years. Results. The patients regained meaning and got on with life through resolute fighting for a meaningful life. We found three patterns of fight; the patients fought with themselves together with the professionals (pattern I). If consensus about the goals and pathway broke down and was not re-established, this fight could turn into a fight against the professionals (pattern II). This would, in turn, cause the patients to fight against themselves. A third pattern (III) was that the patients turned away, either going their own way or suppressing themselves by adapting to the professionals' views. In either case, the patients would feel being left on their own. Conclusion. When the patient and professionals agreed on the way forward, the patient experienced the professionals as supportive. However, if the patient's goals were not consistent with the professionals' views, the patient felt that the professionals withdrew their support. Relevance to clinical practice. If the professional were able to maintain consensus with the patient, they contributed to the patient's process of regaining meaning.