Aspects related to Resilience in People with Spinal Cord Injury

Abstract

Objective Rehabilitation of the spinal cord injury is a continuous process needing adaptation in all aspects\rof life. Successful adaptation to challenging situations is called "resilience". Occupational therapists\rcan help the person reconstruct his/ her identity and adapt by improving their resilience. It is also extensive\rand diverse in concept and definition. It is extremely influenced by the culture and environment.\rThis study aims to narratively review the evidences published on the aspects related to the resilience of\rpeople with spinal cord injury.\rMaterials & Methods Comprehensive electronic search of keywords including “spinal cord injury”, “resilience”\rand “adaptation” was done via Google Scholar, PubMed, Scopus, ScienceDirect and Pro Quest\rand IranMedex to find related articles published within 2000-2015 according to inclusion criteria. From\rthe initially obtained 1823 articles, 1756 articles were omitted due to failure to satisfy the inclusion\rcriteria or being repetitions. After actors underlying resilience and 4 and 5 articles focused on social\rparticipation and psychosocial adaptation after spinal cord injury in respect.\rResults As seen from the included documents, there are various definitions of resilience. Resilience was\rdefined as coping with the conditions after spinal cord injury such that the person takes in his/ her activities\rof daily living with improved mental health and appropriate community mobility. It is also defined as\rthe process that involves a complex interaction of the person with his/ her environment. There are four\rtrajectories in terms with resilience. Fifty percent of people involved are resilient, 25 percent of them\rshowed recovery, 12.8 percent showed delayed distress, and 12.5 percent have chronic dysfunction. This\radaptation is definitely influenced by the surrounding social context since any environmental complication\rcan lead to a decline in resilience. The more the environmental relations are, the simpler adaptation\roccurs. So, it is necessary to notice the communicative and environmental simplifiers in the rehabilitation\rprogram. Family and economic status have a significant role in the resilience of people with spinal\rcord injury. Resilient people with spinal cord injury have better adaptation and lower levels of depression\rwhile entering rehabilitation as well as show more acceptance of the disability during discharge and\rmore satisfaction of their lives. The resilience is extensively impacted by the individual characteristics\rand social circumstances. The resilience is a multidimensional concept that includes contextual factors,\rsocial participation, and mental adaptation. Being a male, having a mild-to-moderate physical job, having\ra high academic level before the injury, and obtaining appropriate education after injury can lead to\rresilience and paid employment later. In contrast, misunderstanding of physical complications, passive\rpersonality, pessimism, and lack of psychosocial support from the family are barriers for being employed\rafter injury. The less the family and environmental barriers are, the better mental health and adaptation\ris anticipated. Factors such as job and suitable education before the injury as well as optimism and positive\rattitude provide effective resilience later. Spirituality and self-control have a good prognosis for resilience.\rThe supportive role of the environment, particularly of that of family members, is also important.\rConclusion Resilience in spinal cord injury needs psychologically more attempt than the physical aspects,\rbecause it needs more time to adapt after a sudden accident. Spirituality, stress management strategies,\roptimism, and social support from family members and friends facilitate resilience. As resilience is\rimpacted by the culture and environment, more studies on the explanation of the aspects related to the\rresilience of Iranian population is recommended.