Rehabilitation Psychology Case Study

Rehabilitation Psychology Case StudyRehabilitation PsychologyCase 2 Mary Lee was only 22 years old and was involved in a serious car accident 1 year ago. She sustained multiple fractures in her spine and has endure a quadriplegic (C5 level). She is now wheelchair bound and inevitably to live with her p arnts (both nearly 60 years old). She is fully dependent for all her ADL and is pondering what to do with the rest of her life. She has perpetually been proud of her reasoned looks before and wanted to be a movie star. Now her swell has left her and she is feeling very lonely and depressed.Leung Kar Ming, KevinWord believe 800 wordsMany victims of serious car accidents survived with impaired physical functions. Hong Kong re stack a high number of traffic accidents with more than 20,200 casualties per year1. Traffic accident (42.1%) is the intimately reported cause of spinal cord stain (SCI)2. In our case, Mary Lee is one of the unfortunate victims sustaining multiple fractures in her spine. Incomplete (30.1%) and complete (20.4%) quadriplegia ar the most frequent categories of persons with SCI2. Less than 1% experienced complete neurologic recovery by hospital discharge2.There are seven factors affecting patients cope with SCI personal resources, health-related factors, social physical context, cognitive appraisal, adaptive tasks, copping skills and health-related outcomes3.I. Personal resourcesThese include self-efficacy (SE), self-esteem, reason of coherence (SOC), spirituality, optimism, intellect and other personality characteristics3,4. These factors are associated with positive coping, and are determinants of adjustment to long term outcomes4,5.Mary was a pretty girl and dreamed of becoming a movie star. The traffic accident took away her health, good looks, relationship and became wheelchair bounded. It is essential to help Mary regain a high SE, self-esteem and SOC.II. Health-related factorsMore than 50% of SCI patients suffer from chronic pai n which significantly affects whole tone of life (QOL)3,4,8,9. Patients who experience more pain tend to catastrophize more and have a decreased mental health well-being. Psychological factors helps contribute to the relationship among pain intensity and depression8,9,10. Substance abuse, especially abuse of drugs prescribed for spasticity and pain, may contribute to further health problems8.In Marys case, it is very most-valuable that clinicians can provide effective pain control, and build a positive relationship with Mary to aid the effectiveness of the treatments.III. Social physical context later on the injury, Mary became fully dependent on her parents. Her parents, at their retirement age, have to learn to provide support and adapt to their daughters functional limitation. Her boyfriend has left her making her very depressed. It is important that these social and physical contexts are addressed.Social context is the relationship, support and expectations of the significan t others. Physical context counselinges on accessibility, mobility, autonomy, as well as the personal space and privacy of the patient3,4. Finding of positive meaning in lives involves a continuous search for comfortable relationships between self, handicap and society4,6,7,10. Encouraging engagement in social activities can work as a distraction technique to increase mood levels7,8. The burden of the caregiver should not be neglected. Care-giving burden is associated with locus of control, social support, and modes of coping. Caregivers also add to the discredit of self by making the injured person entirely dependent on them. Gaining independence from the caregiver is also a key to restoring competency in persons with SCI. Interventions should be tailored towards the needs of the care recipients as well as the caregivers.IV. cognitive appraisalCognitive appraisal is how an individual views a situation. Appraisals have a strong association with adjustment. It is important that foc us on appraisal of the cause of injury is shifted to the appraisal of having an SCI. Such individuals were found to be well-adjusted psychologically.Visible disabilities affected Mary significantly. Assistance to help her regain her self-image, develop coping skills, making the beaver use of her remaining bodily function and adjustments of dealing with disability is important.V. Adaptive tasksMainly focuses on how the individual adapts to the new situation and how they prepare for an uncertain future. Individuals, analogous Mary, should be encouraged to be able to make decisions on choices of care, commitment to achieving individual goals and sustain independence. Such individuals with SCI are more likely to engage in positive coping strategies.VI. Coping skillsEngaging strategies includes self-control, social support, accepting responsibility, problem solving and positive appraisal, resulting in an internal locus of control. Total locus of control, sense of coherence, self-worth, hope, purpose in life and positive affect were consistently associated with greater QOL. Disengaging strategies, however, should be discouraged. These include denial, wish-fulfilling fantasy, self and other blame to SCI and substance abuse.Mary needs to overcome invisible barrier to social contacts. She learns to cope with environmental factors by enhancing functions of her arms and hands and learning wheelchair skills.VII. Health-related outcomesThis is mainly the effects of the coping strategies. Also focus on the reduction of stress, emotion control, self-image, self-esteem and social relationship. The use of cognitive behavioral therapy (CBT) can improve the psychosocial outcomes in individuals with SCI.The society is in high need for clinicians to help patients to recover and resume their normal life activities. Interventions that promote coping and adjustment include 1. physically, helping individuals on environmental adaptations, training on autonomous living skills and pa in management 2. psychologically, with the use of CBT and peer counseling 3. socially, such as providing vocational rehabilitation, social engagement and family counseling.ReferencesCensus and Statistics Department (2013). Hong Kong monthly fend of statistics. Hong Kong Hong Kong Special Administrative RegionNational Spinal pile Injury Statistical Center (U.S.) (2009). Spinal cord injury The facts and fiqures. Birmingham, Ala National Spinal Cord Injury Statistical Center (NSCISC).Martz, E, Livheh, H. (Eds.). (2007). Coping with chronic illness and disability Theoretical, empirical, and clinical aspects. 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