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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Patients' constructions of disability in metastatic spinal cord compression
Author(s): Eva, Gail
Paley, John
Miller, M
Wee, Bee L
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Keywords: Disability
Metastatic spinal cord compression
Spinal cord compression Patients Rehabilitation
Sociology of disability
Disability evaluation
Issue Date: Mar-2009
Date Deposited: 5-Feb-2009
Citation: Eva G, Paley J, Miller M & Wee BL (2009) Patients' constructions of disability in metastatic spinal cord compression. Palliative Medicine, 23 (2), pp. 132-140.
Abstract: Metastatic spinal cord compression (MSCC) is characterised by poor prognosis and serious physical disability. Patients have complex rehabilitation needs, but the evidence on rehabilitation is sparse. This study aimed to ascertain the constructions placed upon disability by patients with MSCC. A series of nine process-tracing, longitudinal case studies, involving 58 interviews with 9 patients, 6 carers, and 29 staff in one NHS region. A context-mechanism-outcome configuration was adopted as a conceptual basis for data collection, together with a constant comparative method of data analysis. Patients’ orientation to disability incorporated two apparently inconsistent attitudes. Patients acknowledged that their situation had changed, and that their future plans would need to accommodate altered circumstances. However, they also resisted the idea of themselves as disabled, wanting to retain an image of themselves as resourceful and resilient. Patients used a number of strategies to reconcile the tension between these two positions. The illusions incorporated into the ‘failure to acknowledge’ pole of this orientation are self-protective and, like other positive illusions, have psychological benefits. Providing effective and acceptable support to patients living with disability relies on professional responses that are able to sustain patients’ sense of their own competence.
DOI Link: 10.1177/0269216308099959
Rights: Published by Sage Publications, copyright 2008

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