September 25, 1998

Study probes how women deal with spinal injuries

Study probes how women deal with spinal injuries

Women veterans with spinal cord injuries are scattered throughout the country, and though the group is small in number, there is a large need for research to help make their lives easier.

Carole Ann Bach, Ph.D., assistant professor of the Practice of Nursing, has spent the past year interviewing women veterans with spinal cord injuries (SCI), hoping to learn more about their rehabilitative needs.

When the three-year study Bach is conducting ends in 2000, she will have interviewed 33 women.

Women with spinal cord injuries make up about 20 percent of all SCI, Bach said. A computer search showed that there are approximately 257 women with SCI throughout the country. Bach contacted the Veterans Administration hospitals where most of them were seen and began plotting her interviewing process. She has traveled to Florida, where there are more than 30 women with SCI, and interviewed other groups in Richmond, Va., and Memphis, site of the VA's SCI rehabilitation facility in Tennessee.

Bach¹s study is funded by the VA's Health Systems Research and Development program. The ultimate goal of the study is to develop an intervention program using videotapes to address the unique needs of women with SCI.

"Most rehabilitation programs are geared toward men and their needs," Bach said. "We wanted to find out what women thought about their rehabilitation and how it was geared toward their needs as women.

"We were interested in what they found helpful and what they didn¹t. Once they got out of the hospital and returned to their homes, we were interested in finding out what would have been helpful prior to leaving rehab and what they would want women with a new injury to know that would be helpful in the adjustment period."

Bach plans to interview each of the women three times, analyzing the information after the first interview and using the data from the second session by phone to check the accuracy of her interpretation and to add any additional information.

Among the questions asked in her interviews are:

o What was your rehabilitative experience like?

o What strategies have you used to manage your life after injury?

o What do you recommend for interventions designed to meet post-injury rehabilitative needs?

o How was rehabilitation geared toward participants¹ needs as women?

o What things were most helpful in preparing you for home? What were least helpful?

o How would you change your rehabilitation experience?

Bach is also interested in comparing the rehabilitation experiences of military and non-military women with SCI.

"Women whose injuries are service-connected have good benefits and have been in rehab for a good amount of time. I don¹t know if that¹s true with non-military women," she said.

Rehabilitation is becoming more important for patients with SCI because the hospital stays have decreased from 6-12 months to 2-4 months or less, Bach said.

The women who have participated in the study vary in the degree of the severity of their injuries. Many are completely paralyzed. Three are walking, but have bowel and bladder problems. The group ranges in age from early 20s to 70 and the length of time since their injury ranges from 2 to 12 years.

Preliminary data from the study indicate that a networking system is one of the major needs of the women interviewed.

"They need other women to talk to. Often a woman is the only woman in a rehabilitation facility at that time. They tend to think they¹re out there by themselves."

Bach began studying rehabilitation issues 30 years ago when she began a master¹s degree program at Washington University in St. Louis.

"I¹m interested in the whole issue of adjustment to disability and how different people define quality of life following a spinal cord injury."