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The development of an evaluation tool to measure the adaptation of spinal injury patients to disability Kao, Jack J. H

Abstract

The purpose of the study was to develop an evaluation tool to measure adaptation of spinal cord injury patients to disability. The Q-Sort technique was used to develop the tool. This tool is intended to enable health professionals, especially nurses, to measure a patient's current status in adaptation to disability, to assess progress in adaptation, and to provide guidelines for intervention. Literature relevant to Q-Methodology and to conceptual frameworks of disability and adaptation to disability was reviewed. In the process of tool development, Q-Sort statements were collected from patients' own descriptions of their current status following injury. Six graduate students in nursing served as panel judges to examine the relevance and importance of the statements which were provided by the patients. Fifty-six statements were selected to be used as the Q-Sort statements. Then, following Crate's adaptation model, the fifty-six statements were distributed into four categories in terms of her four stages of adaptation: (1) denial and disbelief, (2) developing awareness, (3) reorganization and (4) adaptation. To test the validity of statements in the four categories, twenty health professionals {nurses, physiotherapists, vocational counsellors and social workers) were asked to sort the fifty-six items into these same four categories of adaptation. There was high agreement (61-81%) on the distribution of statements into the four categories. The evaluation Q-Sort was tested out on two groups of ten patients each. This test measured the degree of adaptation of each of the twenty patients. Scores showed different levels of adaptation in the two groups of patients. Relevant variables were selected for analysis. Several variables were found to be significant at the 0.05 level.

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