Introduction
Disability is a state of being physically, mentally or psycologically challenged in such a way as to be unable to perform daily chores like any other normal human being. Disability is becoming a growing concern all over the world. An increasingly larger proportion of the U.S. population is today experiencing some type of disability (America Physical Therapy Association, 2007). Paraplegia is one of the most common causes of disabilities around the world and it is mostly caused by road accidents and accidents occuring during sports. Paraplegia is a paralysis condition in which a patient loses some or all the neurological functions of their lower body resulting from an injury to the spinal chord as a result of an accident, trauma, congenital condition such as spina bifida, tumors, scoliosis or other diseases in the spinal canal, in which the upper back or neck is damaged (Dawodu, 2009). Paralysis may at times dissapear when these diseases are cured by treatment. Serious damage to the nerve can not be reversed hence makes paralysis a permanent feature (Parker et al., 2006). Patients who suffer permanent paralysis normally undergo physical and psycological therapy to enable them learn how to use a wheelchair and other supportive devices (American Physical Therapy Association, 2007).
Once the spinal cord is injured, the patient’s brain is unable to commuicate with the lower part of the body. The injury causes the patient to lose sense of movement. During diagnosis and treatment the spinal cord injuries are normally described by the location on the vertebral cord on which they have occured. For instance an injury occuring at the sixth cervical spinal cord section is normally decribed by health care nurses as C6 by the care givers.
Paraplegic condition can either be complete or partial depending on the magnitude of the injury and the location of the injury on the spinal cord. Complete paraplegic creates total paralysis of the legs in addition to a host of other affective conditions such as poor circulation of blood, sexual dysfunction, inability to control the bladder or bowel, susceptibility to pressure sores, muscular atrophy, deep vein thrombosis, experiencing limp muscles especially in the arms and legs and possible lower internal organ disruption. Complete paraplegia is normally a result of damage occuring much higher on the vertebra. Partial paraplegia on the other hand involves injury to the spinal cord occuring at the lowest area of the spinal cord in which some functions of the nerves are not interfered with (Gelis et al., 2009). The most common symptoms of partial paralysis include the ability of the patients to feel part of their lower limbs but unable to stand or walk on their own. However, many variations in symptoms do occur during partial paralysis and in some cases patients whose spinal cords are slightly bruised or swollen may recover their normal functioning (Gelis et al., 2009).
Paraplegia can also be characterised into different groups depending on the magnitude and type of paralysis exibited by the patient. When all the limbs i.e. legs and arms are affected, the situation is called quadriplegia. In monoplegia, only one limb is affected while hemiplegia refers to paralysis of one side of the body. Hemiplegia is relatively common as compared to paraplegia and quadriplegia. Paralyisis that results from genetic disorder is called Hereditary spastistic paraplegia. It is diagnosed by examining the family history in addition to other signs and exclusion of other non-genital causes of spasticity
Impacts of paraplegia on individuals and their families
An individual’s life is abruptly affected due to paraplegia, which often leads to confinement of the patient to the wheel chair.Individuals who were sole breadwinners for their families are reduced to beggars as most of them are unable to work anymore. This inability to provide for the family triggers psycological torture in these individuals leading to stress, disillusion and a life of denial. The end results is deterioration of the patients condition both from the paralysis itself and from stress related ailments such as stomach ulcers with some patients attempting suicide.
Paraplegia not only affects the incapacitated individual but also close family members due to increased independence of the patient as a result of the condition. Adjustment to the way of life and the budget is likely to follow in order for the family to cope with the paraplegic condition. The members of the family may be affected differently with the spouse bearing the full impact. Sexual life is bound to change due to impairment of sexual function of the victim. This in addition to increased stress levels may affect marriages and consequetly lead to divorces. Children are also seriously affected in such cases as they become sad, disillusioned and confused. Their performance in school is also likely to deteriorate. Close knit families are however able to cope relatively well with the condition. Counselling and rehabilitation is therefore required for the whole family to enable them cope with this condition.
The role of nurses in diagnosis, treatment and rehabilitation of paraplegics
Accepting and living with paraplegic condition is not an easy task for most people. The paraplegic therefore needs constant care and support all of which are effectively provided by the nurses during rehabilitation (Gelis et al., 2009).
During therapy and rehabilitation, several tests are given by the caregivers who also include the nurses to enable them identify the exact location of and extent of the injury. These tests are important as they help in planning for the right treatment to be given to the patient (Gelis et al., 2009).
Finding a doctor and a health nurse who is dedicated, caring, compassionate and vigilant is the first step towards good health for a paraplegic patient. Incorporating physical therapy in a paraplegic’s daily routine is also important as it greatly benefits the patient by building muscular strength of body parts that are not affected and also help improve blood circulation. Special care and rehabilitation is strongly recommended for paraplegics.This care is normally given by a team of health caregivers including the nurses whose aim is to help the patient in accepting their condition and learing to live with it. The patients doctor, nurse and various therapists among others form the team of caregivers. The time duration required by paraplegics and quadriplegics in hospital differs slightly. During this period, patients usually undergo physiotherapy and rehabilitation to help them cope with their new condition. A complete cure for paralysis is still not available, but there are clinical trials taking place to help find a cure (Parker et al., 2006)
During the rehabiliation process,nurses and mental health therapists assist the patients and their family members cope with the associated misery and stress caused by the injury while occupational therapists teach the patient how to use special equipments to enable self care (Parker et al., 2006). Physical therapists teach the patient how to use a wheelchair, how to keep the muscles strong and the joints limber while respiratory therapists ensures that a patient’s respiratory system remains healthy. Advice on the best way to care for the skin is also given to paraplegia patients and their family members by the nurses so that they may be in able to guard againt development of pressure sores. The role of nurses in paraplegic’s care therefore cannot be underestimated.
Interproffesional therapy and team care
Team care refers to a multidisciplinary team of experts who come together hence bring particular skills and experience of several health professions together to contribute towards a common purpose (Hayward et al., 2000).One advantage of interproffesional therapy is that it reduces a paraplegics stay at the hospital significantly (Leathard, 2003). Team care must also be well planned to cater for patients in addition to being population based.
Research shows that monodisciplinary models of health care delivery are not effective in modern health care system any longer. (Stone, 2007). Since the concept of interproffesional therapy is relatively new to many health proffesionals, it must be understood properly so as to succeed in solving challenging health problems. Interproffesional care is sub-divided into multidisciplinary, interdisciplinary and transdisciplinary groups (Mitchell, 2005).
In multidisciplinary teams, different health proffesionals work on the same challenge either individually or in collaboration. A spirit of interaction of the various professionals for a common goal is achieved though a limited and transient basis. Memebers of this team are able to work in a coordinated maner though they do not necessarily move. (Mitchell, 2005).
Interdisciplinary teams normally work in collaboration with one another. The members of this team often work together with a common goal in mind and challenging health problems are solved in a team based on contributions of each proffesional in the group.(Hayward et al., 2000). However, marking out proffesional territories and distributing them within the complex system remains a big challenge. Transdisciplinary team refers to a professional practice in which the experts seek to build consensus while opening up their proffesional boundaries in a bid to solve a complex problem. This leads to removal of exhisting barriers between the different proffesionals (Leathard, 2003). Interprofessional working is advantageous as it allows the proffesionals to benefit from knowledge sharing and experiencing opportunities outside one’s own specialisation. Evidence shows that interprofessional practice is an effective contributor to the positive health outcome. Along with the changing of health care system over the world, interprofessional practice which can provide effective team work have the ability to improve the working environment, increase mutual respects of each team members involved in delivery care and share the knowledge between different fields (Mitchell, 2005).
With the increasing rate of paraplegia and other chronic diseases,effective management in care to minimise the effects of these illnesses cannot be overemphasised (Stone, 2007).
Researchers acknowledge that there are some opposition to the concept of interproffesional therapy among some health workers either due to policy misunderstanding or perceived fear of competition. Such stereotypes are a major cause of failure in such noble processes. (Leathard, 2003). Nurses are normally reluctant in adopting interproffessional working practice as most of them see it as a threat to their proffesion. It is suggested that interprofessional collaboration could enhance professional development in nursing (Hayward et al., 2000).
Some of the challenges that inhibit interproffesional teams’ performance include lack of proper communication within the team therefore information is not shared among the team members. Studies have found that increased communication is required to facilitate team interaction and success. Overlaping of roles and duties by the profsessionals ai also a major setback to interprofessional therapy.It is still dificult to obtain an interprofessional approach, because of the inadequate cooperation between health care professionals since they come from different backgrounds, cultures, and working experiences.(L_TIPP, 2009).
In conclusion, interdisciplinary collaboration within interprofesstional practice is an essential and necessary response to the health care problems. It helps professionals as well as patients work with each other in numerous effective ways. Interdisciplinary also helps the health care systems to operate more easily and smoothly.Paraplegic care is a perfect example of how interprofessional practice can lead to positive outcomes. Following the trend of development and technology in society, interprofessional practice should be applied in every health care system because of it benefits.
References
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Gélis, A, Dupeyron, A., Legros, P., Benaïm, C., Pelissier, J. and Fattal, C. (2009). Pressure ulcer risk factors in persons with spinal cord injury. Part 2: the chronic stage. Spinal Cord, 47(9):651–661.
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Learning and Teaching for Interprofessional Practice (L_TIPP), (2009). Interprofessional health education in Australia: The Way Forward. New South Wales. Web.
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Mitchell, P. H. (2005). What’s In A Name? Multidisciplinary, Interdisciplinary, and Transdisciplinary. Journal of Professional Nursing. Web.
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