Understanding adjustment

 A spinal cord injury (SCI) is a profound event that can significantly alter an individual’s life, often leading to changes in mobility, independence and overall quality of life. The challenges faced by individuals with SCI often extend beyond physical difficulties, impacting emotional wellbeing, relationships and social dynamics.

Adjustment to SCI is highly individualised; there are no definitive characteristics that predict how someone might cope or adapt. However, certain factors can influence the adjustment process, particularly in the initial aftermath of the injury, when individuals may grapple with shock, grief and uncertainty. Some factors include:

Environmental factors

• Timely access to rehabilitation: early and appropriate access to rehabilitation services can facilitate adjustment.
• Ongoing support: continued formal (e.g., physiotherapy, psychology) and informal support systems (e.g., peers) are crucial.
• Social support: emotional and practical support from loved ones plays a significant role in adapting to new roles and circumstances.
• Accessibility: housing and community accessibility can greatly impact daily living, independence and engagement in valued activities.
• Financial resources: financial stability and support can facilitate adjustment.
• Equipment and technology: access to assistive devices can enhance independence.
• Meaningful activities: opportunities for employment and hobbies can contribute positively to adjustment.
• Service systems and attitudes: systemic support, community attitudes and service policies can shape the overall experience of individuals with SCI.

Personal factors

• Age and gender: demographic factors (e.g., gender, culture, stage of development) can influence adjustment and the types of support needed.
• Personal beliefs: attitudes towards disability and perceptions of self-worth play a role in how someone adjusts to injury.
• Past experiences or adversity: previous life challenges can shape resilience, stress management and coping strategies.
• Self-efficacy: perceptions of one’s ability to make choices, manage health and access resources can influence adjustment.
• Problem-solving skills: the capacity to develop solution-focused strategies can impact how a person navigates challenges related to injury.
• Locus of control: the extent to which an individual feels able to influence their circumstances can affect coping and adjustment.
• Openness to support: willingness to accept help from others can foster social connections and resilience.

Adjusting to life after an SCI involves navigating complex emotional and practical challenges. By understanding factors that can affect adjustment, healthcare professionals can better support individuals on their journey towards improved wellbeing and quality of life. However, each person’s path is unique, requiring tailored approaches that address individual needs and circumstances.