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Journal of the Korean Academy of Rehabilitation Medicine 1981;5(2):4.
Medical and Social Adjustment Studies of 35 Chronic Spinal Cord Injured Patients
Young Ok Park, M.D., , Chung Hee Oh, M.D.
Dept. of Rehabilitation Medicine, College of Medicine, Korea University
만성 척수손상환자의 의학 및 사회적응에 대한 분석
박영옥, 오정희
고려대학교 의과대학 재활의학과
Abstract

Dysfunction of the spinal cord results in loss of movement and sensation below the level of involvement. Bowel & bladder and sexual functions are also disrupted. The psychological, social and economic effects are devastating for the individual and his family. Also the secondary complications disturb him in maintaining his well-being life and somtimes cause death of chronic spinal cord injured patients. The aim of trement must be to minimize the disability and maximize physical, social, and vocational rehabilitation.

The social situation in our country is so quite different from that of advanced and there is no legislation or after acts were established upon the chronic spinal cord patients after being discharged from the hospitalization.

This study is to observe and analyze the medical and social adjustment of 35 chronic spinal cord injured patients who have been taking a care of in National veterans hospital in July, 1981, and further development procedures are discussed for their rehabilitation program. The total number of patients in this study were 35 (9 quadilplegia, 16 paraplegia), and age ranged from 20 to 61 years.

The following results were obtained.:

1. The causes of 35 chronic spinal cord injured patients were by traffic accident in 13 cases (37.1%), gun-shot and fall in each 8 cases (22.9%) respectively, expolsion 2 cases (5.7%), sports and electrical burn each 1 case (2.9%), and unknown reason in 2 cases (5.7%).

2. The hospitalization time were about 40.25 months for the initial admitted patients and 14.45 months for readmitted for other diseases or complications.

3. The bladder control were taken by suprapubic indwelling catheterization in 9 cases (25.7%), urethral indwelling catheterization in 5 cases (14.3%), Condom drainage 8 cases (22.9%), intermittent catheterization 1 case (2.9%), and self-volding 12 cases (34.3%). The bowel activity were controlled by enema in 18 cases (51.4%), tablet suppository 2 (5.7%), oral laxativels 1 (2.9%), manual 3 (8.6%), mixed 2. (5.7%), and self defecation 9 (25.7%).

4. Penile erection occured in 24 cases (70.6%), and ejaculation in 6 cases (17.6%), and the marrital status were married in 11 cases (31.4%), divorce 5 (14.3%), and single 19 (54.3%).

5. The incidence of complications among 35 patients were decubitus in 28 cases (80.0%), urinary disorder 23 (65.7%), pain 22 (62.9%), ectopic ossification 10 (28.6%), deformity 4 (11.4%).

6. 1) The mean values of 24 hrs urin and serum calcium of 35 cases were 11.37±0.86 mEq/24hr, 9.52±0.18 mg%, but no significant correlation was found between the two.

2) The mean value of 24 hrsurin calcium of patients with (8 cases) and without stone formation (27 cases) were 11.91 mEq/24hrs, 11.21 mEq/24hrs and the seurm calcium were 9.5 mg%, 9.53 mg% respectively. But each differences of 24 hrs urin and serum calcium were not significant between the two groups.

3) The mean value of alkaline phosphatase of 35 cases was 46.36±7.87 u/dl, and 51.47 u/dl in with 10 cases of ectopic ossification, and 44.28 u/dl in without.

(25 cases), but no differential significance was noted between the two groups.

4) 24 cases (42.7%) were revealed positive among 29 urin culture and highest incidence of positive urin cultures occured in patients with urethral indwelling cathter (100.0%), Condom drainage (100.0%), and suprapubic indwelling catheter *83.3%) while the lowest incidence was in patients who were applinace free (16.7%) and the proteus was isolated most frequently (10 cultures) as single infective agent.

7. The economic and soical adjustment of readmitted patients was found to be participating in joint investment in 5 cases, private business in 2, investment in a private money market in 1 case, and 11 cases were inactive.

8. 7 Cases of them hoped to be provided with apartments, 5 cases to continue education when they discharged, another 6 cases did not wish to be discharged, and 2 cases did not have any relatives.

Key Words: Spinal cord injury, Medical adjustment, Social adjustment, Chronicity, Rehabilitation


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