CASE STUDY ON QUADRIPLEGIC

WHO IS A REHABILITATION PSYCHOLOGIST AND WHAT DO THEY INVOLVE?

Rehabilitation psychologists study and work with individuals with

disabilities and chronic health conditions to help them overcome challenges
and improve their quality of life.

Rehabilitation psychologist addresses behavioral and mental

health issues faced by individuals across the lifespan who are affected by any
injury or chronic condition that leads to disability, including issues such as
emotional coping, mental and psychological status.

WHAT DOES QUADRIPLEGIC BASICALLY MEANS?

Quadriplegia, also known as Tetraplegia, is defined as paralysis

caused by illness or injury to a human that result in the partial or total loss of
use of all their limbs and torso; paraplegia is similar but does not affect the
arms. The loss is usually sensory and motor, which means that both sensation
and control are lost. Tetra paresis or quadric paresis, on the other hand,
means muscle weakness affecting all four limbs. It can also be referred as
spinal cord injury.

PHYSICAL PROBLEMS OF QUADRIPLEGIC:

 Weakness and partial loss in function of limbs

 Paralysis

 Total loss of sensation

 Total loss of control in limbs

 Spinal cord damage or degeneration

 Changes in skin sensitivity

PSYCHOLOGICAL PROBLEMS OF QUADRIPLEGIC:

  Anxiety

 Depression

 Sadness

 Loneliness

 Chance of Oneirophobia

 Chance of eating disorders

 Chance of PTSD

 Psychological distress

PHYSIOLOGICAL PROBLEMS OF QUADRIPLEGIC

 Deep vein thrombosis

 Urinary infections

 Muscle spasm

 Osteoporosis

 Pressure ulcers

 Chronic pain

 Respiratory complications

SOCIAL PROBLEMS OF QUADRIPLEGIC:

 Social withdrawal

 Social anxiety

 A-social personality

 Poor communication
  Low rate of marriages

 Transportation problems

WHAT IS C5 LEVEL IN QUADRIPLEGIC?

If the injury is at the C5 vertebra, the person may be

unable to breathe since the spinal cord nerves located between the third and
fifth cervical vertebrae control respiration. Damage to the spinal cord at
the C5 vertebra also affects the vocal cords, biceps, and deltoid muscles in the
upper arms.

CASE STUDY ON QUADRIPLEGIC:

Mary Lee was only 22 years old and was involved in a

serious car accident 1 year ago. She sustained multiple fractures in her spine
and has become a quadriplegic (C5 LEVEL) She is now a wheelchair bound
and needs to live with her parents ( both nearly 60 yrs old) She is fully
dependent for all her ADL and is pondering what to do with the rest of her
life . She has always been proud of her good looks before she wanted to be a
movie star. Now her boyfriend has left her and she is feeling very lonely and
depressed.

POINTS TO DISCUSS WITH:

 Personal resources
 Health related factors
 Cognitive appraisal
 Coping skills
 Social and physical context
 Health related outcomes
 Adaptive tasks

PERSONAL RESOURCES:

Basically personal resources mean a person’s inner strength

which makes them unique from every individual through utilizing those
resources to achieve their goal is that the qualities include self esteem, hope,
self confidence, optimism, resilience etc. considering Mary’s case she was a
person with strong inner strength but after her accident she lost her hope and
optimism and turned them to a negative attitude that she can’t involve with
doing her goals. So as a rehabilitation psychologist we need to first make her
understand about the positive side of her problem and what are the goals that
can be achieved through her positive attitude by ignoring her negative phase.

In her case we need to consider her family resources along with

her personal resource because her family also need to cope with her difficult
situation in-sense they need an financial support, for that they were
dependent on Mary but now the condition has changed so her parents should
have a hope and self confidence to work further for her medical expenses and
they need to stay as a motivational factor for her based on personal resources.

HEALTH RELATED FACTORS:

Considering the health related factors people with SCI may have

additional risk factors for the development of cardiovascular disease.
After SCI, there are often lower levels of good cholesterol, a higher percentage
of body fat, and a higher level of glucose intolerance. Bowel and bladder
control can be affected no matter where the spinal cord is injured. She would
also undergo a chronic pain due to her injury.

As a rehabilitation psychologist we need to help her with

overcoming her health factors through educating her about the importance of
both pharmacological and non-pharmacological interventions and make her
sure that she can come out these conditions through therapies but only if she
has a hope and confidence that these can help her to let out of the condition.

SOCIAL AND PHYSICAL CONTEXT:

Considering the social context it covers with aspects regarding her

society where she works or worked, where she involve interacting with
people, the gender and age factors. Seeing all these factors Mary, had a
boyfriend but after her accident he left her so this would have made an impact
that all male gender would have a same quality so will start with social
withdrawal where it affects her communication, her employment and leads
her to social anxiety. In order to help her with these social problems we need
to make her exposure with people who understand her disability and consider
her also as a normal one.

Considering the physical context it covers upon the factors such as

her living environment, is that her house and her room where she lives in.
before her accident she dreamt herself as becoming a movie star that she
could have emitted her characters in and around her room so we need to
involve in changing her room to other room or incase of single room we can
involve to tell her parents to change the style of her room by sticking on with
motivational quotes, the hanging that makes sound when air enters that can
distract her thinking when she thinks about her trauma, we need to make her
slowly come up with speaking out her ideas and implement them.

COPING SKILLS:

Coping is defined as constantly changing behavioral and cognitive

efforts made by the individual to cope with stressful events. The most
common coping strategies that were reported include an acceptance of the
situation, seeking information, positive reframing, minimization, self-trust and
social trust, and optimism and positive thinking. Some studies indicated that
spirituality and religiousness facilitated patients’ ability to cope with
disability. Others reported that social support predict survival and a higher
quality of life and decreases the rate of depression, susceptibility to illness and
emotional distress.

ADAPTIVE TASKS:

 Plan a daily routine

 Exercise daily

 Go back to work

 Join to a support group

 Surf online to know info’s about schemes, treatment etc

 Involving themselves in recreational activities

 Participate in group therapies

  Try to record your daily experience so that you yourself can
know about your improvement

 Follow breathing exercise

 Never give up with things make it done by motivating

yourself

COGNITIVE APPRAISAL:

 The cognitive appraisals that people make following spinal

cord injury (SCI) about their situation and their ability to cope with it.
Appraisals are thought to be important in determining individual responses to
different events and have been shown to predict psychological well-being
following injury. We need to make her forget the experience of the incident
through therapy sessions that may make her forget about her negatives and
focus on her positive outcomes.

HEALTH RELATED OUTCOMES:

There are types of outcome as positive and negative, Mary at

beginning will have totally the negative outcome if she thinks that she is
negative but she has the positive outcomes such as her quality of life has
changed a bit in healthy manner, she will become a healthy well being or a
positive well being if she cooperates for pharmacological and non
pharmacological interventions. She should keep in mind that she is alive
comparing to people who have died in the accidents that is her greatest
strength to achieve something different from other people.