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  4. Self-management of pain and depression in adults with spinal cord injury: A scoping review

Self-management of pain and depression in adults with spinal cord injury: A scoping review

The Journal of Spinal Cord Medicine, 2020 · DOI: 10.1080/10790268.2018.1523776 · Published: May 1, 2020

Spinal Cord InjuryMental HealthPain Management

Simple Explanation

This scoping review examines existing research on how adults with spinal cord injuries (SCI) self-manage pain and depression using pharmacological and non-pharmacological therapies. The review identifies gaps in knowledge and suggests future research directions to improve self-management strategies for this population. It highlights the need for interventions that address medical, emotional, and role management, utilize multidisciplinary approaches, and evaluate both pharmacological and non-pharmacological therapies.

Study Duration
Not specified
Participants
42 articles were reviewed
Evidence Level
Scoping Review

Key Findings

  • 1
    The majority of studies have focused on self-management of pain, with fewer focusing on depression or both.
  • 2
    Few studies included all core self-management tasks and skills, as defined by Lorig and Holman.
  • 3
    There is a concentration of studies focused on non-pharmacological therapies, instead of evaluating self-management through the use of pharmacological treatments and perhaps more importantly, using both.

Research Summary

This scoping review analyzed the extent, range and nature of available research on what is known about the self-management of pain and depression through the use of pharmacological and non-pharmacological therapies in adults with SCI. Our findings showed that the majority of studies have focused on the self-management of pain, with a minimal number focusing on the self-management of depression or both pain and depression. Our review highlighted a need for future research to address the following: (1) incorporate all three core self-management tasks (medical management, emotional management and role management); (2) utilize a multidisciplinary approach focusing both on pain and depression; (3) evaluate both pharmacological and non-pharmacological therapies; and (4) describe more details about population demographics and clinical characteristics.

Practical Implications

Comprehensive Interventions

Future interventions should incorporate medical, emotional and role management to address the complex needs of individuals with SCI.

Multidisciplinary Approach

Promote multidisciplinary teams to facilitate interventions, potentially improving outcomes related to pain, depression, and coping strategies.

Balanced Therapy Evaluation

Future research should evaluate both pharmacological and non-pharmacological therapies to find optimal combinations for self-management.

Study Limitations

  • 1
    Relevant articles may have been missed despite exhaustive database and grey literature searches.
  • 2
    Results of self-management tasks and skills were limited to studies that explicitly mentioned, incorporated as part of the intervention, or evaluated as an outcome.
  • 3
    Since this is a scoping review, there is no assessment of the quality of the interventions discussed.

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