Integration of psychosocial and medical factors in the care of a 17-year-old with GSW at T5 – a case study




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Background: Rehabilitation psychology involves the application of psychological knowledge in the care of individuals with disabilities and chronic health conditions. This specialty involves ongoing evaluation of a patient’s mental and psychological status and the formation of positive coping skills and behaviors to help the patient achieve a satisfactory and productive life, as defined by the individual patient. Individuals with spinal cord injuries (SCIs) have an increased risk for poor physical, psychological, and social health. This trend is even more pronounced in vulnerable populations, including the poor, racial and ethnic minorities, older adults, and pediatric patients.

Case information: A 17-year-old male presented to Care Now with a gunshot wound (GSW) to the back. The patient was transferred to JPS. CXR showed that the bullet fractured T5 and remained lodged. The patient was diagnosed with incomplete SCI and paraplegia and treated for pulmonary and hepatic lacerations and diaphragm injury. The patient was transferred to Cook Children’s RCU for long-term management. Psychology was consulted to discuss patient’s dissatisfaction with catheterization and concerns on sexual functioning.

Conclusions: The incorporation of rehabilitation psychology in the care of patients with SCIs, particularly in vulnerable populations, has been shown to improve long-term success and independence. It is essential to implement a multi-factorial approach that considers both medical and psychosocial variables in a patient’s treatment plan. Emphasis must be placed on individual priorities of the patient to help the patient achieve acceptance and long-term satisfaction.