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Self-Management of Spinal Cord Injury and Disease

When living with Spinal Cord Injury and Disease (SCI/D), health impacts what someone can do and how much energy they have to do it.  While there is currently no cure for SCI, there are ways to manage the condition to optimize functioning.  One key is to prevent secondary conditions, such as pressure sores, respiratory infections, bowel problems, pain and others, that can decrease independence, increase health care costs and result in more hospital stays. In other words, they can prevent the individual with SCI from getting on with their life. 

Michelle A. Meade, Ph.D. Rehabilitation Psychologist and Assistant Professor in the Department of Physical Medicine at Rehabilitation at the University of Michigan, believes that one way to promote health among this population is to focus on skill development.  That is, Meade believes that secondary conditions can be prevented or minimized by performance of health behaviors or health maintenance steps (like performing pressure reliefs to prevent skin problems) and that being able to perform these behaviors consistently requires self-management skills.  With funding from the PVA Education Foundation (grant #576), Meade developed the self-management program  - Health Mechanics - specifically for individuals with SCI/D. 

Health Mechanic: Tools for the Self-management of Spinal Cord Injury and Disease (SCI/D) is comprehensive yet flexible enough to be used to assist individuals with different backgrounds and levels of experience focus on any one of the myriad of behaviors that are necessary for managing SCI.  The basic skills or tools that are taught in this program are attitude, self-monitoring, problem-solving, communication, organization, and stress management

The Health Mechanics program is written so that it can be used either by individuals with SCI/D or individuals who are working with them to facilitate skill development.  It is constructed as a conversation or discussion with the individual with SCI/D who is reading or using the program. However, facilitators (be they family members, health care providers, peer mentors, or others) can also use this guide, either directly quoting or paraphrasing the language and concepts in this guide. 

A supplemental program – Facilitating Health Mechanics – was also created to assist care providers (i.e., family members, physical and occupational therapists, nurses, physicians) support the development and use of self-management skills as well as to help this group think about their own assumptions, expectations and communication style.   This program was based on the premise that only optimum health care will only be achieved when providers and patients have matching (or at least complementary) expectations.  Together, these programs provide additional tools that both individuals with SCI/D and care providers to use to optimize health. 

Please contact Dr. Meade (mameade@umich.edu) with feedback, errors and suggestions.