Keywords
Nursing
Adaptation
Spinal cord traumas
Nursing process
Standardized nursing terminology
How to Cite
Abstract
Objective: To describe the elements of a middle-range theory about the adaptation process in people with traumatic spinal cord injuries, based on Roy's Adaptation model. Method: A theoretical research study of an explanatory and prescriptive nature, by means of the General Method of Theory Building in Applied Disciplines and of theorization strategies using terminological components for situation-producing theories. Results: The theory was applied to individuals aged at least 18 years old undergoing an adaptation process to spinal cord injuries, in a period of three years after the trauma. Concepts and inter-relations were defined. The research presented 10 relational assertions, 9 theoretical proposals and a number of technologies that guide the Nursing Process. Conclusion: The adaptation process in people with traumatic spinal cord injuries is presented by means of coping responses that arise in the scope of physiological human responses, of self-concept, of role changes and of inter-dependence, modulated by the meaning of life, by previous experiences and by internal stances in relation to the challenges, producing effective or impaired responses.
References
Jazayeri SB, Maroufi SF, Mohammadi E, Dabbagh Ohadi MA, Hagen E, Chalangari M, et al. Incidence of traumatic spinal cord injury worldwide: A systematic review, data integration, and update. World Neurosurg X. 2023;18:100171. https://doi.org/10.1016/j.wnsx.2023.100171. PMID: 36910686.
World Health Organization; The International Spinal Cord Society. International perspectives on spinal cord injury [Internet]. Geneva: WHO; 2013 [citado 2021 Out 20]. Disponível em: https://www.who.int/publications/i/item/international-perspectives-on-spinal-cord-injury.
Ko H-Y. Management and Rehabilitation of Spinal Cord Injuries. Singapore: Springer Singapore; 2019. https://doi.org/10.1007/978-981-10-7033-4
Weidner N, Rupp R, Tansey KE. Neurological Aspects of Spinal Cord Injury. Switzerland: Springer Cham; 2017. https://doi.org/10.1007/978-3-319-46293-6
World Health Organization. Health equity for persons with disabilities: guide for action. Executive summary [Internet]. Geneva: WHO; 2025 [citado 2025 Dez 19]. Disponível em: https://iris.who.int/handle/10665/380145.
Grayev A. Functional Anatomy of the Spinal Cord. Radiol Clin North Am. 2024;62(2):263-272. https://doi.org/10.1016/j.rcl.2023.09.001. PMID: 38272619.
Patek M, Stewart M. Spinal cord injury. Anaesthesia and Intensive Care Medicine. 2023;24(7):406-411. https://doi.org/10.1016/j.mpaic.2023.04.006
Srikandarajah N, Alvi MA, Fehlings MG. Current insights into the management of spinal cord injury. J Orthop. 2023;41:8-13. https://doi.org/10.1016/j.jor.2023.05.007. PMID: 37251726.
Pereira MEM da SM, Araujo TCCF de. Enfrentamento e reabilitação de portadores de lesão medular e seus cuidadores. Psico (Porto Alegre) [Internet]. 2006 [citado 2025 Dez 19];37:37–45. Disponível em: https://revistaseletronicas.pucrs.br/revistapsico/article/view/1410.
Moreira RB, Souza AM. Meanings of acquired disability in adulthood: implications of severe spinal cord injury. Psicol Estud. 2017;22(2):243. https://doi.org/10.4025/psicolestud.v22i2.31669
Rueda Ruiz MB, Aguado Díaz A-L, Alcedo Rodríguez MA. Estrés, afrontamiento y variables psicológicas intervinientes en el proceso de adaptación a la Lesión Medular (LM): una revisión de la bibliografía. Psychosoc Interv [Internet]. 2008 [citado 2025 Dez 19];17(2):109–124. Disponível em: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1132-05592008000200002&lng=es.
Swanson RA, Chermack TJ. Theory building in applied disciplines. San Francisco: Berrett-Koehler Publishers; 2013.
Brandão MAG, Santana RF. Toward a theorizing strategy with components of terminologies, classifications, and nursing theories. Int J Nurs Knowl. 2023;34(3):236-244. https://doi.org/10.1111/2047-3095.12396. PMID: 36205479.
Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z, editors. JBI Reviewer’s Manual. Adelaide: JBI; 2020. https://doi.org/10.46658/JBIRM-20-01
McEwen M, Wills EM. Theoretical Basis for Nursing. Wolters Kluwer; 2018.
Herdman TH, Kamitsuru S, Lopes CT. Diagnósticos de enfermagem da NANDA-I: definições e classificação 2024-2026. 13. ed. Porto Alegre: Artmed; 2024.
Zaccaro KRL. Teoria de médio alcance do processo adaptativo da pessoa com lesão traumática da medula espinhal baseado no modelo de adaptação de Roy [tese]. Rio de Janeiro: Universidade Federal do Rio de Janeiro; 2022.
Meade MA, Yin Z, Lin P, Kamdar N, Rodriguez G, McKee M, et al. Type 2 Diabetes Increases the Risk of Serious and Life-Threatening Conditions Among Adults With Traumatic Spinal Cord Injury. Mayo Clin Proc Innov Qual Outcomes. 2023;7(5):452-461. https://doi.org/10.1016/j.mayocpiqo.2023.08.002. PMID: 37818139.
Trompeter A. The management of traumatic spinal cord injury. Injury. 2023;54(4):1039-1040. https://doi.org/10.1016/j.injury.2023.01.050. PMID: 36797115.
Soegaard K, Sig JR, Nielsen C, Verhaeghe S, Beeckman D, Biering-Sørensen F, et al. "I am just trying to live a life!" -a qualitative study of the lived experience of pressure ulcers in people with spinal cord injuries. J Tissue Viability. 2024;33(1):50-59. https://doi.org/10.1016/j.jtv.2023.11.009. PMID: 38044163.
Livneh H. Can the Concepts of Energy and Psychological Energy Enrich Our Understanding of Psychosocial Adaptation to Traumatic Experiences, Chronic Illnesses and Disabilities?. Front Psychol. 2022;13:768664. https://doi.org/10.3389/fpsyg.2022.768664. PMID: 35310232.
Smith G, Thompson AR, McCulloch A, Moses J. Post-traumatic growth following spinal cord injury: a systematic review and meta-ethnography. Disabil Rehabil. 2025;47(25):6536-6548. https://doi.org/10.1080/09638288.2025.2487564. PMID: 40275537.
Bhattarai M, Shigemoto Y, Smedema SM. Role of self-efficacy on functional limitations among persons with spinal cord injury. Chronic Illn. 2025;21(1):94-104. https://doi.org/10.1177/17423953231203731. PMID: 37750175.
Barreiro RG, Lopes MV de O, Cavalcante L de P. Middle-Range Theory for the Nursing Diagnosis of Low Self-Efficacy in Health. Rev Bras Enferm. 2020;73(5):e20190370. https://doi.org/10.1590/0034-7167-2019-0370. PMID: 32638935.
Nazari S, Moradi M, Danyali Z, Marzaleh MA, Hadi V, Hadi S. Lifestyle assessment in individuals with spinal cord injuries caused by accidents and disasters in qualitative studies published from 1990 to 2020: A meta-synthesis of qualitative study. Health Sci Rep. 2023;6(6):e1328. https://doi.org/10.1002/hsr2.1328. PMID: 37334044.
Halvorsen A, Steinsbekk A, Leiulfsrud AS, Post MWM, Biering-Sørensen F, Pape K. Labour market participation after spinal cord injury. A register-based cohort study. Spinal Cord. 2023;61(4):244-252. https://doi.org/10.1038/s41393-023-00876-4. PMID: 36717734.
Taylan S, Özkan İ, Kolaç N. Dyadic adjustment and the relationship between sexual self-consciousness and sexual dysfunction in individuals with spinal cord injuries: A descriptive study. J Spinal Cord Med. 2024;47(1):79-90. https://doi.org/10.1080/10790268.2022.2135732. PMID: 36441021.
Angel S, Steensgaard R, Kolbaek R, Frimann S. Competing discourses as barriers to change in rehabilitation nursing: a discourse analysis. Front Rehabil Sci. 2023;4:1267401. https://doi.org/10.3389/fresc.2023.1267401. PMID: 38149111.
Ikin Anderson M, Gopinath B, Fiona Jones K, Morey P, Simpson GK. Testing the stability of a family resilience model at 2 and 5 years after traumatic brain injury or spinal cord injury: A longitudinal study. Ann Phys Rehabil Med. 2023;66(6):101734. https://doi.org/10.1016/j.rehab.2023.101734. PMID: 37030248.
Galehdar N, Heydari H. Exploring caregivers' perceptions of community-based service requirements of patients with spinal cord injury: a qualitative study. BMC Prim Care. 2023;24(1):94. https://doi.org/10.1186/s12875-023-02051-3. PMID: 37038113.
Gil-Agudo Á, Megía-García Á, Pons JL, Sinovas-Alonso I, Comino-Suárez N, Lozano-Berrio V, et al. Exoskeleton-based training improves walking independence in incomplete spinal cord injury patients: results from a randomized controlled trial. J Neuroeng Rehabil. 2023;20(1):36. https://doi.org/10.1186/s12984-023-01158-z. PMID: 36964574.
Zhao H, Yang J, Yang J, Jiang H, Qin Y, Lei Q. Evaluation of the improvement of walking ability in patients with spinal cord injury using lower limb rehabilitation robots based on data science. Transl Neurosci. 2023;14(1):20220320. https://doi.org/10.1515/tnsci-2022-0320. PMID: 37954153.
Brehon K, MacIsaac R, Bhatia Z, Buck T, Charbonneau R, Crochetiere S, et al. Outcomes of Implementing a Webinar-Based Strategy to Improve Spinal Cord Injury Knowledge and Community Building: Convergent Mixed Methods Study. JMIR Rehabil Assist Technol. 2023;10:e46575. https://doi.org/10.2196/46575. PMID: 37351945.
Dietz N, Vaitheesh Jaganathan, Alkin V, Mettille J, Boakye M, Drazin D. Machine learning in clinical diagnosis, prognostication, and management of acute traumatic spinal cord injury (SCI): A systematic review. J Clin Orthop Trauma. 2022;35:102046. https://doi.org/10.1016/j.jcot.2022.102046. PMID: 36425281.
Temel MH, Erden Y, Bağcıer F. Information Quality and Readability: ChatGPT's Responses to the Most Common Questions About Spinal Cord Injury. World Neurosurg. 2024;181:e1138-e1144. https://doi.org/10.1016/j.wneu.2023.11.062. PMID: 38000671.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 Online Brazilian Journal of Nursing