EDITORIAL
Expose Your Creativity: Publish in SCI Nursing
Susan S. Thomason, MN, RN, APRN-BC, CRRN

President’s Message
The Art of Leadership
Cathleen M. King, BS, RN, CRRN

FEATURE ARTICLES
The Nature, Meanings, and Dynamics of Lived Experiences of a Person With Syringomyelia: A Phenomenological Study   (Abstract)
Edith L. Hilton, RN, DSN, PhD, CS, APRN, BC, CRRN;
and Lesley J. Henderson, RN, MSN, CNOR

Self-Concept and Body Image in Persons Who Are Spinal Cord Injured With and Without Lower Limb Amputation   (Abstract)
Elizabeth A. Yetzer, MA, MSN, CRRN; Steven Schandler, PhD; Tammy L. Root, MA; and Kathleen Turnbaugh, BA

Patient Dignity in Persons With Spinal Cord Injury   (Abstract)
Heather G. Belanger, PhD; Audrey L. Nelson, PhD, RN, FAAN;
Susan McMillan, PhD, ARNP, FAAN; Deborah Gavin-Dreschnack, BA, PhD(c);
Sandra Holley, PhD, ARNP; and Deborah Rosenberg, PhD

Fall-Related Fractures in Persons With Spinal Cord Impairment: A Descriptive Analysis   (Abstract)
Audrey Nelson, PhD, RN, FAAN; Shahbaz Ahmed, MD, MPH; Jeffrey Harrow, MD, PhD;
Shirley Fitzgerald, PhD; Aurora Sanchez-Anguiano, MD, PhD;
and Deborah Gavin-Dreschnack, BA, PhD(c) 30

PULSE ON PRACTICE
Making a Difference: The SCI Student Internship Program
Edited by Cathy R. Parsa, BSN, MA, RN, C, CRRN

innovation station
Tracheostomy Tubes: Old Devices, New Features
Edited by Fina Canave Jimenez, RN, MEd

research corner
Database Research
Edited by Ann Marie Smith, PhD, RN, CRRN, CS

LEADERSHIP CIRCLE
Never Underestimate the Importance of Networking: An Imperative Process for Career Success!
Edited by Lynn C. Parsons, DSN, RN, CNA

Pediatric perspectives
No Bones About It: The Unique Side of Orthopedic Management in the Child With SCI
Edited by Lisa A. Merenda, MSN, RN, CRRN

BOOK REVIEWS
Edited by Marilyn Ter Maat, MSN, RNC, CNAA, CRRN-A

ABSTRACTS FROM SELECTED LITERATURE
Edited by Terrie Black, MBA, BSN, RN, C, CRRN

AASCIN NEWS
Edited by Cheryl A. Lehman, MSN, RN, CRRN-A

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Nursing Organizations Alliance—“The Alliance”

Syringomyelia, considered a rare neurological disease, is relatively uninvestigated in the nursing literature. The aims of this qualitative phenomenological case study were to discover the nature, meanings, and dynamics of lived experiences of a 52-year-old Caucasian male with syringomyelia. Using van Manen’s Method of Phenomenological inquiry (van Manen, 1990), data were collected, checked, and analyzed according to the philosophy, approach, and methodological procedures of phenomenology. Findings revealed an overarching theme of engulfment by disease. Essential themes included loss of abilities, struggles to adapt to changes, and life as a person who was disabled. Eleven sub-themes were also identified. Implications for nursing practice are discussed.

Spinal cord injury (SCI) requires considerable psychological adjustment to physical limitations and complications. One particularly severe complication of SCI is foot skin breakdown, which can result in lower limb amputation. Relative to SCI adjustment, amputation may produce one of two psychological outcomes: (1.) the fragile self-concept of a person with SCI may be reduced further by limb amputation, or (2.) amputation of a diseased, nonfunctional limb may be associated with restored health and improved self-concept. To better understand the effects of amputation, 26 males with SCI, 11 of whom had a lower limb amputation, were administered the Tennessee Self-Concept Scale (TCS) and the Personal Body Attractiveness Scale (PBAS). The study revealed that persons with SCI with amputation had a higher Physical and Total self-concept scores on the TSCS, showing a slightly more positive self-concept. On the PBAS, although there were no significant differences in the scores for the legs, ankles, or feet, the persons with SCI with amputation had a higher score on the Satisfaction subscale, indicating a slightly greater satisfaction with their thigh in their body image.
Implications for future study include replication with larger sample sizes, inclusion of women in the sample, and a longitudinal study.
Several nursing interventions are identified.

Key words: spinal cord injury, amputation, self-concept, body image

Technology is changing the way nurses provide patient care in spinal cord injury. A key nursing concern is the impact of technology-assisted caregiving tasks (TACT) on the patients’ sense of dignity. Despite frequent use of the term dignity in discussing treatment of persons with disabilities, there is a dearth of empirical research related to this topic. In particular, there have been few attempts to define the construct for the purposes of valid measurement. The purpose of this article is, therefore, to critically review the relevant literature on patient dignity with an aim toward eventual development and validation of a Dignity Assessment Tool.

Key words: technology, dignity, measurement, lifting devices

Falls are a significant cause of injury, disability, and death in the elderly, but little is known about the risk of wheelchair-related falls. The purpose of this study is to describe the incidence, etiology, location of fracture, treatment, and health care utilization of fall-related fractures in persons with spinal cord impairment (SCI). A retrospective review of 45 medical records of patients with SCI who sustained fractures, nonconcomitant with the onset of their initial injury, was completed at a Veterans Health Administration (VHA) SCI service over a 10-year period. Of the 24 veterans who sustained fall-related fractures, three (12%) were found to have repeated falls with fractures. Falls were sustained during activities (more than one wheelchair activity can contribute to a fall; e.g., transfer activity with brake failure in a van) including transfer (44%), reaching (11%), propelling (15%), moving in bed (22%), transferring or riding in a vehicle (30%), and showering (7%). Factors contributing to falls included loss of balance, equipment failure, muscle spasms, excessive speed, not wearing protective straps, and narcolepsy.
Among the 31 fractures sustained in 27 fall episodes in 24 subjects, lower extremity fractures accounted for 97% of the injuries and a fractured 7th rib accounted for one injury (3%). Tibial fractures occurred more frequently than femoral or ankle fractures. Four (15%) fall episodes resulted in bilateral fractures. The treatment of choice was to immobilize the fractured extremity with a soft, well-padded splint. Surgical fixation was performed in only two cases. Over 80% of the patients with fall-related fractures were admitted for inpatient stays with a mean of 66 inpatient days per patient. Hospital days were most often the result of home inaccessibility, inadequate support at home, or surgical intervention.

Key words: wheelchair, falls, spinal cord impairment, descriptive research