Making sense of paraplegia caused by violence-related gunshot injury

Abstract

The overall aim of this study is to explore the subjective experiences of psychotherapeutic interventions and the sense-making process in a group of persons paralysed as a consequence of violence-related gunshot injury. An available and purposive sample of ten participants was selected from public and private hospitals in and around Johannesburg, and from the Association for the Physically Disabled in South Africa. Three females and seven males, between the ages of 26 and 43 years, took part in the research. The participants had all suffered penetrative damage to the spinal cord in the thoracic region as a result of violence related gunshot injury, and are therefore classified as having paraplegia The participants' gunshot injuries had been sustained in incidents ranging from attempted hijacking and armed robbery, to being caught in crime-related crossfire. In-depth interviews were conducted with the participants. A narrative approach was used to examine participants' unique stories, utilising a systematic form of narrative analysis. The thesis consists of three articles, namely 1) The subjective experience of psychotherapeutic interventions in the rehabilitation of persons paralysed as a result of violence-related gunshot injuries; 2) Making sense of paraplegia caused by violence-related gunshot injury; and 3) Therapeutic guidelines for the management of persons paralysed as a result of violence-related gunshot injuries. The findings of article 1 reveal that paraplegic persons had both positive and negative experiences during their hospital rehabilitation. Ultimately, however, positive experiences compensated for negative experiences. This suggests that in the absence of psychotherapeutic interventions, psychosocial adjustment may possibly not be facilitated. The second article indicates that although several barriers prevented participants from making sense of their trauma, meaningful relationships, spiritual growth and a greater appreciation of the value of life were still possible. in the final article guidelines were put forward that include meeting the holistic and adjustment needs of paraplegic persons. Future research is suggested and limitations acknowledged.