Article

PURPOSE: To explore how surgical reconstruction of grip affects everyday life for
patients with tetraplegia, with special emphasis on patients perspective of their
perceived changes. Design: Qualitative method. Subjects: Eleven people (aged
22-73) with tetraplegia who had undergone surgical reconstruction to restore grip
function. METHODS: Qualitative interviews were conducted 7-17 months after
surgery and analysed using Grounded theory. RESULTS: The core concept describing
the participants experienced gains after grip reconstructive surgery was
"enhanced independence". It was associated with changes in both practical and
psychological aspects of independence. Practical aspects identified were:
"perform more activities", "smoother everyday life", "renewed ability to
participate in social activities", "less dependence on assistance" and "less
restricted by physical environment". Psychological aspects of independence
included "regained privacy", "increased manageability", "regained identity",
"recapture a part of the body" and "share positive experiences with relatives and
friends". Encompassing all categories was the concept "self-efficacy in hand
control". It was seen as a result included in the enhanced independency core but
also as an important factor for the development of all the other categories.
CONCLUSION: Participants in this study experienced enhanced independence after
grip reconstructive surgery and rehabilitation. The enhanced independence
included both practical and physical aspects and it influenced all domains using
the International Classification of Function, Disability and Health model; body
function and structure, activities, participation, personal factors and
environmental factors. Implications for Rehabilitation Patients with tetraplegia
experience grip reconstruction as a useful intervention, an enhanced
independence, related to their improved hand control. The increased hand control
impacted not only physical aspects but also practical and psychological aspects.
It also influenced social and community participation and the interference the
environment had on the person. Self-efficacy was both a result of the
intervention and a catalyst allowing the subcategories to develop. Therefore,
self-efficacy in hand control seems to be an important factor to focus on during
the rehabilitation process.

Langue : ANGLAIS