Establishing a super-link system: spinal cord injury rehabilitation nursing

This paper reports a study to identify the needs of clients with spinal cord injury and their family/carers during rehabilitation, and the strategies used by rehabilitation nurses to meet those needs. In Taiwan, spinal cord injury is a major problem with financial implications for the state and major bio-psycho-social and spiritual implications for the individual. Rehabilitation nurses do not have an appropriate nursing theory to guide their care. Using a grounded theory approach, data were collected from October 2002 to March 2003 in a rehabilitation hospital in Taiwan by means of interviews, participant observations and documentary resources; analysis was an interrelated process. A total of 39 interviews was carried out with 31 individuals, including eight rehabilitation nurses, one nurse supervisor, seven clients with tetraplegia, eight with paraplegia and seven family/carers. There were 18 participant observations. Data were analysed using a multi-step analytic procedure, based on the works of Glaser, Charmaz, and Strauss and Corbin. The core category, 'establishing a super-link system', explained the complex structure of interactions observed during the investigation and the importance of developing a middle-range theory entitled the 'Super-Link System Theory'. This theory includes the following four links: 'linking to client', 'linking to family/carer', 'linking to interdisciplinary rehabilitation team' and 'linking to community'. This Super-Link System Theory will help rehabilitation nurses to organize their thinking about spinal cord injury rehabilitation nursing, to transfer their thinking into practice by making links effective, and to promote their professional position in the interdisciplinary rehabilitation team.