Letter to the Editor

Alpha Psychiatry 2022;23(3):140-141

DOI: 10.5152/alphapsychiatry.2022.21715

Culturally Sensitive Psychosocial Care Program for Chinese People with Spinal Cord Injury During Inpatient Rehabilitation

Yan Li¹

Wai Tong Chien²

Daphne Sze Ki Cheung³

Shanshan Wang³

Jing Qin³

Daniel Bressington⁴

¹ School of Nursing, The Hong Kong Polytechnic University, Hong Kong

² The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong

³ School of Nursing, The Hong Kong Polytechnic University, Hong Kong

⁴ College of Nursing and Midwifery, Charles Darwin University, Australia

Corresponding author: Yan Li ✉ yan-nursing.li@polyu.edu.hk

Cite this article as: Li Y, Chien WT, Cheung DSK, Wang SS, Qin J, Bressington D. Culturally sensitive psychosocial care program for chinese people with spinal cord injury during inpatient rehabilitation. Alpha Psychiatry. 2022;23(3):140-141.

Spinal cord injury (SCI) brings sweeping changes to a person’s life, and SCI sufferers often experience substantial loss in physical functions and medical complications, as well as a variety of psychological and social constraints.¹ Therefore, psychosocial interventions targeting those modifiable factors (i.e., cognitive appraisal, coping, and social support) are recommended to be provided to those people who suffer from the injury in the earlier stage, which could ultimately enhance their sense of mastery of their daily lives, and self-efficacy in dealing with stressful situations post-SCI.²!

Our research team developed a culturally sensitive psychosocial care program (coping-oriented supportive program (COSP)) for Chinese people with SCI during inpatient rehabilitation. The COSP was evaluated in clinical trials, and study findings support the positive effects of psychosocial care on a variety of psychosocial outcomes (i.e., coping, depression, anxiety, and quality of life).³ Four key steps were followed in developing the psychosocial care program: (1) identifying appropriate theories; (2) identifying the evidence base and formulating the initial intervention protocol; (3) culture considerations and modifications; and (4) content validation. The COSP program mainly includes 4 phases: phase 1 (first session): orientation and encouragement; phase 2 (second session): cognitive appraisal; phase 3 (third to sixth sessions): coping strategies; and phase 4 (seventh to eighth sessions): social support and future. A series of cultural considerations were addressed in the program. Culture considerations include communication skills facilitation as Chinese people are found to be more conservative in their expression of feelings than people from Western cultures, and they also expect direction/advice from “experts” and they will be reminded to value their role in acting as an active problem solver rather than an only passive recipient.⁴ Chinese people also often emphasize “harmony maintenance,” “collectivism,” and “face-saving” in social relationships, and confucianism left a deep imprint on modern cultural values.⁴ In addition, “fatalism voluntarism” is a typical Chinese coping strategy. All cultural issues were discussed/incorporated in the intervention. A panel of experts rated each of the program items in terms of their appropriateness, and the average content validation index of the intervention manual was 0.97 (range 0.50-1.00), indicating very satisfactory content validity.⁵ In summary, the culturally sensitive intervention developed by our research team was initially built on solid research evidence and theoretical underpinnings. Chinese culture issues were reviewed and considered thoroughly in the refinement of the intervention.

Informed Consent: Written informed consent was obtained from all participants who participated in this study.

Peer-review: Externally peer-reviewed.

Author Contributions: Concept – L.Y., C.W.T., C.D.S.K., W.S.S., Q.J., B.D.; Design – L.Y., C.W.T., C.D.S.K., W.S.S., Q.J., B.D.; Writing – Y.L.; Critical Reviews – L.Y., C.W.T., C.D.S.K., W.S.S., Q.J., B.D.

Acknowledgments: We would like to acknowledge the help from expert review panel in providing valuable feedback on our developed psychosocial care programme.

Declaration of Interests: The authors have no conflicts of interest to declare.

Funding: The authors declared that this study has received no financial support.

References

  1. Alizadeh, A, Dyck, SM, & Karimi-Abdolrezaee, S. (2019). Traumatic spinal cord injury: an overview of pathophysiology, models and acute injury mechanisms. Front Neurol, 10, (https://doi.org/10.3389/fneur.2019.00282).

  2. Li, Y, Chien, WT, Zhu, B, He, H, & Bressington, D. (2021). Predictors of self-efficacy among people with spinal cord injury during inpatient rehabilitation: a cross-sectional study. J Nurs Scholarsh, 53(2), 218-226, (https://doi.org/10.1111/jnu.12632).

  3. Li, Y, Chien, WT, & Bressington, D. (2020). Effects of a coping-oriented supportive programme for people with spinal cord injury during inpatient rehabilitation: a quasi-experimental study. Spinal Cord, 58(1), (https://doi.org/10.1038/s41393-019-0320-2).

  4. Bond, MH. (2010). The Oxford Handbook of Chinese Psychology, Oxford, Oxford Library of Psychology.

  5. Polit, DF, & Beck, CT. (2006). The content validity index: are you sure you know what’s being reported? Critique and recommendations. Res Nurs Health, 29(5), 489-497, (https://doi.org/10.1002/nur.20147).

Received: October 1, 2021
Accepted: January 21, 2022

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