THE ROLE OF PATIENT INFORMATION AND COUNSELLING IN REDUCING SOCIAL STIGMA AND ENHANCING SELF-ESTEEM AMONG SPINAL CORD INJURY PATIENTS USING ORTHOSES

Abstract

This work examines the psychological impact of orthotic devices specifically on self-esteem and social stigma among patients with spinal cord injury. A total of 60 participants were used and divided into two groups by simple randomization lottery method –

Group A, patients who received patient information sheet & counselling which included the details about orthosis, there uses, wearing techniques, its importance etc.

Group B, patients who did not received patient information sheet & detailed counselling about the use of orthosis and were simply given the orthosis as prescribed by the Spine team of doctors.

The usability of orthoses was administered standard measures of self-esteem and social stigma. Data was collected after 4 weeks of orthosis use for both the group A and group B. Independent samples T-tests indicated that there were significant differences between the groups. The self-esteem difference was significantly lower in participants with group B, who just received the orthosis without proper patient information sheet and counselling about the usage (M = 16.3, SD = 5.7) than their counterparts with group A, who received patient information sheet about the detailed usage of orthosis as well as counselling  (M = 39.2, SD = 6.8) with t-stat = -11.66 (p < 0.05). Correspondingly, participants of group B values were more stigmatized (M = 41.5, SD = 9.3) than those with group A (M = 15.3, SD = 7.8) with a t-statistic = 11.87 (p < 0.05). The d values provided by Cohen reflected large effect sizes of self-esteem (d = -3.02) and social stigma (d = 3.05).

These findings indicate that the knowledge about usability and benefits of orthosis with proper counselling have a significant influence on self-esteem and social stigma, which makes it necessary to take the psychological well-being of orthotics users into account. There is a need to conduct research on interventions that will alleviate these adverse psychological outcomes.