Significant events in the rehabilitation process: the spinal cord patient's point of view

The purpose of this study was to identify and evaluate significant events in the hospital phase of rehabilitation. Ten patients with high-level spinal cord injuries were studied 5 days a week for the entire length of their hospital stays (mean stay--109 days). Methods of identifying significant events through tape-recorded, daily logs were developed and found reliable at a level of 0.08 or higher. These events, with a net of days surrounding them, were grouped into categories, and evaluated against a control group of days--in which no significant events were identified. Four measures of depressive affect were evaluated: (1) a self report measure, (2) ratings by the hospital staff, (3) behavioral measure of verbal output, and (4) an endocrine measure, the 24-hour output of urinary tryptamine. Seventy-three percent of reactions on the dependent measures of depressive-elative affect were in the direction predicted by patient evaluations. Significant events were rank ordered according to their average rank on the 4 measures of depressive affect. There are advantages to a longitudinal, multimeasure approach to the rehabilitation career of chronically ill or injured patients.