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See the latest news from the National Spinal Injuries Centre: 

06 September 2018

Metacognitive Factors in Spinal Cord Injury Rehabilitation

Belledeep Dathan, Trainee Clinical Psychologist, University of Oxford

Dr Kevin Jones, Specialist Clinical Psychologist, Department of Clinical Psychology, NSIC

Introduction

During the Spring and Summer of 2018, many inpatients at NSIC took part in a research project with the Department of Clinical Psychology and University of Oxford. The study aimed to learn more about the way people with a spinal cord injury think, and how this can affect the way they feel. Specifically, the study explored whether the way people think about their thoughts (metacognitions) can predict how people with spinal cord injury might feel. At the time of writing, there was no previous research exploring metacognitions in people with a spinal cord injury. This study is therefore unique. By doing this research, it was hoped that therapy approaches could be identified that may further support people with a spinal cord injury who experience depression and anxiety.

Method

41 adults took part in the research. They completed five validated multiple choice questionnaires and a demographic questionnaire. The questionnaires explored anxiety and depression symptoms, thoughts, metacognitions, coping strategies, and level of independence.

Results

Statistical analysis (hierarchical multiple regression) was then conducted on the data collected and the following findings emerged:

  • The way with think about our thoughts (our metacognitions) are a significant predictor of anxiety symptoms.
  • Metacognitions were not found to be a significant predictor of depression symptoms.
  • How functionally independent a person is did not predict anxiety or depression symptoms in a rehabilitation setting.
  • Negative thoughts were also found to be a significant predictor of anxiety and depression symptoms

Clinical Implications

These findings suggest that therapy techniques that address metacognitions may have a beneficial impact on anxiety symptoms for people with spinal cord injury in inpatient rehabilitation.

These findings also suggest that therapy techniques addressing metacognitions may not have an impact on depression. Instead, the findings offer further support for techniques that address people’s thoughts to reduce depression.

Research Implications

This is the first study exploring metacognitions in SCI, and therefore the findings should be interpreted with caution. Future research should aim to recruit a larger population and explore how metacognitions may change over time.

Conclusions

This study provides a unique insight into psychological adjustment in people with a spinal cord injury. It explores the contribution of metacognitions, thoughts, coping and level of independence to anxiety and depression. The findings advocate for the consideration of metacognitions specifically for anxiety. The findings also further highlight the role of thoughts in anxiety and depression symptoms.

31 March 2017

National Spinal Injuries Centre, statement on the use of Oxybutynin and potential increased risk of dementia March 2017.

The NSIC has received several calls following a recent Daily Mail article about the possible link between the Oxybutynin, an anti incontinence drug and dementia. We therefore thought it helpful to offer some further guidance to patients who may be concerned by these news reports.

The National Spinal Injuries Centre does not recommend that spinal cord injured patients stop taking oxybutynin. Stopping oxybutynin suddenly may lead to significant health problems including:

  •  Silent kidney damage as a result of high bladder pressures
  • Autonomic dysreflexia (a life-threatening condition which can lead to sudden increase in blood pressure and other symptoms) in susceptible individuals
  • Urinary incontinence
  • Risk of catheter blockages and urinary tract infections
  • Breakdown of skin due to wet skin rubbing against clothing. 

If you are concerned about this issue, we advise you to not stop taking your medication without speaking to a medical practitioner first. They will decide with you which medicine would suit you best, considering how effective it is at managing symptoms, and whether there is a risk of unwanted side effects for you personally. This advice is also endorsed by Professor Marcus Drake, the urologist at University of Bristol who was quoted in the Daily Mail.

The research article quoted in the Daily Mail and published in 2015 focused on the use of different medicines with “antimuscarinic/ anticholinergic” effects, including hayfever tablets and oxybutynin. Oxybutynin forms a small number of the prescriptions analysed in the paper suggested a possible link between patients who take high doses or long term antimuscarinic medicines and dementia, with oxybutynin listed as an example. That is not to say that oxybutynin will definitely cause dementia and there is lack of consensus about this evidence. It is also worth noting that only adults of age of 65 years old participated in the study.

For further information, patients can read this article which provides an unbiased, evidence-based analysis of the research published in 2015.

http://www.nhs.uk/news/2015/01January/Pages/media-dementia-scare-about-common-drugs.aspx

If patients have concerns, they should contact their clinician.

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  • View the latest SCI newsletter featuring patient and staff achievements, events and team updates.
  • 8 October 2014 - Countess of Wessex visits the NSIC
  • Her Royal Highness the Countess of Wessex took time out during a recent visit to Aylesbury to tour The National Spinal Injuries Centre (NSIC) at Stoke Mandeville Hospital, birthplace of the Paralympic movement.
  • 6 June 2014 - NSIC dietitian wins prestigious BDA Rose Simmonds award
  • Lead dietitian at Stoke Mandeville Hospital's National Spinal Injuries Centre (NSIC), Samford Wong was honoured last night at the British Dietetic Association (BDA) awards in Birmingham. He was awarded the prestigious BDA Rose Simmonds award for 2014, including a prize of £1,500 for his study on the effects of a commercial probiotic drink on spinal injury patients.
  • 9 May 2014 - Living with a spinal cord injury
  • A spinal cord injury can happen to anyone at anytime, from illness or an accident. Every eight hours someone is told they may never walk again due to spinal cord damage. It is estimated that there are 40,000 spinal cord injured people in the UK alone and for these 40,000, lives don’t just stop. Living with a spinal cord injury can take people on new, and unexpected, journeys.
  • 3 March 2014 - Create a work of art - undercover
  • Patients, staff, local artists, children and the public are invited to donate postcard designs on any theme to a local mystery exhibition in support of art therapy for spinal patients at the National Spinal Injuries Centre at Stoke Mandeville Hospital.
  • 18 November 2013 - Would you like to join a world renowned team?
  • Building on the pride felt by our nursing team after the Paralympics at London 2012, it’s an exciting time to join the National Spinal Injuries Centre at Stoke Mandeville Hospital in Buckinghamshire. Would you like to be a nurse at a world renowned specialist national centre for people with spinal cord injury – a centre that is life changing for everyone who comes into contact with it?
  • 24 October 2013 - Unveiling of plaque to honour Sir Ludwig Guttmann
  • Buckinghamshire Healthcare NHS Trust and The Association of Jewish Refugees (AJR) are delighted to announce the unveiling of a special commemorative plaque to honour the life of Sir Ludwig Guttmann today (Thursday 24 October) at the National Spinal Injuries Centre, Stoke Mandeville Hospital.
  • 9 October 2013 - Trust annual staff awards
  • The Trust held their ninth annual staff awards on 30 September at the Waterside Theatre, Aylesbury. The evening celebrated some of our amazing and dedicated staff, including nurses, doctors, support staff and volunteers, including NSIC physiotherapist, Ian Benson.
  • 25 June 2013 - Staff win top awards presented by the Spinal Injuries Association
  • Two members of staff from Buckinghamshire Healthcare NHS Trust, one from the National Spinal Injuries Centre (NSIC) and the other from the department of obstetrics and gynaecology, have won prestigious awards at the very first Women in Spinal Cord Injury awards ceremony, promoted by the Spinal Injuries Association (SIA).
  • 18 Sep 2008 - Paralympics 'truly coming home'
    As the Paralympic flag was handed from China to London in Beijing, celebrations were also under way in
    Stoke Mandeville, Bucks, where the first games for athletes using wheelchairs were hosted in 1948.

 

  • 17 Aug 2008 - NSIC 25th anniversary
    This summer the NSIC building as it now stands celebrated its 25th birthday and a garden party was held on 17 July 2008 in order to commemorate the occasion.

 

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