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Symptom Clusters in Traumatic Spinal Cord Injury: An Exploratory Literature Review

Hunter Revell, Susan M.

Journal of Neuroscience Nursing: April 2011 - Volume 43 - Issue 2 - pp 85-93
doi: 10.1097/JNN.0b013e31820c2533

ABSTRACT: Chronic pain, spasticity, and depression are three common secondary health problems experienced by persons living with traumatic spinal cord injury. Limited research exists related to the interaction of these symptoms and their cumulative effect on patient outcomes and quality of life. This article is a report of an exploratory literature review that uses the conceptual approach of symptom clustering to classify secondary health problems in spinal cord injury. CINAHL, MEDLINE, and PsycINFO databases were searched for studies published in English between 1990 and 2008. Eleven articles met the inclusion criteria for review. Studies were categorized by levels of evidence defined by the American Association of Neuroscience Nurses Clinical Practice Guidelines. Research on the interaction of the symptom pair chronic pain and depression was evident. Several surveys reported the occurrence of multiple symptoms, but none specifically addressed the management of the interactive effects of the symptom cluster chronic pain, spasticity, and depression. Increased disciplinary knowledge of symptom clusters in the spinal cord injury population is needed for research and practice. Furthermore, determining symptom clusters in this population may assist clinicians in providing targeted interventions to simultaneously treat multiple symptoms.

Question or comments about this article may be directed to Susan M. Hunter Revell, PhD RN, at She is an assistant professor, College of Nursing, University of Massachusetts Dartmouth, North Dartmouth, MA.

© 2011 American Association of Neuroscience Nurses