Lincolnshire Post-Polio Library [The late effects of Polio - 13 Psychosocial aspects associated with the late effects of polio]

Lincolnshire Post-Polio Library - A Service of The Lincolnshire Post-Polio Network
The late effects of Polio Information for Health Care Providers
Charlotte Leboeuf

13 PSYCHOSOCIAL ASPECTS ASSOCIATED WITH THE LATE EFFECTS OF POLIO

The typical reaction of many people who survived paralytic polio but were left with physical disabilities is often said to have been to work harder ("Use it or lose it"). Through an ambitious rehabilitation program they were taught to exercise and build up new strength, to ignore pain and to conquer physical handicaps. Many have made outstanding achievements (1).

Due to the stigma commonly associated with physical defects many people who had polio tended to deny their residual impairments. Yet those who were severely affected would have faced continuous struggles, such as:

overcoming physical barriers;
fighting ignorance and prejudice;
making a career;
socializing;
building a family and maintaining a normal social and family life.

Many were also financially disadvantaged due to their impairments and the uncompromising physical environment.

The unique circumstances surrounding the development of an unexpected second disability are thought to result in particular psychosocial difficulties (2-4).

The awareness of symptoms, some of which are similar to those experienced during the acute stage, causes the return of old memories of loneliness, anxiety, discomfort, prolonged inactivity and fear of total disability.

People who lose abilities which they previously gained through strenuous rehabilitation may experience a deep feeling of bereavement. This grief in turn may cause withdrawal from society. It is easy to mistake the secondary symptom, depression, for the primary cause.

Breathing difficulties cause great distress and a fear of total incapacity. Respiratory problems which occur at night cause fatigue and personality changes linked to lack of sleep and oxygen.

Fatigue, pain, worry and depression cause strained interpersonal relationships, putting marriages and friendships at risk.

Not only patients but health professionals may find the situation tricky. There are few practitioners today who have experience in the diagnosis and treatment of polio, and few are aware of the late effects of polio. The difficulty in providing satisfactory diagnosis and treatment may cause frustration and suspicious attitudes in health professionals, which may strain the practitioner-patient relationship. Also, avoidance of care, non-compliance and hostility are understandable reactions in people who have experienced repeated therapeutic disappointments and who are used to taking responsibility for many of their own residual problems.

Obviously, the psychosocial aspects of people experiencing the late effects of polio require tactful assessment.

References:

Kaufert JM, Locker D. Rehabilitation ideology and respiratory support technology. Soc Sci Med 1990;30:867-77. [PubMed Abstract]
Frick NM. Post-polio sequelae and the psychology of second disability. Orthopaedics 1985;8:851-3. [PubMed Abstract]
Conrady LJ, Wish JR, Agre JC et al. Psychological characteristics of polio survivors: A preliminary report. Arch Phys Med Rehabil 1989;70:458-63. [PubMed Abstract]
Westbrook MT, McDowell L. Coping with second disability: Occupational therapy and the late effects of polio (Unpublished manuscript). Cumberland College of Health Sciences, University of Sydney, P.O. Box 170, Lidcombe, NSW 2141 (1990).

This document comprises an index, foreword, introduction and seventeen other sections or subdocuments. Permission for printing copies is granted only on the basis that ALL sections are printed in their entirety and kept together as a single document.

Document preparation: Chris Salter, Original Think-tank, Cornwall, United Kingdom.
Primary Document Reference: <URL:http://www.ott.zynet.co.uk/polio/lincolnshire/library/australia/leop/sectn_13.html>
Alternate Document Reference: <URL:http://www.zynet.co.uk/ott/polio/lincolnshire/library/australia/leop/sectn_13.html>
Created: 7th July 1997
Last modification: 9th January 2002
Last information content change: 6th June 2000