A model for assessing learning readiness for self-direction of care in individuals with spinal cord injuries: a qualitative study.

Methods are needed for assessing and facilitating learning readiness for self-direction of care of individuals with spinal cord injury (SCI). With declining length of stay, self-direction of care is a major learning task for patients with permanent disability. A retrospective study of secondary data gathered from 30 nursing records was used to develop the Rehabilitation Learning Readiness Model for Spinal Cord Injury. The framework evolved from Orem's (1995) self-care deficit nursing theory and two self-directed adult learning models (Grow, 1991; Pratt, 1988). Using qualitative methods of analysis, five stages of learning readiness behavior (Dependent, Involvement, Engagement, Self-Initiation, and Self-Direction) and five corresponding nursing roles (Authority, Guide, Motivator, Mentor, and Consultant), emerged. Expert nurses corroborated the clinical significance of the model. The model is proposed as a conceptual paradigm for use by nurses to assess learning readiness challenges experienced by patients with SCI and to improve teaching roles and practices.