Improvement in functioning is not only a result of reducing disease-specific problems and symptoms, but also of strengthening general resources. This is part of a salutogenic approach, focusing on the factors that contribute to an individual’s health. 151617 These resources must be assessed and, when appropriate, taken into consideration in rehabilitation management. In most cases, the patient possesses valuable resources that can help him or her overcome challenges associated with SCI. 1819

Such resources may include personal attributes and aspects such as coping strategies and environmental factors.20 The resources that each patient brings into rehabilitation will vary, but each will have certain strengths that can be applied to reduce or alleviate problems he or she faces.21 Many of these resources reflect the complete background of the patient’s life and living situation.22

Both the patient and health professional perspectives during the assessment phase can provide valuable information about patient resources. These resources may then be supported or enhanced by the health care team through specific interventions.

In Michael’s case, aspects of his person, personality and environment helped to inform his own goals and the goals set by his health team as well as positively impacting his progress in achieving these goals. Michael's own intrinsic wishes — to attend university, play sports and engage in social activities — were very clear for him, serving as both a coping strategy and an important motivating factor.

Michael's own hopes and intentions for the future also had a positive impact on his progress...

These, in turn, helped Michael and his health care team define his global goal of “full independence and university entry” which, for him, was both desirable and realistic. Michael’s own hopes and intentions for the future also had a positive impact on the progress in his service-programme goal that focused on “independence in the activities of daily living.”

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Many of Michael's resources contributed to the success in these goals. Above-average skill acquisition, his young age, athleticism (and competitiveness by default) and physical fitness, a large and supportive social network, health insurance and financial support all helped Michael reach most of his intervention targets.

Patient resources matter in the rehabilitation process. They help to inform goal-setting and facilitate a patient’s progress in moving towards functional independence. Thus consideration should be given to the resources available to a patient in the assessment phase of the cycle. Such resources have great potential to positively affect goal-setting, intervention planning and implementation - with the hope that this leads to a patient’s increased independence and subsequent autonomy and self-determination.