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Cole S, Wang Z, Chen Z, Hua C, Chen Y, Evans D. Is Spending Nights Away From Home Associated With Participation and Life Satisfaction After Spinal Cord Injury? A Longitudinal Perspective. Top Spinal Cord Inj Rehabil 2023; 29:73-85. [PMID: 38076499 PMCID: PMC10704217 DOI: 10.46292/sci22-00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Background Community reintegration after SCI rehabilitation consists of readjustment not only to the home setting but also to the social and occupational spheres, which often require people to spend nights away from home. Because community reintegration contributes to life satisfaction after SCI, it is necessary to investigate how travel participation is related to occupational and social participation and life satisfaction. Additionally, better management of the long-term effects of SCI requires better understanding of the changes in participation and life satisfaction over time. Objectives To examine how participation and life satisfaction change over time following SCI, and to investigate whether spending nights away from home is associated with occupational and social participation and life satisfaction over time. Methods This is a longitudinal analysis of data extracted from the publicly available database of Spinal Cord Model Systems from 1996 to 2016. A generalized linear mixed model was developed to examine the changes of outcome variables over time while controlling demographic variables. Results Travel and social participation declined while life satisfaction increased as people lived longer with SCI, controlling for confounders. No significant change was identified in occupational participation. Spending nights away from home was significantly and positively associated with social and occupational participation and life satisfaction over time. Although travel participation of people with SCI declined over time, its association with social participation strengthened as the number of postinjury years increased. Conclusion Travel participation plays an important role in successful community reintegration. Rehabilitation services and travel services should provide training and resources on travel after SCI for improved participation and life satisfaction.
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Affiliation(s)
- Shu Cole
- Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | - Zikun Wang
- Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | - Zhongxue Chen
- Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | - Chenggang Hua
- Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | - Yuying Chen
- Department of Physical Medicine and Rehabilitation, The University of Alabama at Birmingham, Birmingham, Alabama
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Deane KC, Kurapati N, Gill E, Vogel LC, Zebracki K. Rural-urban disparities in healthcare factors and long-term health outcomes in individuals with pediatric-onset spinal cord injury. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1102441. [PMID: 37275403 PMCID: PMC10235502 DOI: 10.3389/fresc.2023.1102441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/31/2023] [Indexed: 06/07/2023]
Abstract
Objective Adults with pediatric-onset spinal cord injury (SCI) require long-term care and demonstrate elevated risk of secondary health conditions and psychosocial challenges. Medical providers are typically found in more populous and wealthy areas, resulting in a relative lack of providers in rural areas, a discrepancy even more pronounced among specialty providers. As a result, those who reside in rural regions potentially have unmet medical needs, representing a significant public health concern. The purpose of this study was to assess differences between rural and urban-residing participants with pediatric-onset SCI in factors affecting healthcare usage (e.g., employment, income, access to private insurance, community integration) and long-term healthcare outcomes (i.e., secondary health conditions and psychosocial functioning). Methods Data were gathered from an ongoing study examining long-term outcomes of adults with pediatric-onset SCI. Participants (N = 490) completed measures of sociodemographics, injury characteristics, and medical outcomes. Participant zip codes were classified as rural or urban using the ProximityOne database based on the ZIP Code Tabulation Areas from the 2020 census. Results Individuals residing in rural regions report lower levels of education, income, employment rates, private health insurance, and community integration (mobility, occupation, and social engagement), as well increased incidence of pressure injuries, urinary tract infections, hospitalizations, bowel incontinence, sleep difficulties, and perceived physical health. No differences in incidence of psychosocial functioning were identified. Conclusion Mitigating identified disparities and obstacles to treatment of SCI due to residing in rural environments would result in important improvements in treatment outcomes and future prevention efforts of secondary health complications, improving the overall health of adults with pediatric-onset SCI.
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Affiliation(s)
- Kyle C. Deane
- Department of Psychology, Shriners Children's Chicago, Chicago, IL, United States
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | - Nikhil Kurapati
- Department of Family Medicine, Soin Medical Center, Beavercreek, OH, United States
| | - Emma Gill
- Department of Psychiatry, Northwell Health, Queens, NY, United States
| | - Lawrence C. Vogel
- Department of Psychology, Shriners Children's Chicago, Chicago, IL, United States
- Department of Pediatrics, Rush Medical College, Chicago, IL, United States
| | - Kathy Zebracki
- Department of Psychology, Shriners Children's Chicago, Chicago, IL, United States
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL,United States
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Coker J, Charlifue S, Botticello A, Tate DG, Philippus A, Strober L, Forchheimer M, Monden KR. A Study Protocol for a Multisite Randomized Controlled Trial of an Intervention to Improve Outcomes After Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2022; 28:44-55. [PMID: 36457362 PMCID: PMC9678223 DOI: 10.46292/sci22-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background The consequences of spinal cord injury (SCI) can place significant demands on an individual's coping mechanisms. Interventions to promote psychological adjustment and coping are often included in inpatient rehabilitation programs; however, following discharge, many individuals with SCI do not receive ongoing counseling or education about psychological adjustment to disability. Effective postacute treatment models are needed to help individuals with SCI build skills that help them adapt to the stresses associated with a chronic physical disability, alleviate the consequences of anxiety and depression, and enhance subjective well-being. Objectives To describe the protocol for a randomized clinical trial (RCT) of a 6-week intervention designed to improve psychosocial outcomes after SCI. Methods To test efficacy and replicability of the intervention, we designed a three-arm, multisite RCT with assessments conducted at six time points. Our primary hypothesis is that participants in the Group arm will report greater improvements in psychosocial outcomes than participants who complete the intervention individually via video (Individual arm) or those who do not receive the intervention (Control arm). We also hypothesize that participants in the Group arm will maintain greater improvements in psychosocial outcomes longer than those in the individual or control arms. Conclusion Results of the RCT will be presented and published to professionals and consumers, and intervention training and materials will be made available upon request.
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Affiliation(s)
| | | | | | | | - Angela Philippus
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | | | | | - Kimberley R. Monden
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
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McIntyre A, Sadowsky C, Behrman A, Martin R, Augutis M, Cassidy C, Betz R, Ertzgaard P, Mulcahey MJ. A Systematic Review of the Scientific Literature for Rehabilitation/Habilitation Among Individuals With Pediatric-Onset Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2022; 28:13-90. [PMID: 35521053 PMCID: PMC9009193 DOI: 10.46292/sci21-00046] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives To conduct a systematic review to examine the scientific literature for rehabilitation/habilitation among individuals with pediatric-onset spinal cord injury (SCI). Methods A literature search of multiple databases (i.e., PubMed/MEDLINE, CINAHL, EMBASE, PsychINFO) was conducted and was filtered to include studies involving humans, published as full-length articles up to December 2020, and in English. Included studies met the following inclusion criteria: (1) ≥50% of the study sample had experienced a traumatic, acquired, nonprogressive spinal cord injury (SCI) or a nontraumatic, acquired, noncongenital SCI; (2) SCI onset occurred at ≤21 years of age; and (3) sample was assessed for a rehabilitation/habilitation-related topic. Studies were assigned a level of evidence using an adapted Sackett scale modified down to five levels. Data extracted from each study included author(s), year of publication, country of origin, study design, subject characteristics, rehabilitation/habilitation topic area, intervention (if applicable), and outcome measures. Results One hundred seventy-six studies were included for review (1974-2020) with the majority originating from the United States (81.3%). Most studies were noninterventional observational studies (n = 100; 56.8%) or noninterventional case report studies (n = 5; 2.8%). Sample sizes ranged from 1 to 3172 with a median of 26 (interquartile range [IQR], 116.5). Rehabilitation/habilitation topics were categorized by the International Classification of Functioning, Disability and Health (ICF); most studies evaluated ICF Body Function. There were 69 unique clinical health outcome measures reported. Conclusion The evidence for rehabilitation/habilitation of pediatric-onset SCI is extremely limited; nearly all studies (98%) are level 4-5 evidence. Future studies across several domains should be conducted with novel approaches to research design to alleviate issues related to sample sizes and heterogeneity.
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Affiliation(s)
- Amanda McIntyre
- Parkwood Institute Research, Parkwood Institute, London, Canada
| | - Cristina Sadowsky
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, John Hopkins University, Baltimore, Maryland
,International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, Maryland
| | - Andrea Behrman
- Department of Neurological Surgery, Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
,Kosair Charities Center for Pediatric Neurorecovery, Louisville, Kentucky
| | - Rebecca Martin
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, John Hopkins University, Baltimore, Maryland
,International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, Maryland
| | - Marika Augutis
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institute, Solna, Sweden
| | - Caitlin Cassidy
- St. Joseph’s Health Care London, Parkwood Institute, London, Canada
| | - Randal Betz
- Institute for Spine and Scoliosis, Lawrenceville, New Jersey
,Department of Orthopedics, Mount Sinai Hospital, New York, New York
| | - Per Ertzgaard
- Department of Rehabilitation Medicine, Linköping University, Linköping, Sweden
| | - MJ Mulcahey
- Department of Occupational Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Woodbury, New Jersey
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Zhao H, Zhang Y, Wang W, Cole S. Contribution of travel participation to social integration and life satisfaction after spinal cord injury. Disabil Health J 2021; 14:101167. [PMID: 34247966 DOI: 10.1016/j.dhjo.2021.101167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Research has found that participation in travel declines for people after spinal cord injury (SCI) because the traumatic injury usually results in impaired physical mobility and sensation, and barriers in the environment make travel more challenging. While travel participation can offer numerous physical, psychological, and emotional benefits, empirical evidence on positive outcomes of travel for people after SCI is scarce in the literature. OBJECTIVE To empirically examine the effects of travel participation on social integration and life satisfaction for people with SCI, along with other personal characteristics including income, self-perceived health status, levels of physical independence, occupational activities, and travel barriers. METHODS Cross sectional data are collected from 250 patients enrolled in a SCI Model System. Hierarchical regression analyses, followed by mediation analyses, are conducted to assess the effects of travel participation on social integration and life satisfaction. RESULTS Travel participation along with occupational activities is shown to significantly impact social integration, with participation in occupational activities partially mediating the relation from travel participation to social integration. The significant effect of travel participation on life satisfaction is fully mediated by social integration. Income and self-perceived health status both significantly contribute to social integration and life satisfaction. CONCLUSIONS Travel participation should be considered as an independent domain that directly impacts the social integration of people with SCI, which in turn enhances their life satisfaction. Systematic interventions with standard protocols for travel-related skill training and assessments procedures are needed for people after SCI.
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Affiliation(s)
- HaoAi Zhao
- School of Public Health, Indiana University, Bloomington, IN, 47405, USA
| | - Ye Zhang
- College of Business, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | - Weixuan Wang
- School of Public Health, Indiana University, Bloomington, IN, 47405, USA
| | - Shu Cole
- School of Public Health, Indiana University, Bloomington, IN, 47405, USA.
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Greenham M, Botchway E, Knight S, Bonyhady B, Tavender E, Scheinberg A, Anderson V, Muscara F. Predictors of participation and quality of life following major traumatic injuries in childhood: a systematic review. Disabil Rehabil 2020; 44:2591-2607. [PMID: 33232616 DOI: 10.1080/09638288.2020.1849425] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Review the literature on predictors of participation and quality of life in children and young people who sustained a traumatic brain injury (TBI), spinal cord injury (SCI), and/or multi-trauma in a motor vehicle or other accident or trauma. DESIGN This systematic review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The protocol was registered on PROSPERO (registration number CRD42020131698). Electronic databases were searched for studies published between January 2000 and August 2020. Prospective and retrospective cohort studies were considered and risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool. RESULTS The search yielded 5771 articles of which 30 studies met the inclusion criteria. Nineteen studies included patients with TBI and 11 with SCI. No studies of patients with multi-trauma met criteria. Evidence was found for associations with various factors (e.g., injury severity, level of education, mental health problems), although these findings are limited due to the quality of the studies (5 studies moderate and 25 high risk of bias). CONCLUSION Research on predictors of participation and quality of life following major traumatic injuries in childhood is lacking. More methodologically sound prospective, longitudinal studies are needed across different injury groups to further elucidate predictors of outcome.IMPLICATIONS FOR REHABILITATIONWhile long-term participation and quality of life is influenced by injury characteristics (i.e., injury severity), a number of potential modifiable factors can be targeted to improve outcomes following traumatic injuries in childhood.Young people should be provided with support to stay in school and pursue further education.Early intervention and prevention of mental health problems may improve long-term outcomes.Better management of ongoing medical problems and greater support for functional independence may improve participation.
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Affiliation(s)
- Mardee Greenham
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia
| | - Edith Botchway
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Sarah Knight
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Bruce Bonyhady
- Melbourne Disability Institute, Parkville, VIC, Australia
| | - Emma Tavender
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Adam Scheinberg
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,Department of Paediatrics, Monash University, Clayton, VIC, Australia
| | - Vicki Anderson
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Frank Muscara
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
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Deane KC, Chlan KM, Vogel LC, Zebracki K. Use of Appraisals of DisAbility Primary and Secondary Scale-Short Form (ADAPSS-sf) in individuals with pediatric-onset spinal cord injury. Spinal Cord 2019; 58:290-297. [PMID: 31700146 DOI: 10.1038/s41393-019-0375-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/18/2019] [Accepted: 10/21/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To investigate the psychometric properties and utility of the Appraisals of DisAbility Primary and Secondary Scale-Short Form (ADAPSS-sf), a measure of cognitive appraisals, among adults with pediatric-onset SCI. To examine the relation of the ADAPSS-sf to demographics, injury characteristics, and secondary health and psychosocial outcomes. STUDY DESIGN A structured telephone interview was conducted to obtain measures of ADAPSS-sf, pain, sleep, secondary health complications, and psychosocial functioning. SETTING Community in United States and Canada. PARTICIPANTS Individuals who sustained an SCI at 18 years of age or younger (N = 115) were initially interviewed at age 19 years or older and followed annually. RESULTS Study findings support sound psychometrics of the ADAPSS-sf. The measure demonstrated strong test-retest reliability and internal consistency. There were no differences on ADAPSS-sf scores in relation to current age, gender, race, etiology, injury severity, or injury level. Individuals who sustained SCI at an older age were more likely to endorse negative appraisals of their injury. Results suggest that higher negative SCI-related appraisals were related to higher mental health difficulties. Negative SCI-related appraisals were associated with sleep difficulties, pressure injuries, pain, distress from pain, and poor overall subjective ratings of health. CONCLUSIONS This study confirms the use of the ADAPSS-sf in a pediatric-onset SCI adult population by demonstrating its good internal validity, test-retest reliability, convergent and face validity, and brevity. Moreover, the current study revealed that such appraisals are associated with both psychosocial and secondary health outcomes, further supporting the ADAPSS-sf as a valuable tool for clinicians and researchers.
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Affiliation(s)
- Kyle C Deane
- Shriners Hospitals for Children, Chicago, IL, USA
| | | | - Lawrence C Vogel
- Shriners Hospitals for Children, Chicago, IL, USA.,Rush Medical College, Chicago, IL, USA
| | - Kathy Zebracki
- Shriners Hospitals for Children, Chicago, IL, USA. .,Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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Andrade VSD, Faleiros F, Balestrero LM, Romeiro V, Santos CBD. Social participation and personal autonomy of individuals with spinal cord injury. Rev Bras Enferm 2019; 72:241-247. [PMID: 30916291 DOI: 10.1590/0034-7167-2018-0020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 07/06/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate, based on scientific literature, evidence on social participation and personal autonomy of individuals with spinal cord injury. METHOD Integrative review of the literature including studies published between January 2006 and September 2016, obtained in the databases PubMed, CINAHL and LILACS. The guiding question was: "What evidence is available in the scientific literature about the social participation and/or personal autonomy of individuals with spinal cord injury?" The data were processed by IRaMuTeQ and analyzed by the Hierarchical Descending Classification, according to the expertise of the researchers. RESULTS Six selected studies discussed social participation, one discussed personal autonomy and two discussed both. 107 text segments were retained and gave rise to five classes. CONCLUSION There is little specificity regarding the characteristics of social participation and personal autonomy of individuals with spinal cord injury. The existence of barriers forces them to adopt strategies to participate autonomously.
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Affiliation(s)
- Valéria Sousa de Andrade
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, São Paulo, Brazil
| | - Fabiana Faleiros
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, São Paulo, Brazil
| | - Lais Magro Balestrero
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, São Paulo, Brazil
| | - Viviane Romeiro
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, São Paulo, Brazil
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LaVela SL, Etingen B, Miskevics S, Heinemann AW. What determines low satisfaction with life in individuals with spinal cord injury? J Spinal Cord Med 2019; 42:236-244. [PMID: 29733775 PMCID: PMC6419684 DOI: 10.1080/10790268.2018.1466480] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE To examine variables associated with satisfaction with life (SWL) in individuals with a spinal cord injury (SCI). DESIGN Cross-sectional, national survey to assess SWL, demographic and injury characteristics, health care utilization, chronic conditions (obesity, diabetes, heart problems, lung problems, hypertension, high cholesterol), symptoms (poor sleep, pain, depression), social support, grief/loss, and independence. SETTING/PARTICIPANTS Community-dwelling Veterans with SCI. Outcome Measures/Analyses: Bivariate analyses were conducted to assess differences in demographics, injury characteristics, chronic conditions, symptoms, social support, grief/loss, and independence in individuals who reported low SWL (≤20) vs. average/high SWL (21-35). Multivariate logistic regression assessed factors independently associated with low SWL. RESULTS 896 Veterans with SCI (62%) responded. Average age was 62 years, the majority were male (94%), Caucasian (77%), and had paraplegia (61%). Odds of low SWL were 2.4 times greater for individuals experiencing pain (OR = 2.43, CI95: 1.47-4.02, P = 0.0005). Odds of low SWL were increased for individuals reporting greater grief/loss due to their SCI (OR = 1.14, CI95: 1.10-1.18, P < 0.0001). Lesser odds of low SWL were seen for individuals reporting greater emotional social support (OR = 0.97, CI95: 0.96-0.99, P < 0.0001) and independence (OR = 0.94, CI95: 0.90-0.97, P < 0.0001). CONCLUSIONS Pain and feelings of grief/loss due to injury were associated with low SWL. Self-perceived independence and good social support were associated with better SWL. Along with addressing pain and facilitating independence and social support, these findings suggest that interventions to improve SWL should focus on helping individuals deal with grief/loss due to injury.
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Affiliation(s)
- Sherri L. LaVela
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital, Hines, Illinois, USA,Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA,Correspondence to: Sherri L. LaVela, PhD, MPH, MBA, Department of Veterans Affairs, Edward Hines, Jr. VA Hospital (151-H, Building 1, Office D-312), 5th Avenue & Roosevelt Road, Hines, IL60141, USA; Ph: (708) 202-5895, (708) 202-2499.
| | - Bella Etingen
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital, Hines, Illinois, USA
| | - Scott Miskevics
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital, Hines, Illinois, USA
| | - Allen W. Heinemann
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA,Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Illinois, USA
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Duzgun Celik H, Cagliyan Turk A, Sahin F, Yilmaz F, Kuran B. Comparison of disability and quality of life between patients with pediatric and adult onset paraplegia. J Spinal Cord Med 2018; 41:645-652. [PMID: 28102106 PMCID: PMC6217506 DOI: 10.1080/10790268.2016.1275447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To investigate the factors that affect disability and quality of life in patients with spinal cord injuries (SCIs) and to compare the degree of disability and quality of life in patients with SCI according to over and under 18 years of age when their injury occurred. DESIGN Cohort study. SETTING Two academic hospitals in Istanbul, Turkey. PARTICIPANTS Forty patients with SCI were included in this study. Group 1 included 20 patients with SCI who were younger than 18 years of age when their injury occurred, Group 2 included 20 patients who were older than 18 years of age when their injury occurred. OUTCOME MEASURES Patients' demographics, duration of SCI and degree of disability were assessed using the Craig Handicap Assessment and Reporting Technique (CHART). Quality of life was assessed using the World Health Organization Quality of Life Scale Short Form (WHOQOL-Bref). Depression was assessed using the Beck Depression Inventory (BDI). RESULTS Although there was no significant difference between the BDI scores and CHART scores of the two groups, environment domain scores in the WHOQOL-Bref were significantly higher in Group 2 than in Group 1 (P<0.05). No significant correlation was found between age of SCI onset, disease duration, ASIA scores, depression scores, total CHART scores for all patients. CONCLUSION Adaptation to environment was significantly better in those who suffered SCI during adulthood than in pediatric patients with SCI. Disability level was not associated with age of disease onset, disease duration, neurological status, depression level.
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Affiliation(s)
- Hanife Duzgun Celik
- Private Konak Medical Center, Department of Physical Medicine and Rehabilitation, Sakarya, Turkey
| | - Ayla Cagliyan Turk
- Hitit University Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Corum, Turkey,Correspondence to: Ayla Cagliyan Turk, MD, Department of Physical Medicine and Rehabilitation, Hitit University, Training and Research Hospital, 19200, Corum, Turkey.
| | - Fusun Sahin
- Pamukkale University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Denizli, Turkey
| | - Figen Yilmaz
- Hamidiye Sisli Etfal Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
| | - Banu Kuran
- Hamidiye Sisli Etfal Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
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12
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Pretz CR, Kozlowski AJ, Chen Y, Charlifue S, Heinemann AW. Trajectories of Life Satisfaction After Spinal Cord Injury. Arch Phys Med Rehabil 2016; 97:1706-1713.e1. [DOI: 10.1016/j.apmr.2016.04.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 04/29/2016] [Indexed: 10/21/2022]
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13
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Chen Y, He Y, DeVivo MJ. Changing Demographics and Injury Profile of New Traumatic Spinal Cord Injuries in the United States, 1972-2014. Arch Phys Med Rehabil 2016; 97:1610-9. [PMID: 27109331 DOI: 10.1016/j.apmr.2016.03.017] [Citation(s) in RCA: 150] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 03/04/2016] [Accepted: 03/05/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To document trends in the demographic and injury profile of new spinal cord injury (SCI) over time. DESIGN Cross-sectional analysis of longitudinal data by injury years (1972-1979, 1980-1989, 1990-1999, 2000-2009, 2010-2014). SETTING Twenty-eight Spinal Cord Injury Model Systems centers throughout the United States. PARTICIPANTS Persons with traumatic SCI (N=30,881) enrolled in the National Spinal Cord Injury Database. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Age, sex, race, education level, employment, marital status, etiology, and severity of injury. RESULTS Age at injury has increased from 28.7 years in the 1970s to 42.2 years during 2010 to 2014. This aging phenomenon was noted for both sexes, all races, and all etiologies except acts of violence. The percentage of racial minorities expanded continuously over the last 5 decades. Virtually among all age groups, the average education levels and percentage of single/never married status have increased, which is similar to the trends noted in the general population. Although vehicular crashes continue to be the leading cause of SCI overall, the percentage has declined from 47.0% in the 1970s to 38.1% during 2010 to 2014. Injuries caused by falls have increased over time, particularly among those aged ≥46 years. Progressive increases in the percentages of high cervical and motor incomplete injuries were noted for various age, sex, race, and etiology groups. CONCLUSIONS Study findings call for geriatrics expertise and intercultural competency of the clinical team in the acute and rehabilitation care for SCI. This study also highlights the need for a multidimensional risk assessment and multifactorial intervention, especially to reduce falls and SCI in older adults.
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Affiliation(s)
- Yuying Chen
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL.
| | - Yin He
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL
| | - Michael J DeVivo
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL
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January AM, Zebracki K, Chlan KM, Vogel LC. Mental health and risk of secondary medical complications in adults with pediatric-onset spinal cord injury. Top Spinal Cord Inj Rehabil 2014; 20:1-12. [PMID: 24574817 DOI: 10.1310/sci2001-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate mental health problems in adults with pediatric-onset spinal cord injury (SCI) and explore how these problems relate to the risk of negative outcomes over time. METHOD The study included 466 adults who sustained an SCI prior to age 19 years and had been injured for at least 1 year. Participants were interviewed on an approximately annual basis using a study-specific questionnaire and standardized measures of depression, anxiety, substance use, and community involvement. Generalized estimating equations were used to assess the risk of negative outcomes across time as a function of depression, anxiety, and substance misuse. RESULTS Of the participants who reported on each domain of mental health, 26% reported misuse of alcohol or drugs (122/466), 21% reported problems with depression (78/360), and 29% reported problems with anxiety (49/168). Depression was associated with increased odds of pressure ulcers, urinary tract infections, hospitalizations, pain, and smoking and lower levels of economic independence and mobility. Anxiety was associated with increased odds of hospitalization, pain, and smoking. Substance misuse predicted an increased risk of pressure ulcers, pain, and smoking and decreased odds of occupational involvement. When examining the effect of mental health with time, results showed that depression accelerated the risk of urinary tract infections, respiratory complications, and hospitalizations and anxiety and depression accelerated risk for lower occupational independence. CONCLUSIONS The added burden that mental health difficulties pose for medical and psychosocial outcomes highlight the importance of monitoring and treating mental health symptoms in pediatric-onset SCI.
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Affiliation(s)
- Alicia M January
- Shriners Hospitals for Children-Chicago , Chicago, Illinois ; Marquette University , Milwaukee, Wisconsin
| | - Kathy Zebracki
- Shriners Hospitals for Children-Chicago , Chicago, Illinois ; Loyola University Chicago , Chicago, Illinois
| | | | - Lawrence C Vogel
- Shriners Hospitals for Children-Chicago , Chicago, Illinois ; Rush Medical College , Chicago, Illinois
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Dating and Relationship Psychoeducational Group for Veterans with Spinal Cord Injury/Dysfunction: A Historical Account of an Initial Clinical Course. SEXUALITY AND DISABILITY 2013. [DOI: 10.1007/s11195-013-9330-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kozlowski AJ, Pretz CR, Dams-O'Connor K, Kreider S, Whiteneck G. An introduction to applying individual growth curve models to evaluate change in rehabilitation: a National Institute on Disability and Rehabilitation Research Traumatic Brain Injury Model Systems report. Arch Phys Med Rehabil 2012; 94:589-96. [PMID: 22902887 DOI: 10.1016/j.apmr.2012.08.199] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 07/17/2012] [Accepted: 08/07/2012] [Indexed: 11/28/2022]
Abstract
The abundance of time-dependent information contained in the Spinal Cord Injury and the Traumatic Brain Injury Model Systems National Databases, and the increased prevalence of repeated-measures designs in clinical trials highlight the need for more powerful longitudinal analytic methodologies in rehabilitation research. This article describes the particularly versatile analytic technique of individual growth curve (IGC) analysis. A defining characteristic of IGC analysis is that change in outcome such as functional recovery can be described at both the patient and group levels, such that it is possible to contrast 1 patient with other patients, subgroups of patients, or a group as a whole. Other appealing characteristics of IGC analysis include its flexibility in describing how outcomes progress over time (whether in linear, curvilinear, cyclical, or other fashion), its ability to accommodate covariates at multiple levels of analyses to better describe change, and its ability to accommodate cases with partially missing outcome data. These features make IGC analysis an ideal tool for investigating longitudinal outcome data and to better equip researchers and clinicians to explore a multitude of hypotheses. The goal of this special communication is to familiarize the rehabilitation community with IGC analysis and encourage the use of this sophisticated research tool to better understand temporal change in outcomes.
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Affiliation(s)
- Allan J Kozlowski
- Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, IL 60611, USA.
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An evidence-based review on the influence of aging with a spinal cord injury on subjective quality of life. Spinal Cord 2012; 50:570-8. [PMID: 22450883 DOI: 10.1038/sc.2012.19] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Systematic review. OBJECTIVES To identify changes in subjective quality of life (QoL) as one ages with a spinal cord injury (SCI). SETTING Vancouver, Canada. METHODS Electronic databases were searched for studies reporting on age-related QoL changes over time. Data from relevant studies were transcribed into data extraction forms and analyzed by years post injury (YPI) and chronologic age. Each study was assigned a level of evidence based on a modified Sackett scale. RESULTS In all, 21 studies, each with a low level of evidence, were included for review. The results indicated that regardless of chronologic age, individuals with relatively new SCI have the potential to improve their QoL. Among individuals with advanced YPI, overall QoL is consistently reported as good or excellent over time, however, with variations in different QoL domains. CONCLUSION The QoL of individuals aging with a SCI has the potential to improve, and remain high and stable over time. As the identified studies provide low levels of evidence, more longitudinal research with greater methodological and measurement rigor is needed to corroborate the findings and conclusions of this review.
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Boonstra AM, Reneman MF, Stewart RE, Post MW, Schiphorst Preuper HR. Life satisfaction in patients with chronic musculoskeletal pain and its predictors. Qual Life Res 2012; 22:93-101. [PMID: 22350589 DOI: 10.1007/s11136-012-0132-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2012] [Indexed: 01/22/2023]
Abstract
PURPOSE To determine the life satisfaction of patients with chronic non-malignant musculoskeletal pain (CMP) compared to the general population (GP) and to identify predictors of life satisfaction. METHODS Subjects were patients with CMP (n = 1,082) admitted to multidisciplinary rehabilitation and a general population sample (n = 506). Lisat-9 measures satisfaction with life as a whole and eight life domains. Physical, emotional and social functioning and pain intensity were assessed using the SF-36. Ordinal logistic regression was used to analyse differences between patients with CMP and the GP, and predictors of life satisfaction in patients with CMP. RESULTS Compared to the general population, patients with CMP reported lower satisfaction with 'life as a whole', and with six life domains: self-care, leisure, vocational and financial situation, sex life and contacts with friends. In the CMP group, pain was associated with satisfaction with self-care, vocational situation, partnership, family life and contacts with friends. Marital status, age and mental health were associated with most satisfaction scores. CONCLUSIONS Compared to the general population, patients with CMP reported lower satisfaction with 'life as a whole' and most life domains. The most consistent predictors of life satisfaction were marital status, mental health, vitality and pain.
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Affiliation(s)
- Anne M Boonstra
- 'Revalidatie Friesland', Center for Rehabilitation, PO Box 2, 9244 ZN, Beetsterzwaag, The Netherlands.
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Affiliation(s)
- Harish Hosalkar
- Rady Children's Hospital, UCSD San Diego, San Diego, CA 92123, USA.
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