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Bychkovska O, Pattanakuhar S, Arora M, Postma K, Strøm V, Joseph C, Tederko P, Gemperli A. Gender differences in patient experience among persons with spinal cord injury: A comparison across 22 countries. Disabil Health J 2024:101642. [PMID: 38796406 DOI: 10.1016/j.dhjo.2024.101642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 05/02/2024] [Accepted: 05/15/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND Due to the majority of males within the population of persons with spinal cord injuries (SCI), a male-oriented perception of persons with SCI might affect care provision in the way of prioritizing male needs. OBJECTIVE The objective of this cross-sectional study is to describe the patient experience of persons with SCI by gender. METHODS This study was based on the International Spinal Cord Injury Survey with 12,588 participants from 22 countries. An interval-based patient experience score was attained by partial credit model. Regression analysis was used in exploring the association between patient experience and gender. RESULTS Participants reported very good and good patient experience. Respectful treatment was reported by 78 % of participants; clear explanations by 75 %; involvement in decision-making by 71 %; satisfaction with services by 62 %. The average patient experience score was equal among males and females (average: 64, range: 0-100), with the highest score in participants from the USA (78) and the lowest - in Morocco (44). Patient experience score was not associated with gender. Females had lower odds of reporting better decision-making involvement, yet higher odds of better satisfaction. Older participants, with higher household income and better self-rated health, had lower odds of being satisfied. CONCLUSION The majority of persons with SCI rated their experience as good or very good. Females were more likely to report higher satisfaction with services and lower involvement in decision-making. For other patient experience categories and the overall patient experience score, no association with gender was found.
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Affiliation(s)
- Olena Bychkovska
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
| | - Sintip Pattanakuhar
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland; Department of Rehabilitation Medicine, Chiang Mai University, Chiang Mai, Thailand.
| | - Mohit Arora
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW, Australia; The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Karin Postma
- Rijndam Rehabilitation Center, Rotterdam, the Netherlands; Erasmus MC, University Medical Center Rotterdam, the Netherlands.
| | - Vegard Strøm
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.
| | - Conran Joseph
- Division of Physiotherapy, Stellenbosch University, Stellenbosch, South Africa.
| | - Piotr Tederko
- Rehabilitation Clinic, Postgraduate Medical Education Centre, Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Otwock, Poland.
| | - Armin Gemperli
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Center of Primary and Community Care, University of Lucerne, Lucerne, Switzerland.
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Pattanakuhar S, Kammuang-Lue P, Komaratat N, Chotiyarnwong C, Kovindha A, Gemperli A. Do individuals from an SCI-specialized rehabilitation facility have fewer secondary health conditions than those from a non-SCI-specialized rehabilitation facility? Analysis of the InSCI database from a middle-income country. J Spinal Cord Med 2024:1-10. [PMID: 38251980 DOI: 10.1080/10790268.2023.2289690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVES To determine whether attending an SCI-specialized rehabilitation facility (SSRF) is independently associated with having fewer secondary health conditions (SHCs) in middle-income country contexts. STUDY DESIGN Cross-sectional observational study. SETTING Four rehabilitation facilities in Thailand (one SSRF and three non-SSRF). METHODS Data from a Thai arm of the International Spinal Cord Injury Community Survey (InSCI) were analyzed. SHCs occurring within the last three months were evaluated using the Spinal Cord Injury Secondary Condition Scale. A causal diagram was applied to create a multivariable regression model to determine the independent effect of attending in the SSRF on having SHC as a single condition and as a sum score. RESULTS Three hundred and thirteen individuals with chronic SCI were included in this study. Two hundred and nineteen participants (70%) were recruited from the SSRF. Being recruited from the SSRF was an independent negative correlating factor of the SHC sum score with an unstandardized coefficient of -1.12 (95% CI: -2.00-0.24). Being recruited from the SSRF was also an independent negative correlating factor of having bladder dysfunction, sexual dysfunction, and pressure ulcer SHC with an odds ratio of 0.32 (95% CI: 0.16-0.59), 0.43 (95% CI: 0.22-0.84), and 0.46 (95% CI: 0.24-0.89), respectively. CONCLUSION Attending an SSRF was significantly associated with having fewer SHCs, specifically, bladder dysfunctions, sexual dysfunctions, and pressure ulcers. These results suggest the importance of having SSRF in middle-income countries for delivering effective care to people with SCI and standardized education to health care providers.
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Affiliation(s)
- Sintip Pattanakuhar
- Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Health Services and Clinical Care Unit, Swiss Paraplegic Research, Nottwil, Switzerland
| | - Pratchayapon Kammuang-Lue
- Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Napasakorn Komaratat
- Department of Medical Services, Ministry of Health, Sirindhorn National Medical Rehabilitation Institute, Nonthaburi, Thailand
| | - Chayaporn Chotiyarnwong
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Apichana Kovindha
- Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Armin Gemperli
- Health Services and Clinical Care Unit, Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center of Primary and Community Care, University of Lucerne, Lucerne, Switzerland
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Bychkovska O, Strøm V, Tederko P, Engkasan JP, Juocevičius A, Battistella LR, Arora M, Egen C, Gemperli A. Health System's Role in Facilitating Health Service Access among Persons with Spinal Cord Injury across 22 Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6056. [PMID: 37297660 PMCID: PMC10252714 DOI: 10.3390/ijerph20116056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/23/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
(1) Background: Despite efforts to improve access to health services, between- and within-country access inequalities remain, especially for individuals with complex disabling conditions like spinal cord injury (SCI). Persons with SCI require regular multidisciplinary follow-up care yet experience more access barriers than the general population. This study examines health system characteristics associated with access among persons with SCI across 22 countries. (2) Methods: Study data are from the International Spinal Cord Injury Survey with 12,588 participants with SCI across 22 countries. Cluster analysis was used to identify service access clusters based on reported access restrictions. The association between service access and health system characteristics (health workforce, infrastructure density, health expenditure) was determined by means of classification and regression trees. (3) Results: Unmet needs were reported by 17% of participants: lowest (10%) in Japan, Spain, and Switzerland (cluster 1) and highest (62%) in Morocco (cluster 8). The country of residence was the most important factor in facilitating access. Those reporting access restrictions were more likely to live in Morocco, to be in the lowest income decile, with multiple comorbidities (Secondary Conditions Scale (SCI-SCS) score > 29) and low functioning status (Spinal Cord Independence Measure score < 53). Those less likely to report access restriction tended to reside in all other countries except Brazil, China, Malaysia, Morocco, Poland, South Africa, and South Korea and have fewer comorbidities (SCI-SCS < 23). (4) Conclusions: The country of residence was the most important factor in facilitating health service access. Following the country of residence, higher income and better health were the most important facilitators of service access. Health service availability and affordability were reported as the most frequent health access barriers.
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Affiliation(s)
- Olena Bychkovska
- Swiss Paraplegic Research, Guido A. Zäch Institute, 6207 Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, 6002 Lucerne, Switzerland
| | - Vegard Strøm
- Department of Research, Sunnaas Rehabilitation Hospital, 1453 Nesoddtangen, Norway
| | - Piotr Tederko
- Department of Rehabilitation, Medical University of Warsaw, 02-091 Warsaw, Poland
| | | | | | | | - Mohit Arora
- John Walsh Centre for Rehabilitation Research, The Kolling Institute, St Leonards 2065, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
| | - Christoph Egen
- Department of Rehabilitation Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Armin Gemperli
- Swiss Paraplegic Research, Guido A. Zäch Institute, 6207 Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, 6002 Lucerne, Switzerland
- Center for Primary and Community Care, University of Lucerne, 6002 Lucerne, Switzerland
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Bychkovska O, Tederko P, Strøm V, Juocevicius A, Gemperli A. Does stronger primary care improve access to health services for persons with spinal cord injury? Evidence from eleven European countries. J Spinal Cord Med 2023:1-11. [PMID: 36972217 DOI: 10.1080/10790268.2023.2188390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/18/2023] Open
Abstract
OBJECTIVE To determine the association between the strength of primary care and perceived access to follow-up care services among persons with chronic spinal cord injury (SCI). DESIGN Data analysis of the International Spinal Cord Injury (InSCI) cross-sectional, community-based questionnaire survey conducted in 2017-2019. The association between the strength of primary care (Kringos et al., 2003) and access to health services was established using univariable and multivariable logistic regression analysis, adjusted for socio-demographic and health status characteristics. SETTING Community in eleven European countries: France, Germany, Greece, Italy, Lithuania, the Netherlands, Norway, Poland, Romania, Spain and Switzerland. PARTICIPANTS 6658 adults with chronic SCI. INTERVENTION None. OUTCOME MEASURES Share of persons with SCI that reported unmet healthcare needs as a measure of access. RESULTS Twelve percent of the participants reported unmet healthcare needs: the highest in Poland (25%) and lowest in Switzerland and Spain (7%). The most prevalent access restriction was service unavailability (7%). Stronger primary care was associated with lower odds of reporting unmet healthcare needs, service unavailability, unaffordability and unacceptability. Females, persons of younger age and lower health status, had higher odds of reporting unmet needs. CONCLUSIONS In all investigated countries, persons with chronic SCI face access barriers, especially with service availability. Stronger primary care for the general population was also associated with better health service access for persons with SCI, which argues for further primary care strengthening.
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Affiliation(s)
- Olena Bychkovska
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Piotr Tederko
- Department of Rehabilitation, Medical University of Warsaw, Warsaw, Poland
| | - Vegard Strøm
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | | | - Armin Gemperli
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center of Primary and Community Care, University of Lucerne, Lucerne, Switzerland
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Pattanakuhar S, Ahmedy F, Setiono S, Engkasan JP, Strøm V, Kovindha A. Impacts of Bladder Managements and Urinary Complications on Quality of Life: Cross-sectional Perspectives of Persons With Spinal Cord Injury Living in Malaysia, Indonesia, and Thailand. Am J Phys Med Rehabil 2023; 102:214-221. [PMID: 35700141 DOI: 10.1097/phm.0000000000002066] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The impact of bladder care and urinary complications on quality of life in persons with spinal cord injury who have neurogenic lower urinary tract dysfunction has not been elucidated, especially in those living in low-resource countries. METHODS This multinational cross-sectional survey was conducted in rehabilitation facilities in Malaysia, Indonesia, and Thailand. Community-dwelling adults with traumatic or nontraumatic spinal cord injury participating in the International Spinal Cord Injury Community Survey from 2017 to 2018 were enrolled. Data regarding bladder management/care, presence of bladder dysfunction, urinary tract infection, and quality of life score were extracted from the International Spinal Cord Injury Community Survey questionnaire. The impact of bladder care and urinary complications on quality of life was determined using univariable and multivariable regression analysis. RESULTS Questionnaires from 770 adults were recruited for analysis. After adjusting for all demographic and spinal cord injury-related data, secondary conditions, as well as activity and participation factors, urinary tract infection was an independent negative predictive factor of quality of life score ( P = 0.007, unstandardized coefficients = -4.563, multivariable linear regression analysis, enter method). CONCLUSIONS Among bladder care and urinary complication factors, urinary tract infection is the only factor negatively impacting quality of life. These results address the importance of proper bladder management and urinary tract infection prevention in persons with spinal cord injury to improve their quality of life.
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Affiliation(s)
- Sintip Pattanakuhar
- From the Department of Rehabilitation Medicine, Chiang Mai University, Chiang Mai, Thailand (SP, AK); Rehabilitation Medicine Unit, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia (FA); Department of Physical Medicine and Rehabilitation, University of Indonesia, Jakarta, Indonesia (SS); Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia (JPE); and Sunnaas Rehabilitation Hospital, Nesodden, Norway (VS)
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Hajjioui A, Fourtassi M, Tachfouti N, Laaroussi Z, Boulman S, Boujraf S, Fekete C. People with spinal cord injury in Morocco: results from the very first systematic data collection. Disabil Rehabil 2022; 44:8054-8065. [PMID: 34793274 DOI: 10.1080/09638288.2021.2003451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE To report on the methodology, participant characteristics, and associations of four most frequent environmental barriers with health conditions, general health and quality of life (QoL) in the very first systematic data collection in people with spinal cord injury (SCI) in Morocco. MATERIALS AND METHODS We obtained data from 385 participants of the cross-sectional Moroccan SCI community survey (MorSCI). We used descriptive statistics to describe participant characteristics and regression models to investigate associations of the five most frequently reported environmental barriers with health conditions (secondary conditions, pain intensity, mental health), general health and QoL. RESULTS The most frequently reported environmental barriers were "lack of public services" (92.5%), "financial strain" (93.0%), restricted access to "public transportation" (85.5%), "public places" (83.9%) and "private places" (84.7%). People who perceived those factors as barriers also reported more secondary conditions, higher pain intensity, lower mental health, lower general health, and lower QoL. CONCLUSIONS This study on Moroccans with SCI found that environmental barriers detract from health and QoL. Given that environmental barriers are potentially modifiable, policy interventions present powerful tools to reduce barriers and potentially increase health and QoL in this vulnerable population.IMPLICATIONS FOR REHABILITATIONPublic policy on the construction of transportation and public places is important to make the physical environment accessible for wheelchair users to support their participation in society.The provision of adequate rehabilitation services and specialized post-acute rehabilitation units for people with SCI in Morocco is urgently needed, not only to contribute to health and QoL but also to contribute to their abilities to overcome environmental barriers.Adequate state services including universal health coverage and access to rehabilitation services and assistive devices or adapted tools must be a priority on the policy level to facilitate activities of daily living and reduce barriers.Improving the skills and knowledge of health professionals in SCI rehabilitation and guide policy makers to promote patient education and self-advocacy in the meantime, may help reduce the gap between needs of people with SCI and available support.
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Affiliation(s)
- Abderrazak Hajjioui
- Clinical Neuroscience Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco.,Department of Physical and Rehabilitation Medicine, Hassan II University Hospital, Fez, Morocco
| | - Maryam Fourtassi
- Laboratory of Epidemiology, Clinical Research and Public Health, University Mohammed Premier, Oujda, Morocco
| | - Nabil Tachfouti
- Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - Zainab Laaroussi
- Clinical Neuroscience Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - Salma Boulman
- Clinical Neuroscience Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - Said Boujraf
- Clinical Neuroscience Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - Christine Fekete
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Australian arm of the International Spinal Cord Injury (Aus-InSCI) Community Survey: 2. Understanding the lived experience in people with spinal cord injury. Spinal Cord 2022; 60:1069-1079. [PMID: 35705701 DOI: 10.1038/s41393-022-00817-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Cross-sectional survey. OBJECTIVES To identify common problems across key domains of functioning, health and wellbeing, as well as evaluate self-reported quality of life (QoL) by people with SCI, examining differences by age, gender, injury characteristics and level of mobility. SETTING Data from four state-wide SCI clinical services, one government insurance agency and three not-for-profit consumer organisations. METHODS Participants were 18 years or over with SCI and at least 12 months post-injury, recruited between Mar'18 and Jan'19. The Aus-InSCI questionnaire comprised 193 questions, including socio-demographics, SCI characteristics, body functions and structures, activities and participation, environmental and personal factors, and appraisal of health and well-being. General linear model was used to examine differences in functioning and QoL. RESULTS Participants (mean age 57 years, range 19-94 years) with tetraplegia and/or complete injuries had more health problems, activity/participation problems and environmental barriers. However, self-rated overall QoL did not differ for injury level or completeness. Participants with more recent injuries exhibited lower independence levels, more mental health problems and poorer satisfaction with self and their living conditions. Major activity/participation problems related to intimate relationships and accessing public transportation. Less than half of the working age population were engaged in paid work. The top two environmental barriers frequently related to accessing public places or homes and unfavourable climatic conditions. CONCLUSIONS This large, comprehensive community survey draws a detailed picture of the lived experience of people with SCI in Australia, identifying priority needs, gaps in services and barriers to achieving a full and satisfying life.
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Bychkovska O, Tederko P, Engkasan JP, Hajjioui A, Gemperli A. Healthcare service utilization patterns and patient experience in persons with spinal cord injury: a comparison across 22 countries. BMC Health Serv Res 2022; 22:755. [PMID: 35672727 PMCID: PMC9175375 DOI: 10.1186/s12913-022-07844-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Persons with spinal cord injury frequently visit numerous clinical settings. Such all-around experience of the system may serve as a comprehensive experience indicator. This study compared the patient experience of persons with chronic SCI in relation to healthcare service utilization patterns in 22 countries, hypothesizing that primary-care oriented patterns would offer a better experience. METHODS This study was based on International Spinal Cord Injury Survey with 12,588 participants across 22 countries worldwide. Utilization patterns/clusters were identified by cluster analysis and experience score - by the partial credit model. The association between healthcare utilization and experience at the provider and cluster level was explored by regression analysis. RESULTS The highest share of visits was to primary care physicians (18%) and rehabilitation physicians (16%). Utilization patterns had diverse orientations: from primary care to specialized and from inpatient to outpatient. The experience was reported as very good and good across different dimensions: 84% reported respectful treatment; 81% - clear explanations; 77% - involvement in decision making; 65% - satisfaction with care. The average experience score (0-100) was 64, highest - 74 (Brazil) and the lowest - 52 (Japan, South Korea). Service utilization at provider and at cluster levels were associated with patient experience, but no utilization pattern resulted in uniformly better patient experience. CONCLUSION While there are distinct patterns between countries on how persons with chronic SCI navigate the healthcare system, we found that different utilization patterns led to similar patient experience. The observed difference in patient experience is likely determined by other contextual factors than service utilization.
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Affiliation(s)
- Olena Bychkovska
- Swiss Paraplegic Research, 6207, Nottwil, Switzerland.
- Department of Health Sciences and Medicine, University of Lucerne, 6002, Lucerne, Switzerland.
| | - Piotr Tederko
- Department of Rehabilitation, Medical University of Warsaw, 02637, Warsaw, Poland
| | | | - Abderrazak Hajjioui
- Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, 1975, Fes, Morocco
| | - Armin Gemperli
- Swiss Paraplegic Research, 6207, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, 6002, Lucerne, Switzerland
- Center for Primary and Community Care, University of Lucerne, 6002, Lucerne, Switzerland
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Health care and rehabilitation services utilization, benefits and satisfaction: a community survey of individuals with spinal cord injury in Thailand. Spinal Cord 2022; 60:739-745. [PMID: 35197575 DOI: 10.1038/s41393-022-00777-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 02/10/2022] [Accepted: 02/10/2022] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES This study aimed to explore and report on health care and rehabilitation service utilization, rehabilitation service benefits, and levels of satisfaction of individuals with spinal cord injury (SCI) living in communities in Thailand. SETTING Four rehabilitation facilities in Thailand, two university hospitals (Maharaj Nakorn Chiang Mai Hospital in Chiang Mai Province and Siriraj Hospital in Bangkok), one large provincial hospital (Ratchaburi Hospital in Ratchaburi Province), and one national rehabilitation institute (Sirindhorn National Medical Rehabilitation Institute in Nonthaburi Province). METHODS This study was part of the International Spinal Cord Injury Community Survey (InSCI). Individuals with SCI completed a set of questionnaires, then data related to their health care and rehabilitation services were extracted and analyzed. RESULTS Of the 320 participants, most were male (71%), and the majority were living with paraplegia (73%). In cases of mild illnesses where hospitalization was not required, 46% went to a nearby health service hospital. In cases of serious illnesses where hospitalization was required, 39% went to a higher-level hospital. The majority (80%) were satisfied with their experience with health care services. The three top preferred products and services in descending order were wheelchairs and cushions, increased disability pension, medication and medical equipment including bladder relaxants, urinary catheters and urine bags. CONCLUSIONS Individuals with SCI living in communities in Thailand preferred treatment at a nearby district hospital for mild illnesses with one-third transferring to a higher-level hospital for serious illnesses. The majority were satisfied with the health care services and rehabilitation services.
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Sabariego C, Fellinghauer C, Lee L, Posarac A, Bickenbach J, Kostanjsek N, Chatterji S, Kamenov K, Cieza A. Measuring functioning and disability using household surveys: metric properties of the brief version of the WHO and World Bank model disability survey. ACTA ACUST UNITED AC 2021; 79:128. [PMID: 34253263 PMCID: PMC8273944 DOI: 10.1186/s13690-021-00654-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/06/2021] [Indexed: 12/01/2022]
Abstract
Background The Model Disability Survey (MDS) is the current standard recommended by WHO to collect functioning and disability data. Answering calls from countries requesting a version to be implemented as a module that could be integrated into existing surveys and be used for monitoring disability trends and for data disaggregation, WHO developed the brief MDS. The objectives of this paper are to evaluate the metric properties of the disability metrics generated with the Brief MDS and the precision of the Brief MDS in comparison with the full MDS. Results The partial credit model, a unidimensional model for polytomous data from the Rasch family, was applied to evaluate psychometric properties using data from national MDS implementations in Chile (N = 12,265) and in Sri Lanka (N = 3000). The Brief MDS generates valid metrics for measuring disability, from the perspectives of capacity and performance, thereby achieving good levels of measurement precision in comparison with its full counterpart. Conclusion Given the scarcity of valid functioning and disability modules for household surveys, the Brief MDS represents a milestone in disability measurement. The Brief MDS is currently used by countries to monitor disability trends over time, which is especially important to evaluate the impact of health policies and public health interventions, to disaggregate indicators of the Sustainable Development Goals, and to monitor the implementation of the UN Convention on the Rights of Persons with Disabilities (CRPD). Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00654-9.
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Affiliation(s)
- Carla Sabariego
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland.,Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland
| | - Carolina Fellinghauer
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
| | - Lindsay Lee
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
| | | | - Jerome Bickenbach
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland.,Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland
| | - Nenad Kostanjsek
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Somnath Chatterji
- Department of Data and Analytics, World Health Organization, Geneva, Switzerland
| | - Kaloyan Kamenov
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland.
| | - Alarcos Cieza
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
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11
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Stucki G. Advancing the Rehabilitation Sciences. FRONTIERS IN REHABILITATION SCIENCES 2021; 1:617749. [PMID: 36570606 PMCID: PMC9782672 DOI: 10.3389/fresc.2020.617749] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/13/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Gerold Stucki
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland,Center for Rehabilitation in Global Health Systems, University of Lucerne, Lucerne, Switzerland,Swiss Paraplegic Research, Nottwil, Switzerland,*Correspondence: Gerold Stucki
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