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Kalfas M, Jolley C, Hart N, Rafferty GF, Duncan EL, Nicholson T, Ashworth M, Brewin D, Barrett B, Witard OC, Ridge D, Chalder T. Exploring the Experiences of Living With the Post-COVID Syndrome: A Qualitative Study. Health Expect 2024; 27:e14108. [PMID: 38898594 PMCID: PMC11186847 DOI: 10.1111/hex.14108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 05/20/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
INTRODUCTION Many people experience persistent symptoms for more than 12 weeks following SARS-CoV-2 infection, which is known as post-COVID-19 condition (PCS) or Long COVID (LC). PCS can impair people's quality of life and daily functioning. However, there is a lack of in-depth research exploring the PCS patient journey, as well as gendered aspects of patients' experiences. METHODS Nineteen semi-structured qualitative interviews were conducted with people living with PCS in the United Kingdom (13 women, 6 men). Interviews were transcribed verbatim and analysed inductively using reflexive thematic analysis. RESULTS Five main themes were identified: 'Symptom dismissal', 'Lack of information and support', 'Life before and after Long COVID', 'Psychological impact' and 'Acceptance'. A shift overtime to self-management of symptoms was evident. These themes represent different stages of patients' PCS journey. Narratives indicated that women highlighted dismissal by healthcare professionals (HCPs), which was not as prominent in men's narratives. In addition, women went into more detail about the psychological impact of PCS compared to men. CONCLUSION Women with PCS reported symptom dismissal by HCPs, which may have delayed their diagnosis and negatively affected their well-being. We were not able to explore the experiences of people from non-conforming gender groups. Raising awareness of these issues among HCPs, particularly general practitioners, could improve patient care in PCS. PATIENT OR PUBLIC CONTRIBUTION Patient and public involvement consisted of people who took part in the interviews and commented on the themes' interpretation and study conclusions.
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Affiliation(s)
- Michail Kalfas
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Caroline Jolley
- Centre for Human and Applied Physiological Sciences, King's College LondonFaculty of Life Sciences & MedicineLondonUK
- King's College Hospital NHS Foundation TrustLondonUK
| | - Nicholas Hart
- Centre for Human and Applied Physiological Sciences, King's College LondonFaculty of Life Sciences & MedicineLondonUK
- Lane Fox Clinical Respiratory Physiology Research CentreGuy's & St Thomas's NHS Foundation TrustLondonUK
| | - Gerrard F. Rafferty
- Centre for Human and Applied Physiological Sciences, King's College LondonFaculty of Life Sciences & MedicineLondonUK
| | - Emma L. Duncan
- Department of Twin Research and Genetic EpidemiologyKing's College LondonLondonUK
- Guy's & St Thomas's NHS Foundation TrustLondonUK
| | - Timothy Nicholson
- Institute of Psychiatry, Psychology, and NeuroscienceKing's College LondonLondonUK
| | - Mark Ashworth
- School of Life Course & Population Sciences, King's College LondonGuy's CampusLondonUK
| | - Debbie Brewin
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Barbara Barrett
- School of Life Course & Population Sciences, King's College LondonGuy's CampusLondonUK
| | - Oliver C. Witard
- Centre for Human and Applied Physiological Sciences, King's College LondonFaculty of Life Sciences & MedicineLondonUK
| | - Damien Ridge
- School of Social SciencesUniversity of WestminsterLondonUK
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
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Carroll P, Dervan A, McCarthy C, Woods I, Beirne C, Harte G, O’Flynn D, O’Connor C, McGuire T, Leahy LM, Gonzalez JG, Stasiewicz M, Maughan J, Quinlan J, Smith É, Moriarty F, O’Brien FJ, Flood M. The role of Patient and public involvement (PPI) in pre-clinical spinal cord research: An interview study. PLoS One 2024; 19:e0301626. [PMID: 38683786 PMCID: PMC11057720 DOI: 10.1371/journal.pone.0301626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 03/19/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Patient and public involvement in research (PPI) has many benefits including increasing relevance and impact. While using PPI in clinical research is now an established practice, the involvement of patients and the public in pre-clinical research, which takes place in a laboratory setting, has been less frequently described and presents specific challenges. This study aimed to explore the perspectives of seriously injured rugby players' who live with a spinal cord injury on PPI in pre-clinical research. METHODS Semi-structured interviews were conducted via telephone with 11 seriously injured rugby players living with spinal cord injury on the island of Ireland. A purposive sampling approach was used to identify participants. Selected individuals were invited to take part via gatekeeper in a charitable organisation that supports seriously injured rugby players. Interviews were transcribed verbatim and analysed thematically. FINDINGS Six themes were identified during analysis: 'appreciating potential benefits of PPI despite limited knowledge', 'the informed perspectives of people living with spinal cord injury can improve pre-clinical research relevance', 'making pre-clinical research more accessible reduces the potential for misunderstandings to occur', 'barriers to involvement include disinterest, accessibility issues, and fear of losing hope if results are negative', 'personal contact and dialogue helps people feel valued in pre-clinical research, and 'PPI can facilitate effective dissemination of pre-clinical research as desired by people living with spinal cord injury.' CONCLUSION People affected by spinal cord injury in this study desire further involvement in pre-clinical spinal cord injury research through dialogue and contact with researchers. Sharing experiences of spinal cord injury can form the basis of PPI for pre-clinical spinal cord injury research.
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Affiliation(s)
- Pádraig Carroll
- School of Pharmacy and Biomolecular Science, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Adrian Dervan
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Ciarán McCarthy
- c/o Irish Rugby Football Union Charitable Trust, Dublin, Ireland
| | - Ian Woods
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Cliff Beirne
- Faculty of Sports and Exercise Medicine (Royal College of Physicians in Ireland & RCSI), Dublin, Ireland
| | - Geoff Harte
- c/o Irish Rugby Football Union Charitable Trust, Dublin, Ireland
| | - Dónal O’Flynn
- c/o Irish Rugby Football Union Charitable Trust, Dublin, Ireland
| | - Cian O’Connor
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Tara McGuire
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Liam M. Leahy
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Javier Gutierrez Gonzalez
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Martyna Stasiewicz
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Jack Maughan
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - John Quinlan
- Tallaght University Hospital, Tallaght, Dublin, Ireland
| | - Éimear Smith
- National Rehabilitation Hospital, Dublin, Ireland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Science, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Fergal J. O’Brien
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Michelle Flood
- School of Pharmacy and Biomolecular Science, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
- PPI Ignite Network, Galway, Ireland
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Mofatteh M, Mashayekhi MS, Arfaie S, Chen Y, Malhotra AK, Skandalakis GP, Alvi MA, Afshari FT, Meshkat S, Lin F, Abdulla E, Anand A, Liao X, McIntyre RS, Santaguida C, Weber MH, Fehlings MG. Anxiety and Depression in Pediatric-Onset Traumatic Spinal Cord Injury: A Systematic Review. World Neurosurg 2024; 184:267-282.e5. [PMID: 38143027 DOI: 10.1016/j.wneu.2023.12.092] [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] [Received: 08/21/2023] [Revised: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Traumatic spinal cord injury (TSCI) is a debilitating neurological condition with significant long-term consequences on the mental health and well-being of affected individuals. We aimed to investigate anxiety and depression in individuals with pediatric-onset TSCI. METHODS PubMed, Scopus, and Web of Science databases were searched from inception to December 20th, 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, and studies were included according to the eligibility criteria. RESULTS A total of 1013 articles were screened, and 18 studies with 4234 individuals were included in the final review. Of these, 1613 individuals (38.1%) had paraplegia, whereas 1658 (39.2%) had tetraplegia. A total of 1831 participants (43.2%) had complete TSCI, whereas 1024 (24.2%) had incomplete TSCI. The most common etiology of TSCI with 1545 people (36.5%) was motor vehicle accidents. The youngest mean age at the time of injury was 5.92 ± 4.92 years, whereas the oldest was 14.6 ± 2.8 years. Patient Health Questionnaire-9 was the most common psychological assessment used in 9 studies (50.0%). Various risk factors, including pain in 4 studies (22.2%), reduced sleep quality, reduced functional independence, illicit drug use, incomplete injury, hospitalization, reduced quality of life, and duration of injury in 2 (11.1%) studies, each, were associated with elevated anxiety and depression. CONCLUSIONS Different biopsychosocial risk factors contribute to elevated rates of anxiety and depression among individuals with pediatric-onset TSCI. Individuals at risk of developing anxiety and depression should be identified, and targeted support should be provided. Future large-scale studies with long-term follow-up are required to validate and extend these findings.
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Affiliation(s)
- Mohammad Mofatteh
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK; Neuro International Collaboration (NIC), London, UK.
| | - Mohammad Sadegh Mashayekhi
- Division of Neurosurgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Neuro International Collaboration (NIC), Ottawa, Ontario, Canada
| | - Saman Arfaie
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada; Department of Molecular and Cell Biology, University of California Berkeley, Berkeley, California, USA; Neuro International Collaboration (NIC), Montreal, Quebec, Canada
| | - Yimin Chen
- Department of Neurology, Foshan Sanshui District People's Hospital, Foshan, China; Neuro International Collaboration (NIC), Foshan, China
| | - Armaan K Malhotra
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Neuro International Collaboration (NIC), Toronto, Ontario, Canada
| | - Georgios P Skandalakis
- First Department of Neurosurgery, Evangelismos General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Mohammed Ali Alvi
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Neuro International Collaboration (NIC), Toronto, Ontario, Canada; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Fardad T Afshari
- Department of Neurosurgery, Birmingham Children's Hospital, Birmingham, UK
| | - Shakila Meshkat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Famu Lin
- Department of Neurosurgery, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, China
| | - Ebtesam Abdulla
- Department of Neurosurgery, Salmaniya Medical Complex, Manama, Bahrain
| | - Ayush Anand
- B. P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Xuxing Liao
- Department of Neurosurgery, Foshan Sanshui District People's Hospital, Foshan, China; Department of Surgery of Cerebrovascular Diseases, Foshan First People's Hospital, Foshan, China
| | - Roger S McIntyre
- Neuro International Collaboration (NIC), Toronto, Ontario, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada
| | - Carlo Santaguida
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Michael H Weber
- Division of Orthopaedic Surgery, McGill University, Montreal, Quebec, Canada; The Research Institute of the McGill University Health Centre, Injury, Repair and Recovery Program, Montreal, Quebec, Canada; Montreal General Hospital, Montreal, Quebec, Canada
| | - Michael G Fehlings
- Division of Genetics and Development, Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Neurosurgery and Spinal Program, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
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Thielmann B, Meyer F, Böckelmann I. [Against the mental stress-Resilient work in surgery]. CHIRURGIE (HEIDELBERG, GERMANY) 2024; 95:135-147. [PMID: 37987763 PMCID: PMC10834595 DOI: 10.1007/s00104-023-01977-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Surgery represents a challenging medical discipline. AIM This article focuses on psychological stress in surgery and explains resilience as a protective factor against the consequences of psychological stress, based on selected literature references and own relevant clinical experiences. In this context, the sense of coherence, social support and self-efficacy expectation are discussed in more detail as resilience factors. METHOD Narrative review. RESULTS (CORNER POINTS) Surgery is classified as a challenging medical subspecialty with a high reputation but associated with diverse and varied physical and psychological stress factors. Stress factors differ individually in terms of requirements (can be overdemanding or underdemanding but also stimulating, relevant to learning and meaningful, thus positively or negatively stressful) and resources (potentially beneficial working conditions, experience, or behavior, e.g., social support, scope for action). Fluctuations within surgical specialties and a high dropout rate during residency training are well known and the causes include high psychological stress. In the case of persistent and at the same time insufficient compensation of work stress caused by a lack of or insufficient resources, these can be associated with mental illnesses. Nonetheless, many physicians spend their entire lives working in hospital or private surgical settings and remain healthy, a strong sense of resilience to mental illness may be fundamental to this. Resilience can be present as a personal characteristic or it can be learnt through a process or adapted through positive or negative influences, thus strengthening the personal characteristics. Overall, data on surgeon resilience or interventional studies in resilience research in the surgical setting are limited and provide another research gap. Resilience training (directed at a sense of coherence, social support, strengthening knowledge of coping skills, positive emotions, optimism, hope, self-efficacy expectations, control beliefs or robustness), also clearly indicated in the "robust" medical specialty of surgery, is always individual and should not be generalized. If the surgeon cannot retrieve sufficient resources due to the stressful situation, stress management with its methods is helpful to reduce the psychological stress and to be able to maintain the performance and health of this person. CONCLUSION The consolidation of resilience as a notable aspect of employee management. In collegial interactions, resilience must be based on workplace-based approaches to strengthen coping mechanisms in the face of work stress. Workplace-related stress should also be perceived, addressed and counteracted within the organization, certainly also as an elementary management task.
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Affiliation(s)
- Beatrice Thielmann
- Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
| | - Frank Meyer
- Universitätsklinik für Allgemein-, Viszeral-, Gefäß- und Transplantationschirurgie, Otto-von-Guericke-Universität Magdeburg mit Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland.
| | - Irina Böckelmann
- Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
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Ríos-León M, Onal B, Arango-Lasprilla JC, Augutis M, Graham A, Kelly EH, Kontaxakis A, López-Dolado E, Scheel-Sailer A, Valiullina S, Taylor J. Research Priorities of the Pediatric Spinal Cord Injury Population: An International Insight for Rehabilitation Care. Pediatr Neurol 2024; 151:121-130. [PMID: 38154239 DOI: 10.1016/j.pediatrneurol.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 10/20/2023] [Accepted: 11/26/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Although feedback from people with adult-onset spinal cord injury (SCI) has been considered for new rehabilitation programs, little is known about the priorities of the pediatric-onset SCI population. This study describes and compares health and life (H&L) domain research priorities of youth with pediatric-onset SCI and their parents/caregivers. METHODS A cross-sectional survey, designed by the Pan-European Paediatric Spinal Cord Injury (PEPSCI) Collaboration, was performed at six European countries. Dyad data from 202 participants, youth with pediatric-onset SCI (n = 101) and their parents/caregivers (n = 101), were analyzed with the PEPSCI H&L domain surveys. RESULTS The cohort was composed of 8 to 12-year-olds (30.7%), 13 to 17-year-olds (38.6%), and 18 to 25-year-olds (30.7%). The top three H&L domain research priorities reported by parents/caregivers of 8 to 12-year-olds were "walking/ability to move" (91%), "bladder" function (90%), and "general health/feel" (89%), compared with "physical function" (93%), "general health/feel" (90%), and "walking/ability to move" (89%) rated by parents/caregivers of 13 to 25-year-olds. "Bowel" function (85%), "leg/foot movement" (84%), and "bladder" function (84%) were reported as priorities by 13 to 25-year-olds, whereas "physical function" (84%), "experience at school" (83%), and "general mood" were highlighted by 8 to 12-year-olds. The top 10 priorities preferred by 13 to 25-year-olds when compared with the top 10 priorities reported by their parents/caregivers, included problems related to "bowel" and "pain." CONCLUSIONS Health domain research priorities were highlighted by 13 to 25-year-olds, compared with their parents/caregivers who equally identified H&L domains. This survey will aid health care and clinical research organizations to engage stakeholders to implement a comprehensive research strategy for the pediatric SCI population.
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Affiliation(s)
- Marta Ríos-León
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain.
| | - Bashak Onal
- NHS Buckinghamshire Clinical Commissioning Group, Aylesbury, UK
| | - Juan Carlos Arango-Lasprilla
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain; Department of Cell Biology and Histology, University of the Basque Country, Leioa, Spain; IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Marika Augutis
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Allison Graham
- National Spinal Injuries Centre, Buckinghamshire Healthcare NHS Trust, Stoke Mandeville, UK
| | | | | | - Elisa López-Dolado
- Rehabilitation Department, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
| | - Anke Scheel-Sailer
- Swiss Paraplegic Centre, Nottwil, Switzerland; Department of Health Science and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Svetlana Valiullina
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russia
| | - Julian Taylor
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain; Harris Manchester College, University of Oxford, Oxford, UK
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Ríos-León M, Onal B, Arango-Lasprilla JC, Augutis M, Civicos-Sanchez N, Graham A, Kelly EH, López-Dolado E, Scheel-Sailer A, Subiñas-Medina P, Taylor J. Pediatric health and life domain priorities: A national survey of people with spinal cord injury and their parents and caregivers. J Spinal Cord Med 2024; 47:155-167. [PMID: 35776093 PMCID: PMC10795593 DOI: 10.1080/10790268.2022.2087140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
CONTEXT/OBJECTIVE No information is available regarding priorities for pediatric-onset spinal cord injury (SCI). This study described the Health and Life (H&L) domain priorities of youth with pediatric-onset SCI and their parents/caregivers living in Spain. DESIGN A cross-sectional survey. SETTING Two SCI rehabilitation centers. PARTICIPANTS Sixty participants, youth with pediatric-onset SCI (n = 26) and parents/caregivers (n = 34). INTERVENTIONS Not applicable. OUTCOME MEASURES Median overall priorities calculated on the basis of importance, unhappiness, and research measured with a new survey of pediatric H&L domains and rated using a 5-point Likert Scale. RESULTS A total of 60 surveys were received providing information on 35 individuals with SCI: 2-7-year-olds (25.7%), 8-12-year-olds (22.9%), 13-17-year-olds (31.4%), and 18-25-year-olds (20.0%). The top three overall H&L priorities reported by parents/caregivers of 2-12-year-olds were "parenthood expectations" (84%), "leg/foot movement" (83%), and "bladder" function (83%), compared to "dressing/undressing" (78%), "walking/ability to move" (77%) and "bladder" function (77%) rated for 13-25-year-olds. "Sit-to-stand" (79%), "leg/foot movement" (78%) and "arm/hand movement" (77%) were reported as priorities by 13-25-year-olds. The 13-25-year-olds highlighted "sit-to-stand" (100%), "eating/drinking" (54%), and "physical function" (94%) as their top unhappiness, importance, and research priorities, respectively. Significant differences between tetraplegia and paraplegia were found in "mobility in the community" (unhappiness item) for 13-25-years-old. CONCLUSION Health domains were considered the top overall H&L priorities by parents/caregivers of 13-25-year-olds, compared to life domains reported for their 2-12-year-olds. This survey will aid rehabilitation professionals to engage stakeholders to implement a comprehensive SCI management program for the pediatric population.
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Affiliation(s)
- Marta Ríos-León
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
| | - Bashak Onal
- NHS Buckinghamshire Clinical Commissioning Group, Aylesbury, UK
| | - Juan Carlos Arango-Lasprilla
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country, Leioa, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Marika Augutis
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | | | - Allison Graham
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK
| | | | - Elisa López-Dolado
- Rehabilitation Department, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
| | - Anke Scheel-Sailer
- Swiss Paraplegic Centre, Nottwil, Switzerland
- Department of Health Science and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Patricia Subiñas-Medina
- Servicio de Atención Temprana, Asociación de Familias de Personas con Discapacidad Intelectual y del Desarrollo (APANAS), Toledo, Spain
| | - PEPSCI Collaboration
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
- NHS Buckinghamshire Clinical Commissioning Group, Aylesbury, UK
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country, Leioa, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
- Unidad de Lesionados Medulares, Hospital de Cruces, Barakaldo, Spain
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK
- American Academy of Pediatrics, Itasca, Illinois, USA
- Rehabilitation Department, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
- Swiss Paraplegic Centre, Nottwil, Switzerland
- Department of Health Science and Medicine, University of Lucerne, Lucerne, Switzerland
- Servicio de Atención Temprana, Asociación de Familias de Personas con Discapacidad Intelectual y del Desarrollo (APANAS), Toledo, Spain
- Harris Manchester College, University of Oxford, Oxford, UK
| | - Julian Taylor
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
- Harris Manchester College, University of Oxford, Oxford, UK
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DeShazo JM, Kouwijzer I, de Groot S, Post MWM, Valent LJM, van Leeuwen CMC, Wen H, Cowan RE. Effect of Training for an Athletic Challenge on Illness Cognition in Individuals with Chronic Disability: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:58. [PMID: 38248523 PMCID: PMC10815898 DOI: 10.3390/ijerph21010058] [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: 10/07/2023] [Revised: 12/19/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024]
Abstract
Illness cognitions (IC) influence how a patient adapts to a chronic disease. The aim was (1) to determine if training for a handcycling mountain time trial (HandbikeBattle) improves IC and (2) to identify factors associated with IC change scores. Persons with a chronic disability (N = 220; including N = 151 with spinal cord disorder) trained 5 months and participated in the time trial. The IC Questionnaire measured helplessness, acceptance, perceived benefits and was assessed before training (T1), after training (T2), and four months after the event (T3). Age, sex, body mass index (BMI), time since injury (TSI), disability characteristics, self-efficacy, mental health (MH) and musculoskeletal pain were obtained at T1. Multilevel regression analyses showed that helplessness decreased (from 11.96 to 11.28, p < 0.01) and perceived benefits increased (from 16.91 to 17.58, p < 0.01) from T1 to T2. For helplessness this decrease persisted during follow-up (11.16 at T3). Changes in helplessness were associated with self-efficacy (p = 0.02), MH (p = 0.02) and lesion completeness (p = 0.02), and were independent of disability type (p = 0.66), lesion level (p = 0.30) and demographics such as sex (p = 0.29) and age (p = 0.67). Training with peers may improve helplessness and perceived benefits in individuals with a chronic disability. Especially individuals with MH problems might benefit from training for an athletic challenge with peers to improve illness cognitions, and ultimately, quality of life.
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Affiliation(s)
- Joy M. DeShazo
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (J.M.D.); (H.W.); (R.E.C.)
| | - Ingrid Kouwijzer
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands;
- Amsterdam Rehabilitation Research Center|Reade, 1054 HW Amsterdam, The Netherlands
| | - Sonja de Groot
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands;
- Amsterdam Rehabilitation Research Center|Reade, 1054 HW Amsterdam, The Netherlands
| | - Marcel W. M. Post
- Center of Excellence for Rehabilitation Medicine, UMCU Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, 3583 TM Utrecht, The Netherlands; (M.W.M.P.); (C.M.C.v.L.)
- Center for Rehabilitation, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Linda J. M. Valent
- Research and Development, Heliomare Rehabilitation Center, 1949 EC Wijk aan Zee, The Netherlands;
| | - Christel M. C. van Leeuwen
- Center of Excellence for Rehabilitation Medicine, UMCU Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, 3583 TM Utrecht, The Netherlands; (M.W.M.P.); (C.M.C.v.L.)
| | - Huacong Wen
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (J.M.D.); (H.W.); (R.E.C.)
| | - Rachel E. Cowan
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (J.M.D.); (H.W.); (R.E.C.)
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Han A, Wilroy JD, Yuen HK. Effects of acceptance and commitment therapy on depressive symptoms, anxiety, pain intensity, quality of life, acceptance, and functional impairment in individuals with neurological disorders: a systematic review and meta-analysis. CLIN PSYCHOL-UK 2023. [DOI: 10.1080/13284207.2022.2163158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama, Birmingham, AL, USA
| | - Jereme D. Wilroy
- Department of Physical Medicine and Rehabilitation, University of Alabama, Birmingham, AL, USA
| | - Hon K. Yuen
- Department of Occupational Therapy, University of Alabama, Birmingham, AL, USA
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Tutton E, Gould J, Lamb SE, Costa ML, Keene DJ. 'It Makes Me Feel Old': Understanding the Experience of Recovery From Ankle Fracture at 6 Months in People Aged 50 Years and Over. QUALITATIVE HEALTH RESEARCH 2023; 33:308-320. [PMID: 36745107 PMCID: PMC10061622 DOI: 10.1177/10497323231153605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Ankle fracture is a common injury, and depending on injury severity, treatment may be a support boot, cast or surgery. Older people, particularly those with severe injuries who are asked to restrict weight bearing, struggle with early recovery. To elicit older peoples' experience of recovery 6 months after injury, we drew on a phenomenological approach using interviews. Findings revealed that getting on with life was a way of accepting what it feels like to 'be vulnerable', needing to 'be safe' while determinedly working hard to 'be myself'. Being vulnerable identified endurance of inactivity, loneliness and dependency in the non-weight bearing period of recovery, followed by a struggle to weight bear while lacking confidence and being fearful of falling and causing further damage. Being safe conveyed fragility where sensations, pain and stiffness acted as bodily reminders of injury. Lack of function and awareness of danger led to carefulness where planning or curtailing of activities ensured their safety. Being myself showed a determination to push away from a disrupted self-identify of being older or disabled while being challenged by the continuous process of learning to be more mobile. A lack of readiness for old age created a drive to age well. Despite loss of ability, participants hoped to regain their pre-injury way of living. This study challenges practice that disregards the hard work required to recover from ankle fracture. As comorbidity increases with age, failure to consider this aspect may contribute to frailty in this group of older people.
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Affiliation(s)
- Elizabeth Tutton
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Major Trauma Centre, Oxford UniversityHospitals NHS Foundation Trust, Oxford, UK
| | - Jenny Gould
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sarah E. Lamb
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Matthew L. Costa
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - David J. Keene
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
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10
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Han A, Wilroy JD, Jenkins J, Yuen HK. Effects of a coach-guided videoconferencing acceptance and commitment therapy intervention combined with psychoeducation on distressed individuals living with spinal cord injury: a preliminary mixed-methods study. Disabil Rehabil 2023; 45:644-654. [PMID: 35156500 DOI: 10.1080/09638288.2022.2038283] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE This study examined effects of coach-guided videoconferencing acceptance and commitment therapy (ACT) accompanied by psychoeducation on distressed individuals with spinal cord injury (SCI) and explored participants' experiences in the intervention. MATERIALS AND METHODS Ten people with SCI participated in 8 individual videoconferencing sessions delivered by trained coaches. Data using self-reported questionnaires and individual interviews was collected at pretest and posttest and analyzing using Wilcoxon signed-rank tests and interpretative phenomenological analysis (ClinicalTrials.gov ID: NCT04670406). RESULTS Statistically significant improvements were found in depression, anxiety, stress, grief, engagement in meaningful activities, and self-compassion with medium to large effect sizes. There was no significant change in quality of life, resilience, and ACT processes. Participants gained a new way of thinking by: being aware of thoughts and emotions; exploring perceptions of others; and focusing on the present. Also, the intervention equipped participants to deal with challenges by: improving coping with SCI-related conditions; practicing self-compassion, acceptance, and meditation; and acquiring skills of value-based decision making and committed action. CONCLUSIONS Findings contribute to the limited evidence as the first study that measured effects of videoconferencing ACT on people with SCI. Future randomized controlled trials are needed to measure efficacy of internet-delivered ACT for people with SCI.IMPLICATIONS FOR REHABILITATIONGuided videoconferencing ACT may reduce depressive symptoms, anxiety, stress, and grief and increase engagement in meaningful activities and self-compassion in people with SCI.Professionals may consider ACT as a supportive or adjunct service for people with SCI who experience psychological distress.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jereme D Wilroy
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeremy Jenkins
- Telehealth Private Practice: jeremyjenkins.icouch.me, Edmond, OK, USA
| | - Hon K Yuen
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
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11
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Han A, Kim TH. Efficacy of Internet-Based Acceptance and Commitment Therapy for Depressive Symptoms, Anxiety, Stress, Psychological Distress, and Quality of Life: Systematic Review and Meta-analysis. J Med Internet Res 2022; 24:e39727. [PMID: 36485030 PMCID: PMC9789494 DOI: 10.2196/39727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/24/2022] [Accepted: 10/08/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Acceptance and commitment therapy (ACT) is an empirically supported transdiagnostic approach that involves mindfulness processes and behavior change processes for valued living. OBJECTIVE This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to assess the efficacy of internet-based ACT (iACT) for depressive symptoms, anxiety, stress, psychological distress, and quality of life (QoL). METHODS PubMed, CINAHL, PsycINFO, and SCOPUS databases were searched to identify relevant RCTs published up to June 5, 2021. The included RCTs were assessed using the Cochrane Collaboration risk-of-bias tool. The use of either a random effects model or fixed effects model was determined using I2 statistic values for heterogeneity. Subgroup analyses were conducted according to the type of control group, the use of therapist guidance, delivery modes, and the use of targeted participants, when applicable. RESULTS A total of 39 RCTs met the inclusion criteria. Meta-analyses found small effects of iACT on depressive symptoms, anxiety, stress, psychological distress, and QoL at the immediate posttest and follow-up. There was no significant effect of iACT on stress at follow-up. Subgroup analyses showed small to medium effects of iACT on all the outcomes at the immediate posttest and follow-up compared with the passive control groups. In contrast, subgroup analyses that compared iACT with active control groups found no differences between groups on stress, psychological distress, and QoL at the immediate posttest or on depressive symptoms, anxiety, and stress at follow-up. In addition, subgroup analyses conducted according to the use of therapist guidance, delivery modes, and the use of targeted participants found no statistically significant subgroup differences among studies in all the outcomes, except for the subgroup difference among studies according to the use of targeted participants for depressive symptoms at the immediate posttest (ie, a statistically significant, larger effect of iACT when studies targeted people with depressive symptoms). The overall risk of bias across the studies was unclear. CONCLUSIONS The findings of this study contribute to the body of evidence regarding the effects of iACT on depressive symptoms, anxiety, stress, psychological distress, and QoL and may be applicable in any population, as ACT is a transdiagnostic approach. Few studies have compared iACT with active control conditions, especially for stress and psychological distress at the immediate posttest and follow-up. In addition, the active control conditions varied among the included studies. Further high-quality studies are needed to better understand whether iACT is comparable or superior to other evidence-based interventions, such as cognitive behavioral therapy, in decreasing depressive symptoms, anxiety, stress, and psychological distress and improving QoL.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei Wonju Medical College, Wonju, Republic of Korea
- Department of Psychiatry, Wonju Severance Christian Hospital, Wonju, Republic of Korea
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12
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Angel S. Ten years of living with an injured spinal cord: A qualitative longitudinal study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100100. [PMID: 38745602 PMCID: PMC11080325 DOI: 10.1016/j.ijnsa.2022.100100] [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: 04/11/2022] [Revised: 09/19/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
Purpose Rehabilitation and recovery following spinal cord injury often implies a fundamentally changed life. The aim of this study was to explore the process of living with spinal cord injury for 10 years to identify which factors were most decisive for living a fulfilled life. Materials and methods The present study was a 10-year longitudinal qualitative study based on Ricoeur's hermeneutic-phenomenological approach to explore and interpret people's experiences of life during the first 10 years after they had suffered a spinal cord injury. Interviews were conducted with 10 people during the first year and then again after two, five and 10 years. Results The process over 10 years showed that a satisfying life can be led despite limitations caused by the damaged spine by balancing possibilities and the life wished for. Reduced body function did not have to hinder people from living a satisfying life. Bodily issues can move into the background when new skills and routines are developed. This enabled backgrounding body conditions, letting other matters foreground. Thus, life can be experienced as good and can resemble the lives of other people of the same age, though strains and struggles were an integrated part of every activity. However, the new normal was disturbed when bodily conditions could not be kept stable or worsened due to illness, often related to the damaged spine. If this challenged the new way of living, the body foregrounded and became the primary focus for effort and attention, and the process of balancing possibilities and the life wished for had to be repeated. Conclusions Life 10 years after spinal cord injury can be experienced as good despite limitations, partly resembling life lived by other same-aged people. Having stable bodily conditions allowed other matters to foreground. This was important to the process of reconciling oneself to the situation and balancing possibilities and the life wished for.
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Affiliation(s)
- Sanne Angel
- Corresponding author at: Sanne Angel, Associated Professor, Research unit of nursing and healthcare, Department of Public Health. Aarhus University. Bartolins Alle 2, 8000 Aarhus C. Denmark.
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Sidiropoulos AN, Glasberg JJ, Moore TE, Nelson LM, Maikos JT. Acute influence of an adaptive sporting event on quality of life in veterans with disabilities. PLoS One 2022; 17:e0277909. [PMID: 36441761 PMCID: PMC9704555 DOI: 10.1371/journal.pone.0277909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 11/06/2022] [Indexed: 11/29/2022] Open
Abstract
Veterans with disabilities can experience poor quality of life following military service due to the associated negative physical and psychological ramifications. However, participation in physical activities has shown to induce both physical and mental benefits and improve the quality of life of this population. Adaptive sports, an innovative approach to address the unique physical and psychosocial needs of veterans with disabilities, are becoming more widely used as a rehabilitation tool to improve the quality of life for these veterans. This study aimed to determine the acute influence of participation in a single-day, veteran-based, adaptive kayaking and sailing event on the perceived overall health, quality of life, and quality of social life of veterans with varying disabilities. It was hypothesized that all three categories and the sum score of quality of life would reflect a positive acute response after participation in the community-based physical activity event. Veterans responded to three quality of life-related questions using a 5-point Likert scale before and directly after participating in the event. Findings indicated that an adaptive sporting event can have an acute positive influence on the quality of life of veteran participants, with improvements observed in all three categories of perceived quality of life. Therefore, it is advantageous for the whole-health rehabilitation of veterans with disabilities for the Department of Veterans Affairs to continue to provide opportunities for veterans to participate in non-traditional, community-based activities.
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Affiliation(s)
- Alexis N. Sidiropoulos
- Department of Veterans Affairs, New York Harbor Healthcare System, New York, New York, United States of America
- * E-mail:
| | - Jonathan J. Glasberg
- Department of Veterans Affairs, New York Harbor Healthcare System, New York, New York, United States of America
| | - Timothy E. Moore
- Statistical Consulting Services, Center for Open Research Resources and Equipment, University of Connecticut, Storrs, CT, United States of America
| | - Leif M. Nelson
- Department of Veterans Affairs, National Veterans Sports Programs and Special Events, Washington, DC, United States of America
| | - Jason T. Maikos
- Department of Veterans Affairs, New York Harbor Healthcare System, New York, New York, United States of America
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14
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García-Rudolph A, Saurí J, López Carballo J, Cegarra B, Wright MA, Opisso E, Tormos JM. The impact of COVID-19 on community integration, quality of life, depression and anxiety in people with chronic spinal cord injury. J Spinal Cord Med 2022; 45:681-690. [PMID: 34061728 PMCID: PMC9542626 DOI: 10.1080/10790268.2021.1922230] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
CONTEXT/OBJECTIVE Compare community integration, quality of life, anxiety and depression of people with chronic spinal cord injury (SCI) living in the community before the outbreak of coronavirus SARS-CoV-2 disease (COVID-19) and during it. DESIGN Prospective observational cohort study. SETTING In-person follow-up visits (before COVID-19 outbreak) to a rehabilitation hospital in Spain and on-line during COVID-19. PARTICIPANTS Community dwelling adults (≥ 18 years) with chronic SCI. OUTCOME MEASURES Hospital Anxiety and Depression Scale (HADS), Community Integration Questionnaire (CIQ) and World Health Organization Quality of Life (WHOQOL-BREF) were compared using the Wilcoxon ranked test or paired t-test when appropriate. RESULTS One hundred and seventy five people with SCI assessed on-line between June 2020 and November 2020 were compared to their own assessments before COVID-19. Participants reported significantly decreased Social Integration during COVID-19 compared to pre-pandemic scores (P = 0.037), with a small effect size (d = -0.15). Depression (measured using HADS) was significantly higher than before COVID-19 (P < 0.001) with a moderate effect size (d = -0.29). No significant differences were found in any of the 4 WHOQOL-BREF dimensions (Physical, Psychological, Social and Environmental).Nevertheless, when all participants were stratified in two groups according to their age at on-line assessment, the younger group (19-54 years, N = 85) scored lower during COVID-19 than before, in WHOQOL-BREF Physical (P = 0.004), (d = -0.30) and Psychological dimensions (P = 0.007) (d = -0.29). The older group (55-88 years, N = 0) reported no significant differences in any dimension. CONCLUSIONS COVID-19 impacted HADS' depression and CIQ's social integration. Participants younger than 55 years were impacted in WHOQOL-BREF's physical and psychological dimensions, meanwhile participants older than 55, were not.
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Affiliation(s)
- Alejandro García-Rudolph
- Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain,Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain,Correspondence to: Alejandro García-Rudolph, Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Cami Can Ruti s/n 08916, Badalona, Barcelona, Spain.
| | - Joan Saurí
- Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain,Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Jaume López Carballo
- Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain,Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Blanca Cegarra
- Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain,Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Mark Andrew Wright
- Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain,Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Eloy Opisso
- Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain,Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Josep María Tormos
- Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain,Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
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15
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Singh V, Mitra S. Psychophysiological impact of spinal cord injury: Depression, coping and heart rate variability. J Spinal Cord Med 2022; 46:441-449. [PMID: 35353026 PMCID: PMC10114979 DOI: 10.1080/10790268.2022.2052503] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES The aim was to examine the association of post-injury heart rate variability (HRV), coping with injury (fighting-acceptance), and depression symptoms in individuals with spinal cord injury (SCI). STUDY DESIGN Cross-sectional study. SETTING Tertiary care spinal cord injury hospital. PARTICIPANTS Ninety-one individuals with SCI. METHODS All participants were assessed for HRV using polar heart rate monitor RS 800 CX and completed the Patient Health Questionnaire and Spinal Cord Lesion Coping Strategy questionnaire. Participants were grouped based on level of injury (tetraplegic, high paraplegia, and low paraplegia) and injury duration (early vs. late). Odds ratio calculated the risk of depression using HRV and coping as factors for early and late duration groups. Spearman rho estimated the correlation between three ratios: HRV (LF vs. HF), depression (somatic vs. cognitive), and coping (fighting spirit vs. acceptance) for each level of injury group for early and late duration. RESULTS Individuals with SCI with high HRV had lower odds of depression (OR = 0.14, CI = 0.03-0.78) than individuals with SCI with low HRV in the early duration group. Individuals with SCI with high acceptance had lower odds of depression (OR = 0.19, CI = 0.44-0.79) than individuals with SCI with low acceptance in the later duration group. In the later duration, HRV ratio negatively correlated with coping ratio in individuals with low paraplegia and depression ratio in individuals with high paraplegia. CONCLUSION The aftermath of spinal cord injury might reflect a close association between the physiological response of autonomic variability and psychological response of coping and depression with implications for the level of injury and post-injury duration.
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Affiliation(s)
- Varsha Singh
- Department of Humanities and Social Sciences, IIT-Delhi, Delhi, India
| | - Shambhovi Mitra
- Department of Humanities and Social Sciences, IIT-Delhi, Delhi, India.,Indian Spinal Injuries Centre, Delhi, India
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16
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Hakim S, Gaglani T, Cash BD. Neurogenic Bowel Dysfunction: The Impact of the Central Nervous System in Constipation and Fecal Incontinence. Gastroenterol Clin North Am 2022; 51:93-105. [PMID: 35135667 DOI: 10.1016/j.gtc.2021.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Spinal cord injury and neurogenic bowel dysfunction (NBD) are life-changing events for affected patients. The clinical manifestations of NBD vary depending on the level and severity of the spinal cord lesion. Managing patients with NBD can be complicated by comorbidities, such as immobility, bladder dysfunction, progressive neurologic decline, psychological factors, loss of independence, and social withdrawal, and ideally involves a multimodal, multidisciplinary approach. Evaluation and management should be individualized, depending on the residual neurologic capabilities of the patient and their predominant gastrointestinal symptoms, and commonly involves lifestyle modifications, physical therapy, laxative medications, and surgical interventions.
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Affiliation(s)
- Seifeldin Hakim
- Division of Gastroenterology, Hepatology and Nutrition, The University of Texas Health Science Center at Houston, 6431 Fannin, MSB 4.234, Houston, TX 77030, USA
| | - Tanmay Gaglani
- Department of Internal Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin, Houston, TX 77030, USA
| | - Brooks D Cash
- Division of Gastroenterology, Hepatology and Nutrition, The University of Texas Health Science Center at Houston, 6431 Fannin, MSB 4.234, Houston, TX 77030, USA.
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17
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Ture SD, Ozkaya G, Sivrioglu K. Relationship between neurogenic bowel dysfunction severity and functional status, depression, and quality of life in individuals with spinal cord injury. J Spinal Cord Med 2022; 46:424-432. [PMID: 35108161 PMCID: PMC10114961 DOI: 10.1080/10790268.2021.2021043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES/CONTEXT To evaluate the relationship between severity of neurogenic bowel dysfunction (NBD) and functional status, depression, and quality of life in individuals with spinal cord injury (SCI) and to determine the factors associated with developing moderate-to-severe NBD. DESIGN Cross-sectional study. SETTING University hospital rehabilitation outpatient clinic. PARTICIPANTS Individuals with traumatic SCI, at least one year post-injury (N = 92). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Neurogenic Bowel Dysfunction Score, Functional Independence Measure (FIM), Beck Depression Inventory (BDI), and Short Form-36 (SF-36). RESULTS In the current sample, we found that half of the individuals with SCI had moderate-to-severe NBD. Individuals with moderate and severe NBD had lower motor FIM (P = 0.008 and P = 0.006, respectively) and SF-36 physical functioning (PF) scale (P = 0.020 and P = 0.031, respectively) scores than individuals with very minor NBD. There was no difference in the BDI scores among individuals with different levels of NBD. Individuals with American Spinal Injury Association Impairment Scale (AIS) A injuries were more likely to develop moderate-to-severe NBD than those with AIS C (odds ratio (OR) = 6.52; 95% confidence interval (CI) 1.13-37.79; P = 0.005) or AIS D (OR = 17.19; 95% CI 3.61-81.82; p < 0.001) injuries. CONCLUSION Individuals with moderate-to-severe NBD had higher levels of dependency in activities of daily living and lower SF-36 PF scale scores than individuals with very minor NBD. Among individuals with SCI, completeness of injury was a significant factor for developing moderate-to-severe NBD.
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Affiliation(s)
- Sevda Demir Ture
- Department of Physical Medicine and Rehabilitation, Bursa Uludag University School of Medicine, Bursa, Turkey
| | - Guven Ozkaya
- Department of Biostatistics, Bursa Uludag University School of Medicine, Bursa, Turkey
| | - Koncuy Sivrioglu
- Department of Physical Medicine and Rehabilitation, Bursa Uludag University School of Medicine, Bursa, Turkey
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David SD, Aroke A, Roy N, Solomon H, Lundborg CS, Gerdin Wärnberg M. Measuring socioeconomic outcomes in trauma patients up to one year post-discharge: A systematic review and meta-analysis. Injury 2022; 53:272-285. [PMID: 34706829 DOI: 10.1016/j.injury.2021.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 09/30/2021] [Accepted: 10/08/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Trauma accounts for nearly one-tenth of the global disability-adjusted life-years, a large proportion of which is seen in low- and middle-income countries (LMICs). Trauma can affect employment opportunities, reduce social participation, be influenced by social support, and significantly reduce the quality of life (QOL) among survivors. Research typically focuses on specific trauma sub-groups. This dispersed knowledge results in limited understanding of these outcomes in trauma patients as a whole across different populations and settings. We aimed to assess and provide a systematic overview of current knowledge about return-to-work (RTW), participation, social support, and QOL in trauma patients up to one year after discharge. METHODS We undertook a systematic review of the literature published since 2010 on RTW, participation, social support, and QOL in adult trauma populations, up to one year from discharge, utilizing the most commonly used measurement tools from three databases: MEDLINE, EMBASE, and the Cochrane Library. We performed a meta-analysis based on the type of outcome, tool for measurement, and the specific effect measure as well as assessed the methodological quality of the included studies. RESULTS A total of 43 articles were included. More than one-third (36%) of patients had not returned to work even a year after discharge. Those who did return to work took more than 3 months to do so. Trauma patients reported receiving moderate social support. There were no studies reporting social participation among trauma patients using the inclusion criteria. The QOL scores of the trauma patients did not reach the population norms or pre-injury levels even a year after discharge. Older adults and females tended to have poorer outcomes. Elderly individuals and females were under-represented in the studies. More than three-quarters of the included studies were from high-income countries (HICs) and had higher methodological quality. CONCLUSION RTW and QOL are affected by trauma even a year after discharge and the social support received was moderate, especially among elderly and female patients. Future studies should move towards building more high-quality evidence from LMICs on long-term socioeconomic outcomes including social support, participation and unpaid work.
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Affiliation(s)
- Siddarth Daniels David
- Health Systems and Policy, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Doctors For You, Mumbai, India.
| | - Anna Aroke
- Doctors For You, Mumbai, India; WHO Collaborating Centre for Research in Surgical care delivery in LMICs, BARC Hospital, Mumbai, India
| | - Nobhojit Roy
- Health Systems and Policy, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; WHO Collaborating Centre for Research in Surgical care delivery in LMICs, BARC Hospital, Mumbai, India
| | - Harris Solomon
- Department of Cultural Anthropology and the Duke Global Health Institute, Duke University, USA
| | - Cecilia Stålsby Lundborg
- Health Systems and Policy, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Martin Gerdin Wärnberg
- Health Systems and Policy, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Function, Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Sweden
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Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan,Correspondence to: Tomoyuki Kawada, Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo113-8602, Japan; Ph: 81-3-3822-2131.
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Challenges of Patients with Spinal Cord Injury During the COVID-19 Pandemic: A Qualitative Study. ARCHIVES OF NEUROSCIENCE 2021. [DOI: 10.5812/ans.118744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Spinal cord injury (SCI) is a chronic condition leading to physical and psychological problems along with numerous economic burdens for patients. In late 2019, an unknown disease called COVID-19 broke out, which quickly spread throughout the world. Objectives: The aim of the present study was to determine the challenges of SCI patients during the COVID-19 pandemic. Methods: This was a qualitative study performed among SCI patients after obtaining the code of ethics from the Research Ethics Committee of Ilam University of Medical Sciences in 2021. Data were collected using semi-structured, face-to-face individual interviews, in accordance with health protocols, in a safe environment without stress until reaching data saturation. Data were saturated after interviewing nine patients; to ensure data saturation, two additional interviews were conducted. Each interview lasted between 30 and 45 minutes, depending on the condition of each patient. The written files of the interviews were analyzed using MAXQDA software. Results: The mean age of the participants was 54 years, and 68% of the participants were male. After analyzing the data obtained from in-person interviews, three main themes, including expectations (need for financial support, need for social support, and need for physical support), concerns (fear of loneliness and fear of death), and health needs (health literacy, access to services and how to transmit the disease), were extracted. Conclusions: Considering the challenges in the three areas of expectations, concerns, and health care, it is necessary to take some measures to reduce these challenges.
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Aaby A, Lykkegaard Ravn S, Kasch H, Andersen TE. Structure and conceptualization of acceptance: a split-sample exploratory and confirmatory factor analysis approach to investigate the multidimensionality of acceptance of spinal cord injury. J Rehabil Med 2021; 53:jrm00232. [PMID: 34557928 PMCID: PMC8638728 DOI: 10.2340/16501977-2876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective To determine the multidimensionality of acceptance of spinal cord injury (SCI). Participants Adults with SCI who were admitted to an SCI centre between 1991 and 2020. Methods All eligible participants (n=686) were invited to complete a survey via REDCap. A 4-dimensional model was hypothesized, which included “Accepting Reality”, “Value Change”, “Letting Go of Control” and “Behavioural Engagement”. Items from 3 acceptance scales were selected to collectively reflect these 4 dimensions: (i) Spinal Cord Lesion-related Coping Strategies Questionnaire, (ii) Coping Orientations to Problems Experienced, and (iii) a modified Acceptance and Action Questionnaire. A split-sample principal component analysis (PCA) and confirmatory factor analysis (CFA) approach was used. Results Complete data were provided by 431 participants (62.8%). A PCA on sub-sample one suggested a 4-factor model based on eigenvalues ≥ 1, corresponding to the hypothesized model of acceptance. A CFA on sub-sample 2 showed good model fit, adding further support to the model. Conclusion These findings suggest that acceptance is a multidimensional construct with 4 facets that represent distinct, but interconnected, psychological processes. This model of acceptance can be used as a framework for future research and clinical practice to deepen our understanding of acceptance processes following severe injuries, such as SCI.
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Affiliation(s)
- Anders Aaby
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark.
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Sturm C, Gutenbrunner CM, Egen C, Geng V, Lemhöfer C, Kalke YB, Korallus C, Thietje R, Liebscher T, Abel R, Bökel A. Which factors have an association to the Quality of Life (QoL) of people with acquired Spinal Cord Injury (SCI)? A cross-sectional explorative observational study. Spinal Cord 2021; 59:925-932. [PMID: 34239041 PMCID: PMC8338547 DOI: 10.1038/s41393-021-00663-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional explorative observational study. OBJECTIVES To identify factors which have an association to the self-perceived Quality of Life (QoL) for persons with acquired spinal cord injury (SCI). SETTING Eight specialized SCI-centers in Germany. The GerSCI survey is the German part of the International Spinal Cord Injury Survey (InSCI). METHODS Self-disclosure questionnaire, created from the InSCI group, translated and adapted for Germany. The questionnaire collects a very broad range of data and, and due to its design as a self-report, is particularly suitable for the analysis on QoL. Because of the content, which is binding for all participating states, it allows a direct comparability of the results. Included in Germany were 1479 persons with acquired SCI aged 18 years and older. RESULTS Various factors were identified with high associations to QoL, including changeable and unchangeable ones, such as those of particular importance: pain, sleep problems, sexual dysfunction, age, and time since onset of SCI. Some results confirmed reports of previous studies, others were surprising. CONCLUSION this study provides an important basis for the planned analysis of the InSCI participating countries in the 6 WHO regions. Germany was able to contribute the largest study population. The concrete study design of InSCI allows us to directly compare data and helps us to improve ourselves within the framework of a "learning health system". Medical measures can be orientated towards the found results, in order to ensure the best possible care and support by the therapeutic team, individually adapted to the person, place of residence and impairment.
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Affiliation(s)
- Christian Sturm
- Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany.
| | | | - Christoph Egen
- Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany
| | | | | | - Yorck B Kalke
- RKU - University and Rehabilitation Clinics Ulm, Ulm, Germany
| | - Christoph Korallus
- Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany
| | - Roland Thietje
- Center for spinal injuries, Trauma Hospital Hamburg, Hamburg, Germany
| | - Thomas Liebscher
- Treatment Centre for Spinal Cord Injuries, Trauma Hospital Berlin, Berlin, Germany
| | - Rainer Abel
- SCI Unit, Klinikum Bayreuth GmbH, Bayreuth, Germany
| | - Andrea Bökel
- Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany
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Ucero-Lozano R, López-Pina JA, Ortiz-Pérez A, Cuesta-Barriuso R. Quality of life and its predictors among adult patients with haemophilic arthropathy. An observational study. BMC Musculoskelet Disord 2021; 22:448. [PMID: 33992116 PMCID: PMC8126122 DOI: 10.1186/s12891-021-04319-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/05/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Recurrent hemarthrosis that begin in childhood lead to progressive joint deterioration. Patients with haemophilia have chronic pain, functional disability and a reduced perception of health-related quality of life. PURPOSE To analyse the perceived quality of life of adult patients with haemophilic arthropathy and its relationship with pain, joint condition, kinesiophobia and catastrophism. METHODS Eighty-three adult patients with haemophilia were included in this multicentre, cross-sectional, descriptive study. Perceived quality of life (36-Item Short Form Health Survey), perceived usual and maximum pain (visual analogue scale), joint condition (Haemophilia Joint Health Score), kinesiophobia (Tampa Scale of Kinesiophobia) and catastrophism (Pain Catastrophizing Scale) were assessed. Sociodemographic, clinical and therapeutic variables and drug consumption for pain control were collected. Descriptive statistics used means and standard deviations. The correlation of quality of life with the dependent variables was calculated with the Pearson correlation test. The differences in quality of life as a function of the binomial variables were calculated with Student's t-test for independent samples. RESULTS Physical component of quality of life perceived by patients with hemophilia is lower than Spanish population (30.51 VS 48.85). Regarding the mental component, patients with hemophilia showed higher values (56.07 VS 49.97). Catastrophism correlated (p < .05) with all items of quality of life questionnaire. Kinesiophobia correlated (p < .05) with all items of quality of life except to role-emotional (r = -.18; p > .05). Habitual and maximal joint pain correlated with all items except to role-emotional (r = - .19 and r = - .09, respectively) and mental component score (r = - .16 and r = - .07, respectively). Catastrophism and weekly drug intake were inversely correlated with quality of life. Age was positively correlated with perceived quality of life. There were differences in quality of life as a function of the severity of haemophilia and the intake of drugs for pain control. CONCLUSIONS The perceived quality of life of adult patients with haemophilia is worse than that of the Spanish population. Pain, kinesiophobia, catastrophism, haemophilia severity and the intake of pain-control medication influence the quality of life of these patients.
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Affiliation(s)
| | | | - Alba Ortiz-Pérez
- Health Psychologist, Free Exercise of the Profession, Madrid, Spain
| | - Rubén Cuesta-Barriuso
- Department of Physiotherapy, University of Murcia, Murcia, Spain.
- Royal Victoria Eugenia Foundation, Madrid, Spain.
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Finlay KA, Hearn JH, Chater A. The impact of neurological disability and sensory loss on mindfulness practice. Disabil Rehabil 2021; 44:3825-3833. [PMID: 33621135 DOI: 10.1080/09638288.2021.1887946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Mindfulness-based approaches are increasingly recommended in the management of medical conditions associated with sensory loss and absence, such as Spinal Cord Injury (SCI), Multiple Sclerosis (MS) and Functional Neurological Disorder (FND). Yet the implications of undertaking practices such as body scanning when living with sensory loss have not been considered. This study aimed to explore the impact of sensory loss on the practice and experience of mindfulness in qualified mindfulness teachers with SCI/FND/MS. METHODS Eight mindfulness teachers (5 females, 3 males) with SCI/FND/MS, sensory loss and wheelchair use were recruited from mindfulness teacher databases. In-depth, semi-structured interviews were undertaken, lasting between 50 and 93 min. Interviews were transcribed verbatim and analysed using Interpretative Phenomenological Analysis. Idiographic analyses for descriptive, linguistic and conceptual themes were completed before cross-case analyses. RESULTS Analyses resulted in two superordinate themes: (1) Adopting your Body; and (2) Sensation without Loss. These themes reflected the challenge of overcoming initial resistance to areas of the body with sensory disruption, building a relationship with the whole body, such that sensory awareness could be visualised and experienced without proprioception. CONCLUSIONS Mindfulness offers a unique approach to accepting and working with the body after paralysis or sensory loss. Fundamental to the use of mindfulness with such populations, is the prioritisation of inclusive sensory language and exploring sensory absence as well as sensory presence. The cognitive and emotional outcomes of body scanning may be uniquely elevated in populations with neurophysiological disorders, highlighting the benefits of mindfulness for adaptive and protective self-management.IMPLICATIONS FOR REHABILITATIONMindfulness-based practices which focus on the body and sensation are accessible to people with neurological limitations.Mindfulness techniques can be extended through the use of visualisation strategies to encourage (non-proprioceptive) awareness of paralysed limbs or areas of the body with sensory loss.The language used in mindfulness-based interventions may need adapted by practitioners so that it remains inclusive for people with sensory loss as well as sensory presence.Additional care needs to be taken when using body scans during mindfulness as they have the potential to exacerbate psychological distress in people with reduced sensory awareness.
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Affiliation(s)
- K A Finlay
- School of Psychology Clinical Language Sciences, University of Reading, Reading, UK
| | - J H Hearn
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - A Chater
- School of Sport Science and Physical Activity, University of Bedfordshire, Luton, UK
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Weber L, Voldsgaard NH, Holm NJ, Schou LH, Biering-Sørensen F, Møller T. Exploring the contextual transition from spinal cord injury rehabilitation to the home environment: a qualitative study. Spinal Cord 2021; 59:336-346. [PMID: 33564119 PMCID: PMC7943422 DOI: 10.1038/s41393-020-00608-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 12/04/2020] [Accepted: 12/04/2020] [Indexed: 11/16/2022]
Abstract
Study design Explorative qualitative study based on an interpretative phenomenological approach. Objectives This study explored the possibility of transferring knowledge and skills from a spinal cord injury (SCI) unit to the home environment; the individual and structural factors that potentially influenced this transfer; and its compatibility with a meaningful everyday life. Setting Hospital-based rehabilitation unit and community in Denmark. Methods Fourteen individuals with SCI were selected with maximum variation according to age, sex, marital status, and level of injury. In-depth, semi-structured interviews were conducted in the participants’ homes, 2–10 months after discharge from an SCI unit. Data analysis involved taking an interpretative phenomenological approach combined with a template analysis and applying the transfer of training theory to the discussion. Results Transitioning from the SCI unit to the home environment involved a multidimensional change of context in which most of the participants’ previous life roles had changed. This overarching theme had a decisive influence on: balancing loss and acceptance, facing external structural barriers, and the strength of social relationships when the knowledge and skills acquired at the unit were applied in a meaningful everyday life. Conclusions Transition from the SCI unit to the home environment is influenced by a multidimensional change of context that may restrict the use of acquired skills post-discharge, provide distant prospects for tertiary health promotion, and aggravate the experience of loss in people with SCI. Maintaining relationships is a strong mediator for transferring skills and re-establishing a meaningful everyday life.
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Affiliation(s)
- Lene Weber
- The University Hospitals Centre for Health Research (UCSF), Rigshospitalet, Copenhagen University Hospital, Department, 9701, Copenhagen, Denmark. .,Research Unit on Brain Injury Rehabilitation Copenhagen (RUBRIC), Department of Neurorehabilitation, Traumatic Brain Injury Unit, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Nanna Hoffgaard Voldsgaard
- The University Hospitals Centre for Health Research (UCSF), Rigshospitalet, Copenhagen University Hospital, Department, 9701, Copenhagen, Denmark
| | - Nicolaj Jersild Holm
- Department of Spinal Cord Injuries, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lone Helle Schou
- Department of Nursing and Nutrition, University College Copenhagen, Copenhagen, Denmark
| | - Fin Biering-Sørensen
- Department of Spinal Cord Injuries, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Tom Møller
- The University Hospitals Centre for Health Research (UCSF), Rigshospitalet, Copenhagen University Hospital, Department, 9701, Copenhagen, Denmark
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Kathnelson JD, Kurtz Landy CM, Tamim H, Ditor DS, Gage WH. Utilizing the Delphi Method to Assess Issues of Sexuality for Men Living with Spinal Cord Injury. SEXUALITY AND DISABILITY 2021. [DOI: 10.1007/s11195-020-09673-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gismero-González E, Bermejo-Toro L, Cagigal V, Roldán A, Martínez-Beltrán MJ, Halty L. Emotional Impact of COVID-19 Lockdown Among the Spanish Population. Front Psychol 2020; 11:616978. [PMID: 33391136 PMCID: PMC7773811 DOI: 10.3389/fpsyg.2020.616978] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/26/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has resulted in some populations being confined to their homes as part of infection control measures. This situation can be hard to cope with due to separation from loved ones, prohibition of regular activities, fear of infection, loss of freedom, and so on. These negative impacts cause considerable psychological stress, and all the more so when the situation continues for an extended period, as was the case in Spain. The present study was aimed at investigating the effects of COVID-19 quarantine on the emotional functioning of confined Spanish individuals after 8 weeks of lockdown by means of a cross-sectional study. The possible associations between changes in emotional functioning and demographic variables (age and sex), health habits (physical exercise, following a routine, and smoking), social support, and resilience were also analyzed. METHODS A total of 906 Spanish adults completed an online survey to gather information about their prevailing mood and affects (before and after 8 weeks of lockdown), using the Positive and Negative Affect Schedule (PANAS) (Watson et al., 1988), and other variables related to their habits and protective factors. FINDINGS As expected, the data indicated an increase in negative affects (e.g., "upset," "afraid," "distressed") and a decrease in positive affects after 8 weeks under lockdown, as well as a general decline in overall mood. The largest increases in negative affects were observed in young adults (18-35 years) and women. We did not find any differences between people who were or were not diagnosed with COVID-19. Adhering to a routine, maintaining the same weight, and moderate physical exercise were associated with fewer negative affects, which indicates they are important protective factors, as are perceived social support and resilience. CONCLUSION In order to mitigate the psychological impact of confinement, it is important to develop psychoeducational measures that encourage subjects to adhere to health habits and promote social support and resilience as protective factors. A special preventive focus should be placed on the most vulnerable population groups, namely women and young adults. For a public health lockdown to succeed, its negative consequences must be minimized insofar as possible through adequate knowledge of the risk factors and protective factors, and by means of prevention-oriented organization.
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Affiliation(s)
- Elena Gismero-González
- Department of Psychology and Clinical Unit of Psychology (UNINPSI), Comillas Pontifical University, Madrid, Spain
| | - Laura Bermejo-Toro
- Department of Psychology and Clinical Unit of Psychology (UNINPSI), Comillas Pontifical University, Madrid, Spain
| | - Virginia Cagigal
- Department of Psychology and Clinical Unit of Psychology (UNINPSI), Comillas Pontifical University, Madrid, Spain
| | - Angustias Roldán
- Department of Psychology, Comillas Pontifical University, Madrid, Spain
| | | | - Lucía Halty
- Department of Psychology, Comillas Pontifical University, Madrid, Spain
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Jörgensen S, Costa Andersson MV, Lexell J. Changes in health-related quality of life among older adults aging with long-term spinal cord injury. Spinal Cord 2020; 59:769-776. [PMID: 33184513 PMCID: PMC8257479 DOI: 10.1038/s41393-020-00579-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional and longitudinal. OBJECTIVES To (i) describe health-related quality of life (HRQoL) and changes over 6 years in older adults aging with long-term spinal cord injury (SCI) and (ii) investigate how changes in HRQoL are associated with age, gender, and injury characteristics. SETTING Community in southern Sweden. METHODS From the initial 123 participants (years 2011-2012) in the Swedish Aging with Spinal Cord Injury Study (SASCIS), 77 individuals (32% women, C1-L3, AIS A-D, median age 66 years, median time since injury 31 years, 30% complete injuries) were assessed 6 years later. HRQoL was rated with the Spinal Cord Injury Quality of Life Questionnaire (SCI QL-23). Associations were investigated using multivariable linear regression analyses. RESULTS The median rating of global QoL (scale range 0-100) was relatively high at both assessments (67 and 83, respectively). There was a large variability in all HRQoL-domains and no significant changes over 6 years. As compared to an AIS D injury, a tetraplegia AIS A-C injury and tetraplegia and paraplegia AIS A-C injuries were associated with positive change in depressive symptoms and global QoL, respectively. CONCLUSIONS Older adults aging with long-term SCI show large variations in all HRQoL-domains and have the potential to maintain a high and stable level of HRQoL over time. Persons with AIS D injuries may need increased attention to mitigate negative changes in depressive symptoms and global QoL. Further studies are needed to identify modifiable factors associated with changes in HRQoL in older adults aging with long-term SCI.
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Affiliation(s)
- Sophie Jörgensen
- Department of Health Sciences, Lund University, Lund, Sweden. .,Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.
| | | | - Jan Lexell
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
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