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Daoud A, Nasser Z, Elias C, Elias E. Predictive factors and quality of life assessment among patients with spinal cord injury in the Middle East: a systematic review. Qual Life Res 2024; 33:2081-2094. [PMID: 38700755 DOI: 10.1007/s11136-024-03650-y] [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] [Accepted: 03/11/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE Spinal cord injury (SCI) is impairment of the spinal cord that adversely affects patients' health and quality of life (QoL). The aim of the study was to assess the quality of life (QoL) and related factors in patients with traumatic spinal cord injury in Middle Eastern countries. METHODS PubMed, Ovid Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EBSCOhost, psycINFO, and Google Scholar were systematically searched for eligible studies published in peer-reviewed journals up till October 2023. RESULTS Out of 1060 papers found in the literature, only 18 studies from Iran, Lebanon, and Turkey met the inclusion criteria. The majority of the studies employed the SF-36 scale to assess for QoL. In general, all SCI patients had reduced QoL scores when compared to the healthy population. Some of the factors such as age, education level, the level of injury, time since injury onset, marriage, and job opportunities were correlated with SCI subjects QoL. Our papers were assessed and found to be of both good and high quality. CONCLUSION This review emphasizes the significant shortage of QoL studies among SCI patients in the Middle East countries and highlights the importance of improving the QoL of this marginalized population. This work should enhance the governments to establish rehabilitation centers, social and economic support systems, and mental health services to diminish complications arising from SCI.
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Affiliation(s)
- Ali Daoud
- Department of Biology, Illinois College, Jacksonville, IL, USA
| | - Zeina Nasser
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Charbel Elias
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Elias Elias
- Department of Neurological Surgery, University of Texas Southwestern, 5303 Harry Hines Blvd 7Th Floor, Dallas, TX, USA.
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Krause JS, DiPiro ND, Dismuke-Greer CE, Laursen-Roesler J. Relationships of self-reported opioid and benzodiazepine use with health-related quality of life among adults with spinal cord injury. Disabil Health J 2024:101668. [PMID: 38987087 DOI: 10.1016/j.dhjo.2024.101668] [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: 01/29/2024] [Revised: 05/23/2024] [Accepted: 06/26/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND There is limited understanding of the relationships between prescription opioid and benzodiazepine use and indices of health-related quality of life (HRQOL) among those with spinal cord injuries (SCI). OBJECTIVE To identify the relationships between self-reported prescription opioid and benzodiazepine use and two indicators of HRQOL, number of days in poor physical health and poor mental health in the past 30 days among adults with SCI. METHODS A cross-sectional cohort study of 918 adults with chronic (>1 year), traumatic SCI living in the Southeastern United States was conducted. Participants completed a self-report assessment (SRA). RESULTS In the preliminary model, both opioid and benzodiazepine use were associated with a greater number of days in poor physical health and poor mental health in the past month. After controlling for health conditions (pain intensity, spasticity, anxiety and perceived sleep insufficiency), opioid use was associated with 2.04 (CI = 0.69; 3.39) additional poor physical health days in the past 30 days, and benzodiazepine use was associated with 2.18 (CI = 0.70; 3.64) additional days of poor mental health. Age was associated with greater number of poor physical health days and fewer poor mental health days. Lower income was associated with poor mental health days. Most of the health conditions were significantly related to the number of past month poor physical and mental health days. CONCLUSIONS Opioid and benzodiazepine use are associated with poor physical and mental HRQOL, even after controlling for health conditions. Treatment strategies should consider potential unanticipated negative consequences of pharmacological interventions.
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Affiliation(s)
- James S Krause
- College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
| | - Nicole D DiPiro
- College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
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Badr MS, Martin JL, Sankari A, Zeineddine S, Salloum A, Henzel MK, Strohl K, Shamim-Uzzaman A, May AM, Fung CH, Pandya N, Carroll S, Mitchell MN. Intensive support does not improve positive-airway pressure use in spinal cord injury/disease: a randomized clinical trial. Sleep 2024; 47:zsae044. [PMID: 38422375 DOI: 10.1093/sleep/zsae044] [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: 09/29/2023] [Revised: 01/24/2024] [Indexed: 03/02/2024] Open
Abstract
STUDY OBJECTIVE Treatment of sleep-disordered breathing (SDB) with positive airway pressure (PAP) therapy has unique clinical challenges in individuals living with spinal cord injuries and diseases (spinal cord injury [SCI]/D). Interventions focused on increasing PAP use have not been studied in this population. We aimed to evaluate the benefits of a program to increase PAP use among Veterans with SCI/D and SDB. METHODS Randomized controlled trial comparing a behavioral Intervention (n = 32) and educational control (n = 31), both including one face-to-face and five telephone sessions over 3 months. The intervention included education about SDB and PAP, goal setting, troubleshooting, and motivational enhancement. The control arm included non-directive sleep education only. RESULTS Primary outcomes were objective PAP use (nights ≥4 hours used within 90 days) and sleep quality (Pittsburgh Sleep Quality Index [PSQI] at 3 months). These did not differ between intervention and control (main outcome timepoint; mean difference 3.5 [-9.0, 15.9] nights/week for PAP use; p = .578; -1.1 [-2.8, 0.6] points for PSQI; p = .219). Secondary outcomes included fatigue, depression, function, and quality of life. Only fatigue improved significantly more in the intervention versus the control group (p = .025). Across groups, more PAP use was associated with larger improvements in sleep quality, insomnia, sleepiness, fatigue, and depression at some time points. CONCLUSIONS PAP use in Veterans with SCI/D and SDB is low, and a 3-month supportive/behavioral program did not show significant benefit compared to education alone. Overall, more PAP use was associated with improved symptoms suggesting more intensive support, such as in-home assistance, may be required to increase PAP use in these patients. CLINICAL TRIALS INFORMATION Title: "Treatment of Sleep Disordered Breathing in Patients with SCI." Registration number: NCT02830074. Website: https://clinicaltrials.gov/study/NCT02830074?cond=Sleep%20Apnea&term=badr&rank=5.
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Affiliation(s)
- M Safwan Badr
- Department of Medicine, John D. Dingell VA Medical Center, Detroit, Michigan, USA
- Department of Medicine, Wayne State University School of Medicine, Detroit, MI, USA
| | - Jennifer L Martin
- Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Abdulghani Sankari
- Department of Medicine, John D. Dingell VA Medical Center, Detroit, Michigan, USA
- Department of Medicine, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Medical Education, Ascension Providence Hospital, Southfield, MI, USA
| | - Salam Zeineddine
- Department of Medicine, John D. Dingell VA Medical Center, Detroit, Michigan, USA
- Department of Medicine, Wayne State University School of Medicine, Detroit, MI, USA
| | - Anan Salloum
- Department of Medicine, John D. Dingell VA Medical Center, Detroit, Michigan, USA
- Department of Medicine, Wayne State University School of Medicine, Detroit, MI, USA
| | - M Kristina Henzel
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
- Department of Medicine, VA Northeast Ohio Healthcare System, Cleveland, OH, USA
| | - Kingman Strohl
- Department of Medicine, VA Northeast Ohio Healthcare System, Cleveland, OH, USA
| | - Afifa Shamim-Uzzaman
- Department of Neurology, VA Ann Arbor Healthcare System
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Anna M May
- Department of Medicine, VA Northeast Ohio Healthcare System, Cleveland, OH, USA
| | - Constance H Fung
- Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Nishtha Pandya
- Department of Medicine, John D. Dingell VA Medical Center, Detroit, Michigan, USA
- Department of Medicine, Wayne State University School of Medicine, Detroit, MI, USA
| | - Sean Carroll
- Department of Medicine, John D. Dingell VA Medical Center, Detroit, Michigan, USA
- Department of Medicine, Wayne State University School of Medicine, Detroit, MI, USA
| | - Michael N Mitchell
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
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Sunna T, Elias E, Summaka M, Zein H, Elias C, Nasser Z. Quality of life among men with spinal cord injury in Lebanon: A case control study. NeuroRehabilitation 2019; 45:547-553. [PMID: 31868697 DOI: 10.3233/nre-192916] [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: 11/15/2022]
Abstract
BACKGROUND Spinal cord injury (SCI) is a permanent disability which negatively affects individuals' health and particularly their quality of life. OBJECTIVE To assess the quality of life (QoL) among Lebanese men with spinal cord injury and to compare it to a healthy control group. METHODS A case control study was conducted. Fifty-one Lebanese patients with spinal cord injury and 51 age- sex-matched healthy persons were included in the study. RESULTS Compared to healthy controls, the mean scores of eight domains of SF-36 were significantly lower in SCI group: physical functioning (PF) (26.5 vs 87; p value <0.0001), role limitations due to physical (RP) (57.8 vs 93.6; p value <0.0001), bodily pain (BP) (60.5 vs 90.7; p value, 0.0001), general health (GH) (49.5 vs 76.6; p value <0.0001), vitality (VT) (51.2 vs 71.3; p value <0.0001), social functioning (SF) (68.9 vs 91.2; p value <0.0001), role limitations due to emotional problems (RE) (71.2 vs 91.5; p value 0.003) and mental health (MH) (62.9 vs 79; p value <0.0001). Concerning PCS and MCS scores, SCI patients reported significantly lower scores than control group (p value <0.0001). CONCLUSION Participants with SCI reported reduced QoL in comparison with normal individuals.
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Affiliation(s)
- Tarek Sunna
- Division of Neurosurgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Elias Elias
- Division of Neurosurgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Marwa Summaka
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
| | - Hiba Zein
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
| | - Charbel Elias
- Division of Neurosurgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Zeina Nasser
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
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Comparing life satisfaction and functioning 15 years after September 11, 2001 among survivors with and without injuries: a mixed-method study. Qual Life Res 2019; 28:2787-2797. [PMID: 31073819 DOI: 10.1007/s11136-019-02194-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE This study compares life satisfaction and limited activity days among 9/11 survivors with and without physical injuries using quantitative and qualitative approaches. METHODS The study population included World Trade Center Health Registry enrollees who reported being injured on 9/11 in 2003-2004 and a sample of non-injured enrollees who participated in a cross-sectional substudy. We used multivariable logistic regression to examine differences in life satisfaction and number of limited activity days in the last 30 days between those with and without injuries. The free-response section of the survey was analyzed qualitatively to compare themes of those with and without injuries. RESULTS The final sample consisted of 2821 adult enrollees. Compared to those who were not injured, those who were injured on 9/11 were more likely to report being unsatisfied with their life (adjusted odds ratio (AOR): 1.5, 95% confidence intervals (CI) 1.1-2.0) and have 14 or more limited activity days in the last 30 days (AOR: 1.4, 95% CI 1.0-1.9). Among those who were injured, being partially or completely prevented from working increased the odds of being unsatisfied with life and having 14 or more limited activity days. In qualitative analysis, the emotional trauma experienced from 9/11 was a major and common theme, regardless of injury status. Those with injuries were more likely to express anger/lack of recognition/appreciation, describe substance use/abuse, and have financial/health care access issues. CONCLUSIONS More than 15 years after 9/11, those who were injured continue to be impacted, reporting lower life satisfaction and more functional impairment.
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Woodruff SI, Galarneau MR, McCabe CT, Luu BN, Sack DI, Han PP. Body-Region-Specific Injuries as Predictors of Psychosocial Outcomes Among Those Injured in Combat: Results From the Wounded Warrior Recovery Project. MILITARY PSYCHOLOGY 2018. [DOI: 10.1037/mil0000181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Michael R. Galarneau
- Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, San Diego, California
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Health-related quality of life among US military personnel injured in combat: findings from the Wounded Warrior Recovery Project. Qual Life Res 2018; 27:1393-1402. [DOI: 10.1007/s11136-018-1806-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2018] [Indexed: 10/18/2022]
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Health-related quality of life among adults 65 years and older in the United States, 2011–2012: a multilevel small area estimation approach. Ann Epidemiol 2017; 27:52-58. [DOI: 10.1016/j.annepidem.2016.09.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 09/29/2016] [Accepted: 09/30/2016] [Indexed: 11/17/2022]
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Effect of Spinal Cord Injury on Quality of Life of Affected Soldiers in India: A Cross-Sectional Study. Asian Spine J 2016; 10:267-75. [PMID: 27114767 PMCID: PMC4843063 DOI: 10.4184/asj.2016.10.2.267] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 10/06/2015] [Accepted: 10/28/2015] [Indexed: 11/08/2022] Open
Abstract
STUDY DESIGN A prospective cross-sectional study with convenience sampling approach was done to assess quality of life (QoL) in 100 soldiers and veterans affected by spinal cord injury (SCI). PURPOSE SCI affects almost every aspect of the life of an affected individual. This study was done to measure the impact of SCI on QoL of affected soldiers and veterans using the WHOQOL-BREF questionnaire. OVERVIEW OF LITERATURE The devastating effect of SCI on QoL is well known. However, this study is unique in that it includes soldiers and veterans, who constitute a large, but excluded, cohort in most demographic studies. METHODS A cross-sectional study was done at two SCI rehabilitation centres of the Indian armed forces. Data was collected by face-to-face interviews from 100 patients, which included both sociodemographic data as well as all the questions included in WHOQOL-BREF questionnaire. Statistical analysis was performed using SPSS software. RESULTS Age and marital status did not have any influence on QoL. Level of injury (paraplegic or quadriplegic), level of education and presence of other medical co-morbidities had the most significant influence on QoL. Presence of other medical co-morbidities had a negative influence on QoL. CONCLUSIONS Identification of factors having a positive and negative influence on QoL help in formulating measures and policies that positively influence the QoL following SCI in soldiers. Future longitudinal studies with larger sample sizes and assessment of additional variables in addition to WHOQOL-BREF, like presence/absence of secondary complications, are required to bring about policy changes to provide SCI patients with additional support and increased access to equipment or lifestyle interventions.
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Quality of Life in Iranian men With Spinal Cord Injury in Comparison With General Population. ARCHIVES OF NEUROSCIENCE 2014. [DOI: 10.5812/archneurosci.21529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Litchke LG, Lloyd LK, Schmidt EA, Russian CJ, Reardon RF. Effects of concurrent respiratory resistance training on health-related quality of life in wheelchair rugby athletes: a pilot study. Top Spinal Cord Inj Rehabil 2013; 18:264-72. [PMID: 23459144 DOI: 10.1310/sci1803-264] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE To compare the effects of 9 weeks of training with a concurrent flow resistance (CFR) device versus a concurrent pressure threshold resistance (CPTR) device on health-related quality of life (HRQoL) in wheelchair rugby (WR) athletes. METHOD Twenty-four male WR athletes (22 with tetraplegia, 1 with a spastic cerebral palsy, and 1 with congenital upper and lower limb deformities) were matched by lesion level, completeness of injury, and rugby classification prior to being randomly assigned to 1 of 3 groups: (1) CPTR (n=8), (2) CFR (n=8), or (3) controls (CON, n=8). Pre/post testing included assessment of HRQoL as measured by the Short-Form Health Survey Version 2.0 (SF-36v2). Manufacturer protocol guidelines for the CFR and CPTR groups were followed for breathing exercises. RESULTS Sixteen participants completed the study (CPTR=4, CFR=5, CON=7). The Mann-Whitney U rank order revealed significantly greater reductions in bodily pain (P = .038) and improvements in vitality (P = .028) for CFR versus CON. CONCLUSION Results from this study suggest that training with a CFR device improves some aspects of HRQoL (eg, vitality and bodily pain) in WR athletes. Further research with a larger sample size is needed to examine the impact of these devices on improving HRQoL for wheelchair athletes.
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Fortmann AL, Rutledge T, Corey McCulloch R, Shivpuri S, Nisenzon AN, Muse J. Satisfaction with life among veterans with spinal cord injuries completing multidisciplinary rehabilitation. Spinal Cord 2013; 51:482-6. [DOI: 10.1038/sc.2012.172] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Shen C, Sambamoorthi U. Associations between health-related quality of life and financial barriers to care among women veterans and women non-veterans. Women Health 2012; 52:1-17. [PMID: 22324355 DOI: 10.1080/03630242.2011.641713] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The authors of this study examined the association between health-related quality of life and financial barriers to care, defined as not getting the needed care due to cost considerations. To better understand health-related quality of life among women veterans, the authors compared women veterans to women non-veterans. The authors conducted cross-sectional analyses using data from the 2009 Behavioral Risk Factor Surveillance System survey. The authors assessed four health-related quality of life measures: (1) general health; (2) physical health; (3) mental health; and (4) functional status. The authors performed multinomial logistic regressions to examine the relationship between financial barriers to receiving healthcare and health-related quality of life measures after controlling for other independent variables. The authors included women veterans not in active military duty (N = 3,747) and a matched sample of women non-veterans (N = 3,747), selected using a propensity score method so that they would have distributions of demographic and socioeconomic characteristics similar to those of the veterans. Overall, 14% of women reported financial barriers. Women who reported financial barriers to receiving healthcare were more likely to have poor health-related quality of life in all four dimensions than those who did not report such barriers. Compared to women non-veterans, women veterans did not differ in reported financial barriers but were more likely to report poor health-related quality of life. Reporting financial barriers to receiving needed healthcare was significantly associated with poor health-related quality of life among women. Veteran status was also significantly associated with poor health-related quality of life. These findings suggest the need for healthcare policy makers and practitioners to align emerging new models of healthcare delivery to improve health-related quality of life for women veterans.
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Affiliation(s)
- Chan Shen
- Department of Biostatistics, Universityof Texas, 1400 Pressler Street, Anderson Cancer Center, Houston, TX 77030, USA.
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Stroupe K, Manheim L, Evans C, Guihan M, Ho C, Li K, Cowper-Ripley D, Hogan T, St. Andre J, Huo Z, Smith B. Cost of Treating Pressure Ulcers for Veterans with Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2011. [DOI: 10.1310/sci1604-62] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Teo SHJ, Sew S, Backman C, Forwell S, Lee WK, Chan PL, Dean E. Health of people with spinal cord injury in Singapore: implications for rehabilitation planning and implementation. Disabil Rehabil 2010; 33:1460-74. [PMID: 21091048 DOI: 10.3109/09638288.2010.533812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This study aimed to provide a broad overview of the health of people with spinal cord injury (SCI) in Singapore, so as to highlight areas of potential need. These areas could then guide future research and rehabilitation programme development. METHODS Demographic data, injury information and information about SCI-related secondary impairments, chronic conditions and their associated risk factors, medical and hospital utilisation, participation (Craig Handicap Assessment and Reporting Technique) and life satisfaction (Satisfaction with Life Scale) were collected via interviews from people living with traumatic SCI. RESULTS On average, participants (50 men and 5 women) were aged 48.3 ± 16.54 years and had had their SCIs for 5 years. -75% with tetraplegia. The most prevalent SCI-related secondary impairments were pain, spasms, bladder problems, bowel problems and oedema. Chronic conditions and their associated risk factors were prevalent. Participation and life satisfaction scores were lower than those reported for similar populations cross-culturally. CONCLUSION The study revealed several health areas that may be affecting the overall health of people with SCI in Singapore. By focusing on community reintegration and health promotion, physiotherapists and other rehabilitation professionals may augment health outcomes and improve the quality of life of this population in Singapore.
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Affiliation(s)
- Sock Hui Joy Teo
- Tan Tock Seng Hospital Rehabilitation Centre, Singapore, Singapore.
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Saadat S, Javadi M, Divshali BS, Tavakoli AH, Ghodsi SM, Montazeri A, Rahimi-Movaghar V. Health-related quality of life among individuals with long-standing spinal cord injury: a comparative study of veterans and non-veterans. BMC Public Health 2010; 10:6. [PMID: 20047697 PMCID: PMC2819993 DOI: 10.1186/1471-2458-10-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Accepted: 01/05/2010] [Indexed: 12/03/2022] Open
Abstract
Background Spinal cord-injured (SCI) patients experience poor health-related quality of life (HRQOL) and they usually report lower HRQOL than the general population or population subgroups in Iran and elsewhere. The aim of this study was to compare HRQOL between veterans and non-veterans with SCI in Iran. Methods This was a cross-sectional study. HRQOL was measured using the 36-item Short Form Health Survey (SF-36). Thirty-nine male veterans and 63 non-veteran males with SCI were included in the study. Regression analyses were applied to determine the variables affecting physical and mental health-related quality of life among the patients. Results The male veterans had a lower HRQOL than the non-veterans with SCI. The differences were significant for all measures except for physical and social functioning. The greatest difference was observed for bodily pain (P = 0.001). The regression analysis results indicated that a longer time since injury was associated (P = 0.01) with better physical health-related quality of life (PCS), while being a veteran (P < 0.001) and having a spinal lesion in the cervical region (P = 0.001) were associated with poorer PCS. Older age (P < 0.001) and higher education (P = 0.01) were associated with better mental health-related quality of life (MCS), while being a veteran and having a spinal lesion in the cervical region (P = 0.02) were associated with poorer MCS. Conclusion The study findings showed that veterans with SCI experienced lower HRQOL than their non-veteran counterparts. A qualitative study is recommended to evaluate why HRQOL was lower in veterans than in non-veterans with SCI although veterans had higher incomes as a result of their pensions and increased access to equipment, and medications. To improve quality of life in both veterans and non-veterans with spinal cord injuries, policy changes or implementation of new interventions may be essential so that veterans could receive additional support (e.g. counseling, recreation therapy, vocational therapy, etc.) and non-veterans could meet their basic needs.
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Affiliation(s)
- Soheil Saadat
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Cardiovascular Disease in Persons with Spinal Cord Dysfunction—An Update on Select Topics. Phys Med Rehabil Clin N Am 2009; 20:737-47. [DOI: 10.1016/j.pmr.2009.06.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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