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Watson PK, Stendell L, Quel de Oliveira C, Middleton JW, Arora M, Davis GM. Leisure-time physical activity motives and perceived gains for individuals with spinal cord injury. Spinal Cord 2024; 62:546-552. [PMID: 39080394 PMCID: PMC11368805 DOI: 10.1038/s41393-024-01013-5] [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: 01/23/2024] [Revised: 07/01/2024] [Accepted: 07/05/2024] [Indexed: 09/04/2024]
Abstract
STUDY DESIGN Longitudinal cross-sectional. OBJECTIVES To examine motives to, and perceived gains from, leisure-time physical activity (LTPA) in people with spinal cord injury (SCI). SETTING Community. METHODS One hundred and five physically active individuals with SCI undertook an online survey and a semi-structured interview. The Exercise Motives and Gains Inventory was used to examine the movies towards, and the gains from LTPA, and the Leisure-time Physical Activity Questionnaire was administered via interview to gather LTPA data. A cross-sectional analysis, which included descriptive, inferential, and regression statistics, was conducted on all participants, physical activity (PA) guideline adherers and PA guideline non-adherers. RESULTS The most common motives for LTPA were improvements in health and fitness, management of appearance and weight, and avoidance of illness. The most common gains from LTPA included improved health, fitness, strength and endurance, increased nimbleness, and enjoyment and revitalisation. CONCLUSIONS Whilst health enhancement appears to be a significant motivator for LTPA, other psychosocial aspects, such as affiliation and revitalisation, appear to influence engagement and volume of LTPA. Regular LTPA should be encouraged for its health benefits, and emphasis should be placed on promoting its ability to reduce illness, facilitate affiliation, and manage stress.
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Affiliation(s)
- Paul K Watson
- Discipline of Exercise and Sport Sciences, Sydney School of Health Sciences, Faulty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Laura Stendell
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Camila Quel de Oliveira
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - James W Middleton
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, Sydney, NSW, Australia
- Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Mohit Arora
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, Sydney, NSW, Australia
- Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Glen M Davis
- Discipline of Exercise and Sport Sciences, Sydney School of Health Sciences, Faulty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Almohayya BM, Alotaibi AA. Disability attitudes in healthcare scale: translation and cross-cultural validation into Arabic using various medical samples. Disabil Rehabil 2024:1-10. [PMID: 39078085 DOI: 10.1080/09638288.2024.2385735] [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: 09/18/2023] [Revised: 07/21/2024] [Accepted: 07/24/2024] [Indexed: 07/31/2024]
Abstract
PURPOSE Cross-cultural adaptation of the Disability Attitudes in Health Care Scale (DAHCS) into Arabic to assess the attitude toward people with disabilities. The objective of this study was to: firstly, translate and cross-culturally adapt the DAHCS into Arabic and secondly, assess its psychometric properties. Further, the goal was to investigate bachelor medical students' and doctors' attitude toward people with disabilities and highlight the need to establish the scale's reliability and validity by employing various samples. METHODS A convenience sample of 201 medical students and 105 doctors was used. Arabic DAHCS factors were extracted and confirmed by Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA). RESULTS The findings revealed that medical professionals and students hold a positive attitude toward people with disabilities. The Mann-Whitney U and Kruskal-Wallis tests revealed no significant differences in the study's variables. EFA identified four factors. CFA showed a good fit to the model. Also, convergent and discriminant validity were achieved. Cronbach's Alpha and McDonald's Omega values for all factors were satisfactory. However, the study found a low value of Cronbach's Alpha and Omega for the fourth factor. CONCLUSIONS The DAHCS was cross-culturally adapted into the Arabic language and its validity and reliability were achieved.
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Affiliation(s)
- Bander M Almohayya
- Special Education Department, College of Education, University of Hail, Hail, Saudi Arabia
| | - Abdulhadi A Alotaibi
- Special Education Department, College of Education, Umm Al-Qura University, Makkah, Saudi Arabia
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Hotta GH, Aguiar DP, Alves GCVDM, Oliveira LP, de Leopoldino MAM, Fortes JPA, Oliveira FCDMB, Santos FFU. ORTHOSTATIC SUPPORT IN PARAPLEGIC AND AMPUTEE PATIENTS: A CONTROLLED TRIAL. ACTA ORTOPEDICA BRASILEIRA 2024; 32:e271849. [PMID: 38532862 PMCID: PMC10962110 DOI: 10.1590/1413-785220243201e271849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/19/2023] [Indexed: 03/28/2024]
Abstract
Introduction Functional incapacity caused by physical alterations leads to significant limitations in daily activities and has a major impact on the return of people with disabilities to the social space and the workplace. This calls for an evaluation of the long-term influence of the use of a device specially developed for orthostatic posture on the physiological, biomechanical and functional parameters of amputees and spinal cord patients. Objective The objective was evaluate the effect of postural support device use on function, pain, and biomechanical and cardiologic parameters in spinal cord injury and amputees patients compared to a control group. Methods The orthostatic device was used by the participants for a period of ten consecutive days, for three cycles of 50 minutes each day, and a 15-day follow-up. Participants were positioned and stabilized using adjustable straps on the shoulders, trunk, and hips. The primary outcome was brief pain inventory. Fifteen participants were included the control group, 15 in the amputee group, and 15 in the spinal cord group. Results Our results demonstrate that the use of the device allows the orthostatic position of amputees and spinal cord patients evaluated for ten days, leading to improved functionality and pain in the spinal cord and amputee groups compared to the control group. In addition, no changes were observed for secondary outcomes, indicating that the use of the device did not cause harm interference to patients. Conclusion The long-term use of the orthostatic device is beneficial for improving functionality, reduce pain in amputees and spinal cord injury patients. Level of evidence II; Therapeutic Studies - Investigating the results of treatment.
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Affiliation(s)
- Gisele Harumi Hotta
- Universidade de São Paulo, School of Medicine of Ribeirão Preto, Health Sciences Department, Ribeirão Preto, SP, Brazil
| | - Débora Pinheiro Aguiar
- Centro de Pesquisa, Desenvolvimento e Inovação da Dell, Dell Lead, Fortaleza, CE, Brazil
| | | | - Liana Praça Oliveira
- Centro Universitário Estácio do Ceará, Physiotherapy Department, Fortaleza, Brazil
| | | | | | - Francisco Carlos de Mattos Brito Oliveira
- Centro de Pesquisa, Desenvolvimento e Inovação da Dell, Dell Lead, Fortaleza, CE, Brazil
- Universidade Estadual do Ceará, Computation Sciences Department, Fortaleza, CE, Brazil
| | - Francisco Fleury Uchoa Santos
- Universidade de São Paulo, School of Medicine of Ribeirão Preto, Health Sciences Department, Ribeirão Preto, SP, Brazil
- Centro de Pesquisa, Desenvolvimento e Inovação da Dell, Dell Lead, Fortaleza, CE, Brazil
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Wirth M, Motl RW, Bombardier CH, Bartle B, Wong AWK, Aguina K, LaVela SL. Factors associated with perceived social isolation among veterans with spinal cord injury and disorders: Cross sectional survey. J Spinal Cord Med 2024:1-10. [PMID: 38315055 DOI: 10.1080/10790268.2023.2299500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
CONTEXT/OBJECTIVE Examine demographics, injury characteristics, objective measures of social isolation and health factors that are associated with perceived social isolation (PSI) among Veterans with spinal cord injury and disorders (SCI/D). DESIGN Cross-sectional survey. SETTING The Veterans Health Administrations (VHA) SCI/D system of care. PARTICIPANTS Veterans with SCI/D who have used the VHA health care system. INTERVENTION Not applicable. OUTCOMES MEASURES We assessed unadjusted associations of high PSI (above population mean) vs low (normative/below population mean), and multivariable logistic regression for independent associations with PSI. RESULTS Out of 1942 Veterans with SCI/D, 421 completed the survey (22% response rate). Over half (56%) had PSI mean scores higher than the general population. Among the objective measures, having a smaller social network size was associated with increased odds of high PSI (OR 3.59, P < .0001); additionally, for health factors, having depression (OR 3.98, P < 0.0001), anxiety (OR 2.29, P = 0.009), and post-traumatic stress (OR 2.56, P = 0.003) in the previous 6 months, and having 4 or more chronically occurring secondary conditions (OR 1.78, P = 0.045) was associated with increased odds of high PSI. The most commonly identified contributors to feelings of PSI included mobility concerns (63%), having a SCI/D (61%), and concerns about being a burden on others (57%). CONCLUSIONS Factors such as social network size may be used to identify individuals with SCI/D at risk for PSI. Additionally, by identifying mental health problems, presence of multiple chronically occurring secondary conditions, and Veteran-identified contributors of PSI, we can target these factors in a patient-centered interventions to identify and reduce PSI.
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Affiliation(s)
- Marissa Wirth
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Robert W Motl
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Charles H Bombardier
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Brian Bartle
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Alex W K Wong
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois, USA
| | - Keith Aguina
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Sherri L LaVela
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Jeawon M, Hase B, Miller S, Eng JJ, Bundon A, Chaudhury H, Maffin J, Clarkson R, Wright J, Mortenson WB. Understanding the experiences, needs, and strengths of people with incomplete spinal cord injury who can ambulate. Disabil Rehabil 2024; 46:546-555. [PMID: 36740758 DOI: 10.1080/09638288.2023.2171495] [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: 05/04/2022] [Accepted: 01/17/2023] [Indexed: 02/07/2023]
Abstract
PURPOSE To identify the experiences, needs, and strengths of people with incomplete spinal cord injury who can ambulate and to explore and discuss potential supports, services, and programs that would best assist them in the community. MATERIAL AND METHODS In this qualitative descriptive study, interviews were the primary means of data collection. These were supplemented with descriptive standardized measures of function and life satisfaction. Qualitative data were analyzed thematically. RESULTS Twenty-four participants were interviewed, their average age was 55 years and 46% were female. We identified three themes: 'I really couldn't go there', described the physical and social barriers experienced by participants, 'It'd be really nice to let the public know there are people out there like me' expressed the desire for greater social understanding of incomplete spinal cord injury, and 'I just don't quit', displayed the perseverance that participants demonstrated following their injury. CONCLUSION Findings indicate service providers to improve the inclusion of ambulatory individuals with incomplete spinal cord injury in their programs. Suggestions include designing programs (community, healthcare, return to work, peer support), environments using the principles of universal design for people with incomplete spinal cord injury who ambulate, and increasing consideration of their perspectives.Implication for rehabilitation:People with incomplete spinal cord injury who can ambulate live with invisible impairments, which are often not acknowledged by family, friends, health professionals, and people with complete spinal cord injuryThey may feel excluded from activities (organized by spinal cord injury associations) that were originally designed for people with complete spinal cord injuryGreater awareness among health professionals, friends, family, and people with complete spinal cord injury of the needs of people with incomplete spinal cord injury who can ambulate is needed to increase their inclusion.
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Affiliation(s)
- Murveena Jeawon
- Department of Occupational Sciences and Occupational Therapy, University of British Columbia, Vancouver, Canada
- GF Strong Rehabilitation Centre, Vancouver, Canada
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, Canada
| | - Bethany Hase
- Department of Occupational Sciences and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Susanna Miller
- Department of Occupational Sciences and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Janice J Eng
- GF Strong Rehabilitation Centre, Vancouver, Canada
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
| | - Andrea Bundon
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, Canada
- School of Kinesiology, University of British Columbia, Vancouver, Canada
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, Canada
| | - Jocelyn Maffin
- Spinal Cord Injury - British Columbia, Vancouver, Canada
| | - Ryan Clarkson
- Spinal Cord Injury - British Columbia, Vancouver, Canada
| | - Jenna Wright
- Spinal Cord Injury - British Columbia, Vancouver, Canada
| | - W Ben Mortenson
- Department of Occupational Sciences and Occupational Therapy, University of British Columbia, Vancouver, Canada
- GF Strong Rehabilitation Centre, Vancouver, Canada
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, Canada
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Armstrong A, Oetinger K, Weimer K, Hönig K. Digital psychosocial interventions for individuals with spinal cord injury: a scoping review. Front Psychiatry 2024; 15:1289138. [PMID: 38317764 PMCID: PMC10838963 DOI: 10.3389/fpsyt.2024.1289138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/05/2024] [Indexed: 02/07/2024] Open
Abstract
Objective To provide an overview of the digital mental health care landscape for individuals with spinal cord injury (SCI). Methods PubMed, PsycInfo, and PSYNDEX were searched for articles meeting the following criteria: (1) article written in English or German; (2) digital psychosocial intervention; (3) SCI only; (4) treatment of individuals with SCI and not their relatives or caregivers. Records were screened by title and abstract and records meeting the inclusion criteria were obtained for full text screening. The references of identified articles were screened to find further relevant articles. The literature search was updated before submission. Risk of Bias was assessed by using the Cochrane risk-of-bias tool for randomized trials (RoB 2) and a narrative synthesis was conducted. Results Ten randomized-controlled trials (RCT) and ten non-randomized-controlled trials were identified and compared in this review, evaluating twelve internet- and mobile-based interventions, five smartphone apps, and three virtual reality applications. The interventions were primarily used as stand-alone aftercare programs. While some were not based on any theory, cognitive behavioral therapy mostly served as the theoretical basis for the online interventions. The extent of human support also varied greatly between the studies. The number of intervention modules ranged between 2 and 72. There were also major differences in outcome variables and effects. A meta-analytical evaluation of the data was not conducted due to heterogeneity of studies. Conclusion Digital applications to promote the psychosocial health of individuals with SCI are an emerging field of research with many treatment approaches still to come. First high quality RCT studies report promising results. Unfortunately, not all studies are of high quality or the interventions have been insufficiently adapted to the needs of people with SCI. Therefore, more research is needed to further develop applications, and to generalize and test the effects found in the long term.
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Affiliation(s)
| | - Katja Oetinger
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Centre, Ulm, Germany
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McLeod J, Davis CG. Community peer support among individuals living with spinal cord injury. J Health Psychol 2023; 28:943-955. [PMID: 36924431 PMCID: PMC10467001 DOI: 10.1177/13591053231159483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Peer support is widely assumed to help individuals with spinal cord injury (SCI) adjust, yet the evidence is mixed. We propose that peer support may be more likely to promote adjustment when informal support is lacking. To test this hypothesis, 135 individuals living with SCI receiving peer support (46.7% female; Mage = 42.36, SD = 14.83) completed an online survey assessing aspects of and satisfaction with the peer support and family/friend support that they were receiving as well as measures of adjustment. Although those reporting receiving more peer support were not any better adjusted than those reporting less, individuals who were more satisfied with the peer support they received reported better adjustment. Moreover, the relation of satisfaction with peer support with depressive symptoms was dependent on the level of family/friend support. These findings suggest that peer support is most effective among those lacking support from family and friends.
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Khong CM, Chan J, Pasipanodya E, Dirlikov B, Shem K. Risk Factors Associated With Suicidal Ideation in Individuals With Spinal Cord Injury. Arch Rehabil Res Clin Transl 2023; 5:100284. [PMID: 37744203 PMCID: PMC10517356 DOI: 10.1016/j.arrct.2023.100284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
Objective To assess the frequency of suicidal ideation (SI) among individuals with chronic spinal cord injury (SCI) and to identify risk factors associated with SI. Design Cross-sectional. Setting Community setting. Participants Two hundred and forty-six individuals with chronic SCI participating in the Spinal Cord Injury Model Systems at a Level 1 Trauma center. Interventions Not applicable. Main Outcome Measure SI, as assessed by question 9 of the Patient Health Questionnaire-9. Results Twenty-seven (11.0%) participants endorsed SI; 6 (22.2%) of whom endorsed active SI with a plan of self-harm. Participants who endorsed SI had significantly higher depressive symptoms, lower resilience, and lower satisfaction with life (all Ps<.001). They also had lower perceived health (P<.001), Craig Handicap Assessment & Reporting Technique Short Form (CHART-SF) physical independence (P=.013), and Spinal Cord Injury - Functional Index with Assistive Technology domains of basic mobility (P=.003), self-care (P=.042), and fine motor skills (P=.035). However, participants who endorsed SI were not significantly different in re-hospitalization rates and in other domains of CHART-SF and SCI-AT. Logistic regression, with a forward selection procedure, was used to identify significant predictors of endorsing SI in the context of multiple associated variables. Depressive symptoms (odds ratio [OR]=1.18, P=.020), resilience (OR=0.85, P=.003), and physical independence (OR=0.98, P=.019) remained significant predictors of SI. Conclusion Study findings suggest higher levels of SI among people with SCI, a substantial proportion of whom have active SI. Individuals with SCI who endorse SI have greater burden of poor physical and mental health, as well as poorer functional status and adaptation. Interventions targeting multiple dimensions of quality of life may help reduce risk of SI and suicide among individuals with SCI.
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Affiliation(s)
- Cria-May Khong
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, CA
| | - John Chan
- Department of Physical Medicine and Rehabilitation, Santa Clara Valley Medical Center, San Jose, CA
| | | | - Benjamin Dirlikov
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, CA
| | - Kazuko Shem
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, CA
- Department of Physical Medicine and Rehabilitation, Santa Clara Valley Medical Center, San Jose, CA
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Ortega MA, Fraile-Martinez O, García-Montero C, Haro S, Álvarez-Mon MÁ, De Leon-Oliva D, Gomez-Lahoz AM, Monserrat J, Atienza-Pérez M, Díaz D, Lopez-Dolado E, Álvarez-Mon M. A comprehensive look at the psychoneuroimmunoendocrinology of spinal cord injury and its progression: mechanisms and clinical opportunities. Mil Med Res 2023; 10:26. [PMID: 37291666 PMCID: PMC10251601 DOI: 10.1186/s40779-023-00461-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 06/01/2023] [Indexed: 06/10/2023] Open
Abstract
Spinal cord injury (SCI) is a devastating and disabling medical condition generally caused by a traumatic event (primary injury). This initial trauma is accompanied by a set of biological mechanisms directed to ameliorate neural damage but also exacerbate initial damage (secondary injury). The alterations that occur in the spinal cord have not only local but also systemic consequences and virtually all organs and tissues of the body incur important changes after SCI, explaining the progression and detrimental consequences related to this condition. Psychoneuroimmunoendocrinology (PNIE) is a growing area of research aiming to integrate and explore the interactions among the different systems that compose the human organism, considering the mind and the body as a whole. The initial traumatic event and the consequent neurological disruption trigger immune, endocrine, and multisystem dysfunction, which in turn affect the patient's psyche and well-being. In the present review, we will explore the most important local and systemic consequences of SCI from a PNIE perspective, defining the changes occurring in each system and how all these mechanisms are interconnected. Finally, potential clinical approaches derived from this knowledge will also be collectively presented with the aim to develop integrative therapies to maximize the clinical management of these patients.
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Affiliation(s)
- Miguel A. Ortega
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Oscar Fraile-Martinez
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Cielo García-Montero
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Sergio Haro
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Miguel Ángel Álvarez-Mon
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Diego De Leon-Oliva
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Ana M. Gomez-Lahoz
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Jorge Monserrat
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Mar Atienza-Pérez
- Service of Rehabilitation, National Hospital for Paraplegic Patients, Carr. de la Peraleda, S/N, 45004 Toledo, Spain
| | - David Díaz
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Elisa Lopez-Dolado
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Melchor Álvarez-Mon
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Immune System Diseases-Rheumatology Service and Internal Medicine, University Hospital Príncipe de Asturias (CIBEREHD), 28806 Alcala de Henares, Spain
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Tang X, Huang J, Wang W, Su X, Yu Z. Predictors of activation among persons with spinal cord injury during hospitalization: A cross-sectional study. Jpn J Nurs Sci 2023:e12532. [PMID: 36965136 DOI: 10.1111/jjns.12532] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/05/2022] [Accepted: 02/14/2023] [Indexed: 03/27/2023]
Abstract
AIM To test the contributions of self-efficacy, resilience, social support, and negative moods (i.e., anxiety, depression) to patient activation among persons with spinal cord injury (SCI). METHODS One hundred and twenty-two participants with SCI were recruited from the spinal surgery department at a large general hospital. During the period before discharge after surgery, standardized self-assessment questionnaires were used to collect data on patient activation, self-efficacy, resilience, social support, anxiety, depression, demographics (age, gender, education, marital status), and disease-related information (etiologies, level of injury, American Spinal Injury Association Impairment Scale score). Hierarchical regression analysis, mediation analysis, and moderation analysis were performed in SPSS, Amos, and Jamovi to determine the influencing factors of patient activation. RESULTS Self-efficacy, resilience, social support, anxiety, and depression uniquely explained 38.2% (p < .001) of the variance in patient activation after controlling for demographic and disease-related covariates. The full model explained 53.7% (p < .001) of the variance in patient activation. In the mediation analysis, self-efficacy, resilience, and social support had partial mediating effects (p < .05). In the moderation analysis, marital status moderated the relationship between self-efficacy and patient activation (p < .05). CONCLUSIONS Activation of persons with SCI is a positive psychosocial resource related to higher self-efficacy, resilience, and social support. Marital status may affect activation in persons with SCI. The causal relationship between these psychosocial variables needs to be proved by further intervention studies.
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Affiliation(s)
- Xiangxiang Tang
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China
| | - Jin Huang
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Wenyan Wang
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China
| | - Xiaoping Su
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China
| | - Zepeng Yu
- Center for Medical Ultrasound, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
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Prevalence of Posttraumatic Stress Disorder Symptoms Following Traumatic Spinal Cord Injury: A Systematic Review and Meta-analysis. Harv Rev Psychiatry 2022; 30:271-282. [PMID: 36103682 DOI: 10.1097/hrp.0000000000000340] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Limited evidence is currently available on the prevalence of posttraumatic stress disorder (PTSD) following traumatic spinal cord injury (SCI). This systematic review and meta-analysis aims to assess the prevalence and geographic distribution of PTSD symptoms after SCI. METHODS After a search in the MEDLINE, Embase, Scopus, and Web of Science databases, two reviewers independently summarized relevant studies published through 20 October 2021. Observational studies were included. The studies were eligible if they assessed PTSD symptoms using standard self-report or clinician-based instruments. Data and results were reported using the overall prevalence and the odds ratio (OR), with 95% confidence intervals (CIs). RESULTS 24 articles (5646 patients) met the inclusion criteria. The prevalence of PTSD symptoms ranged from 6.33% (95% CI, 2.73-13.97) to 61.76% (95% CI, 52.07-70.61). Pooled analysis demonstrated that the overall prevalence of PTSD symptoms in SCI patients was significantly higher in developing countries (41.64%; 95% CI, 31.11-52.55) than in developed countries (19.35%; 95% CI, 14.66-24.51) (OR = 1.24; 95% CI, 1.08-1.42; p = .003). The highest prevalence of PTSD symptoms was reported in South Africa (56.25%; 95% CI, 47.01-65.08), followed by Sri Lanka (45.71%; 95% CI, 30.47-61.81), and Greece (43.55%; 95% CI, 31.94-55.91). By contrast, Norway (6.33%; 95% CI, 2.73-13.97), Switzerland/Germany (8.65%; 95% CI, 4.8-13.42), and Denmark (10.71%; 95% CI, 6.89-16.30) were found to have the lowest prevalence of PTSD symptoms after SCI. CONCLUSION Many traumatic SCI patients suffer from PTSD symptoms, and their prevalence seems to be higher in developing countries than in developed countries. These findings underscore the need to consider the psychological aspects of traumatic SCI.
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Sadiki MC, Kibirige I. Strategies employed in coping with physical disabilities acquired during adulthood in rural South Africa. Afr J Disabil 2022; 11:907. [PMID: 36092476 PMCID: PMC9453136 DOI: 10.4102/ajod.v11i0.907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 03/29/2022] [Indexed: 11/01/2022] Open
Abstract
Background Society places people with physical disabilities acquired during adulthood in disadvantaged positions, especially when they cannot participate in activities like their non-disabled counterparts. The situation can be worse for individuals who acquire disabilities during adulthood, where they have to learn to cope with the adulthood-acquired physical disabilities. Objectives This study aimed to identify the types of physical disabilities acquired during adulthood and their causes and explore how participants defined their disabilities and the coping strategies they used. Methods The study used a phenomenological research design. Five adults (three women, two men) with adulthood-acquired disabilities were purposefully selected from a rural area in Limpopo, South Africa. Data were collected using semi-structured interviews. Thematic analysis was used to generate themes about coping strategies study participants used. Results The results show four types of adulthood-acquired disabilities amongst the participants: visual impairment, paraplegia, weakened muscles which led to bilateral amputation, loss of function on both hands and legs. Participants' meanings of their physical adulthood-acquired disabilities ranged from a punishment, pain, not a bother, black magic, to results of doing wrong things to someone. In coming to terms with their adulthood-acquired disabilities, participants used problem- and emotion-focused strategies. Four themes from the participants' responses were spiritual support, social support, substance dependency, access to health and rehabilitation services. Conclusion The study contributes to understanding the experiences of individuals who acquired disabilities in adulthood, how they define their disabilities and the divergent coping strategies they use. This study established that participants used problem-focused, positive emotion-focused and negative emotion-focused coping strategies.
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Affiliation(s)
- Marubini C Sadiki
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa
| | - Israel Kibirige
- Department of Mathematics, Science, and Technology Education, Faculty of Humanities, University of Limpopo, Polokwane, South Africa
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Kendall MB, Amsters D, Schuurs S, Borg DN, Pershouse K, Kuipers P. Longitudinal effects of time since injury and age at injury on outcomes of people with spinal cord injury in Queensland, Australia. Spinal Cord 2022; 60:1087-1093. [PMID: 35764703 DOI: 10.1038/s41393-022-00824-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Longitudinal cohort study. OBJECTIVES To investigate the longitudinal effects of time since injury and age at injury on outcomes of quality of life, physical function, secondary conditions and participation, in people with traumatic spinal cord injury (SCI). SETTING Community resident people with spinal cord injury in Queensland, Australia. METHODS A baseline sample of 270 people with SCI was recruited. Telephone surveys on measures of quality of life (WHOQOL-Bref), secondary conditions (Secondary Conditions Surveillance Instrument, subset), physical functioning (Functional Independence Measure motor subscale) and participation (Community Integration Measure) were conducted each year between 2004 and 2008, and again in 2018. Random-effect within-between models were used to determine the effect of time since injury and age at injury on each outcome variable. Inverse probability-of-censoring weights were used to correct for selection bias. RESULTS There was an effect of time since injury on secondary conditions, with a one-year change associated with 9% higher odds of having worse Secondary Conditions Surveillance Instrument scores (odds ratio = 1.09, 95% confidence interval = 1.02, 1.17; p = 0.006). We did not find any evidence of a time since injury effect on quality of life, physical function, or participation. Similarly, we did not find any evidence of an age at injury effect on any outcome variable. CONCLUSIONS Secondary conditions may increase with longer time since injury among people with SCI, suggesting appropriate formal and informal supports are required to minimise the impact of these emerging health problems as individuals age.
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Affiliation(s)
- Melissa B Kendall
- Transitional Rehabilitation Program, Queensland Spinal Cord Injuries Service, Metro South Health, Brisbane, QLD, Australia. .,Griffith University, Menzies Health Institute Queensland, The Hopkins Centre, Brisbane, QLD, Australia.
| | - Delena Amsters
- Spinal Outreach Team, Queensland Spinal Cord Injuries Service, Metro South Health, Brisbane, QLD, Australia
| | - Sarita Schuurs
- Spinal Outreach Team, Queensland Spinal Cord Injuries Service, Metro South Health, Brisbane, QLD, Australia
| | - David N Borg
- Griffith University, Menzies Health Institute Queensland, The Hopkins Centre, Brisbane, QLD, Australia
| | - Kiley Pershouse
- Spinal Outreach Team, Queensland Spinal Cord Injuries Service, Metro South Health, Brisbane, QLD, Australia
| | - Pim Kuipers
- Griffith University, Menzies Health Institute Queensland, The Hopkins Centre, Brisbane, QLD, Australia
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Amsters D, Kendall M, Schuurs S, Kuipers P. Influences on Participation in Life After Spinal Cord Injury: Qualitative Inquiry Reveals Interaction of Context and Moderators. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:898143. [PMID: 36188957 PMCID: PMC9397943 DOI: 10.3389/fresc.2022.898143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022]
Abstract
BackgroundGreater understanding of the influences on participation in life after spinal cord injury (SCI) can inform rehabilitation theory and practice. Careful qualitative inquiry can reveal subjective meanings associated with the relevant experiences, strategies, and perceptions of those with lived experience of SCI. A search of literature, followed by a thematic synthesis of qualitative studies, was undertaken to bring together these insights in a meaningful way.MethodsThe research question guiding the literature review and synthesis was, What do people with SCI perceive to be the influences on their participation in life? Three critical databases were searched for qualitative studies examining influences on participation in life after SCI. Peer-reviewed studies published after 2006, involving adults with SCI living in countries with advanced economies, were included. Data were extracted from 24 articles and subjected to three-level thematic synthesis—the coding of primary data from the studies, the development of descriptive themes based on an organization of those codes, and the generation of analytical themes.ResultsThe synthesis yielded five analytical themes, supported by 17 descriptive themes. The analytical themes were (1) external contextual influences, (2) personal physical context, (3) personal psychological context, (4) potential moderators of participation outcomes, and (5) temporal dimensions of participating in life after SCI.InterpretationThese themes highlight the complex interactions that shape participation from the perspective of people with SCI. Closer examination of the potential moderators may provide insights into effective rehabilitation interventions.ConclusionsSynthesis of qualitative inquiry provides valuable insights into the perceptions of influences on participation in life from the point of view of people with SCI. The findings of this synthesis are instructive for rehabilitation theory and practice. It can complement what we learn from using the ICF to understand participation.
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Affiliation(s)
- Delena Amsters
- Spinal Outreach Team, Queensland Spinal Cord Injuries Service, Metro South Health, Brisbane, QLD, Australia
- The Hopkins Centre, Menzies Health Institute, Griffith University, Brisbane, QLD, Australia
- *Correspondence: Delena Amsters
| | - Melissa Kendall
- The Hopkins Centre, Menzies Health Institute, Griffith University, Brisbane, QLD, Australia
- Transitional Rehabilitation Program, Queensland Spinal Cord Injuries Service, Metro South Health, Brisbane, QLD, Australia
| | - Sarita Schuurs
- Spinal Outreach Team, Queensland Spinal Cord Injuries Service, Metro South Health, Brisbane, QLD, Australia
- The Hopkins Centre, Menzies Health Institute, Griffith University, Brisbane, QLD, Australia
| | - Pim Kuipers
- Central Queensland Centre for Rural and Remote Health, James Cook University, Emerald, QLD, Australia
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Jervis Rademeyer H, Gastle N, Walden K, Lemay JF, Ho C, Marquez-Chin C, Musselman KE. Activity-based therapy for individuals with spinal cord injury/disease: perspectives of acute care therapists. Spinal Cord Ser Cases 2022; 8:39. [PMID: 35383140 PMCID: PMC8982296 DOI: 10.1038/s41394-022-00508-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 11/21/2022] Open
Abstract
STUDY DESIGN An exploratory descriptive study was conducted. OBJECTIVE To determine if and how occupational therapists (OTs) and physical therapists (PTs) in acute care hospital settings use activity-based therapy (ABT) and its associated technologies. SETTING Acute care hospital settings in Canada. METHODS Semi-structured interviews were conducted with physical and occupational therapists, licensed in Canada, who worked in an acute care neurological setting with individuals with spinal cord injury or disease (SCI/D). To analyze the data, interpretive description was used. NVivo 12 was used for data management. RESULTS Five physical therapists and two occupational therapists were interviewed (n = 7). Two therapists declined after reading a description of the study. Through analysis, the following themes were identified as affecting the delivery of ABT as part of SCI/D rehabilitation in the acute care setting: (1) Impact of patient acuity on ABT participation, (2) ABT approach unique to the acute care setting, and (3) Influence of acute care work environment and therapy practice. Throughout these themes, therapists referred to dosage as a limiting factor affecting ABT delivery. CONCLUSIONS Our research reveals that implementing ABT in an acute care setting is challenging considering the high dosage of movement practice required for ABT. To increase dosage and the use of ABT in acute care, strategies could include early patient education on ABT, strategic use of social supports, and use of portable technology already incorporated in acute care.
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Affiliation(s)
- Hope Jervis Rademeyer
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- KITE Research Institute-Toronto Rehab-University Health Network, Toronto, ON, Canada
| | - Nicole Gastle
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | | | - Jean-François Lemay
- Université de Montréal (École de réadaptation), Montreal, QC, Canada
- Institut de réadaptation Gingras-Lindsay-de-Montréal, Montreal, QC, Canada
| | - Chester Ho
- Division of Physical Medicine & Rehabilitation, Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Cesar Marquez-Chin
- KITE Research Institute-Toronto Rehab-University Health Network, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Kristin E Musselman
- KITE Research Institute-Toronto Rehab-University Health Network, Toronto, ON, Canada.
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
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Matthias MS, Hirsh AT, Ofner S, Daggy J. Exploring the relationships among social support, patient activation, and pain-related outcomes. PAIN MEDICINE 2021; 23:676-685. [PMID: 34718764 DOI: 10.1093/pm/pnab306] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/28/2021] [Accepted: 09/25/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Social support has been linked to more effective pain adaptation. The relationship between social support and other relevant constructs is less well-understood. Chief among these is patient activation, which has robust links to effective self-management, yet has not been well-studied in chronic pain. We sought to better understand these relationships in an effort to inform future intervention strategies for patients with chronic pain. METHODS Using baseline data from a clinical trial with patients with chronic pain (N = 213), we analyzed the relationships among perceived social support and patient activation, depression, anxiety, general health perceptions, pain centrality, pain catastrophizing, and pain intensity and interference. Multiple linear regression was used to examine the effect of social support on outcomes. Patient activation was explored as a mediator of the effect of social support on outcomes. RESULTS Social support was significantly associated with all outcomes except pain. Social support explained the greatest variance in patient activation (squared semi-partial correlation =0.081), followed by depression (0.073) and general health perceptions (0.072). Patient activation was not found to be a significant mediator of the effect of social support on pain-related outcomes. CONCLUSIONS Findings provide insight into the roles of patient activation and social support in chronic pain management. Although patient activation did not mediate the relationship between social support and outcomes, this study is an important step toward gaining a more complete understanding of constructs thought to be related to pain self-management and points to the need to advance theory in this area to guide future research. Such work is needed to optimize interventions for patients with chronic pain.
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Affiliation(s)
- Marianne S Matthias
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN.,Regenstrief Institute, Indianapolis, IN.,Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Purdue University Indianapolis, IN
| | - Susan Ofner
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN
| | - Joanne Daggy
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN
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Qasheesh M, Shaphe MA, Iqbal A, Alghadir AH. Association of psychological variants with functional outcomes among people with spinal cord injury. Sci Rep 2021; 11:20325. [PMID: 34645884 PMCID: PMC8514531 DOI: 10.1038/s41598-021-98808-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 09/14/2021] [Indexed: 12/03/2022] Open
Abstract
This study aimed to investigate the association of psychological variants, including fear, anxiety, and depression, with functional outcomes, including measures of functions and physical performance, among people with spinal cord injury (SCI). An observational study was conducted at the university hospital in Riyadh, Saudi Arabia. Thirty patients, including 19 males (63.33%) and 11 females (36.67%) with a history of traumatic SCI, aged 18–30 years, 1–3 years postinjury T2 and below, with motor complete paraplegia, permanent neurological loss, and the ability to rise from sitting and stand for at least one minute, were included in this study. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Fear Avoidance Belief Questionnaire-Physical Activity (FABQ-PA) were used to assess the psychological variants of participants. The Spinal Cord Independence Measure (SCIM) and Walking Index of Spinal Cord Injury (WISCI-II) were used to assess the functional outcomes. Psychological variants showed a strong negative correlation with functional outcomes (p < 0.05) among people with SCI. In addition, a significant difference was found between females and males with SCI for the scores of psychological variants and functional outcomes. Psychological variants, including fear, anxiety, and depression, were found to be strongly and negatively associated with functional outcomes, including measures of functions and physical performance, and were especially higher among females than males with SCI. Thus, a higher level of fear, anxiety, and depression results in a lower level of measures of functions and physical performance among people with SCI. Depression is the strongest factor that affects the functional outcomes most among people with SCI.
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Affiliation(s)
- Mohammed Qasheesh
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Mohammad Abu Shaphe
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Amir Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, P.O. Box. 10219, Riyadh, 11433, Saudi Arabia.
| | - Ahmad H Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, P.O. Box. 10219, Riyadh, 11433, Saudi Arabia
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18
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Singh A, Contreras Suarez D, You E, Fleitas Alfonzo L, King T. Role of social support in the relationship between financial hardship and multimorbidity-a causal mediation analysis. Eur J Public Health 2021; 31:482-487. [PMID: 33724381 DOI: 10.1093/eurpub/ckab015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Social disadvantage is a key determinant of multimorbidity. Pathways through which social disadvantage leads to multimorbidity are yet undefined. In this study, we first examined the causal effect of moving into financial hardship on multimorbidity among Australian adults, and then the role of social support as a mediator of the relationship between financial hardship and multimorbidity. METHODS Data were obtained from the Household, Income and Labour Dynamics in Australia (HILDA) Survey (2009-2013). We identified individuals who moved into financial hardship between 2010 and 2011 (n = 5775). Inverse probability treatment weighting with regression adjustment was used to examine the relationship between financial hardship and multimorbidity. Causal mediation analysis was applied to decompose the total effect of financial hardship on multimorbidity into the proportion attributable to social support and the proportion not occurring through measured pathways. We accounted for baseline covariates including age, sex, marital status, educational attainment, employment status, income, country of birth, multimorbidity and social support. Bootstrapping with 1000 replications was used to calculate 95% confidence intervals (CIs). RESULTS The risk of multimorbidity was higher in those with financial hardship by 19% [relative risk 1.19 (95% CI: 1.02-1.37) and absolute risk difference 0.036 (95% CI: 0.004-0.067)] than those without financial hardship. Social support accounted for 30% of the total effect of financial hardship on multimorbidity, risk difference 0.009 (95% CI: 0.003-0.018). CONCLUSIONS Financial hardship leads to increased risk of multimorbidity. Interventions directed at increasing social support among those in financial hardship may reduce their risk of multimorbidity.
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Affiliation(s)
- Ankur Singh
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Diana Contreras Suarez
- Melbourne Institute: Applied Economic & Social Research, University of Melbourne, Melbourne, Victoria, Australia
| | - Emily You
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Ludmila Fleitas Alfonzo
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Tania King
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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19
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Borrelli B, Endrighi R, Quintiliani LM, Hughes RB, Pagoto S. Facebook usage, participation patterns, and social support from Facebook activity among smokers with mobility impairments. Transl Behav Med 2021; 11:882-890. [PMID: 33710308 DOI: 10.1093/tbm/ibab005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
People with mobility impairments (MIs; use assistive devices to ambulate) have twice the smoking prevalence versus the general population. A Facebook intervention could improve reach to smokers with MIs, but use and patterns of use are unknown. The study examined: (a) Facebook use and relationship with Facebook-based social support and (b) whether Facebook use differs by motivation to quit smoking. Participants (N = 510; 56.3% female, mean age = 42.4 years) were recruited via a recruitment company to complete a one-time online survey assessing motivation to quit within 30 days, Facebook use (Facebook Activities Scale), reasons for use (Facebook Motives Scale), attitudes (Facebook Intensity Scale), and social support (Facebook Measure of Social Support). The vast majority said that Facebook is part of their daily routine (92.9%), 83% checked Facebook >once a day, and 69% spent >30 min/day on Facebook. Facebook was used to connect with similar others (68.4%), participate in groups (72.9%), decrease loneliness (69.2%), and obtain health information (62.5%); 88% said that they would join a Facebook program to help them quit smoking. A greater number of Facebook friends (rs = .18-.22, p < .001) and greater Facebook use (rs = .20 to rs = .59; p < .001) were correlated with greater perceived social and emotional support. Those motivated to quit posted more frequently (odds ratio [OR] = 1.56, 95% confidence interval [CI] = 1.10, 2.22) and were more likely to indicate that they would join a Facebook group for smoking cessation (OR = 4.15, 95% CI = 2.05, 8.38) than those not motivated. Facebook could circumvent disability and environmental barriers to accessing cessation among this health disparity population.
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Affiliation(s)
- Belinda Borrelli
- Center for Behavioral Science Research, Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - Romano Endrighi
- Center for Behavioral Science Research, Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - Lisa M Quintiliani
- Section of General Internal Medicine, School of Medicine, Boston University, Boston, MA, USA
| | - Rosemary B Hughes
- Rural Institute for Inclusive Communities, University of Montana, Missoula, MT, USA
| | - Sherry Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
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20
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Norwood MF, Lakhani A, Hedderman B, Kendall E. Does being psychologically resilient assist in optimising physical outcomes from a spinal cord injury? Findings from a systematic scoping review. Disabil Rehabil 2021; 44:6082-6093. [PMID: 34284655 DOI: 10.1080/09638288.2021.1952320] [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: 10/20/2022]
Abstract
PURPOSE To systematically search for current research on the role of resilience in the physical rehabilitation of SCI and describe the research to date. MATERIALS AND METHODS The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) approach was used. Five databases were searched for papers published up to March 2020. The sample included adults who have sustained an SCI; outcomes included a physical rehabilitation outcome and a measure of psychological or personal resilience/resilience training. RESULTS The initial search found 2074 studies. 12 studies were included. Six suggest positive effects of resilience on physical functioning/recovery, six report resilience as not affecting physical functioning/recovery. CONCLUSIONS Resilience may positively affect physical outcomes; however, the relationship is under-researched and contrasting findings may be due to measurements and methods employed by research. Future research may distinguish between two sources of resilience following an SCI: prior resilient experiences, and resilience as a product of the injury. Individuals' past events that triggered resilient behaviour may be able to promote a resilient response to an SCI. Focussing on emotional coping may result in poorer outcomes than building a sense of control. Resilience training may affect psychosocial rehabilitation; it is difficult to establish if it would affect physical outcomes. A negative approach to an injury can have negative effects on functioning; when identifying patients for psychoeducational training, those with the presence of negative appraisals of their injury are most in need.IMPLICATIONS FOR REHABILITATIONResilience may positively affect physical outcomes; however, the relationship is under-researched.Individuals' past events that triggered resilient behaviour may be able to promote a resilient response to an SCI.Focussing on emotional coping may result in poorer outcomes than building a sense of control.When identifying patients for psychoeducational training, it may be those with the presence of negative appraisals of their injury that are most in need.
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Affiliation(s)
- Michael Francis Norwood
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Australia
| | - Ali Lakhani
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Australia.,The School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Billy Hedderman
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Australia
| | - Elizabeth Kendall
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Australia
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21
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Ferdiana A, Post MWM, Bültmann U, van der Klink JJL. Barriers and facilitators for work and social participation among individuals with spinal cord injury in Indonesia. Spinal Cord 2021; 59:1079-1087. [PMID: 33828246 DOI: 10.1038/s41393-021-00624-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Qualitative study using in-depth interviews. OBJECTIVES To describe experienced barriers and facilitators for work and social participation among individuals with spinal cord injury (SCI). SETTING Vocational rehabilitation (VR) center in Yogyakarta Province, Indonesia. METHODS Semi-structured interviews were conducted with 12 participants (8 males, 4 females) aged 24-67 years. Five participants still underwent vocational rehabilitation, while seven participants lived in the community. Thematic analysis was used. RESULTS None of the participants who worked before the injury returned to her/his previous occupation, most participants became self-employed. The frequency of participation in social activities decreased substantially. Barriers for work and social participation included health conditions and environmental barriers, including inaccessibility, stigma and discrimination and limited institutional support and services. Identified facilitators for work and social participation were perceived importance of work and social participation, adaptations to disability condition, and social support. CONCLUSION Barriers to engage in work and social activities for individuals with SCI in Indonesia are combination of physical limitations, lack of accessibility, stigma, and institutional barriers. The capacity of social networks such as family in facilitating participation should be strengthened during the VR processes. VR should provide marketing skills and link self-employed clients with the market, in collaboration with the private sector and industries. Immediate policy and programmatic action is needed to enable these individuals to enhance sustainable work and social participation.
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Affiliation(s)
- Astri Ferdiana
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, The Netherlands. .,Department of Public Health, Faculty of Medicine, University of Mataram, Mataram, Indonesia.
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMCU Brain Center, University Medical Center Utrecht and De Hoogstraat, Utrecht, The Netherlands.,University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Ute Bültmann
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, The Netherlands
| | - Jac J L van der Klink
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo, Tilburg, The Netherlands.,Optentia, North-West University, Vanderbijlpark, South Africa
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22
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Rocchi MA, Shi Z, Shaw RB, McBride CB, Sweet SN. Identifying the outcomes of participating in peer mentorship for adults living with spinal cord injury: a qualitative meta-synthesis. Psychol Health 2021; 37:523-544. [PMID: 33754920 DOI: 10.1080/08870446.2021.1890729] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Peer mentorship is a flagship program utilized by Canadian community-based spinal cord injury (SCI) organizations. Through connecting trained SCI peer mentors with fellow adults with SCI, these programs help adults adapt and thrive following their injury. The objective of this meta-synthesis was to work with SCI community organizations and to identify outcomes of participating in community- or rehabilitation-based peer mentorship programs using an integrated knowledge translation approach. DESIGN A meta-synthesis of 21 qualitative peer-reviewed studies and 66 community documents was conducted. MAIN OUTCOME MEASURES A total of 87 outcomes of peer mentorship were identified. RESULTS The outcomes of peer mentorship were grouped according to six higher-order themes: 1) Independence: enhanced self-sufficiency; 2) Personal growth: positive psychological changes; 3) Activities and participation: greater participation in activities and events; 4) Adaptation: adapting to life with disability; 5) Knowledge: obtaining new information, resources, and opportunities; and 6) Connection: developing and maintaining social relationship. CONCLUSION The positive nature of the identified outcomes suggests that participating in peer mentorship can promote improved health and quality of life for adults with SCI. Furthermore, the integrated knowledge translation approach helped identify outcomes that were previously not examined within SCI peer mentorship research, thus providing important insight for future research.
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Affiliation(s)
- Meredith A Rocchi
- Department of Communication, University of Ottawa, Ottawa, Canada.,Department of Kinesiology and Physical Education, McGill University, Montreal, Canada.,Centre for Interdisciplinary Rehabilitation Research in Metropolitan Montreal, Montreal, Canada
| | - Zhiyang Shi
- Department of Kinesiology and Physical Education, McGill University, Montreal, Canada.,Centre for Interdisciplinary Rehabilitation Research in Metropolitan Montreal, Montreal, Canada
| | - Robert B Shaw
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada
| | | | - Shane N Sweet
- Department of Kinesiology and Physical Education, McGill University, Montreal, Canada.,Centre for Interdisciplinary Rehabilitation Research in Metropolitan Montreal, Montreal, Canada
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Conti A, Sperlinga R, Luciani M, Crenna MF, Piovan C, Scavino E, Campagna S. Association between sleep quality and participation in people with spinal cord injury: A preliminary study. J Spinal Cord Med 2021; 46:477-484. [PMID: 33606607 PMCID: PMC10114967 DOI: 10.1080/10790268.2021.1876818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To explore the association between perceived sleep quality and participation in people with spinal cord injury (SCI). DESIGN Cross-sectional study. SETTING Spinal unit at the Città della Salute e della Scienza University Hospital of Turin, Italy. PARTICIPANTS From May to July 2019, 55 consecutive outpatients were recruited. OUTCOME MEASURES A set of structured questionnaires was administered. It included sociodemographic data, the Pittsburgh Sleep Quality Index, the Utrecht Scale for Evaluation of Rehabilitation-Participation, the Spinal Cord Independence Measure Self-Report, the Short Form version 12.2, and the Hospital Anxiety and Depression Scale. T-tests were used to highlight differences between participation and participant characteristics. Bivariate analyses and linear regressions were performed to identify associations between sleep quality and participation. RESULTS Differences in participation occurred mainly in individuals with a higher level of injury, caregiver dependency, and lower functional level. Participants reporting better sleep quality had more frequent (r = -0.36, P < 0.01), less restricted (r = -0.32, P < 0.05), and more satisfactory participation (r = -0.33, P < 0.01). Linear regression analyses showed that poor sleep quality was significantly associated with reduced participation frequency (β = -0.30, P = 0.03) and less satisfaction with participation (β = -0.49, P < 0.001). Moreover, age, number of hours slept at night, and time since injury were associated with satisfaction with participation. CONCLUSIONS An association was found between sleep quality and participation in people with SCI. Given the high prevalence of sleep problems and their association with all dimensions of participation, the promotion of sleep quality should be encouraged because it may positively affect participation.
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Affiliation(s)
- Alessio Conti
- Department of Public Health and Paediatric Sciences, University of Torino, Torino, Italy
| | - Riccardo Sperlinga
- School of Nursing, Catholic University of the Sacred Heart, Torino, Italy
| | - Michela Luciani
- Department of Public Health and Paediatric Sciences, University of Torino, Torino, Italy
| | | | - Chiara Piovan
- Department of Physical Medicine and Rehabilitation, Spinal Unit, A.O.U. Città della Salute e della Scienza University Hospital, Torino, Italy
| | - Enrica Scavino
- School of Nursing, Catholic University of the Sacred Heart, Torino, Italy
| | - Sara Campagna
- Department of Public Health and Paediatric Sciences, University of Torino, Torino, Italy
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Health provider identified barriers and facilitators to weight management for individuals with spinal cord injury. Spinal Cord 2021; 59:1061-1071. [PMID: 33564116 PMCID: PMC8349924 DOI: 10.1038/s41393-021-00614-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 11/20/2022]
Abstract
Study Design: Qualitative descriptive study using semi-structured interviews Objective: The purpose of this study was to examine the barriers and facilitators of weight management in individuals with spinal cord injury (SCI) from the perspective of SCI health care providers. Setting: Veterans Health Administration and Midwest Regional SCI Care Systems Methods: Health care providers (n=25) who care for individuals with SCI completed semi-structured interviews. Thematic analysis methodology was used to identify emergent themes around barriers and facilitators to weight management in SCI. Results: Sixteen subthemes emerged for barriers and 7 subthemes emerged for facilitators for weight management in SCI. Barriers included individual-level factors (e.g., physical ability/mobility limitations, lack of interest, psychological obstacles, lack of knowledge, poor dietary strategies), socio-environmental factors (e.g., challenges with family support, lack of access to weight management resources, dependency on others, difficulties obtaining weight measurement), and organizational factors (e.g., lack of integration/ inconsistent weight management support from healthcare systems, pushing calorie intake early post-injury). Facilitators included individual-level factors (e.g., motivation, education/knowledge, participation in exercise and physical activity) and socio-environmental factors (e.g., positive support network, access to/use of healthy dietary strategies, access to exercise facilities/adaptive equipment, participating in weight management with others). Conclusions: Healthcare providers identified individual-level, socio-environmental, and organizational barriers and facilitators that influence weight management efforts in individuals with SCI. Future weight management resources and programs should consider addressing common barriers identified by healthcare providers, individuals with SCI, and their caregivers, and develop strategies to promote facilitators to enhance weight management in this population.
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Li Y, Chien WT, Zhu B, He H, Bressington D. Predictors of Self-Efficacy Among People With Spinal Cord Injury During Inpatient Rehabilitation: A Cross-Sectional Study. J Nurs Scholarsh 2021; 53:218-226. [PMID: 33555118 DOI: 10.1111/jnu.12632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to investigate the predictors of self-efficacy among Chinese people with spinal cord injury (SCI). DESIGN A cross-sectional, descriptive, correlational design was adopted. METHODS 121 participants were recruited from two rehabilitation hospitals in Shaanxi, China, from August 2016 to June 2017. The Moorong Self-Efficacy Scale was used to assess participants' self-efficacy levels. Participants' sociodemographic or clinical characteristics, functional independence, coping ability (measured using the Brief Coping Orientations to Problems Experienced Inventory), and social support (measured using the Six-item Social Support Questionnaire) were assessed as potential predictors of self-efficacy. A multiple linear regression model was conducted to identify the factors predicting self-efficacy score. RESULTS The mean age of the participants was 41 (SD 11.9) years and 90% were male. Participants' mean self-efficacy score was 53.9 (SD 15.7). Multiple linear regression results indicated that injury type (i.e., paraplegia or tetraplegia; β = 0.290, p < .001) and adaptive coping (β = 0.561, p < .001) were significant predictors, accounting for 62% of the variance in self-efficacy scores. CONCLUSIONS Our findings imply that psychosocial interventions that target enhancing various adaptive coping strategies could have positive effects on self-efficacy in people with SCI. CLINICAL RELEVANCE Injury type and adaptive coping ability are two key factors related to patients' self-efficacy post-SCI. Psychosocial interventions that target enhancing various adaptive coping strategies could have positive effects on self-efficacy in people with SCI.
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Affiliation(s)
- Yan Li
- Research Assistant Professor, School of Nursing, the Hong Kong Polytechnic University, Hong Kong
| | - Wai Tong Chien
- Professor and Director, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Bingqian Zhu
- Research Associate Professor, School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Honggu He
- Associate Professor & Director of Research, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Daniel Bressington
- Professor of Mental Health, College of Nursing and Midwifery, Charles Darwin University, Darwin, Australia
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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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Le Fort M, Lefèvre C, Kieny P, Perrouin-Verbe B, Ravaud JF. The functioning of social support in long-term prevention after spinal cord injury. A qualitative study. Ann Phys Rehabil Med 2020; 64:101454. [PMID: 33189942 DOI: 10.1016/j.rehab.2020.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 09/23/2020] [Accepted: 10/12/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The impact of social support on the long-term condition after a spinal cord injury (SCI) varies across studies mainly involving self-report questionnaires. OBJECTIVE We aimed to establish the common factors associated with social support leading individuals with an SCI to the effective prevention of secondary complications, including via adherence to medical follow-up. METHODS Inclusion criteria were a history of acquired SCI of any etiology, wheelchair use, and age≥18 years at the time of the study. Participants should have completed their initial rehabilitation program in France≥1 year earlier and were also enrolled according to 2 related study variables: routine medical follow-up (patients were or were not followed up) and the medically supervised reporting of a pressure ulcer after the initial rehabilitation session (0 or≥1 pressure ulcers). We performed a preparatory quantitative and qualitative literature review to identify factors affecting long-term follow-up after SCI, then adopted a narrative design with semi-structured interviews, transcribed and analyzed progressively by using qualitative analysis software. RESULTS We included 32 participants. We categorized our results based on the knowledge, attitudes, beliefs and practices of participants with respect to pressure ulcer prevention and long-term medical follow-up. Our narrative approach allowed us to identify 3 main domains relevant to social support: reciprocity, self-management and timing related to social support. CONCLUSIONS Our study showed social support as a dynamic process, a reciprocal phenomenon evolving in variations over time. These findings should be central to short- and long-term therapeutic education programs for patients and for people providing social support. Effective changes should also be implemented through the concept of the Learning Health System.
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Affiliation(s)
- Marc Le Fort
- Neurological PMR department, university hospital, 85, rue Saint-Jacques, 44093 Nantes cedex, France; House of social sciences in disability, School of advanced studies in Public Health (EHESP), 15, avenue du Professeur Léon-Bernard, 35043 Rennes, France.
| | - Chloé Lefèvre
- Neurological PMR department, university hospital, 85, rue Saint-Jacques, 44093 Nantes cedex, France.
| | - Pierre Kieny
- Neurological PMR department, university hospital, 85, rue Saint-Jacques, 44093 Nantes cedex, France.
| | - Brigitte Perrouin-Verbe
- Neurological PMR department, university hospital, 85, rue Saint-Jacques, 44093 Nantes cedex, France.
| | - Jean-François Ravaud
- House of social sciences in disability, School of advanced studies in Public Health (EHESP), 15, avenue du Professeur Léon-Bernard, 35043 Rennes, France; National Institute for Health and Medical research (Inserm), 101, rue de Tolbiac, 75654 Paris cedex 13, France.
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The International Classification of Functioning, Disability, and Health (ICF) as a community participation model for people with multiple sclerosis: A hierarchical regression analysis. THE AUSTRALIAN JOURNAL OF REHABILITATION COUNSELLING 2020. [DOI: 10.1017/jrc.2020.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AbstractMultiple sclerosis (MS) is a central nervous system disorder that impacts more than 400,000 people in the U.S. The disease results in multiple functional impairments that are diverse and varied across individuals. Additonally, MS has a profound impact on community participation which, like other rehabilitation outcomes, cannot be explained on the basis of functional limitations alone. The purpose of this study was to develop and evaluate a model of community participation for people living with MS using the World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF) framework. The model focused on the roles that personal factors have as predictors of community participation, while also serving as mediators and moderators for the relationship between activity limitation and participation. Results from the hierarchical regression analysis indicated that demographic characteristics (i.e. MS type), personal factors (i.e. core self-evaluations (CSE), MS self-management, resilience, and social skills), and activity limitations accounted for 64% of the variance in participation. Further, mediation analysis indicated that CSE mediated the relationship between activity limitation and community participation. Finally, moderation analysis indicated an interaction effect between educational attainment and MS self-management. Implications for future research in rehabilitation and clinical application are discussed.
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Scholten EW, Ketelaar M, Visser-Meily JM, Roels EH, Kouwenhoven M, Post MW. Prediction of Psychological Distress Among Persons With Spinal Cord Injury or Acquired Brain Injury and Their Significant Others. Arch Phys Med Rehabil 2020; 101:2093-2102. [DOI: 10.1016/j.apmr.2020.05.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 05/12/2020] [Accepted: 05/28/2020] [Indexed: 11/28/2022]
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Carrard V, Kunz S, Peter C. Mental health, quality of life, self-efficacy, and social support of individuals living with spinal cord injury in Switzerland compared to that of the general population. Spinal Cord 2020; 59:398-409. [PMID: 33235298 DOI: 10.1038/s41393-020-00582-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 01/22/2023]
Abstract
STUDY DESIGN Comparative study of survey self-report data. OBJECTIVES To compare individuals living with spinal cord injury (SCI) in Switzerland to the general population in terms of mental health, quality of life, self-efficacy, and social support. SETTING Community, Switzerland. METHODS Data from the 2017 community survey of the Swiss Spinal Cord Injury Cohort Study were compared to data from two matched (1:3 nearest neighbor propensity score) general population surveys collected in the same year. Measures of mental health (mental health index, psychological distress item, vitality scale, and energy item), quality of life (WHOQOL-BREF item), self-efficacy (General Self-Efficacy Scale item), and social support (items of relationship satisfaction, living alone, and marital status) were compared across datasets using regression adjusted for non-response correction weights. The analyses were then replicated in subgroups defined by sociodemographic, lesion-related, and secondary health issues factors. RESULTS Individuals with SCI had significantly higher psychological distress and poorer mental health, vitality, energy, and quality of life than the general population, with medium to large effect sizes (Cohen's d: 0.35-1.08). They also had lower self-efficacy and relationship satisfaction, lived more frequently alone, and were more frequently single. Individuals with less severe secondary health issues reported mental health and quality of life more similar to the general population than those reporting more severe issues. CONCLUSIONS This study highlights a significant long-term impact of SCI on well-being and psychosocial resources, underlining the need for ongoing biopsychosocial care beyond inpatient rehabilitation.
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Affiliation(s)
- Valerie Carrard
- Swiss Paraplegic Research (SPF), 6207, Nottwil, Switzerland. .,National Center of Competence in Research LIVES, 1022, Lausanne, Switzerland. .,Department of Health Sciences and Medicine, University of Lucerne, 6002, Lucerne, Switzerland.
| | - Simon Kunz
- Swiss Paraplegic Research (SPF), 6207, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, 6002, Lucerne, Switzerland
| | - Claudio Peter
- Swiss Paraplegic Research (SPF), 6207, Nottwil, Switzerland.,National Center of Competence in Research LIVES, 1022, Lausanne, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, 6002, Lucerne, Switzerland
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Bhattarai M, Jin Y, Smedema SM, Cadel KR, Baniya M. The relationships among self-efficacy, social support, resilience, and subjective well-being in persons with spinal cord injuries. J Adv Nurs 2020; 77:221-230. [PMID: 33009842 DOI: 10.1111/jan.14573] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/26/2020] [Accepted: 08/07/2020] [Indexed: 12/31/2022]
Abstract
AIMS To examine the contribution of self-efficacy, social support, and resilience to subjective well-being (SWB), to examine the mediating effect of resilience in the relationship between social support and SWB, and to investigate if marital status moderates the relationship between social support and SWB among people with spinal cord injuries (SCI). DESIGN A descriptive cross-sectional study, conducted from November 2017-January 2018. METHODS One hundred and two individuals with SCI were recruited from a rehabilitation center and a community setting in Nepal. SWB, self-efficacy, social support, resilience, demographics and injury-related information was collected using self-reported questionnaires. Hierarchical regression analysis, mediation analysis, and moderation analysis were performed in SPSS and R to test the hypotheses. RESULTS Self-efficacy, social support, and resilience uniquely explained 19% of the variance on SWB after controlling for demographic covariates. In the mediation analysis, resilience partially mediated the relationship between social support and SWB. In the moderation analysis, marital status moderated the relationship between resilience and SWB. CONCLUSION Subjective well-being of persons with SCI is associated with many factors. Interventions to strengthen self-efficacy, resilience, and social networks can be effective to enhance SWB. A stronger association between resilience and SWB among single participants reflects the need to provide specific considerations for persons with SCI who are single. Longitudinal and/or experimental studies are needed to further validate these findings. IMPACT This study identified external and internal factors contributing to SWB in persons with SCI. Self-efficacy, social support, and resilience were found to be significantly associated with SWB. Resilience acted as a mediator between social support and SWB. The relationship between resilience and SWB was stronger in single participants than married participants. The findings have potential implications in the field of nursing since nurses are one of the integral members of the SCI rehabilitation team.
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Affiliation(s)
- Muna Bhattarai
- Department of Rehabilitation Psychology & Special Education, University of Wisconsin-Madison, Madison, WI, USA
| | - Yuanyuan Jin
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Susan Miller Smedema
- Department of Rehabilitation Psychology & Special Education, University of Wisconsin-Madison, Madison, WI, USA
| | - Kabita Raj Cadel
- Department of Psychology, Padma Kanya Multiple Campus, Kathmandu, Nepal
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Clarke P, Twardzik E, Meade MA, Peterson MD, Tate D. Social Participation Among Adults Aging With Long-Term Physical Disability: The Role of Socioenvironmental Factors. J Aging Health 2020; 31:145S-168S. [PMID: 31718412 DOI: 10.1177/0898264318822238] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective: This study examined the environmental barriers and facilitators that hinder or promote participation among adults aging with physical disabilities. Method: Data come from an ongoing study of 1,331 individuals aging with long-term physical disability (M = 65 years). Linear regression examined the association between individual and socioenvironmental factors and participation restrictions in work, leisure, and social activities. Results: Pain, fatigue, and physical functional limitations were significant barriers to participation for individuals aging with physical disability. Barriers in the built environment also reduced participation, net of health and functioning. Poor access to buildings was especially problematic for participation among individuals not using any mobility aid to get around. But for those using wheel or walking aids, environmental barriers had no adverse effect on participation. Discussion: These findings highlight the importance of disentangling the role of different environmental factors by distinguishing between assistive technology for mobility and the physical built environment, including their interactive effects.
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The Relationship between Physical Activity Levels and Mental Health in Individuals with Spinal Cord Injury in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124423. [PMID: 32575553 PMCID: PMC7344782 DOI: 10.3390/ijerph17124423] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 12/16/2022]
Abstract
Background: The aim of this study was to assess the relationship between physical activity (PA) levels and mental health in individuals with spinal cord injury (SCI). Methods: Three hospitals in the Seoul metropolitan area were invited to recruit patients with SCI (n = 103). PA levels were measured by the Leisure Score Index of the Godin Leisure-Time Exercise Questionnaire (GLTEQ). The Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7) questionnaire, and Multidimensional Scale of Perceived Social Support (MSPSS) were used to assess mental health. Results: Compared to the least physically active participants (1st tertile, 44.09 ± 52.74 min/week), the most physically active participants (3rd tertile, 670.86 ± 354.97 min/week) scored significantly lower on PHQ-9 (17.03 ± 5.70 vs. 12.49 ± 4.01, p < 0.001), GAD-7 (13.24 ± 4.78 vs. 9.86 ± 3.15, p < 0.001), while significantly higher MSPSS (51.24 ± 10.17 vs. 61.37 ± 11.90, p < 0.001) after the results were adjusted for age, gender, American Spinal Cord Injury Association impairment scale, and impaired spinal cord levels. Multivariate linear regression analysis showed that the PA was a significant predictor of depression (β = −1.50, p = 0.01), anxiety (β = −1.12, p = 0.02), and social support (β = 4.04, p = 0.01). Conclusion: Higher PA participation was associated with lower depression, anxiety, and higher social support scores.
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Profiles of Psychological Adaptation Outcomes at Discharge From Spinal Cord Injury Inpatient Rehabilitation. Arch Phys Med Rehabil 2020; 101:401-411. [DOI: 10.1016/j.apmr.2019.08.481] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 08/17/2019] [Indexed: 11/22/2022]
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Jameel HT, Panatik SA, Nabeel T, Sarwar F, Yaseen M, Jokerst T, Faiz Z. Observed Social Support and Willingness for the Treatment of Patients with Schizophrenia. Psychol Res Behav Manag 2020; 13:193-201. [PMID: 32158288 PMCID: PMC7049275 DOI: 10.2147/prbm.s243722] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 02/05/2020] [Indexed: 11/23/2022] Open
Abstract
Background Schizophrenia is a mental disorder that causes the social breakdown of relationships with others. Patients with schizophrenia interpret reality and verbal communication in an abnormal way. They experience great difficulty in building and maintaining of social relationships within society. They also experience barriers in communication and motivation that hinder their readiness for treatment. The willingness of patients with schizophrenia to be treated improves mental illness, social support and other health-related issues. The main purpose of this study was to explore the relationship between social support and willingness for treatment in patients with Schizophrenia. Methods The qualitative research approach was used to solicit and capture more in-depth information from participants. The research design was phenomenological in nature. A cross-sectional survey method was employed. The sample consisted of twenty female patients diagnosed with schizophrenia, seven psychiatrists, and seven psychologists. A semi-structured interview guide was developed to collect the data. The interview guide covered three themes. The first theme included four questions for patients with schizophrenia. The second theme consisted of six questions for the psychiatrists and the third theme included two questions for the psychologists. Interview data were analysed through frame workanalysis. Results The results of the study showed that social support plays an essential role in the improvement of patients with schizophrenia. Psychiatrists with the help of medication and therapies reduce the negativity and anxiety level of patients and motivate patients to accept treatment. Through counseling, psychologists help patients with schizophrenia build social skills such as the ability to engage in eye contact. Conclusion It is revealed that the social support is closely related to the willingness for treatment in patients with schizophrenia. Therefore, social support is recommended in the course of treatment of patients with schizophrenia.
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Affiliation(s)
- Hafiz Tahir Jameel
- Department of Special Education, Allama Iqbal Open University, Islamabad, Pakistan
| | - Siti Aisyah Panatik
- School of Human Resource Development and Psychology, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Johor Bahru, Johor, Malaysia
| | - Tanzila Nabeel
- Department of Special Education, Allama Iqbal Open University, Islamabad, Pakistan
| | - Farhan Sarwar
- Department of Business Administration and Economics, University of Education, Township Campus, Lahore, Pakistan
| | - Muhammad Yaseen
- Department of Mathematics and Statistics, University of Agriculture, Faisalabad, Pakistan
| | - Tricia Jokerst
- Special Education, Huston-Tillotson University, Austin, TX, USA
| | - Zikra Faiz
- School of Social Sciences and Humanities, University of Management and Technology, Lahore, Pakistan
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Li C, Clark JMR, DiPiro N, Roesler J, Krause JS. Trends in nonroutine physician visits and hospitalizations: findings among five cohorts from the Spinal Cord Injury Longitudinal Aging Study. Spinal Cord 2020; 58:658-666. [DOI: 10.1038/s41393-019-0407-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/11/2019] [Accepted: 12/12/2019] [Indexed: 11/09/2022]
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Hansen WB, Scheier LM. Specialized Smartphone Intervention Apps: Review of 2014 to 2018 NIH Funded Grants. JMIR Mhealth Uhealth 2019; 7:e14655. [PMID: 31359866 PMCID: PMC6690163 DOI: 10.2196/14655] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/25/2019] [Accepted: 06/27/2019] [Indexed: 12/28/2022] Open
Abstract
Background The widespread adoption of smartphones provides researchers with expanded opportunities for developing, testing and implementing interventions. National Institutes of Health (NIH) funds competitive, investigator-initiated grant applications. Funded grants represent the state of the science and therefore are expected to anticipate the progression of research in the near future. Objective The objective of this paper is to provide an analysis of the kinds of smartphone-based intervention apps funded in NIH research grants during the five-year period between 2014 and 2018. Methods We queried NIH Reporter to identify candidate funded grants that addressed mHealth and the use of smartphones. From 1524 potential grants, we identified 397 that met the requisites of including an intervention app. Each grant’s abstract was analyzed to understand the focus of intervention. The year of funding, type of activity (eg, R01, R34, and so on) and funding were noted. Results We identified 13 categories of strategies employed in funded smartphone intervention apps. Most grants included either one (35.0%) or two (39.0%) intervention approaches. These included artificial intelligence (57 apps), bionic adaptation (33 apps), cognitive and behavioral therapies (68 apps), contingency management (24 apps), education and information (85 apps), enhanced motivation (50 apps), facilitating, reminding and referring (60 apps), gaming and gamification (52 apps), mindfulness training (18 apps), monitoring and feedback (192 apps), norm setting (7 apps), skills training (85 apps) and social support and social networking (59 apps). The most frequently observed grant types included Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) grants (40.8%) and Research Project Grants (R01s) (26.2%). The number of grants funded increased through the five-year period from 60 in 2014 to 112 in 2018. Conclusions Smartphone intervention apps are increasingly competitive for NIH funding. They reflect a wide diversity of approaches that have significant potential for use in applied settings.
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Bania TA, Antoniou AS, Theodoritsi M, Theodoritsi I, Charitaki G, Billis E. The Interaction with Disabled Persons Scale: translation and cross-cultural validation into Greek. Disabil Rehabil 2019; 43:988-995. [PMID: 31340137 DOI: 10.1080/09638288.2019.1643420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM Cross-cultural adaptation of the Interaction with Disabled Persons Scale (IDPS) into Greek. METHODS The IDPS was forward and back-translated by two bilingual physiotherapists and a Greek-English translator, respectively. Greek-speaking health professionals provided modifications in order to develop the final version of the Scale. Health professionals filled in the Greek version of the IDPS and the Caring Behaviors Inventory (for criterion validity). The factors of the Greek IDPS were extracted as well. After 8-10 days, the scale was re-distributed to the same health professionals (test-retest reliability) and to a general population sample (discriminant validity). RESULTS Eighty-seven health professionals (36 ± 7.6 years) and 80 general population participants (44 ± 11.6 years) participated. There was a trend for the Greek IDPS variability to predict the variability of the Caring Behaviors Inventory (r2 = 0.05; p = 0.054), but the coefficient of determination was low. An explanatory factor analysis extracted four factors explaining 66.66% of the total variance, confirmed by reliability analysis. The health care professionals had a significantly lower score than the general population in the Greek IDPS (mean difference: -11.0; confidence interval: -7.3 to -14.7), indicating familiarisation with the management of people with disability. The scale reliability and internal consistency were excellent; ICC(2,1) = 0.92 (confidence interval: 0.87-0.95) and Cronbach's α = 0.96 respectively. No ceiling or floor effects were observed. CONCLUSIONS Substantial validity and reliability were observed for the Greek IDPS to assess Greek health professionals' attitudes towards people with disabilities.Implications for rehabilitationThe Greek IDPS version was shown to be comprehensible, and has demonstrated a sufficient amount of validity and reliability for assessing the perceptions and attitudes of Greek health professionals towards people with disabilities.Exploring attitudes towards people with disabilities in Greek-speaking populations, especially health professionals, with a scale such as the Greek IDPS is very important as it can help promote positive changes in approaches towards disability.
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Affiliation(s)
- Theofani A Bania
- Department of Physiotherapy, University of Patras, Aigio, Greece
| | | | - Marina Theodoritsi
- Laboratory of Health Physics & Computational Intelligence, University of Patras, Patras, Greece
| | - Io Theodoritsi
- Faculty of Primary Education, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Evdokia Billis
- Department of Physiotherapy, University of Patras, Aigio, Greece
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Lee Y, Hong I, Lee MJ, Park HY. Identifying Risk of Depressive Symptoms in Adults With Physical Disabilities Receiving Rehabilitation Services: Propensity Score Approaches. Ann Rehabil Med 2019; 43:250-261. [PMID: 31311246 PMCID: PMC6637054 DOI: 10.5535/arm.2019.43.3.250] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/25/2018] [Indexed: 11/16/2022] Open
Abstract
Objective To compare the risk of depressive symptoms in adults with physical disabilities between rehabilitation-receivers and non-receivers. Methods A total of 3,568 adults with physical disabilities were retrieved from the 2014 Korean National Survey on People with Disabilities database. Four covariate adjustment methods (a multivariable regression model, inverse probability of treatment weighting [IPTW] adjusted for normalized weight, IPTW with stabilized weight, and greedy algorithm with 1:1 propensity score matching) were used to estimate the odds of having depressive symptoms. The dependent variable was depressive symptoms and the independent variable was the use of rehabilitation services. Baseline covariates were 19 demographic variables and 10 chronic condition variables. Results The four covariate adjustment methods revealed that adults with physical disabilities receiving rehabilitation services had a higher risk of depressive symptoms than those who did not receive these services (adjusted odds ratio, 1.191–1.294). Conclusion Our findings suggest that adults with physical disabilities receiving rehabilitation services have higher risk of developing depressive symptoms. Therefore, rehabilitation professionals need to pay attention to depressive symptoms and establish therapeutic strategies that can reduce such risk in rehabilitation settings.
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Affiliation(s)
- Yejin Lee
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Ickpyo Hong
- Department of Occupational Therapy, University of Texas Medical Branch, Galveston, TX, USA
| | - Mi Jung Lee
- Department of Occupational Therapy, University of Florida, Gainesville, FL, USA.,Center of Innovation on Disability and Rehabilitation Research (CINDRR), North Florida/South Georgia Veterans Health System, Gainesville, FL, USA
| | - Hae Yean Park
- Department of Occupational Therapy, College of Health Sciences, Yonsei University, Wonju, Korea
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Effects of a coping-oriented supportive programme for people with spinal cord injury during inpatient rehabilitation: a quasi-experimental study. Spinal Cord 2019; 58:58-69. [DOI: 10.1038/s41393-019-0320-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/11/2019] [Accepted: 06/18/2019] [Indexed: 11/08/2022]
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Mashola MK, Mothabeng DJ. Associations between health behaviour, secondary health conditions and quality of life in people with spinal cord injury. Afr J Disabil 2019; 8:463. [PMID: 31309047 PMCID: PMC6620481 DOI: 10.4102/ajod.v8i0.463] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 02/15/2019] [Indexed: 11/19/2022] Open
Abstract
Background The development of secondary health conditions (SHCs) after spinal cord injury (SCI) is common and can affect an individual’s emotional well-being, and his or her health-related quality of life (QOL). Little is known about relationships between performing health-benefiting behaviours and the presence (or absence) of SHCs and QOL, particularly in South Africa. Objectives This research study was conducted in order to determine the associations between health behaviour, SHCs and QOL in people with SCI (PWSCI). Method This cross-sectional study included 36 PWSCI discharged from a private rehabilitation facility in Pretoria, South Africa. The PWSCI completed questionnaires pertaining to lifestyle, independence, presence of SHCs, social support and QOL. Data were analysed using descriptive and inferential statistics such as correlation tests and chi-square test of independence (x2) using the SPSS v25. Moderate, moderately high and high correlations are reported (Pearson r ≥ 0.4). Results were significant if p < 0.05. Results Participation in health-benefiting behaviour was associated with increased QOL (r = 0.457, p < 0.01) and increased social support from family and friends (r = 0.425, p < 0.01), which was associated with increased QOL (r = 0.671, p < 0.001). Not participating in specific neuromusculoskeletal health behaviours was found to be associated with the overall presence of SHCs (r = -0.426, p < 0.01). Conclusions Participating in health-benefiting behaviour can reduce the development of SHCs and subsequently increase QOL in PWSCI. Health professionals must focus on minimising the development of SHCs by providing specific education on good health-benefiting behaviour.
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Affiliation(s)
- Mokgadi K Mashola
- Department of Physiotherapy, University of Pretoria, Pretoria, South Africa
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Guilcher SJT, Catharine Craven B, Bassett-Gunter RL, Cimino SR, Hitzig SL. An examination of objective social disconnectedness and perceived social isolation among persons with spinal cord injury/dysfunction: a descriptive cross-sectional study. Disabil Rehabil 2019; 43:69-75. [PMID: 31130020 DOI: 10.1080/09638288.2019.1616328] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE To describe objective social disconnectedness and perceived social isolation post-spinal cord injury/dysfunction (SCI/D), and to examine associations among social disconnectedness and social isolation by sociodemographic and clinical characteristics. MATERIALS AND METHODS A telephone-based questionnaire was administered to 170 community dwelling individuals with a SCI/D. Social disconnectedness was measured by social network size, composition, and frequency of contact. Social isolation was measured using the revised three item UCLA Loneliness Scale. RESULTS Of the 170 participants, the majority were men (n = 136, 80%), had a traumatic injury (n = 149, 87.6%), and had incomplete tetraplegia (n = 58, 34%). The mean network size was 3.86 (SD = 2.0) of a maximum seven. The mean loneliness score for the sample was 4.93 (SD = 1.87). Factors associated with lower feelings of loneliness included being married, living with a higher proportion of network members, and being employed. Size of networks was not significantly associated with feelings of loneliness. CONCLUSIONS This study highlights the vulnerability for perceived social isolation among persons with SCI/D. The size of network does not seem to matter as much as the frequency and quality of social interactions. Findings reinforce the complexity of social disconnectedness and the importance in understanding the various indicators of social disconnectedness as they relate to social isolation. IMPLICATIONS FOR REHABILITATION Social relationships have been shown to be a vital component of optimal health and well-being. Individuals with a spinal cord injury/dysfunction are faced with a number of challenges in developing and maintaining social relationships and community participation. Rehabilitation professionals should encourage opportunities for social inclusion, employment and community participation to optimize health and well-being for this population.
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Affiliation(s)
- Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada
| | - B Catharine Craven
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Neural Engineering & Therapeutics Team, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.,Division of Physiatry, Department of Medicine, University of Toronto, Toronto, Canada
| | | | - Stephanie R Cimino
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Sander L Hitzig
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
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Gupta S, Jaiswal A, Norman K, DePaul V. Heterogeneity and Its Impact on Rehabilitation Outcomes and Interventions for Community Reintegration in People With Spinal Cord Injuries: An Integrative Review. Top Spinal Cord Inj Rehabil 2019; 25:164-185. [PMID: 31068748 DOI: 10.1310/sci2502-164] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Various injury characteristics such as cause, level, severity, and time since injury divide individuals with spinal cord injury (SCI) into many subgroups. The heterogeneity among individuals' injuries and personal characteristics has significant implications for SCI rehabilitation practice, specifically directed toward community reintegration, which is a key goal of rehabilitation interventions for people with disabilities. Purpose: This study aims to summarize the evidence on attributes that make the SCI population heterogeneous, the impact of these attributes on community reintegration, and the implications of heterogeneity for rehabilitation interventions directed toward optimizing community reintegration. Methods: We used an integrative review approach to conduct this study. MEDLINE, PubMed, CINAHL, EMBASE, Google Scholar, and PsycINFO were searched from inception until May 2017. Out of 670 articles retrieved, 49 provided evidence on the impact of various attributes that make SCI heterogeneous on rehabilitation outcomes related to community reintegration. Results: An array of injury-related, personal, social, and environmental factors are associated with various rehabilitation outcomes that affect community reintegration of people with SCI. There is level 1 evidence that social support, self-efficacy, and self-esteem facilitate community reintegration among people with SCI while there is level 5 evidence that presence of psychological or medical complications decreases it. There is lack of clarity on the impact of injury-related factors on community reintegration. Conclusion: This integrative review found that social support and individuals' self-efficacy can improve community reintegration of people with SCI. However, evidence regarding the impact of injury characteristics on community reintegration is still underdeveloped. Approaches directed at community reintegration should involve components of psychosocial, physical, and vocational rehabilitation while considering personal and societal aspects of an individual's life.
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Affiliation(s)
- Shikha Gupta
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Atul Jaiswal
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Kathleen Norman
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Vincent DePaul
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
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O'Dell L, Earle S, Rixon A, Davies A. Role of peer support for people with a spinal cord injury. Nurs Stand 2019; 34:69-75. [PMID: 30479102 DOI: 10.7748/ns.2018.e10869] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2018] [Indexed: 06/09/2023]
Abstract
UNLABELLED Spinal cord injuries can result in significant physiological and psychological challenges for patients. Nurses have an important role in the rehabilitation of people with a spinal cord injury, as does the provision of peer support by people who are 'living well' after experiencing a spinal cord injury. AIM To explore peer support and whether it can have an effective role in a multidisciplinary team approach to supporting a patient with a spinal cord injury. METHOD This was an independent evaluation that used an online survey, a focus group and telephone interviews to elicit the views of respondents about the Spinal Injury Association (SIA) peer support service in England and Wales. There were four groups of respondents: people with a spinal cord injury; their family and friends; peer support officers; and nurse specialists and other healthcare practitioners. FINDINGS It was identified that peer support officers were valued for their ability to provide a positive role model for people with a spinal cord injury. Healthcare practitioners involved in the care of people with a spinal cord injury also appreciated the training and support they received from peer support officers. CONCLUSION This evaluation demonstrated that peer support officers were regarded as an important element of a multidisciplinary team approach to managing the care of those who had experienced a spinal cord injury. Peer support officers were also considered a valuable source of information and education, particularly for healthcare practitioners working in settings where spinal cord injury was not a common presentation.
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Affiliation(s)
- Lindsay O'Dell
- Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, England
| | - Sarah Earle
- Health and Wellbeing Priority Research Area, Faculty of Wellbeing, Education and Language Studies, The Open University Milton Keynes, England
| | - Andy Rixon
- Wellbeing and Social Care, Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, England
| | - Alison Davies
- Wellbeing and Social Care, Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, England
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LaVela SL, Etingen B, Miskevics S, Heinemann AW. What determines low satisfaction with life in individuals with spinal cord injury? J Spinal Cord Med 2019; 42:236-244. [PMID: 29733775 PMCID: PMC6419684 DOI: 10.1080/10790268.2018.1466480] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE To examine variables associated with satisfaction with life (SWL) in individuals with a spinal cord injury (SCI). DESIGN Cross-sectional, national survey to assess SWL, demographic and injury characteristics, health care utilization, chronic conditions (obesity, diabetes, heart problems, lung problems, hypertension, high cholesterol), symptoms (poor sleep, pain, depression), social support, grief/loss, and independence. SETTING/PARTICIPANTS Community-dwelling Veterans with SCI. Outcome Measures/Analyses: Bivariate analyses were conducted to assess differences in demographics, injury characteristics, chronic conditions, symptoms, social support, grief/loss, and independence in individuals who reported low SWL (≤20) vs. average/high SWL (21-35). Multivariate logistic regression assessed factors independently associated with low SWL. RESULTS 896 Veterans with SCI (62%) responded. Average age was 62 years, the majority were male (94%), Caucasian (77%), and had paraplegia (61%). Odds of low SWL were 2.4 times greater for individuals experiencing pain (OR = 2.43, CI95: 1.47-4.02, P = 0.0005). Odds of low SWL were increased for individuals reporting greater grief/loss due to their SCI (OR = 1.14, CI95: 1.10-1.18, P < 0.0001). Lesser odds of low SWL were seen for individuals reporting greater emotional social support (OR = 0.97, CI95: 0.96-0.99, P < 0.0001) and independence (OR = 0.94, CI95: 0.90-0.97, P < 0.0001). CONCLUSIONS Pain and feelings of grief/loss due to injury were associated with low SWL. Self-perceived independence and good social support were associated with better SWL. Along with addressing pain and facilitating independence and social support, these findings suggest that interventions to improve SWL should focus on helping individuals deal with grief/loss due to injury.
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Affiliation(s)
- Sherri L. LaVela
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital, Hines, Illinois, USA,Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA,Correspondence to: Sherri L. LaVela, PhD, MPH, MBA, Department of Veterans Affairs, Edward Hines, Jr. VA Hospital (151-H, Building 1, Office D-312), 5th Avenue & Roosevelt Road, Hines, IL60141, USA; Ph: (708) 202-5895, (708) 202-2499.
| | - Bella Etingen
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital, Hines, Illinois, USA
| | - Scott Miskevics
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital, Hines, Illinois, USA
| | - Allen W. Heinemann
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA,Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Illinois, USA
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Zürcher C, Tough H, Fekete C. Mental health in individuals with spinal cord injury: The role of socioeconomic conditions and social relationships. PLoS One 2019; 14:e0206069. [PMID: 30785880 PMCID: PMC6382129 DOI: 10.1371/journal.pone.0206069] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 01/27/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To evaluate socioeconomic inequalities in social relationships, and to assess whether socioeconomic conditions and social relationships are independently related to mental health problems in individuals with a physical disability due to spinal cord injury (SCI). METHODS We analyzed cross-sectional data from 511 individuals with SCI aged over 16 years who participated in the community survey of the Swiss SCI Cohort Study (SwiSCI). Indicators for socioeconomic conditions included years of formal education, household income, and financial strain. Social relationships were operationalized by three structural (partner status; social contact frequency; number of supportive relationships) and four functional aspects (satisfaction with: overall social support; family relationships; contacts to friends; partner relationship). General mental health was assessed by the Mental Health Inventory (MHI-5) of SF-36 and depressive symptoms were measured by the Hospital Anxiety and Depression Scale (depression subscale, HADS-D). Established cut-offs for general mental health problems (MHI-5 ≤56) and depressive symptomatology (HADS-D ≥8) were used to dichotomize outcomes. Associations were assessed using logistic regressions. RESULTS Lower household income was predominantly associated with poor structural social relationships, whereas financial strain was robustly linked to poor functional social relationships. Financial strain was associated with general mental health problems and depressive symptomatology, even after controlling for social relationships. Education and household income were not linked to mental health. Poor structural and functional social relationships were related to general mental health problems and depressive symptomatology. Notably, trends remained stable after accounting for socioeconomic conditions. CONCLUSION This study provides evidence for socioeconomic inequalities in social relationships as well as for independent associations of financial strain and poor social relationships with mental health problems in individuals with SCI. Further research may develop strategies to improve mental health in SCI by strengthening social relationships. Such interventions may be especially beneficial for individuals with low income and financial strain.
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Affiliation(s)
- Carmen Zürcher
- Bern University of Applied Sciences, Department of Health Professions, Bern, Switzerland
| | - Hannah Tough
- Swiss Paraplegic Research, Nottwil, Switzerland
- University of Lucerne, Department of Health Sciences and Health Policy, Lucerne, Switzerland
| | - Christine Fekete
- Swiss Paraplegic Research, Nottwil, Switzerland
- University of Lucerne, Department of Health Sciences and Health Policy, Lucerne, Switzerland
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Hossain MS, Islam MS, Rahman MA, Glinsky JV, Herbert RD, Ducharme S, Harvey LA. Health status, quality of life and socioeconomic situation of people with spinal cord injuries six years after discharge from a hospital in Bangladesh. Spinal Cord 2019; 57:652-661. [DOI: 10.1038/s41393-019-0261-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Gómez-Acosta CA. [Psychological factors predictive of healthy lifestyles]. ACTA ACUST UNITED AC 2018; 20:155-162. [PMID: 30569995 DOI: 10.15446/rsap.v20n2.50676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 10/12/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To present a robust statistical model that considers some psychological factors as predictors of healthy lifestyle. MATERIALS AND METHODS A battery composed of validated instruments was applied to evaluate beliefs, healthy practices, coping styles, positive mental health and perceived self-efficacy in a sample of 570 university students from Bogotá, Colombia. Based on the information obtained, descriptive, variance and correlation analyzes were developed, as well as a structural equations model. RESULTS High scores were obtained in the categories 'optimal psychological factors', 'beliefs and healthy practices', except for the 'physical activity practice' and 'less adaptive coping factors' categories. Likewise, significant differences were found in most of the variables measured, as well as important correlations between adaptive psychological factors and healthy practices and beliefs. Finally, the structural equations model that showed the greatest adjustment predicts by 89% the variance of positive mental health based on the interaction between the variables 'coping directed to the problem', 'general satisfaction', 'pro social attitude', 'social skills' and 'self-efficacy'. In turn, the presence of positive mental health, when interacting with healthy beliefs, predicts the occurrence of healthy lifestyles by 63%. CONCLUSION Even when the model is not conclusive, it can provide empirical support to possible health interventions to be implemented in higher education institutions, based on the strengthening of psychological predictive factors.
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Affiliation(s)
- César A Gómez-Acosta
- CG: Psc. M. Sc. Psicología. Ph. D. (c) Psicología. Facultad de Psicología, Fundación Universitaria Sanitas. Bogotá, Colombia.
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Lane GI, Elliott SP. Safely Avoiding Surgery in Adult Neurogenic Bladder. CURRENT BLADDER DYSFUNCTION REPORTS 2018. [DOI: 10.1007/s11884-018-0479-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Wangdell J, Fridén J. Outcomes of reconstructive hand surgery in patients with tetraplegia and neuropathic pain. Spinal Cord 2018; 56:1194-1198. [PMID: 29904187 DOI: 10.1038/s41393-018-0164-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 03/16/2018] [Accepted: 04/03/2018] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Retrospective cohort study OBJECTIVES: To evaluate the impact of preoperative neuropathic pain on outcome and postoperative compliance after grip reconstructive surgery in people with tetraplegia. SETTING Specialized tetraplegia upper-limb surgery center in Sweden. METHODS All patients who underwent grip reconstructive surgery and attended a 6 month follow up during January 2012 and May 2015 were included. Participants were divided into two groups, pain group and no pain group, based on preoperative rating of experienced pain on a visual analog scale. The main outcome measures were grip strength, grasp ability (Grasp and Release Test) and prioritized activity outcome (Canadian Occupational Performance Measure) together with compliance to the rehabilitation plan. RESULTS The study include 37 patients (86% of the cohort). Seventeen patients experienced preoperative pain (46%). There were no differences in outcome between the pain- and the no pain group regarding grip strength (5 vs. 4.6 kg), grip ability or activity performance and satisfaction (COPM improvement of 3.1 vs. 3.0 for performance and 3.6 for both groups in satisfaction). Both groups experienced improvements in all aspects and there were no differences in the ability to fulfill postoperative treatment. CONCLUSIONS Individuals with tetraplegia and preoperative neuropathic pain in the arm/hand improve after grip reconstructions in a similar way to those without pain. Patients with neuropathic pain therefore should be considered as surgery candidates to the same extent as those without pain.
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Affiliation(s)
- J Wangdell
- Centre of Advanced Reconstruction of Extremities (CARE), Sahlgrenska University Hospital, Gothenburg, Sweden. .,Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
| | - J Fridén
- Centre of Advanced Reconstruction of Extremities (CARE), Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Swiss Paraplegic Centre, Nottwil, Switzerland
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