1
|
Cogley C, D'Alton P, Nolan M, Smith E. "You were lying in limbo and you knew nothing": a thematic analysis of the information needs of spinal cord injured patients and family members in acute care. Disabil Rehabil 2022; 44:6804-6814. [PMID: 34465272 DOI: 10.1080/09638288.2021.1970259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE To address the lack of research on the information needs of spinal cord injured (SCI) patients and family members in acute care, in order to inform the provision of appropriate information supports. MATERIALS AND METHODS Semi-structured interviews were conducted with seven traumatic SCI patients and six family members. Reflexive thematic analysis was used to analyse and interpret the data. RESULTS Five themes were generated: (1) "You were lying in limbo and you knew nothing" describes how being situated in non-specialist acute care limited participants' access to information; (2) "You'll never walk again" is not enough describes the need for information about the effects of SCI and the management of secondary conditions; (3) "The delivery was awful" demonstrates the importance of information being explained clearly and empathically; (4) "It was going in one ear and out the other" highlights the need for ongoing conversations with healthcare professionals, as retaining information provided in the early stages post-injury is often difficult; and (5) "Hope" not "false hope" discusses the importance of giving patients and family members hope while simultaneously being realistic about potential recovery. CONCLUSIONS SCI patients and family members had significant unmet information needs in acute care.IMPLICATIONS FOR REHABILITATIONSCI patients and family members had significant unmet information needs while in acute care. Being in non-specialist acute care significantly limited most participants' access to information.During the acute phase of care, most patients and family members would like to know the patient's recovery prognosis, the impact of SCI on the patient's functional independence, how to manage secondary complications, and what to expect in rehabilitation.As patients and family members often had difficulty absorbing information in the early stages post-injury, information should be continuously repeated, reinforced and clarified.HCPs should promote realistic hope for SCI patients and family members even in the absence of neurological recovery, by focusing on what the patient is still capable of while being honest about their prognosis.
Collapse
Affiliation(s)
- Clodagh Cogley
- University College Dublin, Dublin, Ireland.,St. Vincent's University Hospital, Dublin, Ireland
| | - Paul D'Alton
- University College Dublin, Dublin, Ireland.,St. Vincent's University Hospital, Dublin, Ireland
| | - Maeve Nolan
- National Rehabilitation Hospital, Dublin, Ireland
| | - Eimear Smith
- National Rehabilitation Hospital, Dublin, Ireland
| |
Collapse
|
2
|
Jeyathevan G, Jaglal SB, Hitzig SL, Linassi G, Mills S, Noonan VK, Anzai K, Clarke T, Wolfe D, Bayley M, Aslam L, Farahani F, Alavinia SM, Omidvar M, Craven BC. Conception and development of Self-Management indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project. J Spinal Cord Med 2021; 44:S94-S117. [PMID: 34779736 PMCID: PMC8604486 DOI: 10.1080/10790268.2021.1961054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
CONTEXT Although self-management is linked to reduced secondary health complications (SHCs) and enhanced overall quality of life post-spinal cord injury or disease (SCI/D), it is poorly integrated into the current rehabilitation process. Promoting self-management and assuring equity in care delivery is critical. Herein, we describe the selection of Self-Management structure, process and outcome indicators for adults with SCI/D in the first 18 months after rehabilitation admission. METHODS Experts in self-management across Canada completed the following tasks: (1) defined the Self-Management construct; (2) conducted a systematic search of available outcomes and their psychometric properties; and (3) created a Driver diagram summarizing available evidence related to Self-Management. Facilitated meetings allowed development and selection following rapid-cycle evaluations of proposed structure, process and outcome indicators. RESULTS The structure indicator is the proportion of staff with appropriate education and training in self-management principles. The process indicator is the proportion of SCI/D inpatients who have received a self-management assessment related to specific patient self-management goal(s) within 30 days of admission. The outcome indicator is the Skill and Technique Acquisition, and Self-Monitoring and Insight subscores of the modified Health Education Impact Questionnaire. CONCLUSION The structure indicator will heighten awareness among administrators and policy makers regarding the need to provide staff with ongoing training related to promoting self-management skill acquisition. Successful implementation of the Self-Management process and outcome indicators will promote self-management education and skill acquisition as a rehabilitation priority, allow for personalization of skills related to the individual's self-management goal(s), and empower individuals with SCI/D to manage their health and daily activities while successfully integrating into the community.
Collapse
Affiliation(s)
- Gaya Jeyathevan
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Susan B. Jaglal
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Sander L. Hitzig
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,Rehabilitation Sciences Institute, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Gary Linassi
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sandra Mills
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | | | - Karen Anzai
- GF Strong Rehab Centre, Vancouver, British Columbia, Canada
| | | | - Dalton Wolfe
- Parkwood Institute Research, Lawson Health Research Institute, London, Ontario, Canada,School of Health Studies, Western University, London, Ontario, Canada
| | - Mark Bayley
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Division of Physical Medicine and Rehabilitation, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lubna Aslam
- Spinal Cord Injury Ontario, Toronto, Ontario, Canada
| | - Farnoosh Farahani
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - S. Mohammad Alavinia
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Maryam Omidvar
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - B. Catharine Craven
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Division of Physical Medicine and Rehabilitation, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,Correspondence to: B. Catharine Craven, KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, 206-H 520 Sutherland Drive, Toronto, ON, M4G3V9, Canada; Ph: 416-597-3422x6122.
| |
Collapse
|
3
|
Charlton P, Kean T, Liu RH, Nagel DA, Azar R, Doucet S, Luke A, Montelpare W, Mears K, Boulos L. Use of environmental scans in health services delivery research: a scoping review. BMJ Open 2021; 11:e050284. [PMID: 34758992 PMCID: PMC8587593 DOI: 10.1136/bmjopen-2021-050284] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/13/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To examine the extent and nature of evidence on the use of the environmental scan (ES) in the health services delivery literature. DESIGN Scoping review. METHODS This scoping review followed the five-stage scoping review methodology outlined by Khalil et al. A Peer Review of Electronic Search Strategies was completed. Seven electronic databases and the grey literature were searched. Pairs of researchers independently performed two levels of screening and data extraction. Data were analysed using qualitative content and thematic analysis. RESULTS Ninety-six studies were included in the scoping review. Researchers conducted ESs for many purposes, the most common being to examine the current state of programmes, services or policies. Recommendations were informed by ESs in 20% of studies. Most common data collection methods were literature review (71%), key informant or semistructured interviews (46%) and surveys (35%). Over half (53%) of the studies used a combination of passive (looking at information eg, literature, policies, guidelines) and active (looking for information eg, surveys, interviews) approaches to data collection. Person sources of data (eg, healthcare stakeholders, community representatives) and non-person sources of data (eg, documents, electronic databases, the web) were drawn on to a similar extent. The thematic analysis of the definitions/descriptions yielded several themes including instrument of discovery, knowledge synthesis, forward-looking and decision making. Research gaps identified included absence of a standard definition, inconsistencies in terminology and lack of guiding frameworks in the health services delivery context. CONCLUSION ESs were conducted to gather evidence and to help inform decision making on a range of policy and health services delivery issues across the continuum of care. Consistency in terminology, a consensus definition and more guidance on ES design may help provide structure for researchers and other stakeholders, and ultimately advance ES as a methodological approach. A working definition of ES in a health services delivery context is presented.
Collapse
Affiliation(s)
- Patricia Charlton
- Adjunct Faculty, Faculty of Nursing, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Terri Kean
- Faculty of Nursing, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Rebecca H Liu
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Daniel A Nagel
- College of Nursing, University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, Canada
| | - Rima Azar
- Psychobiology of Stress and Health Lab, Psychology Department, Mount Allison University, Sackville, New Brunswick, Canada
| | - Shelley Doucet
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, New Brunswick, Canada
| | - Alison Luke
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, New Brunswick, Canada
| | - William Montelpare
- Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Kim Mears
- Robertson Library, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Leah Boulos
- Maritime SPOR SUPPORT Unit, Halifax, Nova Scotia, Canada
| |
Collapse
|
4
|
Perspectives of wheelchair users with spinal cord injury on fall circumstances and fall prevention: A mixed methods approach using photovoice. PLoS One 2020; 15:e0238116. [PMID: 32857793 PMCID: PMC7454945 DOI: 10.1371/journal.pone.0238116] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 08/09/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction Wheelchair users with spinal cord injury are at a high risk of falls. However, the perspectives of wheelchair users with spinal cord injury on their fall circumstances and their preferences for fall prevention strategies/interventions remain understudied. Therefore, we aimed to: a) describe the circumstances of falls experienced by wheelchair users with spinal cord injury over a six-month period, b) explore their perspectives of why falls occurred in certain situations, and c) explore their perspectives on recommended content/structure of fall prevention strategies/interventions. Methods This sequential explanatory mixed methods study had two phases. Phase I involved tracking of falls experienced by wheelchair users with spinal cord injury over six months, in which participants completed a survey after experiencing a fall to track the number/circumstance of each fall. Data from the surveys were descriptively reported. Phase II involved a photovoice focus group discussion of the survey findings and their preferences for fall prevention strategies/interventions. Data from the focus group discussion were analyzed using a thematic analysis. Results Thirty-two participants completed phase I. More than half of the participants fell at least once in six months. Falls commonly occurred in the afternoon during a transfer, or when participants were wheeling over uneven ground. One-third of the falls caused an injury. Eleven participants that fell during phase I participated in the focus group. Two main themes were identified from the discussion: 1) “circumstances surrounding the falls” (e.g. when falls occurred, the home is a ‘safe space’) and 2) “suggestions and preferences for fall prevention strategies/interventions” (e.g. fall prevention involves all, fall prevention training available as needed). Conclusion Fall prevention strategies/interventions should be an integral component of rehabilitation practices across the lifespan. Participants recommend customizing fall prevention strategies/interventions to their specific needs to guide the structure, content, and delivery of targeted fall prevention programs.
Collapse
|
5
|
Barclay L, Robins L, Migliorini C, Lalor A. Community integration programs and interventions for people with spinal cord injury: a scoping review. Disabil Rehabil 2020; 43:3845-3855. [PMID: 32356499 DOI: 10.1080/09638288.2020.1749889] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aim: The focus of this scoping review was to identify the extent, range, and nature of studies that have been published regarding community integration programs and interventions that support people during the transition home from hospital following spinal cord injury.Methods: Four electronic databases and one search engine were searched for articles published between 2010 and 2020. Grey literature and manual searches were also done.Results: Of the 16 articles included, 8 were published in peer-reviewed journals. Two of these did not include an evaluation. Study designs included but were not limited to pilot studies (n = 2); mixed methods evaluations (n = 2); single-site randomized controlled trials (n = 3); and, non-randomized single-arm study design (n = 1). The articles were from the United States (n = 12), Canada (n = 2), Australia (n = 1), and the United Kingdom (n = 1).Conclusion: The majority of interventions focused on addressing health-related educational needs, followed by community mobility. Goal setting and promoting self-efficacy were identified as important components, and the importance of involvement of people with lived experience was also highlighted. There was a lack of focus on management of relationships, including addressing sexuality needs. This review highlights the need for further empirical evaluation of implemented programs and interventions in this area, particularly in countries other than the USA, to inform service development.IMPLICATIONS FOR REHABILITATIONSuccessful community integration is an important outcome of spinal cord injuries rehabilitation.The majority of published programs focus on health-related educational needs, followed by community mobility.It is recommended that goal setting and promoting self-efficacy are included in programs.It is recommended that people with lived experience of spinal cord injuries are involved in interventions.It is recommended that programs include a focus on management of relationships, including addressing sexuality needs.
Collapse
Affiliation(s)
- Linda Barclay
- Department of Occupational Therapy, Monash University, Frankston, VIC, Australia
| | - Lauren Robins
- School of Primary and Allied Health Care, Monash University, Frankston, VIC, Australia
| | - Christine Migliorini
- Psychosocial Research Centre, Department of Psychiatry, University of Melbourne, Hawthorn, VIC, Australia
| | - Aislinn Lalor
- Department of Occupational Therapy, Monash University, Frankston, VIC, Australia
| |
Collapse
|
6
|
McIntyre A, Marrocco SL, McRae SA, Sleeth L, Hitzig S, Jaglal S, Linassi G, Munce S, Wolfe DL. A Scoping Review of Self-Management Interventions Following Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2020; 26:36-63. [PMID: 32095066 PMCID: PMC7015175 DOI: 10.1310/sci2601-36] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: To conduct a scoping review to identify what components of self-management are embedded in self-management interventions for spinal cord injury (SCI). Methods: In accordance with the approach and stages outlined by Arksey and O'Malley (2005), a comprehensive literature search was conducted using five databases. Study characteristics were extracted from included articles, and intervention descriptions were coded using Practical Reviews in Self-Management Support (PRISMS) (Pearce et al, 2016), Barlow et al (2002), and Lorig and Holman's (2003) taxonomy. Results: A total of 112 studies were included representing 102 unique self-management programs. The majority of the programs took an individual approach (52.0%) as opposed to a group (27.4%) or mixed approach (17.6%). While most of the programs covered general information, some provided specific symptom management. Peers were the most common tutor delivering the program material. The most common Barlow components included symptom management (n = 44; 43.1%), information about condition/treatment (n = 34; 33.3%), and coping (n = 33; 32.4%). The most common PRISMS components were information about condition and management (n = 85; 83.3%), training/rehearsal for psychological strategies (n = 52; 51.0%), and lifestyle advice and support (n = 52; 51.0%). The most common Lorig components were taking action (n = 62; 60.8%), resource utilization (n = 57; 55.9%), and self-tailoring (n = 55; 53.9%). Conclusion: Applying self-management concepts to complex conditions such as SCI is only in the earliest stages of development. Despite having studied the topic from a broad perspective, this review reflects an ongoing program of research that links to an initiative to continue refining and testing self-management interventions in SCI.
Collapse
Affiliation(s)
- Amanda McIntyre
- Lawson Health Research Institute, Parkwood Institute, Ontario, Canada
| | | | | | - Lindsay Sleeth
- Lawson Health Research Institute, Parkwood Institute, Ontario, Canada
| | - Sander Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Susan Jaglal
- Department of Physical Therapy, University of Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
| | - Gary Linassi
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Sarah Munce
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto
| | - Dalton L. Wolfe
- Lawson Health Research Institute, Parkwood Institute, Ontario, Canada
- Health Sciences, Western University, Ontario, Canada
| |
Collapse
|
7
|
Barclay L, Lalor A, Migliorini C, Robins L. A comparative examination of models of service delivery intended to support community integration in the immediate period following inpatient rehabilitation for spinal cord injury. Spinal Cord 2019; 58:528-536. [DOI: 10.1038/s41393-019-0394-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 11/07/2019] [Accepted: 11/22/2019] [Indexed: 11/09/2022]
|
8
|
Rodger S. Evaluating sexual function education for patients after a spinal cord injury. ACTA ACUST UNITED AC 2019; 28:1374-1378. [PMID: 31778344 DOI: 10.12968/bjon.2019.28.21.1374] [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: 11/11/2022]
Abstract
AIM this article shares findings from a service evaluation exploring the views of patients relating to the specialist sexual function education and information provided following a spinal cord injury. BACKGROUND education optimises patients' involvement in their own decision-making and care processes, with the aim of promoting adherence to agreed plans, reducing the risks of post-injury complications, promoting independence and improving quality of life. Sexual function is a well-known quality-of-life indicator and it has been widely documented that it is not well addressed following spinal cord injury. A previous service evaluation exploring education provided to patients with spinal cord injury identified the need for improved provision of sexual function education/information. As a result, weekly 1-hour sessions focused on sexual function for up to three patients of the same sex were held, facilitated by a clinical nurse specialist. The sessions had an open forum structure. They were initially designed to discuss thoughts and feelings around intimacy and sex after a spinal cord injury, but focused on group members' requests. In addition, patients were offered a one-to-one session where the 'mechanics' of sex could be discussed in further detail. DESIGN AND METHODS a service evaluation used a questionnaire survey to collect data from a purposive convenience sample of spinal cord injury patients. Data were collected between July and September 2018. Participants completed a locally designed paper questionnaire, which included Likert-style questions and space to add free text comments. Descriptive analysis of the data was used. RESULTS survey results suggest that the newly formed sexual function education session is positively evaluated in terms of usefulness and all attendees to date would recommend this session to other patients. CONCLUSIONS AND RECOMMENDATIONS following completion of data analysis, findings will inform the further development of sexual function education, with a particular focus on tailoring it to the patient and reducing the stigma around talking about sex.
Collapse
Affiliation(s)
- Sian Rodger
- Clinical Nurse Specialist, London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital, Stanmore, London
| |
Collapse
|
9
|
Rodger S, Bench S. Education provision for patients following a spinal cord injury. ACTA ACUST UNITED AC 2019; 28:377-381. [DOI: 10.12968/bjon.2019.28.6.377] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Sian Rodger
- Clinical Nurse Specialist, London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital, Stanmore, London
| | - Suzanne Bench
- Associate Professor of Nursing, Royal National Orthopaedic Hospital and London South Bank University
| |
Collapse
|
10
|
Allin S, Shepherd J, Tomasone J, Munce S, Linassi G, Hossain SN, Jaglal S. Participatory Design of an Online Self-Management Tool for Users With Spinal Cord Injury: Qualitative Study. JMIR Rehabil Assist Technol 2018; 5:e6. [PMID: 29563075 PMCID: PMC5885063 DOI: 10.2196/rehab.8158] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 11/15/2017] [Accepted: 01/06/2018] [Indexed: 11/13/2022] Open
Abstract
Background Rehospitalization rates resulting from secondary conditions in persons with spinal cord injuries (SCI) are high. Self-management programs for many chronic conditions have been associated with decreases in hospital readmissions. However, in the SCI community, evidence suggests that satisfaction with traditional self-management programs is low. Users with SCI have indicated preference for programs that are online (rather than in-person), that target SCI-specific concerns, and are led by peers with SCI. There is currently no program with all of these features, which addresses self-management of secondary conditions after SCI. Objective The aim of this study was to provide details of a participatory design (PD) process for an internet-mediated self-management program for users with SCI (called SCI & U) and illustrate how it has been used to define design constraints and solutions. Methods Users were involved in development as codesigners, codevelopers, and key informants. Codesigners and codevelopers were recruited from consumer advocacy groups and worked with a core development team. Key informants were recruited from geographically distributed advocacy groups to form a product advisory council that met regularly with the core team. During meetings, codesigners and informants walked through stages of work that typify PD processes such as exploration, discovery, and prototyping. This paper details the process by analyzing 10 meetings that took place between August 2015 and May 2016. Meetings were recorded, transcribed, and subjected to an inductive thematic analysis; resulting themes were organized according to their relationship to PD stages. Results A total of 16 individuals participated in meeting discussions, including 7 researchers and 9 persons with SCI from 4 Canadian provinces. Themes of trust, expertise, and community emerged in every group discussion. The exploration stage revealed interest in online self-management resources coupled with concerns about information credibility. In general, participants indicated that they felt more confident with information received from trusted, in-person sources (eg, peers or health care professionals) than information found online. The discovery stage saw participants propose and discuss concepts to filter credible information and highlight community expertise, namely (1) a community-curated resource database, (2) online information navigators, and (3) group chats with peers. Several tools and techniques were collectively prototyped in an effort to foster trust and community; these are illustrated in the Results section. Conclusions A PD process engaging users as codesigners, codevelopers, and informants can be used to identify design concerns and prototype online solutions to promote self-management after SCI. Future work will assess the usability of the collectively designed tools among a broad population of Canadians with SCI and the tools’ impact on self-efficacy and health.
Collapse
Affiliation(s)
- Sonya Allin
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - John Shepherd
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Jennifer Tomasone
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Sarah Munce
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Gary Linassi
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Susan Jaglal
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
11
|
Loeb SJ, Penrod J, Myers VH, Baney BL, Strickfaden SM, Kitt-Lewis E, Wion RK. Enhancing Care of Aged and Dying Prisoners: Is e-Learning a Feasible Approach? JOURNAL OF FORENSIC NURSING 2017; 13:178-185. [PMID: 28990989 PMCID: PMC5705445 DOI: 10.1097/jfn.0000000000000168] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Prisons and jails are facing sharply increased demands in caring for aged and dying inmates. Our Toolkit for Enhancing End-of-life Care in Prisons effectively addressed end-of-life (EOL) care; however, geriatric content was limited, and the product was not formatted for broad dissemination. Prior research adapted best practices in EOL care and aging; but, delivery methods lacked emerging technology-focused learning and interactivity. PURPOSES Our purposes were to uncover current training approaches and preferences and to ascertain the technological capacity of correctional settings to deliver computer-based and other e-learning training. METHODS An environmental scan was conducted with 11 participants from U.S. prisons and jails to ensure proper fit, in terms of content and technology capacity, between an envisioned computer-based training product and correctional settings. RESULTS Environmental scan findings focused on content of training, desirable qualities of training, prominence of "homegrown" products, and feasibility of commercial e-learning. CONCLUSIONS/IMPLICATIONS This study identified qualities of training programs to adopt and pitfalls to avoid and revealed technology-related issues to be mindful of when designing computer-based training for correctional settings, and participants spontaneously expressed an interest in geriatrics and EOL training using this learning modality as long as training allowed for tailoring of materials.
Collapse
|
12
|
Self-management interventions to improve skin care for pressure ulcer prevention in people with spinal cord injuries: a systematic review protocol. Syst Rev 2016; 5:150. [PMID: 27600153 PMCID: PMC5011862 DOI: 10.1186/s13643-016-0323-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 08/22/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Pressure ulcers are a serious, common, lifelong, and costly secondary complication of spinal cord injury (SCI). Community-dwelling people with a SCI can prevent them with appropriate skin care (i.e. pressure relieving activities, skin checks). Adherence to skin care remains suboptimal however, and self-management interventions that focus on improving this have been designed. Little is known on their content, effectiveness, or theoretical basis. The aim of the proposed systematic review is to synthesize the literature on self-management interventions to improve skin care in people with a SCI. Specific objectives are to describe these interventions in relation to their content, effectiveness, theory base, and adherence to reporting guidelines for intervention description. METHODS The search strategy will combine an electronic search of nine bibliographic databases (MEDLINE, Embase, PsycInfo, CENTRAL, CINAHL, Rehabdata, CIRRIE, PEDro, ERIC) and two trial registers with a manual search of relevant reference lists. Predefined eligibility criteria will be applied in a two-phase selection process involving title and abstract screening, followed by full-text screening. A data extraction spreadsheet will be applied to included papers. Intervention content will be coded using two taxonomies (behaviour change taxonomy; PRISMS self-management support taxonomy). A validated tool (Theory Coding Scheme) and the Template for Intervention Description and Replication (TIDieR) will be used to examine theoretical basis and assess adherence to reporting guidelines for intervention description. A small number of heterogeneous studies are likely to be included in this review therefore a narrative synthesis is planned. DISCUSSION This systematic review will help identify the gaps and priorities to guide future research activities in this area. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016033191.
Collapse
|
13
|
Bea-Muñoz M, Medina-Sánchez M, Flórez-García MT. Quality of websites with patient information about spinal cord injury in Spanish. Spinal Cord 2015; 54:540-5. [PMID: 26481713 DOI: 10.1038/sc.2015.190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 09/06/2015] [Accepted: 09/20/2015] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Descriptive, cross-sectional analysis of websites with information on spinal cord injury (SCI) in Spanish. OBJECTIVE To assess the quality, readability and presence of quality labels on web pages with information about SCI in Spanish. SETTING The Internet. METHODS An Internet search was conducted on Google with the keywords 'lesión medular' (spinal cord injury), 'paraplejia' (paraplegia) and 'tetraplejia' (tetraplegia). The first 50 results of each search were included. The quality of websites was assessed with the LIDA tool while the readability was assessed with the Flesch-Szigriszt index and the INFLESZ scale. We also checked the presence of any quality label. RESULTS After excluding duplicated and irrelevant results, 33 websites were analysed. Only four of them had a quality label. The mean score of the LIDA tool was 61.12% (medium quality), and the worst results were those referring to the reliability of the information. The readability of the web pages was somewhat difficult, with a mean of 48.22 in the Flesch-Szigriszt index. Only eight of the websites showed normal readability. We observed no differences in either the quality or the readability of the websites according to their origin or the presence of quality labels. CONCLUSIONS The websites analysed present a medium quality. Mainly, they should improve the reliability of their contents and their readability, including more quality labels. For SCI information in Spanish to be understandable and to provide valuable content, websites analysed in our study need to improve the quality parameters.
Collapse
Affiliation(s)
- M Bea-Muñoz
- Neurological Rehabilitation Unit, Rehabilitation Service, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | |
Collapse
|