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Marshall K, Patterson F, Fleming J, Gustafsson L, Atresh S. "Be ready to learn": a qualitative study of the patient perspective of falls and fall prevention following discharge from a spinal injuries unit. Disabil Rehabil 2024; 46:3108-3115. [PMID: 37559389 DOI: 10.1080/09638288.2023.2245755] [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: 02/07/2023] [Revised: 07/29/2023] [Accepted: 08/03/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE Falls following a spinal cord injury (SCI) can have physical and psychological consequences, although some risk of falls may be acceptable to enable participation in meaningful activity. The study aimed to explore the patients' perspective of falls and fall prevention after discharge from a inpatient spinal injuries unit. METHODS An interpretive descriptive approach guided the study. Semi structured interviews were conducted in the 6-12 months post discharge period. Thematic analysis was used to analyze the data and identify themes. RESULTS Fifteen individuals with SCI, with a mean age of 57 years and varied fall experiences were included. Three themes were identified including: 1. Expectation of falling; 2. Learning from my own experience and the experience of others' and 3. How to prevent falls. Learning from their own experience and the experience of others was highly valued by persons with SCI and influenced expectations of falls. A variety of strategies were used to prevent falls. CONCLUSIONS Strategies that include learning from others, include activities that are individual and provide skills in self-reflection may aid to make fall prevention meaningful.
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Affiliation(s)
- Kathryn Marshall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Department of Occupational Therapy, Princess Alexandra Hospital, Brisbane, Australia
| | - Freyr Patterson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Louise Gustafsson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Sridhar Atresh
- Queensland Spinal Cord Injuries Service, Division of Rehabilitation, Princess Alexandra Hospital, Brisbane, Australia
- School of Medicine, The University of Queensland, Brisbane, Australia
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2
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Melin J, Axwalter E, Åhrén G, Sunnerhagen KS, Lundgren-Nilsson Å, Wangdell J. Research priorities to enhance life for people with spinal cord injury: a Swedish priority setting partnership. Spinal Cord 2023; 61:570-577. [PMID: 37474593 PMCID: PMC10564619 DOI: 10.1038/s41393-023-00913-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 06/22/2023] [Accepted: 06/28/2023] [Indexed: 07/22/2023]
Abstract
STUDY DESIGN Mixed-method consensus development project. OBJECTIVE To identify the top ten research priorities for spinal cord injury (SCI). SETTING Nationwide in Sweden in 2021-22. METHODS The PSP process proposed by the James Lind Alliance was used. It comprises two main phases: question identification and priority selection. People living with SCI, relatives of people with SCI as well as health professionals and personal care assistants working with people with SCI were included. RESULTS In the first phase, 242 respondents provided 431 inputs addressing potentially unanswered questions. Of these, 128 were beyond the scope of this study. The remaining 303 were merged to formulate 57 questions. The literature review found one question answered, so 56 questions proceeded to the prioritisation. In the second phase, the interim prioritisation survey, 276 respondents ranked the 56 questions. The top 24 questions then proceeded to the final prioritisation workshop, at which 23 participants agreed on the top ten priorities. CONCLUSIONS This paper reveals issues that people living with SCI, relatives of people with SCI as well as health professionals and personal care assistants working with people with SCI find difficult to get answered. The top-priority questions for people living with SCI in Sweden concern specialist SCI care and rehabilitation, followed by a number of questions addressing physical health. Other topics, from the 56 key questions include Mental health, Ageing with SCI, Community support and personal care assistance, and Body functions. This result can guide researchers to design appropriate studies relevant to people with SCI. SPONSORSHIP The project was funded by the Gothenburg Competence Centre for Spinal Cord Injury and the Swedish Association for Survivors of Accident and Injury (RTP).
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Affiliation(s)
- Jeanette Melin
- Gothenburg Competence Centre for Spinal Cord Injury, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
- Division Safety and Transport, Department Measurement Science and Technology, RISE Research Institutes of Sweden, Gothenburg, Sweden
| | - Emelie Axwalter
- Gothenburg Competence Centre for Spinal Cord Injury, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gunilla Åhrén
- Gothenburg Competence Centre for Spinal Cord Injury, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Katharina S Sunnerhagen
- Gothenburg Competence Centre for Spinal Cord Injury, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Clinical Neuroscience, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Department of Neurocare, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Åsa Lundgren-Nilsson
- Gothenburg Competence Centre for Spinal Cord Injury, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Clinical Neuroscience, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Department of Neurocare, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Johanna Wangdell
- Gothenburg Competence Centre for Spinal Cord Injury, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.
- Department of Hand Surgery, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.
- Centre for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital/Mölndal, Gothenburg, Sweden.
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3
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Morton RL, Tuffaha H, Blaya-Novakova V, Spencer J, Hawley CM, Peyton P, Higgins A, Marsh J, Taylor WJ, Huckson S, Sillett A, Schneemann K, Balagurunanthan A, Cumpston M, Scuffham PA, Glasziou P, Simes RJ. Approaches to prioritising research for clinical trial networks: a scoping review. Trials 2022; 23:1000. [PMID: 36510214 PMCID: PMC9743749 DOI: 10.1186/s13063-022-06928-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/15/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Prioritisation of clinical trials ensures that the research conducted meets the needs of stakeholders, makes the best use of resources and avoids duplication. The aim of this review was to identify and critically appraise approaches to research prioritisation applicable to clinical trials, to inform best practice guidelines for clinical trial networks and funders. METHODS A scoping review of English-language published literature and research organisation websites (January 2000 to January 2020) was undertaken to identify primary studies, approaches and criteria for research prioritisation. Data were extracted and tabulated, and a narrative synthesis was employed. RESULTS Seventy-eight primary studies and 18 websites were included. The majority of research prioritisation occurred in oncology and neurology disciplines. The main reasons for prioritisation were to address a knowledge gap (51 of 78 studies [65%]) and to define patient-important topics (28 studies, [35%]). In addition, research organisations prioritised in order to support their institution's mission, invest strategically, and identify best return on investment. Fifty-seven of 78 (73%) studies used interpretative prioritisation approaches (including Delphi surveys, James Lind Alliance and consensus workshops); six studies used quantitative approaches (8%) such as prospective payback or value of information (VOI) analyses; and 14 studies used blended approaches (18%) such as nominal group technique and Child Health Nutritional Research Initiative. Main criteria for prioritisation included relevance, appropriateness, significance, feasibility and cost-effectiveness. CONCLUSION Current research prioritisation approaches for groups conducting and funding clinical trials are largely interpretative. There is an opportunity to improve the transparency of prioritisation through the inclusion of quantitative approaches.
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Affiliation(s)
- Rachael L. Morton
- grid.1013.30000 0004 1936 834XNational Health and Medical Research Council Clinical Trials Centre (NHMRC CTC), University of Sydney, Sydney, Australia
| | - Haitham Tuffaha
- grid.1003.20000 0000 9320 7537Centre for the Business and Economics of Health, University of Queensland, Brisbane, Australia
| | - Vendula Blaya-Novakova
- grid.1013.30000 0004 1936 834XNational Health and Medical Research Council Clinical Trials Centre (NHMRC CTC), University of Sydney, Sydney, Australia
| | - Jenean Spencer
- Australian Clinical Trials Alliance (ACTA), Melbourne, Victoria Australia
| | - Carmel M. Hawley
- grid.1003.20000 0000 9320 7537Australasian Kidney Trials Network (AKTN), Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Phil Peyton
- grid.418175.e0000 0001 2225 7841Australian and New Zealand College of Anaesthetists (ANZCA), Melbourne, Australia
| | - Alisa Higgins
- grid.1002.30000 0004 1936 7857Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University, Melbourne, Victoria Australia
| | - Julie Marsh
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, West Perth, Australia
| | - William J. Taylor
- grid.29980.3a0000 0004 1936 7830University of Otago, Rehabilitation Teaching and Research Unit, Dunedin, New Zealand
| | - Sue Huckson
- grid.489411.10000 0004 5905 1670Australian and New Zealand Intensive Care Society (ANZICS), Camberwell, Victoria Australia
| | - Amy Sillett
- grid.467202.50000 0004 0445 3920AstraZeneca Australia, Macquarie Park, New South Wales Australia
| | - Kieran Schneemann
- Australian Clinical Trials Alliance (ACTA), Melbourne, Victoria Australia ,grid.467202.50000 0004 0445 3920AstraZeneca Australia, Macquarie Park, New South Wales Australia
| | | | - Miranda Cumpston
- Australian Clinical Trials Alliance (ACTA), Melbourne, Victoria Australia ,grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
| | - Paul A. Scuffham
- grid.1003.20000 0000 9320 7537Centre for the Business and Economics of Health, University of Queensland, Brisbane, Australia
| | - Paul Glasziou
- grid.1033.10000 0004 0405 3820Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia
| | - Robert J. Simes
- grid.1013.30000 0004 1936 834XNational Health and Medical Research Council Clinical Trials Centre (NHMRC CTC), University of Sydney, Sydney, Australia
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4
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Arejan RH, Azadmanjir Z, Ghodsi Z, Dehghan HR, Sharif-Alhoseini M, Tabary M, Khaleghi-Nekou M, Naghdi K, Vaccaro AR, Zafarghandi MR, Rahimi-Movaghar V. How Can Policymakers be Encouraged to Support People With Spinal Cord Injury-Scoping Review. Global Spine J 2022; 12:732-741. [PMID: 33878912 PMCID: PMC9109570 DOI: 10.1177/21925682211005406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
STUDY DESIGN Scoping review. OBJECTIVE Regarding that inappropriate medical care approaches, absence of rehabilitation services, and existing barriers in physical, social, and policy environments lead to poor outcomes in individuals with spinal cord injury (SCI) and provision for appropriate interventions and care must be created by health policymakers, we conducted this scoping review to investigate how policymakers can be persuaded to set new plans for individuals with SCI. METHODS This review was performed according to Arksey and O'Malley's framework. PubMed was searched in February2019 without language limitation. We looked for other potential gray literature sources and some professional websites. References sections of selected articles were also scanned for other relevant literature. RESULTS We included literature that met inclusion criteria to answer our research question. The literature was divided into 3 categories. The first category included economic impact of SCI. The second category included the role of research and developing research strategy. The third category included effective interaction and communication with policymakers. CONCLUSION It is essential to consider multiple factors for influencing policymakers' decisions. These factors include knowing how to communicate with policymakers and presenting constructive ideas, providing a source of valid, reliable, and consistent data, considering the role of patients' advocacy groups and Non-Governmental Organizations (NGOs), and presentation of the importance of early intervention in reducing healthcare system costs. Ultimately, the goal is to have a comprehensive and flexible plan for influencing policymakers.
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Affiliation(s)
- Roya Habibi Arejan
- Sina Trauma and Surgery Research
Center, Tehran University of Medical Sciences, Tehran, Iran
- Rehabilitation Office, State
Welfare Organization of Iran, Tehran, Iran
| | - Zahra Azadmanjir
- Sina Trauma and Surgery Research
Center, Tehran University of Medical Sciences, Tehran, Iran
- Health Information Management
Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Ghodsi
- Sina Trauma and Surgery Research
Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Dehghan
- Research Center for Health
Technology Assessment and Medical Informatics, School of Public Health, Shahid
Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research
Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Tabary
- Experimental Medicine Research
Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Melika Khaleghi-Nekou
- Sina Trauma and Surgery Research
Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Khatereh Naghdi
- Sina Trauma and Surgery Research
Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alexander R. Vaccaro
- Department of Orthopedics and
Neurosurgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA,
USA
| | | | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research
Center, Tehran University of Medical Sciences, Tehran, Iran
- Brain and Spinal Cord Injury
Research Center, Neuroscience Institute, Tehran University of Medical Sciences,
Tehran, Iran
- Department of Neurosurgery,
Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Universal Scientific Education and
Research Network (USERN), Tehran, Iran
- Institute of Biochemistry and
Biophysics, University of Tehran, Tehran, Iran
- Spine Program, University of
Toronto, Toronto, Canada
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5
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Borg K, Wright B, Sannen L, Dumas D, Walker T, Bragge P. Ambulances are for emergencies: shifting attitudes through a research-informed behaviour change campaign. Health Res Policy Syst 2019; 17:31. [PMID: 30922335 PMCID: PMC6437887 DOI: 10.1186/s12961-019-0430-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 02/28/2019] [Indexed: 12/25/2022] Open
Abstract
Background In Victoria, Australia, emergency calls requesting an ambulance have been increasing at a rate higher than population growth. While most of these calls are for genuine emergencies, many do not require an immediate ambulance response. A collaborative research approach was undertaken to address this issue. The aim of this paper was to evaluate the effectiveness of applying a behaviour change approach to this challenge by first addressing antecedents of behaviour (attitudes, awareness and knowledge). Methods The project included a formative research phase to inform the design of a mass media campaign and subsequent evaluation of the campaign. Results Results indicated that the campaign was successful in increasing community attitudes towards ambulances as being for emergencies only, particularly among those familiar with the campaign material and with other health service options (such as telephone advice lines). Conclusions These findings provide support for adopting the Forum approach to increase the chances that a mass media campaign will achieve its stated objectives. Recommendations for future campaign activities are discussed. Electronic supplementary material The online version of this article (10.1186/s12961-019-0430-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kim Borg
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton, Victoria, 3800, Australia.
| | - Breanna Wright
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton, Victoria, 3800, Australia
| | - Liz Sannen
- Victorian Department of Health and Human Services, Melbourne, Australia
| | | | | | - Peter Bragge
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton, Victoria, 3800, Australia
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6
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Dorstyn D, Roberts R, Murphy G, Craig A, Kneebone I, Stewart P, Chur-Hansen A, Marshall R, Clark J, Migliorini C. Work and SCI: a pilot randomized controlled study of an online resource for job-seekers with spinal cord dysfunction. Spinal Cord 2018; 57:221-228. [PMID: 30262878 DOI: 10.1038/s41393-018-0200-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/22/2018] [Accepted: 08/22/2018] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN A prospective, parallel randomized controlled trial (RCT). OBJECTIVES To test the preliminary effects of an online resource targeted to job-seekers with spinal cord injury or disorder (SCI/D), and to determine the feasibility of proceeding to a full-scale RCT. SETTING A community cohort in Australia. METHODS Forty-eight adults (M = 42 years, SD = 10.95, 27 males) were randomized to receive 4-weeks access to the Work and SCI resource (n = 25) or to a wait-list control group (n = 23). The Work and SCI intervention involved six stand-alone learning modules which provided job-searching and career-planning information through text, videos, and interactive activities. Self-report measures were administered at baseline and after 4 weeks: Job Procurement Self-Efficacy Scale (JSES), Life Orientation Test-Revised (LOT-R), and Patient Health Questionnaire-9 (PHQ-9). RESULTS Online usage data identified high uptake of the Work and SCI resource, although study attrition was problematic. Intention-to-treat analyses failed to reach statistical significance, whereas complete data revealed a significant interaction effect for optimism (LOT-R). CONCLUSION Further research to develop and enhance Work and SCI is indicated. Remediable strategies to optimize recruitment and statistical power in a future definitive RCT are discussed. SPONSORSHIP This project was funded by the auDA Foundation (project 16019).
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Affiliation(s)
- Diana Dorstyn
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, SA, Australia.
| | - Rachel Roberts
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Gregory Murphy
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
| | - Ashley Craig
- Northern Clinical School, Faculty of Medicine and Health, Kolling Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Ian Kneebone
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Peter Stewart
- PQSA - The Paraplegic and Quadriplegic Association of South Australia, Dulwich, SA, Australia
| | - Anna Chur-Hansen
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Ruth Marshall
- South Australian Spinal Cord Injury Research Centre, Hampstead Rehabilitation Centre, Northfield, SA, Australia.,Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Jillian Clark
- South Australian Spinal Cord Injury Research Centre, Hampstead Rehabilitation Centre, Northfield, SA, Australia.,Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Christine Migliorini
- Department of Occupational Therapy, School of Primary Health Care, Monash University, Frankston, VIC, Australia
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7
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Noonan VK, Chan E, Bassett-Spiers K, Berlowitz DJ, Biering-Sørensen F, Charlifue S, Graco M, Hayes KC, Horsewell J, Joshi P, Markelis D, Smith V, Waheed Z, Brown DJ. Facilitators and Barriers to International Collaboration in Spinal Cord Injury: Results from a Survey of Clinicians and Researchers. J Neurotrauma 2018; 35:478-485. [PMID: 28728503 PMCID: PMC5793947 DOI: 10.1089/neu.2017.5036] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
International collaboration in spinal cord injury (SCI) research is necessary to overcome the challenges often encountered by clinicians and researchers, including participant recruitment, high cost, and the need for specialized expertise. However, international collaboration poses its own obstacles. The objective of this study was to conduct an international online survey to assess barriers and facilitators to international SCI clinical research, potential initiatives to facilitate future collaborations, and the use of SCI-specific data sets and standards. Results were analyzed using descriptive statistics. Of 364 total respondents, 213 completed the survey, with the majority of these participants based in North America (38%), Asia (22%), Europe (18%), and Oceania (16%). Over half had more than 10 years of experience in SCI research or clinical practice (57%) and 60% had previous experience with international collaborations. Funding was identified as a top barrier (82%), a facilitator (93%), and a proposed future initiative (97%). Communication and technology were also identified as strong facilitators and proposed future initiatives. The International Standards for Neurological Classification of SCI were used by 69% of participants, the International Standards to document remaining Autonomic Function after SCI by 13% of participants, and the International SCI Data Sets by 45% of participants. As the need for international collaborations in SCI research increases, it is important to identify how clinicians and researchers can be supported by SCI consumer and professional organizations, funders, and networks. Furthermore, unique solutions to overcome modifiable barriers and creation of new facilitators are also needed.
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Affiliation(s)
| | - Elaine Chan
- Rick Hansen Institute, Vancouver, British Columbia, Canada
| | | | - David J. Berlowitz
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
- Spinal Research Institute, Melbourne, Victoria, Australia
| | - Fin Biering-Sørensen
- Clinic for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Marnie Graco
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
| | - Keith C. Hayes
- Ontario Neurotrauma Foundation, Toronto, Ontario, Canada
| | - Jane Horsewell
- The European Spinal Cord Injury Federation, Nottwil, Switzerland
| | - Phalgun Joshi
- Rick Hansen Institute, Vancouver, British Columbia, Canada
| | - Debora Markelis
- Institute for Safety, Compensation and Recovery Research, Melbourne, Victoria, Australia
- WorkSafe Victoria, Melbourne, Australia
| | - Verna Smith
- Institute for Safety, Compensation and Recovery Research, Melbourne, Victoria, Australia
- Victoria University of Wellington, Wellington, New Zealand
| | - Zeina Waheed
- Rick Hansen Institute, Vancouver, British Columbia, Canada
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8
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Ryerson Espino SL, Kelly EH, Rivelli A, Zebracki K, Vogel LC. It is a marathon rather than a sprint: an initial exploration of unmet needs and support preferences of caregivers of children with SCI. Spinal Cord 2017; 56:284-294. [PMID: 29187744 DOI: 10.1038/s41393-017-0022-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 09/25/2017] [Accepted: 09/28/2017] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Focus group study. OBJECTIVES Explore unmet needs and support preferences of caregivers of youth with spinal cord injury (SCI). SETTING One pediatric specialty rehabilitation hospital system in the United States. METHODS Four focus groups were conducted with a convenience sample of 26 caregivers who were primarily mothers (96%) and married (65%), and had at least some college education (85%). Children living with SCI were on average 12.8 years old (SD = 3.3, 8-18). The average age of injury was 4.7 years (SD = 4.4, 0-16.2); mean injury duration was 8.2 years (SD = 3.9, 2-16); 77% had paraplegia; and 58% were male. Focus groups were digitally recorded, transcribed verbatim, and coded using thematic analysis and NVivo. RESULTS Qualitative data highlighted caregiver perspectives on unmet needs relating to two phases of care: acute and rehabilitation vs. current life with SCI, and two kinds of stressors: those associated with SCI and care vs. those related to other areas of the caregivers' lives, especially their families. Caregivers described stressful interactions with care systems and community services, articulated several concerns regarding well-being of family members, and noted that both they and their children with SCI experienced isolation. Caregivers articulated preferences for additional support from professionals and peers. CONCLUSIONS Data suggest the need for ongoing caregiver interventions and strengthened family-centered care systems, including professional assistance navigating health systems and peer support. Intervention development would benefit from further qualitative data collection with additional caregivers of youth with SCI, including multiple family members, and families from more diverse care settings.
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Affiliation(s)
- Susan L Ryerson Espino
- Shriners Hospitals for Children, Chicago, IL, USA. .,Marquette University, Milwaukee, WI, USA.
| | - Erin H Kelly
- Shriners Hospitals for Children, Chicago, IL, USA.,American Academy of Pediatrics, Elk Grove Village, IL, USA.,University of Illinois, Chicago, IL, USA
| | | | - Kathy Zebracki
- Shriners Hospitals for Children, Chicago, IL, USA.,Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lawrence C Vogel
- Shriners Hospitals for Children, Chicago, IL, USA.,Rush Medical College, Chicago, IL, USA
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9
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Lo C, Tran Y, Anderson K, Craig A, Middleton J. Functional Priorities in Persons with Spinal Cord Injury: Using Discrete Choice Experiments To Determine Preferences. J Neurotrauma 2016; 33:1958-1968. [PMID: 27080545 DOI: 10.1089/neu.2016.4423] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Major goals of rehabilitation and health interventions in people with spinal cord injury (SCI) are to improve functional independence, increase social participation, and enhance quality of life (QOL). Determining functional areas perceived by consumers as most important can assist in research prioritization, planning for delivery of health services, and policy development. Five high priority areas of functioning for the SCI population (arm/hand use, walking, bladder/bowel control, sexual function, and relief of pain) were chosen to determine the preferences for these five attributes. A discrete choice experiment was conducted involving 151 persons with SCI sampled from Australia and the United States of America. Consistent with prior research, arm/hand function had the highest preference, with odds ratios of subjects being 44-76% more likely to choose arm/hand function over the other four functions. Preference for normal arm/hand function was found to be significantly more preferred by the group with paraplegia compared with those with tetraplegia; that is, retaining and not trading off existing arm/hand function for other improved functions. There were no significant differences found in preferences between bladder/bowel function and walking or elimination of pain, although walking was preferred in earlier (≤ 10) post-injury years and pain amelioration became more important with a longer duration (>10 years) post-injury. Sexual function had the lowest preference when traded against the other four functions. Understanding the functional preferences of persons with SCI will help to inform future research design, as well as enabling successful translation of research into practice and health policy, meeting the needs of people with SCI.
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Affiliation(s)
- Charles Lo
- 1 John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, The University of Sydney , Kolling Institute, Sydney, New South Wales, Australia
| | - Yvonne Tran
- 1 John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, The University of Sydney , Kolling Institute, Sydney, New South Wales, Australia
| | - Kim Anderson
- 2 Department of Education, The Miami Project to Cure Paralysis, Department of Neurological Surgery, Lois Pope Life Center, University of Miami , Miami, Florida
| | - Ashley Craig
- 1 John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, The University of Sydney , Kolling Institute, Sydney, New South Wales, Australia
| | - James Middleton
- 1 John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, The University of Sydney , Kolling Institute, Sydney, New South Wales, Australia
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10
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Bragge P, Piccenna L, Middleton J, Williams S, Creasey G, Dunlop S, Brown D, Gruen R. Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part II: Background to a research strategy. Spinal Cord 2015; 53:721-8. [PMID: 26099209 DOI: 10.1038/sc.2015.86] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 02/24/2015] [Accepted: 02/26/2015] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Literature review/semi-structured interviews. OBJECTIVE To develop a spinal cord injury (SCI) research strategy for Australia and New Zealand. SETTING Australia. METHODS The National Trauma Research Institute Forum approach of structured evidence review and stakeholder consultation was employed. This involved gathering from published literature and stakeholder consultation the information necessary to properly consider the challenge, and synthesising this into a briefing document. RESULTS A research strategy 'roadmap' was developed to define the major steps and key planning questions to consider; next, evidence from published SCI research strategy initiatives was synthesised with information from four one-on-one semi-structured interviews with key SCI research stakeholders to create a research strategy framework, articulating six key themes and associated activities for consideration. These resources, combined with a review of SCI prioritisation literature, were used to generate a list of draft principles for discussion in a structured stakeholder dialogue meeting. CONCLUSION The research strategy roadmap and framework informed discussion at a structured stakeholder dialogue meeting of 23 participants representing key SCI research constituencies, results of which are published in a companion paper. These resources could also be of value in other research strategy or planning exercises. SPONSORSHIP This project was funded by the Victorian Transport Accident Commission and the Australian and New Zealand Spinal Cord Injury Network.
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Affiliation(s)
- P Bragge
- National Trauma Research Institute, Monash University and The Alfred Hospital, Melbourne, Victoria, Australia
| | - L Piccenna
- National Trauma Research Institute, Monash University and The Alfred Hospital, Melbourne, Victoria, Australia
| | - J Middleton
- John Walsh Centre for Rehabilitation Research, The University of Sydney, Sydney, New South Wales, Australia
| | - S Williams
- The Spinal Cord Injury Network, Sydney, New South Wales, Australia
| | - G Creasey
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
| | - S Dunlop
- Experimental and Regenerative Neuroscience, School of Animal Biology, The University of Western Australia, Crawley, Western Australia, Australia
| | - D Brown
- Spinal Research Institute, Heidelberg, Victoria, Australia
| | - R Gruen
- Monash University, Melbourne, Victoria, Australia.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Bragge P, Piccenna L, Middleton JW, Williams S, Creasey G, Dunlop S, Brown D, Gruen RL. Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part I: rapid review of SCI prioritisation literature. Spinal Cord 2015; 53:714-20. [DOI: 10.1038/sc.2015.85] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 01/21/2015] [Accepted: 02/16/2015] [Indexed: 01/08/2023]
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