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Salmiranta E, Areskoug Josefsson K, Ockander M, Augutis M, Masterson D. The voice of caregivers of children and adolescents with spinal cord injuries: A scoping review. J Spinal Cord Med 2024; 47:315-326. [PMID: 36745084 PMCID: PMC11044720 DOI: 10.1080/10790268.2022.2164455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
CONTEXT Participation in SCI research with caregivers of children and adolescents with spinal cord injury (SCI) can occur in a range of different ways. This review explores the extent to which caregivers' participation is connected to what might be called a voice. OBJECTIVES To explore the voice of caregivers by collating available research with the participation of caregivers of children and adolescents with SCI, and synthesizing how the research has been conducted. METHODS The databases CINAHL, ERIC, MEDLINE, PsycInfo, and Scopus were searched for articles published between January 2008 and March 2022. Descriptive and narrative information was extracted and factors describing how caregivers participated were identified using an inductive approach. RESULTS Twenty-nine articles were identified, of which 28 had affiliations connected to the USA, and 25 to Shriners Hospitals for Children. In most of the articles, the caregivers were invited to participate in the research to complete or develop measures. Information from the caregivers was often captured using close-structured questions and summarized quantitatively with little or no exploration of the perspectives of the caregivers. CONCLUSION The voice of caregivers of children and adolescents with SCI in research is limited by representativeness, the pre-determined emphasis, a lack of involvement in the process, and the reported narrative. By reflecting on voice, caregivers can have their experiences and perspectives acted upon to a greater extent to bring change, ultimately leading to improved care and health for children and adolescents with SCI.
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Affiliation(s)
- Elin Salmiranta
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Kristina Areskoug Josefsson
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Faculty of Health Science, University West, Trollhättan, Sweden
- Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Marlene Ockander
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Marika Augutis
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institute, Solna, Sweden
| | - Daniel Masterson
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Ryerson Espino SL, O’Rourke K, Kelly EH, January AM, Vogel LC. Coping, Social Support, and Caregiver Well-Being With Families Living With SCI: A Mixed Methods Study. Top Spinal Cord Inj Rehabil 2022; 28:78-98. [PMID: 35145337 PMCID: PMC8791416 DOI: 10.46292/sci21-00013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To explore coping, problem solving, social support, and well-being among family caregivers of adults with spinal cord injury (SCI). METHODS This was a mixed methods study (qualitative interviews and standardized surveys) with a diverse sample of 39 adults with SCI and their caregivers from four rehabilitation hospitals in the United States, including one Veterans Affairs (VA) hospital. Cluster analysis was used to explore whether distinct profiles of caregivers could be identified, and it was used in conjunction with qualitative data to explore patterns in well-being. Measures of well-being included leisure time satisfaction, social integration, anxiety, depression, physical health complaints, caregiver burden, and quality of life. RESULTS The importance of individual and extra-individual resources, namely coping and social support, emerged from early qualitative analyses and guided subsequent mixed methods examination of the data. A cluster analysis yielded three caregiver profiles: (1) effective problem solvers with moderate satisfaction with social support, (2) mixed problem solvers with stronger negative orientations and mixed satisfaction with social support, and (3) low endorsers overall. Profiles helped us explore patterns across our data set and efficiently identify differences in caregiver social support, coping, well-being, and unmet needs. CONCLUSION Data echo the need for multimodal interventions aimed at skill development, respite options, and screening, support, information, and referral around mental health and burden. SCI care and rehabilitation programs should consider incorporating strategies for bolstering effective caregiver problem-solving skills, reducing negativity and ambivalence, and enhancing social support.
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Affiliation(s)
| | - Kerry O’Rourke
- Marquette University, Milwaukee, Wisconsin
,Shriners Children’s Chicago, Chicago, Illinois
| | | | - Alicia M. January
- Marquette University, Milwaukee, Wisconsin
,Purdue University Northwest, Hammond, Indiana
| | - Lawrence C. Vogel
- Marquette University, Milwaukee, Wisconsin
,Shriners Children’s Chicago, Chicago, Illinois
,Rush University, Chicago, Illinois
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McIntyre A, Sadowsky C, Behrman A, Martin R, Augutis M, Cassidy C, Betz R, Ertzgaard P, Mulcahey MJ. A Systematic Review of the Scientific Literature for Rehabilitation/Habilitation Among Individuals With Pediatric-Onset Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2022; 28:13-90. [PMID: 35521053 PMCID: PMC9009193 DOI: 10.46292/sci21-00046] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives To conduct a systematic review to examine the scientific literature for rehabilitation/habilitation among individuals with pediatric-onset spinal cord injury (SCI). Methods A literature search of multiple databases (i.e., PubMed/MEDLINE, CINAHL, EMBASE, PsychINFO) was conducted and was filtered to include studies involving humans, published as full-length articles up to December 2020, and in English. Included studies met the following inclusion criteria: (1) ≥50% of the study sample had experienced a traumatic, acquired, nonprogressive spinal cord injury (SCI) or a nontraumatic, acquired, noncongenital SCI; (2) SCI onset occurred at ≤21 years of age; and (3) sample was assessed for a rehabilitation/habilitation-related topic. Studies were assigned a level of evidence using an adapted Sackett scale modified down to five levels. Data extracted from each study included author(s), year of publication, country of origin, study design, subject characteristics, rehabilitation/habilitation topic area, intervention (if applicable), and outcome measures. Results One hundred seventy-six studies were included for review (1974-2020) with the majority originating from the United States (81.3%). Most studies were noninterventional observational studies (n = 100; 56.8%) or noninterventional case report studies (n = 5; 2.8%). Sample sizes ranged from 1 to 3172 with a median of 26 (interquartile range [IQR], 116.5). Rehabilitation/habilitation topics were categorized by the International Classification of Functioning, Disability and Health (ICF); most studies evaluated ICF Body Function. There were 69 unique clinical health outcome measures reported. Conclusion The evidence for rehabilitation/habilitation of pediatric-onset SCI is extremely limited; nearly all studies (98%) are level 4-5 evidence. Future studies across several domains should be conducted with novel approaches to research design to alleviate issues related to sample sizes and heterogeneity.
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Affiliation(s)
- Amanda McIntyre
- Parkwood Institute Research, Parkwood Institute, London, Canada
| | - Cristina Sadowsky
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, John Hopkins University, Baltimore, Maryland
,International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, Maryland
| | - Andrea Behrman
- Department of Neurological Surgery, Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
,Kosair Charities Center for Pediatric Neurorecovery, Louisville, Kentucky
| | - Rebecca Martin
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, John Hopkins University, Baltimore, Maryland
,International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, Maryland
| | - Marika Augutis
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institute, Solna, Sweden
| | - Caitlin Cassidy
- St. Joseph’s Health Care London, Parkwood Institute, London, Canada
| | - Randal Betz
- Institute for Spine and Scoliosis, Lawrenceville, New Jersey
,Department of Orthopedics, Mount Sinai Hospital, New York, New York
| | - Per Ertzgaard
- Department of Rehabilitation Medicine, Linköping University, Linköping, Sweden
| | - MJ Mulcahey
- Department of Occupational Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Woodbury, New Jersey
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Haywood C, Pyatak E, Leland N, Henwood B, Lawlor MC. A Qualitative Study of Caregiving for Adolescents and Young Adults With Spinal Cord Injuries: Lessons From Lived Experiences. Top Spinal Cord Inj Rehabil 2019; 25:281-289. [PMID: 31844380 PMCID: PMC6907026 DOI: 10.1310/sci2504-281] [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: 11/11/2022]
Abstract
Objective: To examine characteristics of caregiving from the perspectives of adolescents and young adults (AYAs) with spinal cord injuries (SCIs) and their informal caregivers to address outstanding gaps in knowledge relating to definitions of caregiving and its associated practices for this population. Methods: A multiphase qualitative design was applied, using phenomenological and narrative methods to capture data in participants' homes and communities. Participants were recruited from rehabilitation hospitals and community organizations throughout Los Angeles County, California. Inclusion criteria for AYAs included being 15-22 years old, having acquired an SCI within the previous 5 years, and using a wheelchair for mobility. The AYAs nominated persons they identified as primary caregivers to also participate. Data were collected through individual and group interviews as well as activity observations. Results: Data from the 17 participants (9 AYAs and 8 informal, primary caregivers) revealed ways in which the meaning of caregiving varied among dyads. Caregiving practices extended beyond physical assistance to include support for a range of day-to-day activities spanning from practical needs to facilitating developmental trajectories. Although AYAs expressed ideas about preferred caregiver characteristics, care partnerships appeared to be guided more by availability than preference. Conclusion: Phenomenological analysis revealed that the meaning of "caregiving" and its associated practices are highly individualized for AYAs with SCIs. Caregiving is rooted in personal needs related to effects of SCI and developmental goals. Everyday practices are shaped by individual relationships and the beliefs of AYAs and their caregivers. Addressing influences of caregiving on long-term health and function may require attention to developmental processes, caregiver "fit," and ways care is, or can be, distributed throughout broader networks according to personal needs and preferences.
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Affiliation(s)
- Carol Haywood
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Elizabeth Pyatak
- University of Southern California, Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Los Angeles, California
| | - Natalie Leland
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Benjamin Henwood
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Los Angeles, California
| | - Mary C. Lawlor
- University of Southern California, Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Los Angeles, California
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Relatives of people with spinal cord injury: a qualitative study of caregivers' metamorphosis. Spinal Cord 2018; 56:548-559. [PMID: 29563575 DOI: 10.1038/s41393-018-0092-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 01/05/2018] [Accepted: 02/01/2018] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Qualitative study. OBJECTIVE To detect the major challenges and needs reported by family member caregivers of people with spinal cord injury (SCI). SETTING Family member caregivers of people with SCI and expert professionals were evaluated. This study was conducted in Spain, and most of the participants attended the National Paraplegics Hospital of Toledo. METHODS We performed 25 semi-structured interviews. The data were analyzed from a phenomenological perspective using the Colaizzi method. RESULTS The metamorphosis of the caregiver is a complex personal and family-related process. Analysis of the adjustment phase of the caregiving role allowed us to describe three stages, patterns, and trends. Five basic needs were identified. CONCLUSIONS People with SCI and their primary caregivers experienced changes in every sphere of their lives. Their most important needs were psychological support, social support, economic resources, information, training throughout the process of suffering, and the creation of informal groups of mutual aid.
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