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Jindal R, Bansal P, Gupta S, Garg SK. Quality of life after traumatic thoracolumbar spinal cord injury: a North Indian perspective. Spinal Cord 2023; 61:374-382. [PMID: 37161055 DOI: 10.1038/s41393-023-00900-7] [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: 10/05/2021] [Revised: 04/27/2023] [Accepted: 04/27/2023] [Indexed: 05/11/2023]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES To determine the Quality of Life (QOL) in individuals with traumatic Spinal Cord Injury (SCI) of thoracolumbar region in Indian population, the factors affecting QOL and to compare this to other SCI populations. SETTING Tertiary level hospital in low-middle income country. METHODS 93 individuals with SCI of minimum 1 year duration since injury were included in the study. Baseline demographics, socioeconomic parameters, and incidence of complications were ascertained. World Health Organisation Quality of Life-BREF (WHOQOL-BREF) score was used for measurement of QOL and was then compared to healthy Indian population and other SCI studies. Subgroup analysis was done to find out impact of variables on different domains of WHOQOL-BREF. RESULTS The median (IQR) age of the study participants was 35 (25, 45) with a male predominance. The median (IQR) duration since injury in the study population was 50 (26, 70) months. Lowest mean (SD) score was observed in the psychological domain -50.3 (12.1) and comparison to healthy Indian and high-income SCI populations revealed drastically decreased scores across all domains (p < 0.01). Employed individuals and housewives had significantly higher scores across all domains than unemployed individuals (p < 0.05). American Spinal Injury Association Impairment Scale (AIS) grade, socioeconomic status, pain and presence of complications all had significant impact on domain scores (p < 0.05). Multiple regression analysis revealed that mobilisation status and pain had the greatest effect on QOL. CONCLUSION Individuals with SCI have low QOL scores as compared to general Indian population as well as SCI individuals from a high resource setting. Pain and dependent mobilisation were found to be most significant predictors of poor WHOQOL-BREF domain scores. Housewives were found to have domain scores comparable to employed individuals. Presence of complications negatively impacts QOL.
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Affiliation(s)
- Rohit Jindal
- Department of Orthopaedics, Government Medical College and Hospital (GMCH), Chandigarh, India
| | - Parth Bansal
- Department of Orthopaedics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
| | - Sandeep Gupta
- Department of Orthopaedics, Government Medical College and Hospital (GMCH), Chandigarh, India
| | - Sudhir Kumar Garg
- Department of Orthopaedics, Government Medical College and Hospital (GMCH), Chandigarh, India
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Dixon R, Derrett S, Samaranayaka A, Harcombe H, Wyeth EH, Beaver C, Sullivan M. Life satisfaction 18 months and 10 years following spinal cord injury: results from a New Zealand prospective cohort study. Qual Life Res 2023; 32:1015-1030. [PMID: 36701016 PMCID: PMC10063493 DOI: 10.1007/s11136-022-03313-w] [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] [Accepted: 11/29/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE To examine the life satisfaction outcomes after spinal cord injury (SCI) and to identify the factors associated with life satisfaction at 18 months and 10 years post-SCI in New Zealand (NZ). METHODS Adults (16-64 years) were recruited between 2007 and 2009 from NZ's two spinal units following first admission for SCI. Interviews at 6 months, 18 months, and 10 years post-SCI examined demographic, physical, psychosocial, economic, and environmental characteristics. Multivariable regression models were used to identify predictors of life satisfaction at each timepoint. RESULTS Overall, 118 people participated at 6 months, 103 at 18 months, and 63 at 10 years post-SCI. Pre-SCI, 90% of participants were satisfied with life, 67% were satisfied at 18 months, and 78% at 10 years. At 18 months post-SCI, participants who reported: never or sometimes using a wheelchair, no problems with self-care, no problems with anxiety or depression, no/lesser disability, or fewer secondary health conditions (SHCs) at 6 months post-SCI were more likely to be satisfied (p < 0.05), compared to those without these characteristics. Participants who experienced considerable disability at 6 months post-SCI were 22% less likely to be satisfied 10 years post-SCI compared to those experiencing no/lesser disability (p = 0.028). CONCLUSIONS A higher proportion of participants were satisfied at both 18 months and 10 years post-SCI than not satisfied. To improve the likelihood of satisfaction with life, increased focus on reducing disability and providing supports for those using wheelchairs, experiencing anxiety/depression or problems with self-care, and effects of SHCs are promising for future potential interventions.
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Affiliation(s)
- Ruby Dixon
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Sarah Derrett
- Division of Health Sciences, Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, New Zealand.
| | - Ari Samaranayaka
- Division of Health Sciences, Biostatistics Centre, University of Otago, Dunedin, New Zealand
| | - Helen Harcombe
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Emma H Wyeth
- Division of Health Sciences, Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, New Zealand
| | - Carolyn Beaver
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Martin Sullivan
- School of Social Work, Massey University, Palmerston North, New Zealand
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Coker J, Charlifue S, Botticello A, Tate DG, Philippus A, Strober L, Forchheimer M, Monden KR. A Study Protocol for a Multisite Randomized Controlled Trial of an Intervention to Improve Outcomes After Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2022; 28:44-55. [PMID: 36457362 PMCID: PMC9678223 DOI: 10.46292/sci22-00013] [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: 11/19/2022]
Abstract
Background The consequences of spinal cord injury (SCI) can place significant demands on an individual's coping mechanisms. Interventions to promote psychological adjustment and coping are often included in inpatient rehabilitation programs; however, following discharge, many individuals with SCI do not receive ongoing counseling or education about psychological adjustment to disability. Effective postacute treatment models are needed to help individuals with SCI build skills that help them adapt to the stresses associated with a chronic physical disability, alleviate the consequences of anxiety and depression, and enhance subjective well-being. Objectives To describe the protocol for a randomized clinical trial (RCT) of a 6-week intervention designed to improve psychosocial outcomes after SCI. Methods To test efficacy and replicability of the intervention, we designed a three-arm, multisite RCT with assessments conducted at six time points. Our primary hypothesis is that participants in the Group arm will report greater improvements in psychosocial outcomes than participants who complete the intervention individually via video (Individual arm) or those who do not receive the intervention (Control arm). We also hypothesize that participants in the Group arm will maintain greater improvements in psychosocial outcomes longer than those in the individual or control arms. Conclusion Results of the RCT will be presented and published to professionals and consumers, and intervention training and materials will be made available upon request.
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Affiliation(s)
| | | | | | | | - Angela Philippus
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | | | | | - Kimberley R. Monden
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
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Satisfaction scores can be used to assess the quality of care and service in spinal rehabilitation. Spinal Cord 2022; 60:1023-1029. [DOI: 10.1038/s41393-022-00819-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 05/28/2022] [Accepted: 05/30/2022] [Indexed: 11/08/2022]
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Santino N, Larocca V, Hitzig SL, Guilcher SJ, Craven BC, Bassett-Gunter RL. Physical activity and life satisfaction among individuals with spinal cord injury: Exploring loneliness as a possible mediator. J Spinal Cord Med 2022; 45:173-179. [PMID: 32379551 PMCID: PMC8986296 DOI: 10.1080/10790268.2020.1754651] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Context: There has been no known research investigating the association between leisure time physical activity (LTPA), loneliness, and life satisfaction among people with spinal cord injury or dysfunction (SCI/D). The relationship between these constructs is worthy of consideration given the positive health impacts of LTPA, the negative health impacts of loneliness, and heightened negative effects of loneliness on life satisfaction for individuals with SCI/D.Objectives: To examine the relationship between LTPA and loneliness, and examine loneliness as a possible mediator of the relationship between LTPA and life satisfaction among individuals with SCI/D.Design and Participants: Community dwelling individuals with SCI/D (N = 170) participated in a telephone-based survey as part of a larger project.Measures: LTPA (i.e. The Leisure Time Physical Activity Questionnaire-SCI, UCLA Loneliness Scale-3, and the Life Satisfaction Questionnaire-11 were administered to the participants.Results: Significant bivariate relationships were observed between LTPA and life satisfaction (r = .18, P = .02), LTPA and loneliness (r = -.15, P = .045), and loneliness and life satisfaction (r = -.69, P < .001). Mediation analyses suggest that loneliness significantly mediated the relationship between LTPA and life satisfaction (indirect effect = .003, 95% bootstrap CI = .0004 to .0062, CSI = .113).Conclusion: This was the first study to show evidence of a negative association between LTPA and loneliness among people with SCI/D, and to establish a conceptual model for understanding the potential mediating role of loneliness in the relationship between LTPA and life satisfaction among people with SCI/D.
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Affiliation(s)
- Nicholas Santino
- School of Kinesiology & Health Science, Faculty of Health, York University, Toronto, Canada
| | - Victoria Larocca
- School of Kinesiology & Health Science, Faculty of Health, York University, 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
| | - Sara J.T. Guilcher
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- MAP 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 of 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
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Zhao H, Zhang Y, Wang W, Cole S. Contribution of travel participation to social integration and life satisfaction after spinal cord injury. Disabil Health J 2021; 14:101167. [PMID: 34247966 DOI: 10.1016/j.dhjo.2021.101167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Research has found that participation in travel declines for people after spinal cord injury (SCI) because the traumatic injury usually results in impaired physical mobility and sensation, and barriers in the environment make travel more challenging. While travel participation can offer numerous physical, psychological, and emotional benefits, empirical evidence on positive outcomes of travel for people after SCI is scarce in the literature. OBJECTIVE To empirically examine the effects of travel participation on social integration and life satisfaction for people with SCI, along with other personal characteristics including income, self-perceived health status, levels of physical independence, occupational activities, and travel barriers. METHODS Cross sectional data are collected from 250 patients enrolled in a SCI Model System. Hierarchical regression analyses, followed by mediation analyses, are conducted to assess the effects of travel participation on social integration and life satisfaction. RESULTS Travel participation along with occupational activities is shown to significantly impact social integration, with participation in occupational activities partially mediating the relation from travel participation to social integration. The significant effect of travel participation on life satisfaction is fully mediated by social integration. Income and self-perceived health status both significantly contribute to social integration and life satisfaction. CONCLUSIONS Travel participation should be considered as an independent domain that directly impacts the social integration of people with SCI, which in turn enhances their life satisfaction. Systematic interventions with standard protocols for travel-related skill training and assessments procedures are needed for people after SCI.
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Affiliation(s)
- HaoAi Zhao
- School of Public Health, Indiana University, Bloomington, IN, 47405, USA
| | - Ye Zhang
- College of Business, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | - Weixuan Wang
- School of Public Health, Indiana University, Bloomington, IN, 47405, USA
| | - Shu Cole
- School of Public Health, Indiana University, Bloomington, IN, 47405, USA.
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Hartung J, Spormann SS, Moshagen M, Wilhelm O. Structural differences in life satisfaction in a U.S. adult sample across age. J Pers 2021; 89:1232-1251. [PMID: 34091894 DOI: 10.1111/jopy.12654] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Many studies investigating age-related mean differences in life satisfaction disregard potential differences in the structure of the life satisfaction construct. Because developmental tasks at different life stages vary and thus the salience of specific life domains (e.g., health, finances, relationships, etc.) might differ, life satisfaction might differ between age groups in its underlying structure and meaning. METHOD To address this issue, we investigated the covariance structure of life satisfaction as measured by the Satisfaction with Life Scale (SWLS) and the domains of health satisfaction and financial satisfaction with local structural equation modeling. We analyzed data from 8341 U.S. citizens between the ages of 30 and 97 who participated in the Panel Study of Income Dynamics. Furthermore, we explored the association of respondents' health and financial status with life satisfaction. RESULTS Both the SWLS and domain items were found to be invariant across age. The health and financial status accounted for small proportions of variance in overall life satisfaction and the respective domain satisfactions significantly at all ages. CONCLUSION The current analysis indicates that across the adult age range, general life satisfaction is qualitatively the same, and health and financial satisfaction are equally integrated into overall life satisfaction.
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Hitzig SL, Cimino SR, Alavinia M, Bassett-Gunter RL, Craven BC, Guilcher SJT. Examination of the Relationships Among Social Networks and Loneliness on Health and Life Satisfaction in People with Spinal Cord Injury/Dysfunction. Arch Phys Med Rehabil 2021; 102:2109-2116.e1. [PMID: 33932359 DOI: 10.1016/j.apmr.2021.03.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 02/12/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the associations among social networks and loneliness on health and life satisfaction in adults with chronic spinal cord injury/dysfunction (SCI/D). DESIGN Cross-sectional telephone survey study. SETTING Tertiary spinal cord injury rehabilitation center in Ontario, Canada. PARTICIPANTS Community-dwelling adults with chronic SCI/D (N=170). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The main outcome measures were the Short-Form 36 to assess health and the Life Satisfaction-11 to assess life satisfaction. RESULTS A hierarchical regression model predicting physical health accounted for 24% (P<.001) of the variance. The only social network variable to significantly contribute to the model was having a higher proportion of network members living in one's household (P<.05). A model predicting mental health accounted for 44% (P<.001) of the variance, with having a higher proportion of network members living in one's household (P<.05) and lower feelings of loneliness (P<.001) associated with better mental health. Finally, the model predicting life satisfaction accounted for 62% (P<.001) of the variance, with lower greater levels of social network intimacy (P<.01) and lower feelings of loneliness (P<.001) being significant predictors. CONCLUSIONS These findings highlight the importance of having access to network members in one's home for better physical and mental health after SCI/D as well as the negative association between loneliness and mental health and life satisfaction. There is a need for approaches to ensure that people with SCI/D in the community feel supported to mitigate feelings of loneliness to optimize their health and wellbeing.
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Affiliation(s)
- Sander L Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario; Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario.
| | - Stephanie R Cimino
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Mohammad Alavinia
- Neural Engineering & Therapeutics Team, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario; Division of Physiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario
| | | | - B Catharine Craven
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario; Neural Engineering & Therapeutics Team, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario; Division of Physiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
| | - Sara J T Guilcher
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
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Hitzig SL, Jeyathevan G, Farahani F, Noonan VK, Linassi G, Routhier F, Jetha A, McCauley D, Alavinia SM, Omidvar M, Craven BC. Development of community participation indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project. J Spinal Cord Med 2021; 44:S79-S93. [PMID: 34779731 PMCID: PMC8604477 DOI: 10.1080/10790268.2021.1955204] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Community participation following spinal cord injury/disease (SCI/D) can be challenging due to associated primary impairments and secondary health conditions as well as difficulties navigating both the built and social-emotional environment. To improve the quality of SCI/D rehabilitation care to optimize community participation, the SCI-High Project developed a set of structure, process and outcome indicators for adults with SCI/D in the first 18 months after rehabilitation admission. A pan-Canadian Working Group of diverse stakeholders: (1) defined the community participation construct; (2) conducted a systematic review of available outcomes and their psychometric properties; (3) constructed a Driver diagram summarizing available evidence associated with community participation; and (4) prepared a process map. Facilitated meetings allowed selection and review of a set of structure, process and outcome indicators. The structure indicator is the proportion of SCI/D rehabilitation programs with availability of transition living setting/independent living unit. The process indicators are the proportion of SCI/D rehabilitation inpatients who experienced: (a) a therapeutic community outing prior to rehabilitation discharge; and, (b) those who received a pass to go home for the weekend. The intermediary and final outcome measures are the Moorong Self-Efficacy Scale and the Reintegration to Normal Living Index. The proposed indicators have the potential to inform whether inpatient rehabilitation for persons with SCI/D can improve self-efficacy and lead to high levels of community participation post-rehabilitation discharge.
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Affiliation(s)
- 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
| | - Gaya Jeyathevan
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Farnoosh Farahani
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | | | - Gary Linassi
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - François Routhier
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Québec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Québec, Canada
| | - Arif Jetha
- Institute for Work & Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, 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
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
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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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Hitzig SL, Titman R, Orenczuk S, Clarke T, Flett H, Noonan VK, Bain P, Mills S, Farahani F, Wiest MJ, Jeyathevan G, Alavinia SM, Craven BC. Development of Emotional Well-Being indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project. J Spinal Cord Med 2019; 42:85-98. [PMID: 31573461 PMCID: PMC6783797 DOI: 10.1080/10790268.2019.1605750] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Context: Emotional Well-Being (EWB) post-spinal cord injury or disease (SCI/D) is a critical aspect of adjustment to disability. Advancing care and assuring equity in care delivery within this rehabilitation care domain is essential. Herein, we describe the selection of EWB structure, process and outcome indicators for adults with SCI/D in the first 18 months after rehabilitation admission. Methods: A pan-Canadian Working Group completed the following tasks: (1) defined the EWB construct; (2) conducted a systematic review of available outcomes and their psychometric properties; (3) constructed a Driver diagram summarizing available evidence associated with EWB; and, (4) prepared a process map. Facilitated meetings allowed selection and review of feedback 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 EWB and access to experts and resources. The process indicator is the proportion of SCI/D patients who were screened for depression and anxiety symptoms at rehabilitation admission and rehabilitation discharge. The intermediary outcome is the proportion of SCI/D patients at risk for depression or anxiety at rehabilitation discharge based on screening symptom scores. The final outcomes are: (a) proportion of individuals at risk for depression or anxiety based on screening symptom scores; and (b) proportion of individuals who received referral for EWB services or intervention. Conclusion: The proposed indicators have a low administrative burden and will ensure feasibility of screening for depression and anxiety at important transition points for individuals with SCI/D. We anticipate that the current structures have inadequate resources for at-risk individuals identified during the screening process.
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Affiliation(s)
- Sander L. Hitzig
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada,Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Rebecca Titman
- Division of Physical Therapy and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Steven Orenczuk
- Parkwood Institute Research, St. Joseph’s Health Care, London, ON, Canada,Spinal Cord Injury Alberta, Edmonton, Canada
| | | | - Heather Flett
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Vanessa K. Noonan
- Rick Hansen Institute, Vancouver, BC, Canada,Blusson Spinal Cord Centre, Vancouver, BC, Canada
| | - Patricia Bain
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada
| | - Sandra Mills
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada
| | - Farnoosh Farahani
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada
| | - Matheus Joner Wiest
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada
| | - Gaya Jeyathevan
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada
| | - S. Mohammad Alavinia
- Division of Physical Therapy and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada,KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada
| | - B. Catharine Craven
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Division of Physical Therapy and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada,Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada,KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada,Correspondence to: B. Catharine Craven, Neural Engineering & Therapeutic Team, Toronto Rehabilitation Institute- University Health Network, Lyndhurst Centre, 520 Sutherland Drive, Toronto, ON M4G 3V9, Canada.
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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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Barclay L, New PW, Morgan PE, Guilcher SJT. Satisfaction with life, health and well-being: comparison between non-traumatic spinal cord dysfunction, traumatic spinal cord injury and Australian norms. Spinal Cord Ser Cases 2019; 5:50. [PMID: 31632708 PMCID: PMC6786362 DOI: 10.1038/s41394-019-0193-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/23/2019] [Accepted: 05/09/2019] [Indexed: 01/07/2023] Open
Abstract
Study design Cross-sectional survey. Objectives The objective of this study is to compare self-reported satisfaction with life, and self-reported health and well-being of people with NTSCD, to that of people with TSCI, and with Australian population. Setting Victoria, Australia. Methods Participants completed surveys by post or email. The Satisfaction with Life Scale (SWLS) and the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were used to assess self-reported satisfaction with life, and health and well-being. Descriptive statistics are reported including median and interquartile range (IQR). The Mann-Whitney U-test was used to investigate differences between groups. Results There were 41 participants: NTSCD (n = 14) and TSCI (n = 27). There were no significant differences in the median scores on the SWLS for NTSCD and TSCI, but both groups scored lower than the Australian non-disabled sample mean. There were significant differences between NTSCD and TSCI for SF-36 domains physical functioning, role limitations physical and vitality (p < 0.05). Median scores for both groups in all eight domains were lower than the means of the comparative Australian sample, except for role limitations emotional. Conclusions There were more apparent difficulties for people with NTSCD in completing desired functional tasks than those with TSCI. Both groups had lower self-reported satisfaction with life, and lower reported health and well-being in comparison to samples of non-disabled Australians.
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Affiliation(s)
- Linda Barclay
- Monash University, Department of Occupational Therapy, 47-49 Moorooduc Highway, Frankston, VIC 3199 Australia
| | - Peter W. New
- Spinal Rehabilitation Service, Caulfield Hospital, Alfred Health, 260 Kooyong Road, Caulfield, VIC 3162 Australia
| | - Prue E. Morgan
- Monash University, Department of Physiotherapy, 47- 49 Moorooduc Highway, Frankston, VIC 3199 Australia
| | - Sara J. T. Guilcher
- University of Toronto, Leslie Dan Faculty of Pharmacy, 144 College Street, Toronto, ON M5S 3M2 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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Mortenson WB, Singh G, MacGillivray M, Sadeghi M, Mills P, Adams J, Sawatzky B. Development of a Self-Management App for People with Spinal Cord Injury. J Med Syst 2019; 43:145. [PMID: 31011881 DOI: 10.1007/s10916-019-1273-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 04/03/2019] [Indexed: 12/27/2022]
Abstract
With decreasing inpatient rehabilitation lengths of stay, there may be a greater risk of spinal cord injury (SCI) populations being discharged into the community without the self-management skills needed to prevent secondary complications. Recent advancements in mobile health has made mobile apps a feasible method of delivering population-based, self-management interventions to address SCI-specific secondary complications. The objective of this study is to describe stakeholder perspectives on the development of a functional mobile app to facilitate self-management skills needed to prevent secondary complications following recent SCI during inpatient rehabilitation. A user-centered design approach was used that involved an evolving mobile app and the collection of prospective qualitative data. Stakeholders from three groups were enrolled in the study: individuals admitted for rehabilitation following SCI (n = 20) and informal (n = 7) and formal (n = 48) caregivers. Iterative feedback was gathered from rehabilitation inpatients during ongoing interactions and via post-discharge exit questionnaires, from informal caregivers via one-on-one interviews, and from formal caregivers via series of focus groups at various phases throughout the design process. Three main themes emerged from the analysis: (1) being individualized and user friendly (i.e., developing an app that is simple and easy to use to facilitate universal uptake), (2) targeting goals to promote self-management (i.e., adopting self-management skills relative to personal goals and confidence), and (3) increasing participation and support-seeking to facilitate lifestyle change (i.e., encouraging leisure activities to facilitate community integration). Key stakeholder perspectives contributed to the development of a self-management mobile app that will be evaluated in future research.
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Affiliation(s)
- W Ben Mortenson
- International Collaboration on Repair Discoveries, Vancouver, Canada.
- G.F. Strong Rehabilitation Centre, Vancouver, Canada.
- Department of Occupational Sciences and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
| | - Gurkaran Singh
- International Collaboration on Repair Discoveries, Vancouver, Canada
- Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Megan MacGillivray
- International Collaboration on Repair Discoveries, Vancouver, Canada
- Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Mahsa Sadeghi
- Department of Neurology, Wayne State School of Medicine & Detroit Medical Centre, Detroit, MI, USA
| | - Patricia Mills
- G.F. Strong Rehabilitation Centre, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Bonita Sawatzky
- International Collaboration on Repair Discoveries, Vancouver, Canada
- Department of Orthopaedics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Vural M, Yalcinkaya EY, Celik EC, Gunduz B, Bozan A, Erhan B. Assessment of quality of life in relation to spasticity severity and socio-demographic and clinical factors among patients with spinal cord injury. J Spinal Cord Med 2018; 43:193-200. [PMID: 30508404 PMCID: PMC7054937 DOI: 10.1080/10790268.2018.1543093] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Objective: To assess the impact of spasticity severity as well as socio-demographic and clinical factors on quality of life (QOL) and to identify factors predicting poor QOL among patients with spinal cord injury (SCI)Design: Descriptive cross-sectional study.Setting: Tertiary care clinic in Istanbul, Turkey.Participants: A total of 110 patients with SCI (mean (SD) age: 43.8 (14.7) years, 58.2% were males) were enrolled.Assessments: The American Spinal Injury Association (ASIA) Impairment Scale (AIS), Modified Ashworth Scale (MAS) and Turkish version of the World Health Organization Quality of life questionnaire (WHOQOL-BREF) were utilized to determine the SCI category, severity of spasticity and QOL scores, respectively.Outcome measures: The WHOQOL-BREF scores were evaluated with respect to the severity of spasticity, aetiology and duration of SCI, AIS category and method of bladder management.Results: The mean (SD) physical health (41.9 (15.3) vs. 46.5 (10.9), P = 0.029), social relationships (45.6 (20.2) vs. 53.8 (17.3), P = 0.025) and total WHOQOL-BREF scores were significantly lower in patients with more severe spasticity. Multivariate linear regression analysis revealed that severity of spasticity was a significant predictor of decreased WHOQOL-BREF total scores, physical domain scores and social relations domain scores by 11.381 (P = 0.007), 11.518 (P = 0.005) and 17. 965 (P = 0.004), respectively.Conclusion: In conclusion, addressing QOL in relation to severity of spasticity for the first time among Turkish SCI patients, our findings revealed a negative impact of the spasticity severity on the WHOQOL-BREF scores, particularly for physical health and social relationship domains.
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Affiliation(s)
- Meltem Vural
- University of Health Sciences, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey,Correspondence to: Meltem Vural, University of Health Sciences, Bakirkoy Dr Sadi Konuk Training Hospital, Zuhuratbaba Mh. Tevfik Saglam Cd. No:11 Bakirkoy, Istanbul, Turkey.
| | - Ebru Yilmaz Yalcinkaya
- University of Health Sciences, Istanbul Gaziosmanpasa Taksim Training and Research Hospital, Istanbul, Turkey
| | - Evrim Coskun Celik
- University of Health Sciences, Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey
| | - Berrin Gunduz
- University of Health Sciences, Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Bozan
- Mardin Kiziltepe State Hospital, Mardin, Turkey
| | - Belgin Erhan
- University of Health Sciences, Istanbul Gaziosmanpasa Taksim Training and Research Hospital, Istanbul, Turkey
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Work and wellbeing-related consequences of different return-to-work pathways of persons with spinal cord injury living in Switzerland. Spinal Cord 2018; 56:1166-1175. [PMID: 29895876 DOI: 10.1038/s41393-018-0135-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 03/23/2018] [Accepted: 04/03/2018] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Observational study based on the 2012 community survey of the Swiss Spinal Cord Injury Cohort Study (SwiSCI). OBJECTIVES To investigate work and wellbeing-related consequences of different return-to-work (RTW) pathways after SCI. SETTING Community-based. METHODS Using a subsample of 243 SwiSCI participants, we determined whether a respondent had returned to the pre-injury employer, started with a new employer or had not returned to gainful employment post-SCI. For each pathway, descriptive statistics were provided and work and wellbeing-related consequences were examined with regression analyses. RESULTS One hundred eleven (45.7%) participants had returned to their pre-injury employer, 80 (32.9%) had changed employers and 52 (21.4%) had never returned to paid work post-SCI. Although returning to the pre-injury employer was associated with a shorter RTW time and a higher current weekly work time compared with starting work with a new employer, no significant differences were found with regard to current employment status and post-SCI work duration. Concerning wellbeing-related outcomes (i.e., income, quality of life and life satisfaction), the two pathways did not differ. CONCLUSIONS Although lasting RTW had beneficial wellbeing outcomes, the specific pathway initially taken (i.e., pre-injury vs. new employer) appeared less crucial. Although the two pathways seem equally viable, longitudinal data are required to corroborate the present findings, and future research needs to clarify the role of the client triage system and of vocational rehabilitation practices with regard to person-job match and its impact on job satisfaction and job performance.
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Dwyer K, Mulligan H. The experiences of individuals with a spinal cord injury following discharge from inpatient rehabilitation. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2017. [DOI: 10.12968/ijtr.2017.24.8.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kathryn Dwyer
- Postgraduate student School of Physiotherapy, University of Otago, New Zealand; Physiotherapist, Home Action Team (Division of Laura Fergusson Trust), Christchurch, New Zealand
| | - Hilda Mulligan
- Senior Lecturer, School of Physiotherapy, University of Otago, New Zealand
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Rivers CS, Fallah N, Noonan VK, Whitehurst DG, Schwartz CE, Finkelstein JA, Craven BC, Ethans K, O'Connell C, Truchon BC, Ho C, Linassi AG, Short C, Tsai E, Drew B, Ahn H, Dvorak MF, Paquet J, Fehlings MG, Noreau L. Health Conditions: Effect on Function, Health-Related Quality of Life, and Life Satisfaction After Traumatic Spinal Cord Injury. A Prospective Observational Registry Cohort Study. Arch Phys Med Rehabil 2017; 99:443-451. [PMID: 28732686 DOI: 10.1016/j.apmr.2017.06.012] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 05/31/2017] [Accepted: 06/11/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To analyze relations among injury, demographic, and environmental factors on function, health-related quality of life (HRQoL), and life satisfaction in individuals with traumatic spinal cord injury (SCI). DESIGN Prospective observational registry cohort study. SETTING Specialized acute and rehabilitation SCI centers. PARTICIPANTS Participants (N=340) from the Rick Hansen Spinal Cord Injury Registry (RHSCIR) who were prospectively recruited from 2004 to 2014 were included. The model cohort participants were 79.1% men, with a mean age of 41.6±17.3 years. Of the participants, 34.7% were motor/sensory complete (ASIA Impairment Scale [AIS] grade A). INTERVENTIONS None. MAIN OUTCOME MEASURES Path analysis was used to determine relations among SCI severity (AIS grade and anatomic level [cervical/thoracolumbar]), age at injury, education, number of health conditions, functional independence (FIM motor score), HRQoL (Medical Outcomes Study 36-Item Short-Form Health Survey [Version 2] Physical Component Score [PCS] and Mental Component Score [MCS]), and life satisfaction (Life Satisfaction-11 [LiSat-11]). Model fit was assessed using recommended published indices. RESULTS Goodness of fit of the model was supported by all indices, indicating the model results closely matched the RHSCIR data. Higher age, higher severity injuries, cervical injuries, and more health conditions negatively affected FIM motor score, whereas employment had a positive effect. Higher age, less education, more severe injuries (AIS grades A-C), and more health conditions negatively correlated with PCS (worse physical health). More health conditions were negatively correlated with a lower MCS (worse mental health), however were positively associated with reduced function. Being married and having higher function positively affected Lisat-11, but more health conditions had a negative effect. CONCLUSIONS Complex interactions and enduring effects of health conditions after SCI have a negative effect on function, HRQoL, and life satisfaction. Modeling relations among these types of concepts will inform clinicians how to positively effect outcomes after SCI (eg, development of screening tools and protocols for managing individuals with traumatic SCI who have multiple health conditions).
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Affiliation(s)
| | | | - Vanessa K Noonan
- Rick Hansen Institute, Vancouver, BC, Canada; University of British Columbia, Vancouver, BC, Canada
| | - David G Whitehurst
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | | | | | - B Catharine Craven
- Division of PM&R, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Karen Ethans
- Department of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Colleen O'Connell
- Physical Medicine & Rehabilitation, Faculty of Medicine, Dalhousie University, Fredericton, NB, Canada
| | - B Catherine Truchon
- Institut national d'excellence en santé et en services sociaux, Québec, QC, Canada
| | - Chester Ho
- Division of Physical Medicine & Rehabilitation, Department of Clinical Neurosciences, University of Calgary, Foothills Hospital, Calgary, AB, Canada
| | - A Gary Linassi
- Physical Medicine and Rehabilitation, University of Saskatchewan, Saskatoon, SK, Canada
| | - Christine Short
- Department of Medicine, Dalhousie University, Nova Scotia Rehabilitation Centre, Halifax, NS, Canada
| | - Eve Tsai
- Division of Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
| | - Brian Drew
- Department of Orthopaedic Surgery, McMaster University, Hamilton, ON, Canada
| | - Henry Ahn
- Department of Surgery, University of Toronto Spine Program, Toronto, ON, Canada
| | | | | | - Michael G Fehlings
- Department of Surgery, University of Toronto Spine Program, Toronto, ON, Canada
| | - Luc Noreau
- Département de réadaptation, Faculté de médecine, Université Laval, Québec, QC, Canada
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Hitzig SL, Hunter JP, Ballantyne EC, Katz J, Rapson L, Craven BC, Boschen KA. Outcomes and reflections on a consensus-building workshop for developing a spinal cord injury-related chronic pain research agenda. J Spinal Cord Med 2017; 40:258-267. [PMID: 26828394 PMCID: PMC5472012 DOI: 10.1080/10790268.2015.1136115] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Context/ Objective: Chronic pain following spinal cord injury (SCI) is a prevalent secondary health condition that significantly impacts quality of life (QoL). Although growing, the number of available effective pain management approaches for SCI is limited. Recognizing the need to "kick-start" activity on this topic, a consensus-building workshop on developing a research agenda for SCI-related chronic pain was held in 2006 with an expert panel. The present paper describes the processes of the consensus-workshop and its associated outcomes towards advancing the research agenda for SCI-related pain in Canada. A commentary on the current state of knowledge regarding SCI-related pain is also provided. METHODS Thirty-nine stakeholders (researchers, clinicians, policy-makers, SCI advocates, and people with SCI) attended the consensus-workshop. A modified Delphi approach was employed to gain consensus on identifying the top five SCI pain research priorities for improving QoL post-SCI. As well, project planning along with infrastructure support opportunities were discussed. RESULTS The top five pain research priorities were: 1) pain management and treatment; 2) measurement tools; 3) health services policy and advocacy; 4) knowledge transfer; and 5) mechanisms of pain. Recommendations related to the priorities and related resources were generated, and pilot work was initiated. CONCLUSIONS The consensus workshop provided an initial roadmap for research on SCI-related chronic pain, and supported five pilot projects on the identified priorities. Reflections on the current research landscape in Canada and abroad suggest increased activity towards addressing pain post-SCI but evidence-based approaches are still lacking.
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Affiliation(s)
- Sander L. Hitzig
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
- Institute for Life Course and Aging, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Judith P. Hunter
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Elena C. Ballantyne
- St- Joseph's Healthcare, Hamilton, Ontario, Canada
- Bieman-Copland & Associates, St. Catharines, Ontario, Canada
| | - Joel Katz
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
- Department of Psychology, Faculty of Health, York University, Toronto, Ontario, Canada
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Linda Rapson
- Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - B. Catharine Craven
- Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kathryn A. Boschen
- Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada
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Secondary Health Conditions, Activity Limitations, and Life Satisfaction in Older Adults With Long-Term Spinal Cord Injury. PM R 2016; 9:356-366. [DOI: 10.1016/j.pmrj.2016.09.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 09/05/2016] [Accepted: 09/10/2016] [Indexed: 11/19/2022]
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Rosengren L, Brogårdh C, Jacobsson L, Lexell J. Life satisfaction and associated factors in persons with mild to moderate Parkinson’s disease. NeuroRehabilitation 2016; 39:285-94. [DOI: 10.3233/nre-161359] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Lina Rosengren
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
| | - Christina Brogårdh
- Department of Health Sciences, Physiotherapy Research Group, Lund University, Lund, Sweden
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Lars Jacobsson
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
- Department of Rehabilitation Medicine, Sunderby Hospital, Luleå, Sweden
| | - Jan Lexell
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
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Psychosocial aspects of spinal cord injury pain: a meta-analysis. Spinal Cord 2016; 54:640-8. [PMID: 27163453 DOI: 10.1038/sc.2016.66] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 03/24/2016] [Accepted: 03/24/2016] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Meta-analysis. OBJECTIVES Although the association between modifiable psychosocial factors and spinal cord injury (SCI) pain has been identified, the full range of psychological and social difficulties for those who experience acute and/or persistent pain remains unclear. This meta-analysis consolidates the available evidence, using the International Classification of Functioning, Disability and Health (ICF) as a reference framework. METHODS Nineteen studies that examined persistent neuropathic, nociceptive or mixed pain subtypes in adults with a SCI (newly acquired and chronic; Nparticipants=2934) were identified from electronic database searches. Standardised mean differences between SCI pain and no-pain groups on self-reported psychosocial outcomes were calculated, along with 95% confidence intervals, fail-safe Ns and heterogeneity statistics. RESULTS Twenty individual outcomes were grouped into nine ICF-related categories. Emotional functions were the most frequent (100%) psychosocial outcomes assessed, with pain contributing to heightened stress (d=-0.85), depression (d=-2.49) anxiety (d range=-0.85 to -1.45), poor self-efficacy (d=-0.77), lowered wellbeing (d range=-0.67 to -1.02) and decreased use of adaptive coping, such as illness acceptance (d=-0.85). Activity limitations and participation restriction were examined by seven studies (43%), although these findings were largely characterised by single studies. CONCLUSIONS Multicomponent treatments that target mood disturbance and foster community connections are important in SCI pain management. However, to improve the comparability of future studies, SCI pain research must adopt definitions of pain consistent with the International Spinal Cord Injury Pain Classification along with validated outcomes that map onto the ICF framework.
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Use of multivariate linear regression and support vector regression to predict functional outcome after surgery for cervical spondylotic myelopathy. J Clin Neurosci 2015; 22:1444-9. [PMID: 26115898 DOI: 10.1016/j.jocn.2015.04.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 04/05/2015] [Indexed: 11/24/2022]
Abstract
This study introduces the use of multivariate linear regression (MLR) and support vector regression (SVR) models to predict postoperative outcomes in a cohort of patients who underwent surgery for cervical spondylotic myelopathy (CSM). Currently, predicting outcomes after surgery for CSM remains a challenge. We recruited patients who had a diagnosis of CSM and required decompressive surgery with or without fusion. Fine motor function was tested preoperatively and postoperatively with a handgrip-based tracking device that has been previously validated, yielding mean absolute accuracy (MAA) results for two tracking tasks (sinusoidal and step). All patients completed Oswestry disability index (ODI) and modified Japanese Orthopaedic Association questionnaires preoperatively and postoperatively. Preoperative data was utilized in MLR and SVR models to predict postoperative ODI. Predictions were compared to the actual ODI scores with the coefficient of determination (R(2)) and mean absolute difference (MAD). From this, 20 patients met the inclusion criteria and completed follow-up at least 3 months after surgery. With the MLR model, a combination of the preoperative ODI score, preoperative MAA (step function), and symptom duration yielded the best prediction of postoperative ODI (R(2)=0.452; MAD=0.0887; p=1.17 × 10(-3)). With the SVR model, a combination of preoperative ODI score, preoperative MAA (sinusoidal function), and symptom duration yielded the best prediction of postoperative ODI (R(2)=0.932; MAD=0.0283; p=5.73 × 10(-12)). The SVR model was more accurate than the MLR model. The SVR can be used preoperatively in risk/benefit analysis and the decision to operate.
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Litwak B, Dobie A, Safadi W. Lifestyle changes of a family caring for a 25-year-old quadriplegic man after delayed spinal cord infarction. BMJ Case Rep 2015; 2015:bcr2015211100. [PMID: 26055609 PMCID: PMC4460525 DOI: 10.1136/bcr-2015-211100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2015] [Indexed: 11/04/2022] Open
Abstract
Worldwide, 110-190 million people over the age of 15 years are estimated to live with severe disability-a physical state of being defined by the WHO as "the equivalent of disability inferred for conditions such as quadriplegia, severe depression, or blindness." Modes and qualities of disability care undoubtedly vary globally, dependent on income, health infrastructure and culture. Quadriplegia has a unique set of emotional and physical challenges that demand a great deal from care regimens and health systems. This case study examines a specific-and successful-configuration of quadriplegic care in a Druze village in the Golan and looks to the economic, geographic and sociocultural aspects of care.
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Affiliation(s)
- Baila Litwak
- Medical School for International Health, Ben Gurion University, Beer Sheva, Israel
| | - Aaron Dobie
- Medical School for International Health, Ben Gurion University, Beer Sheva, Israel
| | - Wajdi Safadi
- Department of General Surgery, Ziv Hospital affiliated to the Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
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Evaluation of a community reintegration outpatient program service for community-dwelling persons with spinal cord injury. Rehabil Res Pract 2014; 2014:989025. [PMID: 25574397 PMCID: PMC4276116 DOI: 10.1155/2014/989025] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 10/26/2014] [Accepted: 11/20/2014] [Indexed: 11/17/2022] Open
Abstract
Objective. To evaluate the effectiveness of a community reintegration outpatient (CROP) service for promoting well-being and
community participation following spinal cord injury (SCI).
Participants. Community-dwelling adults (N = 14) with traumatic and nontraumatic SCI. Interventions. The CROP service is a 12-week (1 × week; 120 minutes) interprofessional closed therapeutic education service. Main Outcome Measure(s). Moorong Self-Efficacy Scale (MSES); Impact on Participation and Autonomy (IPA); Positive Affect and Negative Affect Scale (PANAS); Coping Inventory of Stressful Situations (CISS); World Health Organization Quality of Life (WHOQOL-BREF); semistructured qualitative interviews. Methods. Twenty-one participants were recruited from two subsequent CROP services, with only 14 persons completing all data assessments.
Data were collected at baseline (week 0), at exit (week 12), and at a three-month follow-up. Semistructured interviews were conducted at exit. Results. Self-efficacy (MSES) and positive affect (PANAS) improved from baseline to exit (P < .05), but the changes were not maintained at follow-up. Qualitative analysis identified four major themes related to therapeutic benefits: (1) role of self; (2) knowledge acquisition; (3) skill application; and (4) group processes. Conclusions. Participation in a therapeutic education service has the potential to improve well-being in persons with SCI, but there is a need to identify strategies to maintain long-term gains.
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Lee SI, Mortazavi B, Hoffman HA, Lu DS, Li C, Paak BH, Garst JH, Razaghy M, Espinal M, Park E, Lu DC, Sarrafzadeh M. A Prediction Model for Functional Outcomes in Spinal Cord Disorder Patients Using Gaussian Process Regression. IEEE J Biomed Health Inform 2014; 20:91-9. [PMID: 25423659 DOI: 10.1109/jbhi.2014.2372777] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Predicting the functional outcomes of spinal cord disorder patients after medical treatments, such as a surgical operation, has always been of great interest. Accurate posttreatment prediction is especially beneficial for clinicians, patients, care givers, and therapists. This paper introduces a prediction method for postoperative functional outcomes by a novel use of Gaussian process regression. The proposed method specifically considers the restricted value range of the target variables by modeling the Gaussian process based on a truncated Normal distribution, which significantly improves the prediction results. The prediction has been made in assistance with target tracking examinations using a highly portable and inexpensive handgrip device, which greatly contributes to the prediction performance. The proposed method has been validated through a dataset collected from a clinical cohort pilot involving 15 patients with cervical spinal cord disorder. The results show that the proposed method can accurately predict postoperative functional outcomes, Oswestry disability index and target tracking scores, based on the patient's preoperative information with a mean absolute error of 0.079 and 0.014 (out of 1.0), respectively.
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Abstract
CONTEXT/OBJECTIVE Health preference values relate to a person's state of well-being, and is a single metric anchored at 0 (death) and 1 (perfect health). Health preference plays a key role in health economics and health policy, particularly in interpreting the results of cost-effectiveness studies, and supports the allocation of healthcare resources. The current study used elements of the International Classification of Functioning, Disability and Health (ICF) framework to predict health preference in persons with spinal cord injury (SCI). METHODS Data were collected by telephone survey on (1) demographics, (2) impairment (etiology, neurological level of injury, and ASIA impairment scale), (3) secondary health conditions (SHCs) using the SCI-Secondary Conditions Scale-Modified, (4) functional abilities using the Spinal Cord Independence Measure (SCIM), and (5) health preference using the Health Utilities Index-Mark III (HUI-Mark III) among adults with chronic SCI. Variables were categorized according to ICF headings and hierarchical regression analyses were used to predict HUI-Mark III scores. RESULTS Adults with chronic traumatic or non-traumatic SCI (N = 357) reported a mean health preference score of 0.27 (±0.27). In predicting health preference, our model accounted for 55.1% of the variance with "body functions and structure", and "activity and participation", significantly contributing to the model (P < 0.0001). In particular, older age, being employed, and having higher SCIM scores were positively associated with health preference. Conversely, a higher SHC impact score was associated with poorer health preference. CONCLUSIONS Variables representative of "activity and participation" largely influence health preference among persons with chronic SCI, which may be amenable to intervention. These findings could be applied to advocate for health promotion and employment support programs to maximize well-being in persons aging with chronic SCI in the community.
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Cobb J, Dumont FS, Leblond J, Park SE, Noonan VK, Noreau L. An Exploratory Analysis of the Potential Association Between SCI Secondary Health Conditions and Daily Activities. Top Spinal Cord Inj Rehabil 2014; 20:277-88. [PMID: 25477741 PMCID: PMC4252128 DOI: 10.1310/sci2004-277] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Secondary health conditions (SHCs) are common following traumatic spinal cord injury (tSCI) and are believed to influence a person's ability to participate in daily activities (DAs). This association should be understood so that health care providers may target interventions with clarity and purpose to manage SHCs and facilitate DAs to maximal effect. OBJECTIVE To explore the association between SHCs and DAs expressed as the increased chance of not participating as much as wanted in a DA when an SHC is present. METHODS Community-dwelling persons with tSCI (n = 1,137) responded to the SCI Community Survey. The occurrence and frequency of 21 SHCs were determined. The extent of participation in 26 DAs was measured. The relative risk (RR) of not participating as much as wanted in a DA when a SHC is present was calculated. RESULTS When some SHC were present, the RR of not participating as much as wanted increased significantly (range, 15%-153%; P < .001). Certain SHCs (light-headedness/dizziness, fatigue, weight problems, constipation, shoulder problems) were associated with a greater chance of not participating in many DAs. No single SHC was associated with every DA and conversely not every DA was associated with an SHC. CONCLUSIONS Maximizing participation in DAs requires minimizing SHCs in every instance. Understanding the association between SHCs and DAs may facilitate targeted care resulting in less severe SHCs, greater participation in DAs, and benefits to both the individual and society.
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Affiliation(s)
- John Cobb
- Vancouver General Hospital, Vancouver, Canada
- Rick Hansen Institute, Vancouver, Canada
| | - Frédéric S. Dumont
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and Université Laval, Quebec City, Canada
| | - Jean Leblond
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and Université Laval, Quebec City, Canada
| | | | - Vanessa K. Noonan
- Rick Hansen Institute, Vancouver, Canada
- Division of Spine, Department of Orthopedics, University of British Columbia, Vancouver, Canada
| | - Luc Noreau
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and Université Laval, Quebec City, Canada
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Trigeminal neurosensory deficit and patient reported outcome measures: the effect on life satisfaction and depression symptoms. PLoS One 2013; 8:e72891. [PMID: 24009712 PMCID: PMC3757017 DOI: 10.1371/journal.pone.0072891] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Accepted: 07/14/2013] [Indexed: 11/19/2022] Open
Abstract
Objectives To investigate the effect of persistent neurosensory disturbance of the lingual nerve (LN) or inferior alveolar nerve (IAN) on life satisfaction and depression symptoms. Methods This study recruited patients with persistent LN or IAN deficit as a consequence of lower third molar surgery for 12 months or more to form the study group. A control group was formed by matching age and gender of recruited subjects in the study group with patients without the neurosensory complications. Life satisfaction was assessed with Satisfaction With Life Scale (SWLS) and depression symptoms were assessed with 20-item Center for Epidemiological Studies Depression scale (CESD-20). Results Fourty-eight participants (24 cases and 24 controls) were recruited. Patients with LN or IAN deficits after lower third molar surgery were less satisfied with their lives when compared to the control group (p<0.001). They were presenting with more depression symptoms (p = 0.001). 45.8% of the study group subjects had a CESD-20 score of 16 or above. Older patients presented with more depression symptoms among the subjects with neurosensory disturbance after lower third molar surgery (p = 0.02). Conclusions Individuals with permanent trigeminal neurosensory deficit after lower third molar surgery have worse life satisfaction and more depressive symptoms when compared to those who did not suffer from the surgical complication.
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Perrier MJ, Smith BM, Latimer-Cheung AE. Narrative environments and the capacity of disability narratives to motivate leisure-time physical activity among individuals with spinal cord injury. Disabil Rehabil 2013; 35:2089-96. [PMID: 23919641 DOI: 10.3109/09638288.2013.821179] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Few individuals with spinal cord injury (SCI) engage in the recommended amount of leisure time physical activity (LTPA). Yet little is known about how, and why, active individuals engage in specific types of LTPA. This study explored how a unique narrative environment and disability narratives motivated individuals with SCI to engage in LTPA. METHOD Fourteen individuals with SCI from a physical activity program participated in approximately hour-long interviews. Interviews were then subjected to a narrative analysis. RESULTS Individuals who used a restitution narrative (n = 6) were motivated to engage in functional LTPA because of the desire to maintain the body and restore the past self. The individual who used the chaos narrative (n = 1) preferred solitary LTPA as exposure to others with SCI was a constant reminder of the lost, pre-injury self. Individuals who used a quest narrative (n = 7) explored LTPA options that fit with their interests; these individuals were open to new types of LTPA, such as sport and outdoor recreation. CONCLUSION The plot of three disability narratives can all motivate the pursuit of LTPA; however, not all types of LTPA are seen as equal. LTPA interventions can be enhanced through the lessons learned from this unique type of environment. IMPLICATIONS FOR REHABILITATION Despite individuals' views about their disability, they can still be motivated to engage in routine LTPA. Different theoretical determinants, such as health or social benefits, hold different relevance for LTPA among individuals with differing disability narratives. The environment provided by practitioners can therefore elicit some stories of SCI while stifling others. Open narrative environment will attract individuals to listen and maintain involvement in LTPA.
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Affiliation(s)
- Marie-Josée Perrier
- School of Kinesiology and Health Studies, Queen's University , Kingston , Canada and
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Suttiwong J, Vongsirinavarat M, Vachalathiti R, Chaiyawat P. Impact on participation and autonomy questionnaire: psychometric properties of the thai version. J Phys Ther Sci 2013; 25:769-74. [PMID: 24259849 PMCID: PMC3820408 DOI: 10.1589/jpts.25.769] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 03/01/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The present study aimed to cross-culturally translate and evaluate the reliability and validity of the Thai version of the Impact on Participation and Autonomy (IPA) in persons with spinal cord injury (SCI). [Subjects] One hundred and thirty-nine persons with SCI who lived in the community were recruited for this study. [Methods] The IPA was translated following the guideline for cross-cultural adaptation of self-report measures. The reliability and validity was examined in 139 persons with SCI. For the test-retest reliability, 30 participants completed the Thai version of the IPA twice with a 2-week interval. [Results] The translated questionnaire and its items had moderate to good reliability, with the ICC(3,1) ranging from 0.76 to 0.93. The internal consistency for all domains was high, with Cronbach's alpha ranging from 0.86 to 0.90. The convergent validity, discriminant validity, and construct validity were supported. [Conclusion] The Thai version of the IPA is a reliable and valid instrument for assessing the level of community participation in Thai persons with spinal cord injury.
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Chan JYC, Chan F, Ditchman N, Phillips B, Chou CC. Evaluating Snyder’s Hope Theory as a Motivational Model of Participation and Life Satisfaction for Individuals With Spinal Cord Injury: A Path Analysis. REHABILITATION RESEARCH, POLICY, AND EDUCATION 2013. [DOI: 10.1891/2168-6653.27.3.171] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objective: To evaluate Snyder’s (2002) hope theory as a motivational model of community participation and life satisfaction.Design: Quantitative descriptive design using path analysis.Setting: Manitoba chapter of the Canadian Paraplegic Association.Participants: One-hundred and sixteen participants with spinal cord injuries who were members of the Manitoba chapter of the Canadian Paraplegic Association.Results: The respecified path-analytic hope model of participation and life satisfaction fits the data reasonably well, with χ2/df = 2.58; GFI = .95; and CFI = .95. Participation—with indirect effects of causality, perceived control, resilience, agency thinking, and pathways thinking—explained 32% of the variance in life satisfaction. Causality and agency thinking—with indirect effects of perceived control, resilience, and pathways thinking—explained 40% of the variance in participation.Conclusion: Synder’s hope theory as a motivational model of participation and life satisfaction was validated with minor modifications to the model. The respecified model indicated that causality had a direct effect on participation; pathways thinking had a direct link to agency thinking; and pathways thinking only had an indirect effect on participation through agency thinking.
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Bruno MA, Laureys S, Demertzi A. Coma and disorders of consciousness. HANDBOOK OF CLINICAL NEUROLOGY 2013; 118:205-13. [PMID: 24182379 DOI: 10.1016/b978-0-444-53501-6.00017-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Patients in coma, vegetative state/unresponsive wakefulness syndrome, and in minimally conscious states pose medical, scientific, and ethical challenges. As patients with disorders of consciousness are by definition unable to communicate, the assessment of pain, quality of life, and end-of-life preferences in these conditions can only be approached by adopting a third-person perspective. Surveys of healthcare workers' attitudes towards pain and end of life in disorders of consciousness shed light on the background of clinical reality, where no standard medical-legal framework is widely accepted. On the other hand, patients with locked-in syndrome, who are severely paralyzed but fully conscious, can inform about subjective quality of life in serious disability and help us to understand better the underlying factors influencing happiness in disease. In the medico-legal arena, such ethical issues may be resolved by previously drafted advance directives and, when absent, by surrogate representation. Lately, functional medical imaging and electrophysiology provide alternative means to communicate with these challenging patients and will potentially mediate to extract responses of medical-ethical content. Eventually, the clinical translation of these advanced technologies in the medical routine is of paramount importance for the promotion of medical management of these challenging patients.
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Affiliation(s)
- Marie-Aurélie Bruno
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
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Hitzig SL, Noreau L, Balioussis C, Routhier F, Kairy D, Craven BC. The development of the spinal cord injury participation and quality of life (PAR-QoL) tool-kit. Disabil Rehabil 2012; 35:1408-14. [PMID: 23173618 DOI: 10.3109/09638288.2012.735340] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Accurate descriptions of the impact of spinal cord injury (SCI)-related secondary health conditions (SHCs) on quality of life (QoL) are important to help guide the direction of resources and evaluation of therapies. However, selecting an appropriate outcome tool can be a challenge due to several clinical, theoretical and measurement issues. In order to help improve practices related to QoL measurement, a web-based Participation and QoL (PAR-QoL) tool-kit was designed to support researchers and clinicians with the outcome measure selection process. METHOD The content of the PAR-QoL website ( www.parqol.com ) was developed through a series of systematic reviews of the SHC literature. Outcome tools identified in the studies were classified using Dijker's (2005) theoretical framework. RESULTS A total of 199 studies were identified and categorized across eight different SHCs. Measures from the studies were extrapolated, and details regarding their [1] sensitivity to SHC impact [2], psychometric properties for SCI and [3] underlying QoL constructs were summarized onto a website. CONCLUSIONS A better understanding of SHC impact on QoL will improve the quality of research, which in turn may provide better evidence for securing the necessary resources to help persons with SCI manage their health.
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Affiliation(s)
- Sander L Hitzig
- Toronto Rehabilitation Institute, Lyndhurst Centre - University Health Network, Toronto, Ontario, Canada.
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Craven C, Hitzig SL, Mittmann N. Impact of impairment and secondary health conditions on health preference among Canadians with chronic spinal cord injury. J Spinal Cord Med 2012; 35:361-70. [PMID: 23031173 PMCID: PMC3459565 DOI: 10.1179/2045772312y.0000000046] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
CONTEXT/OBJECTIVES To describe the relationships between secondary health conditions and health preference in a cohort of adults with chronic spinal cord injury (SCI). STUDY DESIGN Cross-sectional telephone survey. SETTING Community. PARTICIPANTS Community-dwelling adult men and women (N = 357) with chronic traumatic and non-traumatic SCI (C1-L3 AIS A-D) who were at least 1 year post-injury/onset. INTERVENTIONS Not applicable. OUTCOME MEASURES Health Utilities Index-Mark III (HUI-Mark III) and SCI Secondary Conditions Scale-Modified (SCS-M). RESULTS SCS-M responses for different secondary health conditions were used to create "low impact = absent/mild" and "high impact = moderate/significant" secondary health condition groups. Analysis of covariance was used to examine differences in HUI-Mark III scores for different secondary health conditions while controlling for impairment. The mean HUI-Mark III was 0.24 (0.27, range, -0.28 to 1.00). HUI-Mark III scores were lower (P < 0.001) in high impact groups for spasms, bladder and bowel dysfunction, urinary tract infections, autonomic dysreflexia, circulatory problems, respiratory problems, chronic pain, joint pain, psychological distress, and depression compared with the low impact groups. As well, HUI-Mark III scores were lower (P < 0.05) in high impact groups for pressure sores, unintentional injuries, contractures, heterotopic bone ossification, sexual dysfunction, postural hypotension, cardiac problems, and neurological deterioration than low-impact groups. CONCLUSION High-impact secondary health conditions are negatively associated with health preference in persons with SCI. Although further work is required, the HUI-Mark III data may be a useful tool for calculating quality-adjusted life years, and advocating for additional resources where secondary health conditions have substantial adverse impact on health.
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Affiliation(s)
- Catharine Craven
- Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
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Coggrave MJ, Ingram RM, Gardner BP, Norton CS. The impact of stoma for bowel management after spinal cord injury. Spinal Cord 2012; 50:848-52. [PMID: 22710944 DOI: 10.1038/sc.2012.66] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
STUDY DESIGN Multi-centre, retrospective self-report postal survey. OBJECTIVES To characterise spinal cord injured (SCI) individuals with a stoma, their stoma management and outcomes, to identify sources of information and support for decision making and to explore the impact of a stoma on life satisfaction. SETTING Five UK spinal cord injury centres. METHODS A study-specific questionnaire accompanied by self-concept, life satisfaction and mood measures, and three simple rating scales for satisfaction, impact and restriction on life were sent to all known ostomates at five participating centres. RESULTS Respondents were 92 individuals, mean age 56 years, mean duration of injury 26 years, 91% with colostomy. Multiple sources of information were utilised in deciding on surgery; discussion with other SCI ostomates was important. Duration of bowel care, faecal incontinence, bowel-related autonomic dysreflexia, dietary manipulation and laxative use were all significantly reduced following surgery. Rectal mucous discharge was the most common and bothersome post-stoma problem. Satisfaction with stoma was high; provision of sufficient information preoperatively was important, those with ileostomy were more dependent and less satisfied. Life satisfaction and physical self-concept were both lower in this sample than in previously reported samples of SCI individuals without reported bowel difficulties or stoma. CONCLUSION The findings of this study of self-selected respondents with a stoma for bowel management after SCI emphasised the benefits of stoma in selected individuals and the importance of timely intervention, the complexity of the associated decision-making and of preoperative counselling. The impact of bowel dysfunction on physical self-concept warrants investigation.
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Affiliation(s)
- M J Coggrave
- The National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK.
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Boonstra AM, Reneman MF, Stewart RE, Post MW, Schiphorst Preuper HR. Life satisfaction in patients with chronic musculoskeletal pain and its predictors. Qual Life Res 2012; 22:93-101. [PMID: 22350589 DOI: 10.1007/s11136-012-0132-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2012] [Indexed: 01/22/2023]
Abstract
PURPOSE To determine the life satisfaction of patients with chronic non-malignant musculoskeletal pain (CMP) compared to the general population (GP) and to identify predictors of life satisfaction. METHODS Subjects were patients with CMP (n = 1,082) admitted to multidisciplinary rehabilitation and a general population sample (n = 506). Lisat-9 measures satisfaction with life as a whole and eight life domains. Physical, emotional and social functioning and pain intensity were assessed using the SF-36. Ordinal logistic regression was used to analyse differences between patients with CMP and the GP, and predictors of life satisfaction in patients with CMP. RESULTS Compared to the general population, patients with CMP reported lower satisfaction with 'life as a whole', and with six life domains: self-care, leisure, vocational and financial situation, sex life and contacts with friends. In the CMP group, pain was associated with satisfaction with self-care, vocational situation, partnership, family life and contacts with friends. Marital status, age and mental health were associated with most satisfaction scores. CONCLUSIONS Compared to the general population, patients with CMP reported lower satisfaction with 'life as a whole' and most life domains. The most consistent predictors of life satisfaction were marital status, mental health, vitality and pain.
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Affiliation(s)
- Anne M Boonstra
- 'Revalidatie Friesland', Center for Rehabilitation, PO Box 2, 9244 ZN, Beetsterzwaag, The Netherlands.
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Hitzig SL, Romero Escobar EM, Noreau L, Craven BC. Validation of the Reintegration to Normal Living Index for community-dwelling persons with chronic spinal cord injury. Arch Phys Med Rehabil 2012; 93:108-14. [PMID: 22200389 DOI: 10.1016/j.apmr.2011.07.200] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Revised: 07/21/2011] [Accepted: 07/22/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the validity (construct, concurrent) of the Reintegration to Normal Living (RNL) Index for measurement of community participation in adults with chronic spinal cord injury (SCI). DESIGN Cross-sectional telephone survey. SETTING Rehabilitation institute. PARTICIPANTS Community-dwelling adult men and women (N=617) with SCI who were at least 1 year postinjury. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES RNL Index and Satisfaction With Life Scale (SWLS). RESULTS Reliability of the RNL Index was determined by using Cronbach α, and construct validity was established through confirmatory factor analysis (CFA). In addition, general linear models to predict RNL Index scores were conducted to establish concurrent validity. The RNL Index is a reliable measure of community participation (α=.87). CFA analyses suggested that the RNL Index loads onto a 2-factor solution and is distinct from the SWLS. Significant predictors of RNL Index score included years post-injury, impairment, ambulatory status, employment, and poor health, which yielded R(2)=.26 (P<.001). CONCLUSIONS The RNL Index is a valid and reliable measure of community participation for persons with chronic SCI of traumatic cause.
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Affiliation(s)
- Sander L Hitzig
- Lyndhurst Centre, Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
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Abstract
STUDY DESIGN Secondary analysis of cross-sectional data. OBJECTIVES To identify differences in earnings among participants with spinal cord injury (SCI) and their relation to demographic, injury, educational and employment-related factors. SETTING People living with SCI in the community who were members of a disability support organization. METHODS A total of 76 members who have had traumatic SCI for at least 2 years, between 15 and 64 years of age at time of study and were working before SCI were interviewed over the phone. The earnings were categorized as more, same or less than before SCI or no income for those unemployed. RESULTS Of the 76 participants (who averaged about 15.1 years post SCI), only 13 participants (17.1%) were earning more than before injury, whereas majority were in the category of having no income, being unemployed at time of study, n=36 (47.4%). Factors positively related to earnings were having more years in education, both at time of injury and at time of survey. As anticipated, those currently in full time and paid employments were earning more while receipt of financial compensation was negatively related to earnings. CONCLUSION Despite a lengthy period of time post SCI, only a minority were earning more, reflecting poorly on the quality of post SCI employment experience. The rehabilitation team should therefore focus on improving both educational and vocational opportunities for persons with SCI and aim for full time, paid employments. The current workers' compensation scheme renders the recipient at a static income and may need to be revised.
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Islam MS, Hafez MA, Akter M. Characterization of spinal cord lesion in patients attending a specialized rehabilitation center in Bangladesh. Spinal Cord 2011; 49:783-6. [PMID: 21502957 DOI: 10.1038/sc.2011.36] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
STUDY DESIGN This study was designed as a cross-sectional study. OBJECTIVES The objective of this study was to find out the clinical types and sociodemographic characteristics of patients with spinal cord lesion (SCL). SETTING Centre for the Rehabilitation of the Paralysed (CRP). METHODS Data were collected by face-to-face interview, with a structured interview schedule from admitted patients. Descriptive measures and χ(2)-test were applied for data analysis. RESULTS Of 107 patients, majority (20%) belonged to age group of 25-29 years (mean 31±12.2 years). About 83% were males; 65% married and 54% illiterate. Agricultural and other day laborers constituted the major occupation groups with mean monthly family income of US $60 (±$53). About 92% came from rural area and 84% belonged to nuclear family. About one-third of the patients were referred by the medical college hospitals. About 65% of the patients were admitted at 1-29 days of lesion with longest duration of 3 years. Patients were mostly (93%) traumatic. Fifty-four percent had paraplegia and most common skeletal level segment was cervical (44%). About 43% had pressure sores at admission. Eighty-nine percent needed management for bladder function through the use of catheter. Age, sex and occupation were associated with type of paralysis, skeletal level of injury and neurological condition; physical status, causes of lesion, type of injury and skeletal level of injury; and skeletal level of injury, respectively (P<0.05). CONCLUSION Major cause of SCL was traumatic. Available treatment facilities were inadequate and needed improvement through government and private initiatives.
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Affiliation(s)
- M S Islam
- Department of Physiotherapy, Bangladesh Health Professions Institute, CRP-Chapain, Savar, Dhaka, Bangladesh.
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Return to work after spinal cord injury: factors related to time to first job. Spinal Cord 2011; 49:924-7. [DOI: 10.1038/sc.2011.16] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Bruno MA, Bernheim JL, Ledoux D, Pellas F, Demertzi A, Laureys S. A survey on self-assessed well-being in a cohort of chronic locked-in syndrome patients: happy majority, miserable minority. BMJ Open 2011; 1:e000039. [PMID: 22021735 PMCID: PMC3191401 DOI: 10.1136/bmjopen-2010-000039] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Objectives Locked-in syndrome (LIS) consists of anarthria and quadriplegia while consciousness is preserved. Classically, vertical eye movements or blinking allow coded communication. Given appropriate medical care, patients can survive for decades. We studied the self-reported quality of life in chronic LIS patients. Design 168 LIS members of the French Association for LIS were invited to answer a questionnaire on medical history, current status and end-of-life issues. They self-assessed their global subjective well-being with the Anamnestic Comparative Self-Assessment (ACSA) scale, whose +5 and -5 anchors were their memories of the best period in their life before LIS and their worst period ever, respectively. Results 91 patients (54%) responded and 26 were excluded because of missing data on quality of life. 47 patients professed happiness (median ACSA +3) and 18 unhappiness (median ACSA -4). Variables associated with unhappiness included anxiety and dissatisfaction with mobility in the community, recreational activities and recovery of speech production. A longer time in LIS was correlated with happiness. 58% declared they did not wish to be resuscitated in case of cardiac arrest and 7% expressed a wish for euthanasia. Conclusions Our data stress the need for extra palliative efforts directed at mobility and recreational activities in LIS and the importance of anxiolytic therapy. Recently affected LIS patients who wish to die should be assured that there is a high chance they will regain a happy meaningful life. End-of-life decisions, including euthanasia, should not be avoided, but a moratorium to allow a steady state to be reached should be proposed.
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Affiliation(s)
- Marie-Aurélie Bruno
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
| | - Jan L Bernheim
- Department of Human Ecology and End-of-Life Care Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Didier Ledoux
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
| | - Frédéric Pellas
- Médecine Rééducative, Hôpital Caremeau, CHU Nîmes, Nîmes and Association for Locked-in Syndrome (ALIS), Paris, France
| | - Athena Demertzi
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
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Trajectories in the Course of Life Satisfaction After Spinal Cord Injury: Identification and Predictors. Arch Phys Med Rehabil 2011; 92:207-13. [DOI: 10.1016/j.apmr.2010.10.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Accepted: 10/11/2010] [Indexed: 11/20/2022]
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Teo SHJ, Sew S, Backman C, Forwell S, Lee WK, Chan PL, Dean E. Health of people with spinal cord injury in Singapore: implications for rehabilitation planning and implementation. Disabil Rehabil 2010; 33:1460-74. [PMID: 21091048 DOI: 10.3109/09638288.2010.533812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This study aimed to provide a broad overview of the health of people with spinal cord injury (SCI) in Singapore, so as to highlight areas of potential need. These areas could then guide future research and rehabilitation programme development. METHODS Demographic data, injury information and information about SCI-related secondary impairments, chronic conditions and their associated risk factors, medical and hospital utilisation, participation (Craig Handicap Assessment and Reporting Technique) and life satisfaction (Satisfaction with Life Scale) were collected via interviews from people living with traumatic SCI. RESULTS On average, participants (50 men and 5 women) were aged 48.3 ± 16.54 years and had had their SCIs for 5 years. -75% with tetraplegia. The most prevalent SCI-related secondary impairments were pain, spasms, bladder problems, bowel problems and oedema. Chronic conditions and their associated risk factors were prevalent. Participation and life satisfaction scores were lower than those reported for similar populations cross-culturally. CONCLUSION The study revealed several health areas that may be affecting the overall health of people with SCI in Singapore. By focusing on community reintegration and health promotion, physiotherapists and other rehabilitation professionals may augment health outcomes and improve the quality of life of this population in Singapore.
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Affiliation(s)
- Sock Hui Joy Teo
- Tan Tock Seng Hospital Rehabilitation Centre, Singapore, Singapore.
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Cerniauskaite M, Quintas R, Boldt C, Raggi A, Cieza A, Bickenbach JE, Leonardi M. Systematic literature review on ICF from 2001 to 2009: its use, implementation and operationalisation. Disabil Rehabil 2010; 33:281-309. [PMID: 21073361 DOI: 10.3109/09638288.2010.529235] [Citation(s) in RCA: 162] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE To present a systematic literature review on the state of the art of the utilisation of the International Classification of Functioning, Disability and Health (ICF) since its release in 2001. METHOD The search was conducted through EMBASE, MEDLINE and PsychInfo covering the period between 2001 and December 2009. Papers were included if ICF was mentioned in title or abstract. Papers focussing on the ICF-CY and clinical research on children and youth only were excluded. Papers were assigned to six different groups covering the wide scenario of ICF application. RESULTS A total of 672 papers, coming from 34 countries and 211 different journals, were included in the analysis. The majority of publications (30.8%) were conceptual papers or papers reporting clinical and rehabilitation studies (25.9%). One-third of the papers were published in 2008 and 2009. CONCLUSIONS The ICF contributed to the development of research on functioning and on disability in clinical, rehabilitation as well as in several other contexts, such as disability eligibility and employment. Diffusion of ICF research and use in a great variety of fields and scientific journals is a proof that a cultural change and a new conceptualisation of functioning and disability is happening.
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Affiliation(s)
- Milda Cerniauskaite
- Neurology, Public Health and Disability Unit-Scientific Directorate, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
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Hetz SP, Latimer AE, Arbour-Nicitopoulos KP, Martin Ginis KA. Secondary complications and subjective well-being in individuals with chronic spinal cord injury: associations with self-reported adiposity. Spinal Cord 2010; 49:266-72. [DOI: 10.1038/sc.2010.100] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Migliorini CE, New PW, Tonge BJ. Quality of life in adults with spinal cord injury living in the community. Spinal Cord 2010; 49:365-70. [PMID: 20697422 DOI: 10.1038/sc.2010.102] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN The study design used is cross-sectional descriptive survey. OBJECTIVES The aim of this study is to describe the subjective and objective quality of life (QoL) of adults with chronic non-traumatic spinal cord injury (NT-SCI) and to compare the objective and subjective QoL of adults with chronic NT-SCI with adults who have a chronic traumatic spinal cord injury (T-SCI) and the general population. SETTING Living in the general community (non-residential care), Australia. PARTICIPANTS The study included 443 adults with SCI (T-SCI, n=381) (NT-SCI, n=62), all SCI ≥6 months duration. INTERVENTION Not applicable. MAIN OUTCOME MEASURES Objective and subjective QoL domains--Comprehensive QoL Scale for Adults, version 5 (COMQoL-A5); acceptance subscale--the Spinal Cord Lesion Coping Strategies Questionnaire, version 1 Australia (SCL CSQ v1.0 Australia). RESULTS Despite demographic differences, only the objective QoL domain material (higher in NT-SCI) and the subjective QoL domain health (lower in NT-SCI) were significantly different between the SCI subgroups. In contrast, five of the seven objective domains and four of the seven subjective domains were significantly lower in the SCI sample as a whole, compared with the general population. Post hoc analyses suggested that aetiology of the SCI was not responsible for QoL differences within the cohort with SCI. CONCLUSION On the whole, aetiology makes little difference to QoL outcomes after SCI. The QoL of adults with chronic T-SCI and NT-SCI fall significantly below that of the general population in most domains.
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Affiliation(s)
- C E Migliorini
- Centre for Developmental Psychiatry and Psychology, School of Psychology and Psychiatry, Monash University, Clayton, Victoria, Australia.
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Understanding age effects associated with changes in secondary health conditions in a Canadian spinal cord injury cohort. Spinal Cord 2009; 48:330-5. [DOI: 10.1038/sc.2009.135] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Norman C, Bender JL, Macdonald J, Dunn M, Dunne S, Siu B, Hitzig SL, Jadad AR, Hunter J. Questions that individuals with spinal cord injury have regarding their chronic pain: A qualitative study. Disabil Rehabil 2009; 32:114-24. [DOI: 10.3109/09638280903033248] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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