1
|
Moecke DP, Camp PG. Social support from the physiotherapist and the therapeutic relationship in physiotherapy: bridging theory to practice. Physiother Theory Pract 2024:1-11. [PMID: 38949505 DOI: 10.1080/09593985.2024.2372687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 06/21/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND/PURPOSE Therapeutic relationship and social support are critical components in physiotherapy that shape patient outcomes. However, defining these constructs, discerning their similarities and differences, and measuring them pose challenges. This article aims to facilitate scientific and clinical advancement on social support and the therapeutic relationship in physiotherapy by (a) providing conceptual clarity, (b) discussing measurement tools, and (c) offering practical recommendations for the deliberate incorporation of these constructs in clinical practice. METHODS This is a perspective paper drawing on examples from existing research. KEY RESULTS Assessing the nature and strength of social support and promoting naturally occurring social support networks are practical ways for physiotherapists to foster social support in physiotherapy clinical practice. Physiotherapists can offer direct support, facilitate the development of an individual's social skills, and promote participation in group activities. To strengthen the therapeutic relationship, it is important to maintain good communication, foster connectedness with the patient, demonstrate professional skills, and adopt a reflective practice. Physiotherapists are encouraged to establish clear roles and responsibilities, prioritize individualized patient-centered care, and involve patients in shared decision-making, ensuring congruence in goals and expectations. Willingness to dedicate time and energy within and beyond direct patient-therapist interactions can foster connections. Moreover, using the body - which is the main point of contact with patients - and physical touch can help physiotherapists to connect with patients. Finally, physiotherapists must be prepared to address and mend any conflicts which can impact the relationship's trajectory. CONCLUSION Social support and therapeutic relationships are complementary aspects of one's health care, and it is crucial to purposefully account for both in physiotherapy practice to optimize person-centered care and rehabilitation outcomes.
Collapse
Affiliation(s)
- Débora Petry Moecke
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada
- Rehabilitation Sciences Graduate Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Pat G Camp
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
| |
Collapse
|
2
|
Monden KR, Charlifue S, Philippus A, Kilbane M, Muston-Firsch E, MacIntyre B, Welch A, Baldessari J, Coker J, Morse LR. Exploring perspectives on assistive technology use: barriers, facilitators, and access. Disabil Rehabil Assist Technol 2024; 19:1676-1686. [PMID: 37368979 DOI: 10.1080/17483107.2023.2227235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 04/21/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE This qualitative study explored perceived barriers and facilitators to access and utilization of assistive technology (AT) among Veterans and civilians living with tetraplegia. We also explored differences in access to and utilization of AT between civilians and Veterans. MATERIALS AND METHODS Semi-structured focus groups were conducted with 32 adults (15 Veterans, 17 non-Veterans) living with tetraplegia between the ages of 18 and 65 and who were at least one-year post-injury. Focus groups were conducted at two rehabilitation sites: Craig Hospital and the Louis Stokes Cleveland VA Medical Center. Participants were asked to discuss what they perceive as (1) the facilitators and barriers of AT access and utilization, and (2) the value of AT use in everyday living. Data were analyzed using thematic analysis of verbatim transcripts. RESULTS AND CONCLUSIONS Facilitators of AT utilization and access included being connected to resources, trial-and-error, and knowledge gained from peers. Barriers to AT use included cost of devices, a general lack of awareness of resources, and requirements for eligibility; the latter two themes were endorsed solely by Veteran participants. Benefits of AT included increased independence, participation, productivity, quality of life, and safety. Findings highlight key facilitators of AT procurement and use, barriers that contribute to underutilization of AT, and important benefits experienced as a result of using AT that underscore the importance of AT for individuals with SCI.
Collapse
Affiliation(s)
- Kimberley R Monden
- Department of Rehabilitation Medicine, University of MN Medical School, Minneapolis, MN, USA
| | | | - Angela Philippus
- Department of Rehabilitation Medicine, University of MN Medical School, Minneapolis, MN, USA
| | - Martin Kilbane
- Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
| | | | | | - Abigail Welch
- Research Department, Craig Hospital, Englewood, CA, USA
| | | | | | - Leslie R Morse
- Department of Rehabilitation Medicine, University of MN Medical School, Minneapolis, MN, USA
| |
Collapse
|
3
|
Bray EA, Salamonson Y, Everett B, George A, Chapman IA, Ramjan L. Transitioning between paediatric and adult healthcare services: a qualitative study of the experiences of young people with spinal cord injuries and parents/caregivers. BMJ Open 2022; 12:e065718. [PMID: 36418132 PMCID: PMC9684994 DOI: 10.1136/bmjopen-2022-065718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Healthcare transition (HCT) interventions are pivotal to paediatric rehabilitation. However, there has been limited research focusing on HCT in young people with spinal cord injury (SCI). To date, little has been reported on key factors that may contribute to a positive or negative transition experience and what, if any, are the gaps in the transition process. This study explored the experiences of transition from paediatric to adult healthcare for young people with SCI and parents/caregivers in pursuit of co-designing and developing an intervention to support transition. DESIGN, SETTING AND PARTICIPANTS This qualitative study forms part of the planning phase of a larger participatory action research project. It supports obtaining a rich understanding of the phenomenon and the issues and actions necessary to achieve change. Semi-structured individual interviews were conducted online between April and June 2021 with young people with SCI and parents/caregivers who had transitioned or were preparing for the transition from paediatric to adult healthcare in NSW, Australia. The interviews were analysed using an inductive reflexive thematic analysis approach. RESULTS The study recruited nine participants, five young people with SCI and four parents/caregivers. The interviews provided invaluable insight into young people with SCI and their parents'/caregivers' experiences of HCT. As HCT experiences were often less than optimal and needs were not adequately met, some recommendations were offered. These included a coordinated and streamlined handover from paediatric to adult healthcare providers, and a 'one-stop shop' for young people with SCI and their parents/caregivers to access transition information, such as how it occurs, who to call for ongoing support and advice, and tips on how to transition successfully. CONCLUSION Providing a coordinated and streamlined handover process as well as access to more context-related information could improve the transition experiences of young people with SCI and parents/caregivers, resulting in improved health outcomes and greater independence. TRIAL REGISTRATION ACTRN12621000500853.
Collapse
Affiliation(s)
- Emily Alice Bray
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Yenna Salamonson
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
- Ingham Institute Applied Medical Research, Liverpool, New South Wales, Australia
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Bronwyn Everett
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Ajesh George
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
- Ingham Institute Applied Medical Research, Liverpool, New South Wales, Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Isabel A Chapman
- SpineCare Foundation, a Division of Northcott, Parramatta, New South Wales, Australia
| | - Lucie Ramjan
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
- Ingham Institute Applied Medical Research, Liverpool, New South Wales, Australia
| |
Collapse
|
4
|
McIntyre A, Sadowsky C, Behrman A, Martin R, Augutis M, Cassidy C, Betz R, Ertzgaard P, Mulcahey MJ. A Systematic Review of the Scientific Literature for Rehabilitation/Habilitation Among Individuals With Pediatric-Onset Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2022; 28:13-90. [PMID: 35521053 PMCID: PMC9009193 DOI: 10.46292/sci21-00046] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives To conduct a systematic review to examine the scientific literature for rehabilitation/habilitation among individuals with pediatric-onset spinal cord injury (SCI). Methods A literature search of multiple databases (i.e., PubMed/MEDLINE, CINAHL, EMBASE, PsychINFO) was conducted and was filtered to include studies involving humans, published as full-length articles up to December 2020, and in English. Included studies met the following inclusion criteria: (1) ≥50% of the study sample had experienced a traumatic, acquired, nonprogressive spinal cord injury (SCI) or a nontraumatic, acquired, noncongenital SCI; (2) SCI onset occurred at ≤21 years of age; and (3) sample was assessed for a rehabilitation/habilitation-related topic. Studies were assigned a level of evidence using an adapted Sackett scale modified down to five levels. Data extracted from each study included author(s), year of publication, country of origin, study design, subject characteristics, rehabilitation/habilitation topic area, intervention (if applicable), and outcome measures. Results One hundred seventy-six studies were included for review (1974-2020) with the majority originating from the United States (81.3%). Most studies were noninterventional observational studies (n = 100; 56.8%) or noninterventional case report studies (n = 5; 2.8%). Sample sizes ranged from 1 to 3172 with a median of 26 (interquartile range [IQR], 116.5). Rehabilitation/habilitation topics were categorized by the International Classification of Functioning, Disability and Health (ICF); most studies evaluated ICF Body Function. There were 69 unique clinical health outcome measures reported. Conclusion The evidence for rehabilitation/habilitation of pediatric-onset SCI is extremely limited; nearly all studies (98%) are level 4-5 evidence. Future studies across several domains should be conducted with novel approaches to research design to alleviate issues related to sample sizes and heterogeneity.
Collapse
Affiliation(s)
- Amanda McIntyre
- Parkwood Institute Research, Parkwood Institute, London, Canada
| | - Cristina Sadowsky
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, John Hopkins University, Baltimore, Maryland
,International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, Maryland
| | - Andrea Behrman
- Department of Neurological Surgery, Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
,Kosair Charities Center for Pediatric Neurorecovery, Louisville, Kentucky
| | - Rebecca Martin
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, John Hopkins University, Baltimore, Maryland
,International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, Maryland
| | - Marika Augutis
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institute, Solna, Sweden
| | - Caitlin Cassidy
- St. Joseph’s Health Care London, Parkwood Institute, London, Canada
| | - Randal Betz
- Institute for Spine and Scoliosis, Lawrenceville, New Jersey
,Department of Orthopedics, Mount Sinai Hospital, New York, New York
| | - Per Ertzgaard
- Department of Rehabilitation Medicine, Linköping University, Linköping, Sweden
| | - MJ Mulcahey
- Department of Occupational Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Woodbury, New Jersey
| | | |
Collapse
|
5
|
Ottomanelli L, Goetz LL, Barnett SD, Njoh E, Fishalow J. Factors associated with past and current employment of veterans with spinal cord injury. J Spinal Cord Med 2022; 45:137-147. [PMID: 32634338 PMCID: PMC8890580 DOI: 10.1080/10790268.2020.1769950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Objective: The purpose of this study was to examine variables predictive of post-SCI return to employment and current employment among a large cohort of veterans with Spinal Cord Injury (SCI) treated within the Veterans Health Administration (VHA) SCI System of Care.Design: Cross sectional analysis of data obtained during in-person baseline interviews and follow-up phone interviews.Setting: Seven SCI Centers within Veteran Affairs Medical Centers.Participants: 1047 veterans with SCI receiving inpatient or outpatient care in VHA.Results: Only 29.8% were employed post-SCI, 27.9% reported employment within the immediate 5 years before the baseline interview, but only 9.2% reported current employment at the time of the baseline interview. Significant predictors of current employment among these veterans with SCI included recent employment experience, history of legal problems, duration of SCI, education, and life satisfaction.Conclusions: The baseline employment rate following SCI of a large, representative sample, was 29.8%. Greater duration of SCI predicted unemployment, likely due to the older age of this population. Additional years of education promoted current and post-SCI employment, while a history of legal problems was a barrier to employment.
Collapse
Affiliation(s)
- Lisa Ottomanelli
- James A. Haley Veterans’ Hospital and Clinics, Tampa, Florida, USA,Department of Mental Health and Rehabilitation Counseling, University of South Florida, Tampa, Florida, USA,Correspondence to: Lisa Ottomanelli, James A. Haley Veterans’ Hospital and Clinics, 8900 Grand Oaks Circle, Tampa, FL33637, USA.
| | - Lance L. Goetz
- Hunter Holmes McGuire VA Medical Center and Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Scott D. Barnett
- James A. Haley Veterans’ Hospital and Clinics, Tampa, Florida, USA
| | - Eni Njoh
- James A. Haley Veterans’ Hospital and Clinics, Tampa, Florida, USA
| | - Jaclyn Fishalow
- James A. Haley Veterans’ Hospital and Clinics, Tampa, Florida, USA
| |
Collapse
|
6
|
Greenham M, Botchway E, Knight S, Bonyhady B, Tavender E, Scheinberg A, Anderson V, Muscara F. Predictors of participation and quality of life following major traumatic injuries in childhood: a systematic review. Disabil Rehabil 2020; 44:2591-2607. [PMID: 33232616 DOI: 10.1080/09638288.2020.1849425] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Review the literature on predictors of participation and quality of life in children and young people who sustained a traumatic brain injury (TBI), spinal cord injury (SCI), and/or multi-trauma in a motor vehicle or other accident or trauma. DESIGN This systematic review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The protocol was registered on PROSPERO (registration number CRD42020131698). Electronic databases were searched for studies published between January 2000 and August 2020. Prospective and retrospective cohort studies were considered and risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool. RESULTS The search yielded 5771 articles of which 30 studies met the inclusion criteria. Nineteen studies included patients with TBI and 11 with SCI. No studies of patients with multi-trauma met criteria. Evidence was found for associations with various factors (e.g., injury severity, level of education, mental health problems), although these findings are limited due to the quality of the studies (5 studies moderate and 25 high risk of bias). CONCLUSION Research on predictors of participation and quality of life following major traumatic injuries in childhood is lacking. More methodologically sound prospective, longitudinal studies are needed across different injury groups to further elucidate predictors of outcome.IMPLICATIONS FOR REHABILITATIONWhile long-term participation and quality of life is influenced by injury characteristics (i.e., injury severity), a number of potential modifiable factors can be targeted to improve outcomes following traumatic injuries in childhood.Young people should be provided with support to stay in school and pursue further education.Early intervention and prevention of mental health problems may improve long-term outcomes.Better management of ongoing medical problems and greater support for functional independence may improve participation.
Collapse
Affiliation(s)
- Mardee Greenham
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia
| | - Edith Botchway
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Sarah Knight
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Bruce Bonyhady
- Melbourne Disability Institute, Parkville, VIC, Australia
| | - Emma Tavender
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Adam Scheinberg
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,Department of Paediatrics, Monash University, Clayton, VIC, Australia
| | - Vicki Anderson
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Frank Muscara
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|
7
|
|
8
|
Carney J, Fisher R, Augutis M, Charlifue S, Biering-Sørensen F, Höfers W, Hwang M, Wayne New P, Post M, Sadowsky C, Vogel L, Augustine L, Dent K, Mulcahey MJ. Development of the International Spinal Cord Injury/Dysfunction Education Basic Data Set. Spinal Cord Ser Cases 2019; 5:87. [PMID: 31700685 PMCID: PMC6821817 DOI: 10.1038/s41394-019-0229-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 08/02/2019] [Accepted: 08/11/2019] [Indexed: 11/08/2022] Open
Abstract
Study design Consensus among international experts. Objectives The objective of this project was to develop the International Spinal Cord Injury/Dysfunction (SCI/D) Education Basic Data Set. Setting International expert working group. Methods The published guidelines for developing the International SCI Basic Data Sets were used to develop the International SCI/D Education Basic Data Set. Existing measures and literature on education and disability were reviewed to develop a preliminary draft of the basic education data set through iterative modifications via biweekly conference calls and email communication. The draft was disseminated to the larger International Workgroup for Development of Pediatric SCI/D Basic Data Sets and then to the members of the International Spinal Cord Society (ISCoS), American Spinal Injury Association (ASIA), and relevant expert groups and interested individuals for comments. All feedback received was taken into consideration before the final data set was approved by ISCoS and ASIA. Results The finalized version of the International SCI/D Education Basic Data Set Version 1.0 contains 16 items divided into three domains: school setting/therapeutic services, school participation/academic success, and barriers/attitudes. Most of the variables have been adapted from established measures. This data set is intended for children and youth up to and including high school, but not for emerging adults in higher education or postsecondary vocational training or trade schools. Conclusion The International SCI/D Education Basic Data Set has been developed for collection of a minimal amount of highly relevant information on the education experience in children and youth with SCI/D. Further validation work is needed. Sponsorship This project was funded by the Rick Hansen Institute, Research Award #G2015-27 (Mulcahey, PI).
Collapse
Affiliation(s)
- Joan Carney
- Rehabilitation Department, Kennedy Krieger Rehabilitation Institute, Baltimore, MD USA
| | | | - Marika Augutis
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | | | - Fin Biering-Sørensen
- Department of Spinal Cord Injuries, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Wiebke Höfers
- Physiotherapy Department, Sunnaas Hospital, Bjørnemyr, Norway
| | - Miriam Hwang
- Research Department, Shriners Hospitals for Children, Chicago, IL USA
| | - Peter Wayne New
- Epworth-Monash Rehabilitation Unit, Department of Epidemilogy and Preventitive Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | - Marcel Post
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Utrecht and De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - Cristina Sadowsky
- Rehabilitation Department, Kennedy Krieger Rehabilitation Institute, Baltimore, MD USA
| | - Lawrence Vogel
- Research Department, Shriners Hospitals for Children, Chicago, IL USA
| | - Lilly Augustine
- School of Education and Psychology, Jönköping University, Jönköping, Sweden
| | - Kathryn Dent
- Department of Occupational Therapy, Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Jefferson (Philadelphia University+Thomas Jefferson University), Philadelphia, PA USA
| | - M. J. Mulcahey
- Department of Occupational Therapy, Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Jefferson (Philadelphia University+Thomas Jefferson University), Philadelphia, PA USA
| |
Collapse
|
9
|
Krause JS, Dismuke-Greer CE, Jarnecke M, Reed KS. Differential Odds of Employment and Estimation of Earnings Among Those With Spinal Cord Injury. REHABILITATION COUNSELING BULLETIN 2019. [DOI: 10.1177/0034355219848493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Our purpose was to identify demographic, educational, and injury-related characteristics associated with odds of employment and estimates of differential earnings among participants with spinal cord injury (SCI). Self-report assessments were obtained from 1,983 participants who had traumatic SCI, were 18+ years old, and less than 65 years of age. All were recruited into the current cross-sectional study from previous studies of health and aging from the Midwestern and Southeastern United States. Midwestern participants had 2.41 higher odds of employment. Older age at injury was associated with lower odds of employment. There were no sex differences in the odds of employment, but women had an estimated US$19,431 lower conditional earnings. Non-Hispanic Blacks had 69% lower odds of employment, and those working had an estimated US$12,058 lower earnings. Ambulatory participants had higher odds of employment (odds ratio [OR] = 4.66) and higher conditional earnings (US$17,277) than those with the most severe SCI. Those with 4-year or postgraduate degrees had substantially higher odds of employment (OR = 4.15, OR = 5.72, respectively) and higher conditional earnings (US$29,990, US$44,580, respectively) compared with those with a high school certificate or less. These findings underscore the importance of policies to promote the optimal quality employment outcomes for people with SCI.
Collapse
Affiliation(s)
| | | | | | - Karla S. Reed
- Medical University of South Carolina, Charleston, USA
| |
Collapse
|
10
|
Haywood C, Pyatak E, Leland N, Henwood B, Lawlor MC. A Qualitative Study of Caregiving for Adolescents and Young Adults With Spinal Cord Injuries: Lessons From Lived Experiences. Top Spinal Cord Inj Rehabil 2019; 25:281-289. [PMID: 31844380 PMCID: PMC6907026 DOI: 10.1310/sci2504-281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: To examine characteristics of caregiving from the perspectives of adolescents and young adults (AYAs) with spinal cord injuries (SCIs) and their informal caregivers to address outstanding gaps in knowledge relating to definitions of caregiving and its associated practices for this population. Methods: A multiphase qualitative design was applied, using phenomenological and narrative methods to capture data in participants' homes and communities. Participants were recruited from rehabilitation hospitals and community organizations throughout Los Angeles County, California. Inclusion criteria for AYAs included being 15-22 years old, having acquired an SCI within the previous 5 years, and using a wheelchair for mobility. The AYAs nominated persons they identified as primary caregivers to also participate. Data were collected through individual and group interviews as well as activity observations. Results: Data from the 17 participants (9 AYAs and 8 informal, primary caregivers) revealed ways in which the meaning of caregiving varied among dyads. Caregiving practices extended beyond physical assistance to include support for a range of day-to-day activities spanning from practical needs to facilitating developmental trajectories. Although AYAs expressed ideas about preferred caregiver characteristics, care partnerships appeared to be guided more by availability than preference. Conclusion: Phenomenological analysis revealed that the meaning of "caregiving" and its associated practices are highly individualized for AYAs with SCIs. Caregiving is rooted in personal needs related to effects of SCI and developmental goals. Everyday practices are shaped by individual relationships and the beliefs of AYAs and their caregivers. Addressing influences of caregiving on long-term health and function may require attention to developmental processes, caregiver "fit," and ways care is, or can be, distributed throughout broader networks according to personal needs and preferences.
Collapse
Affiliation(s)
- Carol Haywood
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Elizabeth Pyatak
- University of Southern California, Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Los Angeles, California
| | - Natalie Leland
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Benjamin Henwood
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Los Angeles, California
| | - Mary C. Lawlor
- University of Southern California, Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Los Angeles, California
| |
Collapse
|
11
|
Duzgun Celik H, Cagliyan Turk A, Sahin F, Yilmaz F, Kuran B. Comparison of disability and quality of life between patients with pediatric and adult onset paraplegia. J Spinal Cord Med 2018; 41:645-652. [PMID: 28102106 PMCID: PMC6217506 DOI: 10.1080/10790268.2016.1275447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To investigate the factors that affect disability and quality of life in patients with spinal cord injuries (SCIs) and to compare the degree of disability and quality of life in patients with SCI according to over and under 18 years of age when their injury occurred. DESIGN Cohort study. SETTING Two academic hospitals in Istanbul, Turkey. PARTICIPANTS Forty patients with SCI were included in this study. Group 1 included 20 patients with SCI who were younger than 18 years of age when their injury occurred, Group 2 included 20 patients who were older than 18 years of age when their injury occurred. OUTCOME MEASURES Patients' demographics, duration of SCI and degree of disability were assessed using the Craig Handicap Assessment and Reporting Technique (CHART). Quality of life was assessed using the World Health Organization Quality of Life Scale Short Form (WHOQOL-Bref). Depression was assessed using the Beck Depression Inventory (BDI). RESULTS Although there was no significant difference between the BDI scores and CHART scores of the two groups, environment domain scores in the WHOQOL-Bref were significantly higher in Group 2 than in Group 1 (P<0.05). No significant correlation was found between age of SCI onset, disease duration, ASIA scores, depression scores, total CHART scores for all patients. CONCLUSION Adaptation to environment was significantly better in those who suffered SCI during adulthood than in pediatric patients with SCI. Disability level was not associated with age of disease onset, disease duration, neurological status, depression level.
Collapse
Affiliation(s)
- Hanife Duzgun Celik
- Private Konak Medical Center, Department of Physical Medicine and Rehabilitation, Sakarya, Turkey
| | - Ayla Cagliyan Turk
- Hitit University Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Corum, Turkey,Correspondence to: Ayla Cagliyan Turk, MD, Department of Physical Medicine and Rehabilitation, Hitit University, Training and Research Hospital, 19200, Corum, Turkey.
| | - Fusun Sahin
- Pamukkale University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Denizli, Turkey
| | - Figen Yilmaz
- Hamidiye Sisli Etfal Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
| | - Banu Kuran
- Hamidiye Sisli Etfal Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
| |
Collapse
|
12
|
Relationships between type of pain and work participation in people with long-standing spinal cord injury: results from a cross-sectional study. Spinal Cord 2018; 56:453-460. [DOI: 10.1038/s41393-017-0048-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 11/29/2017] [Accepted: 12/01/2017] [Indexed: 11/08/2022]
|
13
|
Pandya SP. Spirituality in Rehabilitation Counseling of Adults With Physical Disabilities: Views of Practitioners Across Countries. REHABILITATION COUNSELING BULLETIN 2017. [DOI: 10.1177/0034355217723553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of the study is to understand the views of practitioners across countries, on spirituality for rehabilitation counseling of adults with congenital and acquired disabilities. A survey of 1,269 practitioners in the field of disability across 15 countries was conducted. Results showed that practitioners had a favorable view of spirituality. Logistic regression results highlight several cross-country nuances in practitioners’ views toward spirituality for rehabilitation counseling, and more so, differentials in terms of adults with congenital and acquired physical disabilities. Practitioners who focused on a client-centered approach vis-à-vis those who diversified also into macro-level work of networking and advocacy, and specifically those who had high self-reported spirituality, proposed that for adults with congenital physical disabilities, spirituality enabled living with disabilities, as against a rationalization and justification of the disability. They favored mindfulness techniques as the modes of working with the clients and reported that by cultivating relational consciousness, spirituality enabled meeting the social goal of rehabilitation counseling. Furthermore, practitioners from affluent nations placed a premium on the deconstructing potential of spirituality and its facilitative role in enabling the clients themselves, and significant others, to transcend the ability/disability binary. The study foregrounds the importance of spiritually sensitive approaches in rehabilitation counseling.
Collapse
|
14
|
Abstract
It is important to maximize vocational achievement following spinal cord injury. Despite this recognition, unemployment remains a prevalent problem and continues to challenge rehabilitation professionals. This study aimed to examine the employment status and determinants of employability for individuals with spinal cord injury in Taiwan. A cross-sectional survey was conducted. A total of 353 participants aged 18-65 years were recruited from four branches of the Association of People with Spinal Cord Injury. The results showed that, of the participants, 107 were employed at the time of the survey, with an employment rate of 30.3%. Logistic regression analyses indicated that individuals with a college degree or higher [odds ratio (OR)=3.03; 95% confidence intervals (CI): 1.30-7.07], aged 26-40 years (OR=8.51; 95% CI: 3.14-23.02) and 41-55 years (OR=3.06; 95% CI: 1.31-7.18), sustaining injury longer than 10 years (OR=9.89; 95% CI: 2.61-37.46), experiencing less functional limitations (OR=0.90; 95% CI: 0.86-0.95), and perceiving greater social support (OR=1.04; 95% CI: 1.01-10.7) were associated with higher likelihood of employment. Vocational rehabilitation services can use the results to target efforts toward those at risk of unemployment.
Collapse
Affiliation(s)
- I-C Huang
- Graduate Institute of Rehabilitation Counseling, National Changhua University of Education, Changhua City, Taiwan
| |
Collapse
|
15
|
Kulshrestha R, Kumar N, Chowdhury JR, Osman A, El Masri W. Long-term outcome of paediatric spinal cord injury. TRAUMA-ENGLAND 2017. [DOI: 10.1177/1460408617706387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Spinal cord injuries are relatively uncommon in children and evidence about long-term outcomes is limited. This study was performed to determine the frequency of common long-term complications in patients sustaining spinal injury in childhood (0–18 years) and who were followed up at a single dedicated spinal injuries centre in the UK. Method A retrospective review of clinical records of all patients injured at or less than 18 years of age between 1971 and 1999. Complications studied were renal, bowel, musculoskeletal, pressure ulcers and post-traumatic syringomyelia. Long-term social outcomes of independence, employment and driving were also assessed. Results Of 69 individuals (47 males, 22 females) the median age at injury was 17 years (range 0–18 y); 68% were older than 13 years at injury and 74% had traumatic injuries. Patients had an average duration of 27 years (12–43 years) of spinal injury – half had a neurological level of T6 and above, 80% had paraplegia and 20% had quadriplegia. Discussion Patients with both complete and incomplete spinal cord injury have minimal neurological recovery. Managing medical complications is vital as only 11.5% had normal voiding and 10.6% had normal bowel function. The incidence of skin ulcers increases with duration of spinal cord injury and scoliosis is higher in the non-traumatic injury group. Spasticity is observed in 66.6% and post-traumatic syringomyelia in 11.7%. Long-term social outcomes are good with 75% patients able to do independent care, 46% could drive and 39% managed employment or higher education. Conclusions This study documents the long-term outcomes and complications of spinal cord injuries sustained in childhood. With initial active physiological conservative management of the majority of patients, patient education and ongoing support the majority of patients achieved long-term survival and led independent and productive lives.
Collapse
Affiliation(s)
- Richa Kulshrestha
- Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, UK
| | - Naveen Kumar
- Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, UK
| | - J Roy Chowdhury
- Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, UK
| | - Aheed Osman
- Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, UK
| | | |
Collapse
|
16
|
Transcutaneous Electrical Nerve Stimulation for Management of Limb Spasticity. Am J Phys Med Rehabil 2016; 95:309-18. [DOI: 10.1097/phm.0000000000000437] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
17
|
Reed KS, Meade MA, Krause JS. Impact of Health Behaviors and Health Management on Employment After SCI: Psychological Health and Health Management. Top Spinal Cord Inj Rehabil 2016; 22:111-120. [PMID: 29339853 DOI: 10.1310/sci2202-111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: The purpose of this study was to examine the relationship between employment and psychological health and health management as described by individuals with spinal cord injury (SCI) who were employed at least once following injury. Methods: A qualitative approach used 6 focus groups at 2 sites with 44 participants who were at least 10 years post SCI. All had been employed at some point since injury. Heterogeneous and homogeneous groups were delineated based on specific characteristics, such as education, gender, or race. Group sessions followed a semi-structured interview format with questions about personal, environmental, and policy related factors influencing employment following SCI. All group sessions were recorded, transcribed, and coded into conceptual categories to identify topics, themes, and patterns. Inferences were drawn about their meaning. NVivo 10 software using the constant comparative method was used for data analysis. Results: Narratives discussed the relationship between employment and psychological and emotional health and health management. Four themes were identified: (1) adjustment and dealing with emotional reactions, (2) gaining self-confidence, (3) preventing burnout, and (4) attitudes and perspectives. Most themes reflected issues that varied based on severity of injury as well as stage of employment. Conclusions: Individuals with SCI who are successful in working following injury must determine how to perform the behaviors necessary to manage their health and prevent emotional or physical complications. The emotional consequences of SCI must be recognized and addressed and specific behaviors enacted in order to optimize employment outcomes.
Collapse
Affiliation(s)
- Karla S Reed
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston
| | - Michelle A Meade
- Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor
| | - James S Krause
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston
| |
Collapse
|
18
|
Meade MA, Reed KS, Krause JS. The Impact of Health Behaviors and Health Management on Employment After SCI: Physical Health and Functioning. Top Spinal Cord Inj Rehabil 2016; 22:39-48. [PMID: 29398892 DOI: 10.1310/sci2201-39] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: Research has shown that employment following spinal cord injury (SCI) is related to health and functioning, with physical health and functioning after SCI frequently identified as a primary barrier to employment. Objective: To examine the relationship between employment and behaviors associated with the management of physical health and functioning as described by individuals with SCI who have been employed post injury. Methods: A qualitative approach using 6 focus groups at 2 sites included 44 participants with SCI who had worked at some time post injury. Heterogeneous and homogeneous groups were created based on specific characteristics, such as education, gender, or race. A semi-structured interview format asked questions about personal, environmental, and policy-related factors influencing employment after SCI. Groups were recorded, transcribed, and entered into NVivo before coding by 2 reviewers. Results: Within the area of behaviors and management of physical health and functioning, 4 overlapping themes were identified: (1) relearning your own body and what it can do; (2) general health and wellness behaviors; (3) communication, education, and advocacy; and (4) secondary conditions and aging. Specific themes articulate the many types of behaviors individuals must master and their impact on return to work as well as on finding, maintaining, and deciding to leave employment. Conclusions: Individuals with SCI who are successfully employed after injury must learn how to perform necessary behaviors to manage health and function in a work environment. The decision to leave employment often appears to be associated with secondary complications and other conditions that occur as persons with SCI age.
Collapse
Affiliation(s)
- Michelle A Meade
- Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor
| | - Karla S Reed
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston
| | - James S Krause
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston
| |
Collapse
|
19
|
Hwang M, Zebracki K, Vogel LC. Occupational characteristics of adults with pediatric-onset spinal cord injury. Top Spinal Cord Inj Rehabil 2016; 21:10-9. [PMID: 25762856 DOI: 10.1310/sci2101-10] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Employment rates among individuals with spinal cord injury (SCI) are lower than in the general population and little is known about the specific occupations in which they are employed. OBJECTIVES To describe specific occupations of adults with pediatric-onset SCI using the 2010 Standard Occupational Classification (SOC) system and to determine associations between SOC occupations and demographic factors. METHODS Cross-sectional data specific to education and employment were collected from the last interviews of a larger longitudinal study. Occupations were categorized according to the 2010 SOC system. SOC groups were compared within gender level of injury and final education. RESULTS Of the 461 total participants 219 (47.5%) were employed and specific occupations were available for 179. Among the SOC groups Education Law Community Service Arts and Media Occupations were most prevalent (30.2%) followed by Management Business and Finance Occupations (21.1%) Computer Engineering and Science Occupations (10.6%) Administrative and Office Support Occupations (10.0%) Service Occupations (7.3%) Healthcare Practitioners and Technical Occupations (3.9%) and Production Occupations (3.4%). Differences were found in the distribution of SOC groups between gender levels of injury and final education groups. CONCLUSION A wide variety of occupations were reported in adults with pediatric-onset SCI generally in concordance with final education and functional ability levels.
Collapse
Affiliation(s)
- Miriam Hwang
- Shriners Hospitals for Children , Chicago, Illinois
| | - Kathy Zebracki
- Shriners Hospitals for Children , Chicago, Illinois ; Department of Psychology, Loyola University , Chicago, Illinois
| | - Lawrence C Vogel
- Shriners Hospitals for Children , Chicago, Illinois ; Department of Pediatrics, Rush Medical College , Chicago, Illinois
| |
Collapse
|
20
|
Marti A, Boes S, Lay V, Reuben Escorpizo PT, Trezzini B. The association between chronological age, age at injury and employment: Is there a mediating effect of secondary health conditions? Spinal Cord 2015; 54:239-44. [DOI: 10.1038/sc.2015.159] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 08/06/2015] [Accepted: 08/10/2015] [Indexed: 11/09/2022]
|
21
|
Spencer NJ, Blackburn CM, Read JM. Disabling chronic conditions in childhood and socioeconomic disadvantage: a systematic review and meta-analyses of observational studies. BMJ Open 2015; 5:e007062. [PMID: 26338834 PMCID: PMC4563224 DOI: 10.1136/bmjopen-2014-007062] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 07/23/2015] [Accepted: 07/30/2015] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To determine the association of socioeconomic disadvantage with the prevalence of childhood disabling chronic conditions in high-income countries. STUDY DESIGN Systematic review and meta-analyses. DATA SOURCES 6 electronic databases, relevant websites, reference lists and experts in the field. STUDY SELECTION 160 observational studies conducted in high-income countries with data on socioeconomic status and disabling chronic conditions in childhood, published between 1 January 1991 and 31 December 2013. DATA EXTRACTION AND SYNTHESIS Abstracts were reviewed, full papers obtained, and papers identified for inclusion by 2 independent reviewers. Inclusion decisions were checked by a third reviewer. Where reported, ORs were extracted for low versus high socioeconomic status. For studies reporting raw data but not ORs, ORs were calculated. Narrative analysis was undertaken for studies without data suitable for meta-analysis. RESULTS 126 studies had data suitable for meta-analysis. ORs for risk estimates were: all-cause disabling chronic conditions 1.72 (95% CI 1.48 to 2.01); psychological disorders 1.88 (95% CI 1.68 to 2.10); intellectual disability 2.41 (95% CI 2.03 to 2.86); activity-limiting asthma 2.20 (95% CI 1.87 to 2.85); cerebral palsy 1.42 (95% CI 1.26 to 1.61); congenital abnormalities 1.41 (95% CI 1.24 to 1.61); epilepsy 1.38 (95% CI 1.20 to 1.59); sensory impairment 1.70 (95% CI 1.39 to 2.07). Heterogeneity was high across most estimates (I(2)>75%). Of the 34 studies without data suitable for meta-analysis, 26 reported results consistent with increased risk associated with low socioeconomic status. CONCLUSIONS The findings indicate that, in high-income countries, childhood disabling chronic conditions are associated with social disadvantage. Although evidence of an association is consistent across different countries, the review provides limited evidence to explain the association; future research, using longitudinal data, will be required to distinguish low socioeconomic status as the cause or consequence of childhood disabling chronic conditions and the aetiological pathways and mechanisms.
Collapse
Affiliation(s)
| | | | - Janet M Read
- Warwick Medical School, University of Warwick, Coventry, UK
| |
Collapse
|
22
|
Trenaman L, Miller WC, Querée M, Escorpizo R. Modifiable and non-modifiable factors associated with employment outcomes following spinal cord injury: A systematic review. J Spinal Cord Med 2015; 38:422-31. [PMID: 25989899 PMCID: PMC4612197 DOI: 10.1179/2045772315y.0000000031] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [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 Employment rates in individuals with spinal cord injury (SCI) are approximately 35%, which is considerably lower than that of the general population. In order to improve employment outcomes a clear understanding of what factors influence employment outcomes is needed. OBJECTIVE To systematically review factors that are consistently and independently associated with employment outcomes in individuals with SCI, and to understand the magnitude of their influence. METHODS Through an electronic search of MEDLINE/PubMed, EMBASE, CINAHL, PsycINFO, Social Science Abstracts and Social Work databases, we identified studies published between 1952-2014 that investigated factors associated with employment outcomes following SCI. Exclusion criteria included: (1) reviews (2) studies not published in English (3) studies not controlling for potential confounders through a regression analysis, or (4) studies not providing an effect measure in the form of OR, RR, or HR. Data were categorized based on the International Classification of Functioning, Disability and Health framework, with each domain sub-categorized by modifiability. First author, year of publication, sample size, explanatory and outcome variables, and effect measures were extracted. RESULTS Thirty-nine studies met the inclusion criteria. Twenty modifiable and twelve non-modifiable factors have been investigated in the context of employment following SCI. Education, vocational rehabilitation, functional independence, social support, and financial disincentives were modifiable factors that have been consistently and independently associated with employment outcomes. CONCLUSION A number of key modifiable factors have been identified and can inform interventions aimed at improving employment outcomes for individuals with SCI. Future research should focus on determining which factors have the greatest effect on employment outcomes, in addition to developing and evaluating interventions targeted at these factors.
Collapse
Affiliation(s)
| | - William C Miller
- Correspondence to: William C Miller, FCAOT, Department of Occupational Science and Occupational Therapy, University of British Columbia, T325–2211 Wesbrook Mall, Vancouver, BC, Canada V6 T 2B5. E-mail:
| | | | | |
Collapse
|
23
|
|
24
|
Chemodenervation for treatment of limb spasticity following spinal cord injury: a systematic review. Spinal Cord 2015; 53:252-64. [PMID: 25582713 DOI: 10.1038/sc.2014.241] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 11/28/2014] [Accepted: 12/03/2014] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Systematic review. OBJECTIVES To systematically review the literature on chemodenervation with botulinum toxin (BoNT) or phenol/alcohol for treatment of limb spasticity following spinal cord injury (SCI). SETTING British Columbia, Canada. METHODS EMBASE, MEDLINE, CINAHL, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials were searched for English language studies published up until March 2014. Studies were assessed for eligibility and quality by two independent reviewers. RESULTS No controlled trials were identified. A total of 19 studies were included: 9 involving BoNT and 10 involving phenol/alcohol. Owing to the clinically diverse nature of the studies, meta-analysis was deemed inappropriate. The studies produced level 4 and level 5 evidence that chemodenervation with BoNT or alcohol/phenol can lead to improvement in outcome measurements classified in the body structure and function, as well as activity domains of the International Classification of Functioning, Disability and Health framework. The Modified Ashworth Scale (MAS) was the most commonly used outcome measure. All six studies on BoNT and three of the four studies on phenol/alcohol measuring MAS reported a decrease in at least one point. An improvement in MAS was not always associated with improvement in function. The effect of phenol/alcohol has the potential to last beyond 6 months; study follow-up did not occur beyond this time point. CONCLUSION Chemodenervation with BoNT or phenol/alcohol may improve spasticity and function in individuals with SCI. However, there is a lack of high-quality evidence and further research is needed to confirm the efficacy of these interventions.
Collapse
|
25
|
Griffen JA, Rapport LJ, Coleman Bryer R, Scott CA. Driving Status and Community Integration After Stroke. Top Stroke Rehabil 2015; 16:212-21. [DOI: 10.1310/tsr1603-212] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
26
|
Jetha A, Dumont FS, Noreau L, Leblond J. A life course perspective to spinal cord injury and employment participation in Canada. Top Spinal Cord Inj Rehabil 2014; 20:310-20. [PMID: 25477744 DOI: 10.1310/sci2004-310] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Few studies have examined life course differences in the employment of Canadians with spinal cord injury (SCI). OBJECTIVE To compare employment participation of young/middle-aged and older adults with SCI and to examine the association between employment and demographic and health factors, SCI-related needs, and social role participation at the 2 life phases. METHODS A sample of young/middle-aged (18-54 years; n = 959) and older adults (55-64 years; n = 364) with SCI was recruited as part of a larger Canadian community survey. Pre- and postinjury employment were compared. Demographic and health factors, number of unmet SCI needs, and social role participation were collected and compared by life phase and employment status. Two multivariable logistic regression models were conducted and compared for young/middle-aged and older adults. RESULTS Close to one-third of participants with SCI were working post injury (32%), a decline from the 62% of respondents working prior to their injury. Participants were more likely to work in less physically demanding job sectors including business/administration or health/science/teaching. An examination of life phase differences showed that young/middle-aged adults were more likely to be employed post injury (36%) when compared to older respondents (12% employed) who were more likely to report being retired (43%). Multivariable analyses revealed that for young/middle-aged adults, being married, attaining a postsecondary education, and having fewer unmet SCI needs were related to employment. Among older adults, having a traumatic injury was related to involvement in paid work. For both young/middle-aged and older adults, participating in more social roles was related to working. CONCLUSION A life course perspective is important to understanding similarities and differences between young/middle-aged and older adults with SCI in their employment participation. Tailored programs and policies should be designed to promote labor force involvement at different phases of the working life course.
Collapse
Affiliation(s)
- Arif Jetha
- Liberty Mutual Research Institute for Safety , Hopkinton, Massachusetts ; Department of Work Environment, University of Massachusetts-Lowell
| | - Frédéric S Dumont
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and Université Laval , Quebec City , Canada
| | - Luc Noreau
- 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
| |
Collapse
|
27
|
|
28
|
Hwang M, Zebracki K, Chlan KM, Vogel LC. Longitudinal employment outcomes in adults with pediatric-onset spinal cord injury. Spinal Cord 2014; 52:477-82. [PMID: 24663002 DOI: 10.1038/sc.2014.32] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 02/10/2014] [Accepted: 02/21/2014] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Longitudinal survey. OBJECTIVES To determine in adults with pediatric-onset spinal cord injury (SCI) employment outcomes, longitudinal changes in employment over time and changes in psychosocial outcomes associated with employment status. SETTING Community setting. METHODS Adults who had sustained a SCI before 19 years of age and had completed at least three consecutive annual interviews were included in the study. Generalized estimating equation models were formulated to obtain odds ratio (OR) of change in employment status and outcomes over time. RESULTS Total 1691 interviews were conducted in 283 participants, 182 men and 101 women (88% Caucasian; age at baseline, 27.3±3.7 years; duration at baseline, 12.7±5.0 years). At the last interview (age, 34.4±5.2 years; duration, 19.9±6.1 years), 49.5% were employed and 47.0% had a baccalaureate or post-baccalaureate degree. There was no significant change in employment status over time (OR 1.01, confidence interval (CI) 0.98-1.04). Odds of employment increased over time in participants who were women (1.04, CI 1.00-1.08), married (1.05, CI 1.02-1.08) and attained baccalaureate (1.03, CI 1.00-1.07) or post-baccalaureate (1.05, CI 1.02-1.08) degree. Employment odds decreased with occurrence of autonomic dysreflexia (0.80, CI 0.65-0.99), spasticity (0.80, CI 0.59-0.99) or chronic medical condition (0.83, CI 0.71-0.98). Life satisfaction scores increased over time in those who remained employed (1.11, CI 1.01-1.22); odds of depression increased over time in those who remained unemployed (1.13, CI 1.04-1.23). CONCLUSION Employment status remained relatively stable in adults with pediatric-onset SCI; however, changes in employment were associated with education, secondary health conditions and psychosocial well-being.
Collapse
Affiliation(s)
- M Hwang
- 1] Orthopaedic Rehabilitation and Engineering Center, Marquette University, Milwaukee, WI, USA [2] Department of Clinical Research, Shriners Hospitals for Children, Chicago, IL, USA
| | - K Zebracki
- 1] Department of Psychology, Shriners Hospitals for Children, Chicago, IL, USA [2] Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - K M Chlan
- Department of Clinical Research, Shriners Hospitals for Children, Chicago, IL, USA
| | - L C Vogel
- 1] Department of Pediatrics, Shriners Hospitals for Children, Chicago, IL, USA [2] Department of Pediatrics, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
29
|
Kang EN, Shin HI, Kim HR. Factors that influence employment after spinal cord injury in South Korea. Ann Rehabil Med 2014; 38:38-45. [PMID: 24639924 PMCID: PMC3953361 DOI: 10.5535/arm.2014.38.1.38] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 09/05/2013] [Indexed: 11/29/2022] Open
Abstract
Objective To investigate employment status after spinal cord injury (SCI) and identify personal, family, and injury characteristics those affect their employment in South Korea. Methods Participants were 334 community-dwelling persons 20-64 years of age who had sustained SCI for more than one year. Investigators visited each participant's home to carry out the survey. Bivariate and binary logistic regression analyses were performed to identify personal, family, and injury characteristics that influenced employment after SCI. Results Employment rate decreased significantly from 82.5% to 27.5% after SCI. Logistic regression showed that the probability of employment was higher in men than women, and in individuals older than 45 years at the time of injury than those aged 31-45 years of age. Moreover, employment was higher in individuals injured for longer than 20 years than those injured for 1-5 years and in individuals with incomplete tetraplegia than those with complete paraplegia. Employment was lower in individuals with SCI caused by industrial accidents than those injured in non-industrial accidents. Conclusion Injury characteristics are the most important predictors of employment in persons with SCI. For persons with lower employment rate, individualized vocational rehabilitation and employment-support systems are required.
Collapse
Affiliation(s)
- Eun-Na Kang
- Korea Institute for Health and Social Affairs, Seoul, Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hye-Ri Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| |
Collapse
|
30
|
Participation in organized sports is positively associated with employment in adults with spinal cord injury. Am J Phys Med Rehabil 2013; 92:393-401. [PMID: 23478458 DOI: 10.1097/phm.0b013e3182876a5f] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to determine the association between participation in organized sports programs and employment in adults with chronic spinal cord injury. DESIGN This is a cross-sectional study of 149 adults with chronic spinal cord injury. Motor level and completeness of injury were confirmed by physical examination. Information related to demographics, employment, level of education, body mass index, duration of injury, participation in individually planned exercise, and participation in organized sports was obtained using a standardized questionnaire. Multivariable logistic regression analyses were used to assess factors associated with employment. RESULTS In univariate analyses, employment was associated with younger age (P = 0.001) and a higher level of education (P = 0.01), whereas obesity decreased the likelihood of employment (P = 0.04). Participation in organized sports approached significance (P = 0.06). In the multivariable analysis and after adjusting for age, education, and body mass index, participation in organized sports was significantly associated with employment (odds ratio, 2.4; P = 0.04). Sex, duration of injury, wheelchair use, and participation in individually planned exercise were not significantly associated with employment (P = 0.16-0.94). CONCLUSIONS In the adults with chronic spinal cord injury, participation in organized sports was positively associated with employment. Further studies are necessary to determine the causative nature of this association and how various factors related to sports participation may contribute.
Collapse
|
31
|
Anderson CJ, Vogel LC. Domain-specific satisfaction in adults with pediatric-onset spinal cord injuries. Spinal Cord 2012; 41:684-91. [PMID: 14639448 DOI: 10.1038/sj.sc.3101533] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Interview using a structured questionnaire and standardized measures. OBJECTIVES To determine domain-specific satisfaction levels in adults with pediatric-onset spinal cord injuries (SCI), to determine factors associated with these levels of satisfaction, and to determine the relationship of domain-specific satisfaction to overall life satisfaction in this population. SETTING US and Canada. METHODS The participants were adults who sustained SCI at age 18 years or younger and were 24 years of age or older at the time of interview and did not have significant head injury. In addition to providing information about themselves, including education level, employment, marital status, and community participation, they were asked to rate their level of satisfaction in seven domains: transportation in the community, educational achievement, employment opportunities, income, social/recreational opportunities, dating opportunities, and sexual experience. They also completed the satisfaction with life scale (SWLS), the Craig handicap assessment and reporting technique, the functional independence measure, and the short-form-12 perceived health scale. RESULTS A total of 216 individuals were interviewed. The mean age at injury was 14 years and the mean age at interview was 29 years. From most satisfied to least satisfied, the domains were ranked in the following order: satisfaction with transportation in the community, educational achievement, social and recreational opportunities, sexual experiences, dating opportunities, job opportunities, and income. Age at interview, gender, and perceived health were identified in regression analyses as predictors of some of the domain-specific satisfactions, but the primary predictive factors were in the area of participation. Neither severity of neurologic impairment nor level of functional independence were predictors for any of the domains. Satisfaction in each of the domains was significantly associated with SWLS and satisfaction with dating, job opportunities, education, and income were identified as predictive factors in a regression analysis. CONCLUSIONS Dating opportunities, job opportunities, and income are the three domains in which adults with pediatric-onset SCI are least satisfied and those domains have a significant impact on overall satisfaction.
Collapse
Affiliation(s)
- C J Anderson
- Shriners Hospitals for Children, Chicago, IL 60707, USA
| | | |
Collapse
|
32
|
Carlozzi NE, Gade V, Rizzo AS, Tulsky DS. Using virtual reality driving simulators in persons with spinal cord injury: three screen display versus head mounted display. Disabil Rehabil Assist Technol 2012; 8:176-80. [PMID: 22775982 DOI: 10.3109/17483107.2012.699990] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Virtual reality (VR) is a relatively new technology that is currently utilized in a wide variety of settings to test and train individuals in specialized skills. This study examines methods for improving driver retraining protocols for persons with spinal cord injury (SCI). METHOD We compared a VR driving simulator, under two different display conditions, a head mounted display (HMD) and a three screen display (TSD) to identify the best method for retraining driving skills following SCI. RESULTS Although there was minimal evidence for driving performance difficulties in the HMD condition relative to the TSD condition (e.g. greater number of times for being off course and longer stopping latencies for the HMD condition), rates of simulator sickness did not differ between display conditions. CONCLUSIONS Taken together, findings suggest that both the HMD and the TSD are reasonable simulator options for driver retraining in SCI.
Collapse
Affiliation(s)
- Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
| | | | | | | |
Collapse
|
33
|
Abstract
STUDY DESIGN Cross-sectional survey. OBJECTIVES To assess the prevalence of substance use in young adults with pediatric-onset spinal cord injury (SCI) and its relationship with demographic factors, and medical and psychosocial outcomes. SETTING Young adults living in the United States who received pediatric SCI care at one of three SCI programs at the Shriners Hospitals for Children. METHODS Individuals aged 21-25 years who had sustained SCI before the age of 19 were interviewed with a structured questionnaire including standardized outcome measures: FIM, satisfaction with life scale (SWLS), short-form 12 health survey (SF-12), patient health questionnaire-9 (PHQ-9) depression scale, and Craig handicap assessment and recording technique (CHART). RESULTS Sample included 215 individuals with a mean age at interview of 23.3 (s.d.=0.9) years and mean age at injury of 13.2 (s.d.=4.9) years. In all, 24% had a college degree, 36% were employed and 12% were married. Regular substance use was reported by 28% for tobacco, 55% for alcohol and 11% for marijuana. Tobacco use was associated with depressive symptoms and unemployment; alcohol use was associated with having a college degree, single status and independent mobility; and marijuana use was associated with not having a college degree. There were no significant associations between substance use and injury-related factors or life satisfaction. CONCLUSION Substance use in young adults with pediatric-onset SCI was associated with factors such as education, employment, marital status and depressive symptoms. Clinicians caring for youth with SCI should counsel patients and caregivers regarding the use of substances and potential associations with outcomes in adulthood.
Collapse
|
34
|
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.
Collapse
Affiliation(s)
- Sander L Hitzig
- Lyndhurst Centre, Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
| | | | | | | |
Collapse
|
35
|
Vogel LC, Betz RR, Mulcahey MJ. Spinal cord injuries in children and adolescents. HANDBOOK OF CLINICAL NEUROLOGY 2012; 109:131-48. [PMID: 23098710 DOI: 10.1016/b978-0-444-52137-8.00008-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This chapter provides an overview of spinal cord injuries (SCI) in children and adolescents, including epidemiology, medical and musculoskeletal complications, rehabilitation and psychosocial aspects. Males are more commonly affected than females during adolescence; however, as the age at injury decreases, the preponderance of males becomes less marked, and by 3 years of age the number of females with SCIs equals that of males. The neurologic level and degree of completeness varies with age; among children injured prior to 12 years of age approximately two-thirds are paraplegic and approximately two-thirds have complete lesions. Among adolescents, approximately 50% have paraplegia and 55% have complete lesions. Management of pediatric-onset SCI should be family centered and developmentally based, responsive to the dynamic changes that occur during growth and development. Distinctive anatomical and physiological features of children and adolescents, along with growth and development, are responsible for unique manifestations and complications of pediatric SCI. SCI without radiological abnormalities (SCIWORA), birth injuries, lap-belt injuries, upper cervical injuries, and the delayed onset of neurological deficits are relatively unique to pediatric SCI. Children who sustain their SCI before puberty experience a higher incidence of musculoskeletal complications, such as scoliosis and hip dislocation.
Collapse
|
36
|
Rigles B, Ipsen C, Arnold N, Seekins T. Experiences of Rural Vocational Rehabilitation Clients Who Leave the System Prematurely: A Qualitative Exploration. REHABILITATION COUNSELING BULLETIN 2011. [DOI: 10.1177/0034355210396948] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Vocational rehabilitation (VR) clients who leave the system prematurely experience worse employment outcomes than clients who stay in services. The authors conducted this study to learn about factors leading to premature exit by rural VR clients. Results will inform survey development for a large longitudinal study on this topic. The authors content coded 27 qualitative telephone interviews with former rural VR clients who exited the system prematurely. Reported reasons for premature exit included (a) discrepancies between services provided and services desired, (b) unmet counselor expectations, (c) counselor—client relationship problems, (d) health issues, (e) limited job opportunities, (f) work disincentives, and (g) slow service speed. VR might reduce premature exits by helping clients better understand the VR process, including the types of VR services offered and associated counselor expectations.
Collapse
Affiliation(s)
| | | | | | - Tom Seekins
- The University of Montana, Missoula, MT, USA
| |
Collapse
|
37
|
Vogel LC, Chlan KM, Zebracki K, Anderson CJ. Long-term outcomes of adults with pediatric-onset spinal cord injuries as a function of neurological impairment. J Spinal Cord Med 2011; 34:60-6. [PMID: 21528628 PMCID: PMC3066497 DOI: 10.1179/107902610x12883422813787] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE To identify outcomes of participation, life satisfaction, and medical complications as a function of impairment in adults with pediatric-onset spinal cord injury (SCI). METHODS Study participants were adults who sustained SCI at age 18 years or younger and were interviewed at age 24 years or older (M = 26.9, SD = 3.5). The telephone interview included a questionnaire and several standardized measures: FIM instrument (FIM), Craig Handicap Assessment and Reporting Technique (CHART), SF-12 Health Survey, and Satisfaction with Life Scale. Using the International Standards for Neurological Classification of Spinal Cord Injury and the American Spinal Injury Association (ASIA) Impairment Scale (AIS), subjects were grouped into four impairment categories: C1-C4 ABC, C5-C8 ABC, T1-L4 ABC, and AIS D. RESULTS Of the 410 participants, 62% were male, 54% had tetraplegia, 70% had AIS A lesions, and average age at injury was 14 years (SD = 4.3). Of the 407 subjects who had complete neurological information, 59 had C1-C4 ABC, 140 had C5-C8 ABC, 168 had T1-L4 ABC, and 40 had AIS D lesions. The outcomes were delineated for education, employment, independent living and driving, marriage, participation, medical complications, health-related quality of life, and global life satisfaction, in addition to the ASIA motor score and FIM motor scores, for each of the four impairment groups. CONCLUSIONS This information should help focus interventions that facilitate positive outcomes in relationship to the severity of impairment. In addition, these data can provide a level of expectation about long-term outcomes for newly injured children and their parents.
Collapse
Affiliation(s)
- Lawrence C. Vogel
- Shriners Hospitals for Children, Chicago, IL, USA,Rush Medical College, Chicago, IL, USA,Correspondence to: Lawrence C Vogel, Shriners Hospitals for Children, Chicago, 2211 N Oak Park Ave, Chicago, IL 60707, USA.
| | | | - Kathy Zebracki
- Shriners Hospitals for Children, Chicago, IL, USA,Rush Medical College, Chicago, IL, USA
| | | |
Collapse
|
38
|
Perceived participation, experiences from persons with spinal cord injury in their transition period from hospital to home. Int J Rehabil Res 2010; 33:346-55. [DOI: 10.1097/mrr.0b013e32833cdf2a] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
39
|
Krause JS, Reed KS. Barriers and facilitators to employment after spinal cord injury: underlying dimensions and their relationship to labor force participation. Spinal Cord 2010; 49:285-91. [DOI: 10.1038/sc.2010.110] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
40
|
Ried S. Transition of Youth From Pediatric to Adult Care: Physician’s Perspective and Recommendations. Top Spinal Cord Inj Rehabil 2010. [DOI: 10.1310/sci1601-38] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
41
|
Zebracki K, Anderson C, Chlan K, Vogel L. Outcomes of Adults With Pediatric-Onset Spinal Cord Injury: Longitudinal Findings and Implications on Transition to Adulthood. Top Spinal Cord Inj Rehabil 2010. [DOI: 10.1310/sci1601-17] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
42
|
Marini I, Glover-Graf NM. Religiosity and Spirituality Among Persons With Spinal Cord Injury: Attitudes, Beliefs, and Practices. REHABILITATION COUNSELING BULLETIN 2010. [DOI: 10.1177/0034355210368868] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A total of 157 persons with spinal cord injury completed the Spirituality and Spinal Cord Injury Survey in relation to their spiritual and/or religious attitudes, beliefs, and practices in terms of adapting to their disability. Factor analysis accounting for 69% of the variance revealed four factors related to Spiritual Help and Improvement (36%), Spiritual Decline (22%), Punishment/Atonement (6%), and Body/Mind Improvements (5%). Participants were further classified by time since injury, which statistically indicated that some individuals tend to become more focused on religious or spiritual practices and beliefs regarding cure soon after injury; however, these behaviors and beliefs tend to dissipate over time. The majority of participants expressed overall satisfaction with God or a Spiritual Power (G/SP) and that G/SP helped them cope, gave them meaning, and was a source of happiness in their lives. Implications for rehabilitation counselors and educators are discussed.
Collapse
Affiliation(s)
- Irmo Marini
- University of Texas-Pan American, Edinburg, TX, USA,
| | | |
Collapse
|
43
|
|
44
|
Wang G, Grembowski D, Watts C. Risk of losing insurance during the transition into adulthood among insured youth with disabilities. Matern Child Health J 2010; 14:67-74. [PMID: 19517074 DOI: 10.1007/s10995-009-0470-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To compare insured youth (age 15-25 years) with and without disabilities on risk of insurance loss. We conducted a cross-sectional study using data from the Survey of Income and Program Participation 2001. Descriptive statistics characterized insured youth who maintained and lost insurance for at least 3 months over a 3-year time frame. We conducted logistic regression to calculate the association between disability and insurance loss. Adjustment variables were gender, race, ethnicity, age, work or school status, poverty status, type of insurance at study onset, state generosity, and an interaction between disability and insurance type. This study includes 2,123 insured youth without disabilities, 320 insured youth with non-severe disabilities, and 295 insured youth with severe disabilities. Thirty-six percent of insured youth without disabilities lost insurance compared to 43% of insured youth with non-severe disabilities and 41% of insured youth with severe disabilities (P = .07). Youth with non-severe disabilities on public insurance have an estimated 61% lower odds of losing insurance (OR: 0.39; 95% CI: 0.16, 0.93; P = .03) compared to youth without disabilities on public insurance. Further, youth with severe disabilities on public insurance have an estimated 81% lower odds of losing insurance (OR: 0.19; 95% CI: 0.09, 0.40; P < .001) compared to youth without disabilities. When examining youth with private insurance, we find that youth with severe disabilities have 1.63 times higher odds (OR: 1.63; 95% CI: 1.03, 2.57; P = .04) of losing health insurance compared to youth without disabilities. Insurance type interacts with disability severity to affect odds of insurance loss among insured youth.
Collapse
Affiliation(s)
- Grace Wang
- Institute for Public Health Genetics, University of Washington, Box 357236, Seattle, WA 98195-7236, USA.
| | | | | |
Collapse
|
45
|
Lidal IB, Hjeltnes N, Røislien J, Stanghelle JK, Biering-Sørensen F. Employment of persons with spinal cord lesions injured more than 20 years ago. Disabil Rehabil 2010; 31:2174-84. [PMID: 19903127 DOI: 10.3109/09638280902946952] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The primary objective was to study factors influencing post-injury employment and withdrawal from work in persons who sustained traumatic spinal cord injury (SCI) more than 20 years ago. A secondary objective was to study life satisfaction in the same patients. METHOD A cross-sectional study with retrospective data of 165 SCI-patients admitted to Sunnaas Rehabilitation Hospital 1961-1982. Multiple logistic regression was used to identify predictors for obtaining work post-injury. A Cox proportional hazards regression model was used to study factors influencing early withdrawal from work, i.e. time from injury until discontinuing employment. RESULTS Sixty-five percent of the participants were employed at some point after the injury. Thirty-five percent still had work at the time of the survey. The odds of obtaining work after injury were higher in persons of younger age at injury, higher in males versus females, higher for persons with paraplegia versus tetraplegia, and for persons classified as Frankel D-E compared to a more severe SCI. Factors associated with shorter time from injury until discontinuing employment were higher age at injury, incidence of injury after 1975 versus before, and a history of pre-injury medical condition(s). Life satisfaction was better for currently employed participants. CONCLUSION The study indicates a low employment-rate in persons with SCI, even several years after injury. From the results, we suggest more support, especially to persons of older age at injury and/or with a history of pre-injury medical condition(s), to help them to obtain work and sustain employed for more years after injury.
Collapse
Affiliation(s)
- Ingeborg Beate Lidal
- Sunnaas Rehabilitation Hospital and Faculty of Medicine, University of Oslo, 1450 Nesoddtangen, Norway.
| | | | | | | | | |
Collapse
|
46
|
Krause JS, Saunders L, Staten D. Race-Ethnicity, Education, and Employment After Spinal Cord Injury. REHABILITATION COUNSELING BULLETIN 2009. [DOI: 10.1177/0034355209345161] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this article was to identify the relationship between race-ethnicity and employment after spinal cord injury (SCI), while evaluating interrelationships with gender, injury severity, and education. The authors used a cohort design using the most current status from a post-injury interview from the National SCI Statistical Center. Participants included 14,454 adults ages 18 to 64, at least 1 year post-injury, not currently students or homemakers, and with residual impairment. Primary outcome was self-reported gainful employment. A total of 26.8% were working, and Caucasians were most likely to work followed by Hispanics and African Americans. Education and injury severity were strong predictors of working but did not attenuate the relationship between race and working. African American women were more likely to work than African American men, but this relationship was not significant for other race groups. Further research is needed to identify modifiable risk factors that can decrease the gap in post-injury employment between African Americans and other races.
Collapse
Affiliation(s)
| | - Lee Saunders
- Medical University of South Carolina, Charleston, SC,
USA
| | - David Staten
- South Carolina State University, Orangeburg, SC, USA
| |
Collapse
|
47
|
|
48
|
Krause JS, Reed KS. Obtaining Employment After Spinal Cord Injury: Relationship With Pre- and Postinjury Education. REHABILITATION COUNSELING BULLETIN 2008. [DOI: 10.1177/0034355208329443] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The authors identify the association of educational milestones obtained before and after spinal cord injury (SCI) with postinjury employment (PIE). Survey data were collected from 1,362 adults younger than 65, with traumatic SCI of at least 1 year duration who were not currently attending school. The sole outcome was obtaining PIE—whether the individual had worked at any time since SCI onset. Approximately 54% of eligible participants worked post-SCI. Logistic regression was used to identify the odds of employment as a function of the educational milestones while controlling for other characteristics.With the exception of a high school certificate, completing educational milestones after injury was associated with substantially higher odds of employment than when they were completed prior to injury. The results underscore the need for postinjury education, even among individuals who have extensive training and education at the time of injury.
Collapse
|
49
|
Wang G, Grembowski D, Watts C. Risk of Losing Insurance During the Transition into Adulthood Among Insured Youth with Disabilities. Matern Child Health J 2008. [DOI: 10.1007/s10995-008-0429-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
50
|
Rapport LJ, Bryer RC, Hanks RA. Driving and Community Integration After Traumatic Brain Injury. Arch Phys Med Rehabil 2008; 89:922-30. [DOI: 10.1016/j.apmr.2008.01.009] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2007] [Accepted: 01/10/2008] [Indexed: 11/27/2022]
|