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Prins H, Donia S, Rockall S, Hektner J, Hawes S, Laskin JJ, Chernesky J, Noonan VK. Implementing Lived Experience Workshops in Regional Areas of British Columbia to Enhance Clinicians' Confidence in Spinal Cord Injury Care: An Evaluation. Healthcare (Basel) 2024; 12:731. [PMID: 38610153 PMCID: PMC11011360 DOI: 10.3390/healthcare12070731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
In British Columbia (BC), there are challenges accessing specialized spinal cord injury care and resources. This paper evaluated the impact of spinal cord injury health educational workshops delivered in regional communities that were informed by persons with lived experience. A community survey was conducted with 44 persons with lived experience in a BC region to identify priority SCI health-related topics. Twenty-five topics were ranked from 1-14, with bowel and bladder management ranked 1 and 4, sexual health ranked 5, and pressure injuries ranked 7. Clinical perspectives on the priorities were collected from 102 clinicians in the BC region, who independently ranked 14 of these SCI topics and considered the former 4 topics to be lower clinical priority (ranked 11-14). These priorities informed a series of SCI clinical education workshops held at healthcare facilities in three regional cities. The goals were to improve clinicians' knowledge and confidence levels when managing spinal cord injury health and to facilitate person-centred care. Positive feedback demonstrated that educational workshops supported by lived experience perspectives effectively enhanced the clinicians' understanding of spinal cord injury and their priorities. Future plans include engaging more administrators as part of this initiative and conducting workshops in other regions of BC.
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Affiliation(s)
- Hannah Prins
- Praxis Spinal Cord Institute, Vancouver, BC V5Z 1M9, Canada; (H.P.); (S.D.); (S.R.); (J.H.); (S.H.); (J.J.L.); (J.C.)
- Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Scott Donia
- Praxis Spinal Cord Institute, Vancouver, BC V5Z 1M9, Canada; (H.P.); (S.D.); (S.R.); (J.H.); (S.H.); (J.J.L.); (J.C.)
| | - Shannon Rockall
- Praxis Spinal Cord Institute, Vancouver, BC V5Z 1M9, Canada; (H.P.); (S.D.); (S.R.); (J.H.); (S.H.); (J.J.L.); (J.C.)
| | - James Hektner
- Praxis Spinal Cord Institute, Vancouver, BC V5Z 1M9, Canada; (H.P.); (S.D.); (S.R.); (J.H.); (S.H.); (J.J.L.); (J.C.)
| | - Spring Hawes
- Praxis Spinal Cord Institute, Vancouver, BC V5Z 1M9, Canada; (H.P.); (S.D.); (S.R.); (J.H.); (S.H.); (J.J.L.); (J.C.)
| | - James J. Laskin
- Praxis Spinal Cord Institute, Vancouver, BC V5Z 1M9, Canada; (H.P.); (S.D.); (S.R.); (J.H.); (S.H.); (J.J.L.); (J.C.)
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - John Chernesky
- Praxis Spinal Cord Institute, Vancouver, BC V5Z 1M9, Canada; (H.P.); (S.D.); (S.R.); (J.H.); (S.H.); (J.J.L.); (J.C.)
| | - Vanessa K. Noonan
- Praxis Spinal Cord Institute, Vancouver, BC V5Z 1M9, Canada; (H.P.); (S.D.); (S.R.); (J.H.); (S.H.); (J.J.L.); (J.C.)
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Ríos-León M, Onal B, Arango-Lasprilla JC, Augutis M, Graham A, Kelly EH, Kontaxakis A, López-Dolado E, Scheel-Sailer A, Valiullina S, Taylor J. Research Priorities of the Pediatric Spinal Cord Injury Population: An International Insight for Rehabilitation Care. Pediatr Neurol 2024; 151:121-130. [PMID: 38154239 DOI: 10.1016/j.pediatrneurol.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 10/20/2023] [Accepted: 11/26/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Although feedback from people with adult-onset spinal cord injury (SCI) has been considered for new rehabilitation programs, little is known about the priorities of the pediatric-onset SCI population. This study describes and compares health and life (H&L) domain research priorities of youth with pediatric-onset SCI and their parents/caregivers. METHODS A cross-sectional survey, designed by the Pan-European Paediatric Spinal Cord Injury (PEPSCI) Collaboration, was performed at six European countries. Dyad data from 202 participants, youth with pediatric-onset SCI (n = 101) and their parents/caregivers (n = 101), were analyzed with the PEPSCI H&L domain surveys. RESULTS The cohort was composed of 8 to 12-year-olds (30.7%), 13 to 17-year-olds (38.6%), and 18 to 25-year-olds (30.7%). The top three H&L domain research priorities reported by parents/caregivers of 8 to 12-year-olds were "walking/ability to move" (91%), "bladder" function (90%), and "general health/feel" (89%), compared with "physical function" (93%), "general health/feel" (90%), and "walking/ability to move" (89%) rated by parents/caregivers of 13 to 25-year-olds. "Bowel" function (85%), "leg/foot movement" (84%), and "bladder" function (84%) were reported as priorities by 13 to 25-year-olds, whereas "physical function" (84%), "experience at school" (83%), and "general mood" were highlighted by 8 to 12-year-olds. The top 10 priorities preferred by 13 to 25-year-olds when compared with the top 10 priorities reported by their parents/caregivers, included problems related to "bowel" and "pain." CONCLUSIONS Health domain research priorities were highlighted by 13 to 25-year-olds, compared with their parents/caregivers who equally identified H&L domains. This survey will aid health care and clinical research organizations to engage stakeholders to implement a comprehensive research strategy for the pediatric SCI population.
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Affiliation(s)
- Marta Ríos-León
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain.
| | - Bashak Onal
- NHS Buckinghamshire Clinical Commissioning Group, Aylesbury, UK
| | - Juan Carlos Arango-Lasprilla
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain; Department of Cell Biology and Histology, University of the Basque Country, Leioa, Spain; IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Marika Augutis
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Allison Graham
- National Spinal Injuries Centre, Buckinghamshire Healthcare NHS Trust, Stoke Mandeville, UK
| | | | | | - Elisa López-Dolado
- Rehabilitation Department, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
| | - Anke Scheel-Sailer
- Swiss Paraplegic Centre, Nottwil, Switzerland; Department of Health Science and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Svetlana Valiullina
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russia
| | - Julian Taylor
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain; Harris Manchester College, University of Oxford, Oxford, UK
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Ríos-León M, Onal B, Arango-Lasprilla JC, Augutis M, Civicos-Sanchez N, Graham A, Kelly EH, López-Dolado E, Scheel-Sailer A, Subiñas-Medina P, Taylor J. Pediatric health and life domain priorities: A national survey of people with spinal cord injury and their parents and caregivers. J Spinal Cord Med 2024; 47:155-167. [PMID: 35776093 PMCID: PMC10795593 DOI: 10.1080/10790268.2022.2087140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
CONTEXT/OBJECTIVE No information is available regarding priorities for pediatric-onset spinal cord injury (SCI). This study described the Health and Life (H&L) domain priorities of youth with pediatric-onset SCI and their parents/caregivers living in Spain. DESIGN A cross-sectional survey. SETTING Two SCI rehabilitation centers. PARTICIPANTS Sixty participants, youth with pediatric-onset SCI (n = 26) and parents/caregivers (n = 34). INTERVENTIONS Not applicable. OUTCOME MEASURES Median overall priorities calculated on the basis of importance, unhappiness, and research measured with a new survey of pediatric H&L domains and rated using a 5-point Likert Scale. RESULTS A total of 60 surveys were received providing information on 35 individuals with SCI: 2-7-year-olds (25.7%), 8-12-year-olds (22.9%), 13-17-year-olds (31.4%), and 18-25-year-olds (20.0%). The top three overall H&L priorities reported by parents/caregivers of 2-12-year-olds were "parenthood expectations" (84%), "leg/foot movement" (83%), and "bladder" function (83%), compared to "dressing/undressing" (78%), "walking/ability to move" (77%) and "bladder" function (77%) rated for 13-25-year-olds. "Sit-to-stand" (79%), "leg/foot movement" (78%) and "arm/hand movement" (77%) were reported as priorities by 13-25-year-olds. The 13-25-year-olds highlighted "sit-to-stand" (100%), "eating/drinking" (54%), and "physical function" (94%) as their top unhappiness, importance, and research priorities, respectively. Significant differences between tetraplegia and paraplegia were found in "mobility in the community" (unhappiness item) for 13-25-years-old. CONCLUSION Health domains were considered the top overall H&L priorities by parents/caregivers of 13-25-year-olds, compared to life domains reported for their 2-12-year-olds. This survey will aid rehabilitation professionals to engage stakeholders to implement a comprehensive SCI management program for the pediatric population.
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Affiliation(s)
- Marta Ríos-León
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
| | - Bashak Onal
- NHS Buckinghamshire Clinical Commissioning Group, Aylesbury, UK
| | - Juan Carlos Arango-Lasprilla
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country, Leioa, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Marika Augutis
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | | | - Allison Graham
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK
| | | | - Elisa López-Dolado
- Rehabilitation Department, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
| | - Anke Scheel-Sailer
- Swiss Paraplegic Centre, Nottwil, Switzerland
- Department of Health Science and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Patricia Subiñas-Medina
- Servicio de Atención Temprana, Asociación de Familias de Personas con Discapacidad Intelectual y del Desarrollo (APANAS), Toledo, Spain
| | - PEPSCI Collaboration
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
- NHS Buckinghamshire Clinical Commissioning Group, Aylesbury, UK
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country, Leioa, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
- Unidad de Lesionados Medulares, Hospital de Cruces, Barakaldo, Spain
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK
- American Academy of Pediatrics, Itasca, Illinois, USA
- Rehabilitation Department, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
- Swiss Paraplegic Centre, Nottwil, Switzerland
- Department of Health Science and Medicine, University of Lucerne, Lucerne, Switzerland
- Servicio de Atención Temprana, Asociación de Familias de Personas con Discapacidad Intelectual y del Desarrollo (APANAS), Toledo, Spain
- Harris Manchester College, University of Oxford, Oxford, UK
| | - Julian Taylor
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
- Harris Manchester College, University of Oxford, Oxford, UK
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MacKay C, Lee L, Best K, Campbell J, Cimino SR, Cowley H, Delvin M, Dilkas S, Landry M, Marzolini S, Mayo A, Oh P, Payne M, Viana R, Totosy de Zepetnek J, Domingo A, King S, Miller WC, Robert M, Tang A, Zidarov D, Zucker-Levin A, Hitzig SL. Developing a research agenda on exercise and physical activity for people with limb loss in Canada. Disabil Rehabil 2022; 44:8130-8138. [PMID: 34843420 DOI: 10.1080/09638288.2021.2003877] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE There is a lack of high-quality evidence about the effects of exercise or physical activity interventions for adults with lower limb amputations (LLAs). A planning meeting involving stakeholders (i.e., people with LLA, community advocates, health care providers, researchers) was organized to identify key research priorities related to exercise and physical activity for people with LLAs. METHODS We used a collaborative prioritized planning process with a pre-meeting survey and 2-day virtual meeting that included: identification and prioritization of challenges or gaps; identification and consolidation of solutions; and action planning. This process integrated a modified Delphi approach, including anonymous feedback in two surveys. RESULTS Thirty-five stakeholders participated. Six challenges related to exercise and physical activity for people with LLA were prioritized. One solution was prioritized for each challenge. After consolidation of solutions, participants developed five research action plans for research including: developing an on-line interface; developing and evaluating peer-support programs to support physical activity; examining integration of people with LLA into cardiac rehabilitation; development and evaluation of health provider education; and determining priority outcomes related to physical activity and exercise. CONCLUSIONS This collaborative process resulted in an action plan for amputation research and fostered collaborations to move identified priorities into action.IMPLICATIONS FOR REHABILITATIONLower limb amputations impact mobility leading to lower levels of physical activity.There are research gaps in our understanding of the effects of exercise or physical activity interventions for adults with lower limb amputations.Through a collaborative planning process, participants prioritized research directions on physical activity and exercise for people with LLA to advance research in the field.Action plans for research focused on developing online resources, peer support, cardiac rehabilitation for people with LLA, health provider education and determining priority outcomes related to physical activity and exercise.
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Affiliation(s)
- Crystal MacKay
- West Park Healthcare Centre, Toronto, Canada.,Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Leanna Lee
- West Park Healthcare Centre, Toronto, Canada
| | - Krista Best
- Faculté de médecine, Universite Laval, Quebec City, Canada
| | | | - Stephanie R Cimino
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | | | | | - Steven Dilkas
- West Park Healthcare Centre, Toronto, Canada.,Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Mireille Landry
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Women's College Hospital, Toronto, Canada
| | - Susan Marzolini
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
| | - Amanda Mayo
- Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.,Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Paul Oh
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
| | - Michael Payne
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Canada.,Parkwood Institute, St. Joseph's Health Care, London, Canada
| | - Ricardo Viana
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Canada.,Parkwood Institute, St. Joseph's Health Care, London, Canada
| | | | | | | | - William C Miller
- GF Strong Rehab Centre, Vancouver, Canada.,Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Maxime Robert
- Faculté de médecine, Universite Laval, Quebec City, Canada
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Diana Zidarov
- Faculté de Médecine, École de réadaptation, Université de Montréal, Montréal, Canada.,Centre de Recherche Interdisciplinaire en Réadaptation (CRIR), Institut de réadaptation Gingras-Lindsay-de-Montréal, Montréal, Canada
| | - Audrey Zucker-Levin
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Canada
| | - Sander L Hitzig
- Rehabilitation Sciences Institute, Temerty 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, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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Onal B, León MR, Augutis M, Mattacola E, Graham A, Hart K, Kelly E, Scheel-Sailer A, Taylor J. Health and LifeDomain ResearchPriorities in Children, Adolescents and Young Adults With Pediatric-Onset Spinal Cord Injury: A National Cross-Sectional Survey in England. Top Spinal Cord Inj Rehabil 2022; 28:91-110. [PMID: 35521061 PMCID: PMC9009198 DOI: 10.46292/sci21-00053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background Although feedback from people with adult-onset spinal cord injury (SCI) has been considered in developing research programs, little is known about pediatric-onset SCI priorities. Objectives To describe the health and life (H&L) domain research priorities of youth with pediatric-onset SCI living in England. Methods Youth with pediatric-onset SCI (≥6 months) were recruited from five English rehabilitation centers and invited with their parents/caregivers to complete the age-appropriate surveys designed by the Pan-European Paediatric Spinal Cord Injury (PEPSCI) collaboration. Results A total of 73 surveys were received (32 from participants with SCI and 41 from their parents/caregivers), providing information on 47 individuals with SCI: 2- to 7-year-olds (29.8%), 8- to 12-year-olds (19.2%), 13- to 17-year-olds (17.0%), and 18 to 25-year-olds (34.0%). The top three research priorities reported by parents/caregivers of 2- to 12-year-old and 13- to 25-year-olds were pain (81%/89%), physical function (91%/83%) and health care access (78%/78%). Eighty-nine percent of 8- to 12-year-olds emphasized schooling, peer relationships, and general mood as their research priorities. The top three research priorities for Health or Life domains reported by 13- to 25-year-olds included spasms (95%), pain (91%), pressure injuries (91%), health care access (83%), physical function (78%), and daily personal needs (74%). Conclusion Although there should be an emphasis on addressing important life domain issues for 8- to 12-year-olds with SCI, adolescents and young adults mostly prioritized health domain research priorities in addition to health care access. This survey will aid health care and clinical research organizations to engage stakeholders to implement a comprehensive SCI research strategy in England for the pediatric population.
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Affiliation(s)
- Bashak Onal
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK
,Stoke Mandeville Spinal Research, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire, UK
,Buckinghamshire Clinical Commissioning Group, Aylesbury, UK
| | - Marta Ríos León
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
| | - Marika Augutis
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Emily Mattacola
- School of Psychology, University of Buckingham, Buckingham, UK
| | - Allison Graham
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK
| | - Kirsten Hart
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK
| | - Erin Kelly
- American Academy of Pediatrics, Itasca, Illinois, USA
| | | | | | - Julian Taylor
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK
,Stoke Mandeville Spinal Research, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire, UK
,Sensorimotor Function Group, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
,Harris Manchester College, University of Oxford, Oxford, UK
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Milligan J, Lee J, Smith M, Donaldson L, Athanasopoulos P, Bassett-Spiers K, Howcroft J, Howcroft JW, Jeji T, Joshi PB, Mehan U, Noonan V. Advancing primary and community care for persons with spinal cord injury: Key findings from a Canadian summit. J Spinal Cord Med 2020; 43:223-233. [PMID: 30557085 PMCID: PMC7054958 DOI: 10.1080/10790268.2018.1552643] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Context: Persons with spinal cord injury (SCI) experience significant challenges when they access primary care and community services.Design: A provincial summit was held to direct research, education, and innovation for primary and community care for SCI.Setting: Toronto, Ontario, Canada.Participants: Key stakeholders (N = 95) including persons with SCI and caregivers, clinicians from primary care, rehabilitation, and specialized care, researchers, advocacy groups, and policy makers.Methods: A one-day facilitated meeting that included guest speakers, panel discussions and small group discussions was held to generate potential solutions to current issues related to SCI care and to foster collaborative relationships to advance care for SCI. Perspectives on SCI management were shared by primary care, neurosurgery, rehabilitation, and members of the SCI communityOutcome Measures: Discussions were focused on five domains: knowledge translation and dissemination, application of best practices, communication, research, and patient service accessibility.Results: Summit participants identified issues and prioritized solutions to improve primary and community care including the creation of a network of key stakeholders to enable knowledge creation and dissemination; an online repository of SCI resources, integrated health records, and a clinical network for SCI care; development and implementation of strategies to improve care transitions across sectors; implementation of effective care models and improved access to services; and utilization of empowerment frameworks to support self-management.Conclusions: This summit identified priorities for further collaborative efforts to advance SCI primary and community care and will inform the development of a provincial SCI strategy aimed at improving the system of care for SCI.
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Affiliation(s)
- James Milligan
- Centre for Family Medicine Family Health
Team, Kitchener, Canada
- Department of Family Medicine, Faculty of Health
Sciences, McMaster University, Hamilton, Canada
| | - Joseph Lee
- Centre for Family Medicine Family Health
Team, Kitchener, Canada
- Department of Family Medicine, Faculty of Health
Sciences, McMaster University, Hamilton, Canada
| | - Matt Smith
- Centre for Family Medicine Family Health
Team, Kitchener, Canada
| | | | | | | | - Jeremy Howcroft
- Centre for Family Medicine Family Health
Team, Kitchener, Canada
| | | | - Tara Jeji
- Ontario Neurotrauma Foundation,
Toronto, Canada
| | | | - Upender Mehan
- Centre for Family Medicine Family Health
Team, Kitchener, Canada
- Department of Family Medicine, Faculty of Health
Sciences, McMaster University, Hamilton, Canada
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Hitzig SL, Mayo AL, Kayssi A, Viana R, MacKay C, Devlin M, Dilkas S, Domingo A, Hebert JS, Miller WC, Andrysek J, Azhari F, Baltzer HL, de Mestral C, Dittmer DK, Dudek NL, Grad S, Guilcher SJT, Habra N, Hunter SW, Journeay WS, Katz J, King S, Payne MW, Underwood HA, Zariffa J, Aternali A, Atkinson SL, Brooks SG, Cimino SR, Rios J. Identifying priorities and developing strategies for building capacity in amputation research in Canada. Disabil Rehabil 2020; 43:2779-2789. [PMID: 32036731 DOI: 10.1080/09638288.2020.1720831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Compared to other patient population groups, the field of amputation research in Canada lacks cohesion largely due to limited funding sources, lack of connection among research scientists, and loose ties among geographically dispersed healthcare centres, research institutes and advocacy groups. As a result, advances in clinical care are hampered and ultimately negatively influence outcomes of persons living with limb loss. OBJECTIVE To stimulate a national strategy on advancing amputation research in Canada, a consensus-workshop was organized with an expert panel of stakeholders to identify key research priorities and potential strategies to build researcher and funding capacity in the field. METHODS A modified Delphi approach was used to gain consensus on identifying and selecting an initial set of priorities for building research capacity in the field of amputation. This included an anonymous pre-meeting survey (N = 31 respondents) followed by an in-person consensus-workshop meeting that hosted 38 stakeholders (researchers, physiatrists, surgeons, prosthetists, occupational and physical therapists, community advocates, and people with limb loss). RESULTS The top three identified research priorities were: (1) developing a national dataset; (2) obtaining health economic data to illustrate the burden of amputation to the healthcare system and to patients; and (3) improving strategies related to outcome measurement in patients with limb loss (e.g. identifying, validating, and/or developing outcome measures). Strategies for moving these priorities into action were also developed. CONCLUSIONS The consensus-workshop provided an initial roadmap for limb loss research in Canada, and the event served as an important catalyst for stakeholders to initiate collaborations for moving identified priorities into action. Given the increasing number of people undergoing an amputation, there needs to be a stronger Canadian collaborative approach to generate the necessary research to enhance evidence-based clinical care and policy decision-making.IMPLICATIONS FOR REHABILITATIONLimb loss is a growing concern across North America, with lower-extremity amputations occurring due to complications arising from diabetes being a major cause.To advance knowledge about limb loss and to improve clinical care for this population, stronger connections are needed across the continuum of care (acute, rehabilitation, community) and across sectors (clinical, advocacy, industry and research).There are new surgical techniques, technologies, and rehabilitation approaches being explored to improve the health, mobility and community participation of people with limb loss, but further research evidence is needed to demonstrate efficacy and to better integrate them into standard clinical care.
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Affiliation(s)
- Sander L Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Amanda L Mayo
- Physical Medicine and Rehabilitation, St. John's Rehab Hospital, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Ahmed Kayssi
- Division of Vascular Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Ricardo Viana
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | | | | | | | | | - Jacqueline S Hebert
- Department of Medicine, Faculty of Medicine and Dentistry, Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, Canada
| | - William C Miller
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Jan Andrysek
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
| | - Fae Azhari
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Canada
| | - Heather L Baltzer
- Division of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Charles de Mestral
- St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada
| | - Douglas K Dittmer
- Physical Medicine & Rehabilitation, Grand River Hospital, Kitchener, Canada
| | - Nancy L Dudek
- Division of Physical Medicine and Rehabilitation, University of Ottawa, Ottawa, Canada
| | - Sharon Grad
- Department of Physical Medicine and Rehabilitation, Hamilton Health Sciences, McMaster University, Hamilton, Canada
| | - Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Natalie Habra
- Division of Physical Medicine and Rehabilitation, Gingras-Lindsay Montreal Rehabilitation Institute, University of Montreal, Montreal, Canada
| | - Susan W Hunter
- School of Physical Therapy, Western University, London, Canada
| | | | - Joel Katz
- Department of Psychology, Faculty of Health, York University, Toronto, Canada
| | - Sheena King
- G.F. Strong Rehabilitation Centre, Vancouver, Canada
| | - Michael W Payne
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Heather A Underwood
- Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, Canada
| | - José Zariffa
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Andrea Aternali
- Department of Psychology, Faculty of Health, York University, Toronto, Canada
| | - Samantha L Atkinson
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Stephanie G Brooks
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Stephanie R Cimino
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Jorge Rios
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
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Ullrich PM. "People Who Have Something Better To Do Don't Suffer As Much". J Spinal Cord Med 2017; 40:255-257. [PMID: 28402229 PMCID: PMC5472011 DOI: 10.1080/10790268.2017.1314881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Philip M. Ullrich
- Correspondence to: Philip M. Ullrich, PhD, Behavioral Health Services, Kaiser Permanente Washington, Seattle, WA, USA.
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