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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.
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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
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Tang X, Huang J, Wang W, Su X, Yu Z. Predictors of activation among persons with spinal cord injury during hospitalization: A cross-sectional study. Jpn J Nurs Sci 2023:e12532. [PMID: 36965136 DOI: 10.1111/jjns.12532] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/05/2022] [Accepted: 02/14/2023] [Indexed: 03/27/2023]
Abstract
AIM To test the contributions of self-efficacy, resilience, social support, and negative moods (i.e., anxiety, depression) to patient activation among persons with spinal cord injury (SCI). METHODS One hundred and twenty-two participants with SCI were recruited from the spinal surgery department at a large general hospital. During the period before discharge after surgery, standardized self-assessment questionnaires were used to collect data on patient activation, self-efficacy, resilience, social support, anxiety, depression, demographics (age, gender, education, marital status), and disease-related information (etiologies, level of injury, American Spinal Injury Association Impairment Scale score). Hierarchical regression analysis, mediation analysis, and moderation analysis were performed in SPSS, Amos, and Jamovi to determine the influencing factors of patient activation. RESULTS Self-efficacy, resilience, social support, anxiety, and depression uniquely explained 38.2% (p < .001) of the variance in patient activation after controlling for demographic and disease-related covariates. The full model explained 53.7% (p < .001) of the variance in patient activation. In the mediation analysis, self-efficacy, resilience, and social support had partial mediating effects (p < .05). In the moderation analysis, marital status moderated the relationship between self-efficacy and patient activation (p < .05). CONCLUSIONS Activation of persons with SCI is a positive psychosocial resource related to higher self-efficacy, resilience, and social support. Marital status may affect activation in persons with SCI. The causal relationship between these psychosocial variables needs to be proved by further intervention studies.
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Affiliation(s)
- Xiangxiang Tang
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China
| | - Jin Huang
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Wenyan Wang
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China
| | - Xiaoping Su
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China
| | - Zepeng Yu
- Center for Medical Ultrasound, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
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Viaene AM, Roggeman S, Vanhaute OA, Raes A, Colman R, Everaert K. Nocturnal bladder emptying and Quality of Life in patients with spinal cord injury. Eur J Phys Rehabil Med 2022; 58:397-404. [PMID: 34652085 PMCID: PMC9980489 DOI: 10.23736/s1973-9087.21.07104-5] [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: 11/08/2022]
Abstract
BACKGROUND Little is known about the relationship between sleep disruption due to nocturnal bladder emptying and Quality of Life in patients with spinal cord injury. AIM The aim of this study was to evaluate the possible influence of number of nocturnal bladder emptying, bladder emptying method and nocturnal incontinence on the Quality of Life of patients with spinal cord injury. DESIGN The design of this paper is a cross-sectional descriptive study. SETTING The setting is in- and outpatient. POPULATION Seventy-nine patients aged between 18 and 77 years with SCI in a first rehabilitation period or follow-up. METHODS Patients were asked to complete Short Form-36 and Incontinence Quality of Life questionnaires and a medical information form. Independent samples t-tests and ANOVA were used to compare scores between groups. RESULTS The response rate was 71 out of 79 (89%; 51 males and 20 females). 16 paraplegic and 4 tetraplegic patients were chronic, 29 paraplegic and 22 tetraplegic patients were in rehabilitation therapy or had finished this treatment recently. The paraplegic group had a significantly better Short Form-36 total score and emotional function score, while the tetraplegic group had a significantly better Incontinence Quality of Life total score and avoidance and limiting behavior score. The paraplegic patients with 0-1 nocturnal bladder emptying had better Short Form-36-derived Quality of Life than those with ≥2 emptying. Quality of Life score was not associated with gender, leg oedema, incontinence, or acute/chronic group. Incontinence Quality of Life score was significantly better for patients with incomplete spinal cord injury. Fully completed questionnaires were returned by 36 patients; at least 1 item was missing for 35 participants. CONCLUSIONS General Short Form-36-derived Quality of Life was better for the paraplegic population. Incontinence-related Quality of Life was better in tetraplegic patients, most of whom used suprapubic catheterization. Paraplegic patients had compromised sleep and Quality of Life when the patient had to wake up two or more times at night to empty the bladder by voiding or intermittent catheterization. The high number of incomplete responders indicates the shortcomings of Quality-of-Life questionnaires for wheelchair-bound patients with spinal cord injury. CLINICAL REHABILITATION IMPACT The use of suprapubic catheterization should be considered to improve Quality of Life for tetraplegic patients. For paraplegic patients, we must focus urological policy on aiming to reduce the number of nighttime bladder emptying to one or none.
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Affiliation(s)
- Annick M Viaene
- Department of Physical Medicine and Orthopedic Surgery, Ghent University Hospital, Ghent, Belgium -
| | - Saskia Roggeman
- Department of Urology, Ghent University Hospital, Ghent, Belgium.,Department of Research and Policy, Psychiatric Center Sint-Jan-Baptist, Zelzate, Belgium
| | - Omer A Vanhaute
- Strategic Policy Cell, Ghent University Hospital, Ghent, Belgium
| | - Ann Raes
- Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Roos Colman
- Unit of Biostatistics, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
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van Diemen T, Tran Y, Stolwijk-Swuste JM, Roels EH, van Nes IJW, Post MWM. Trajectories of Self-Efficacy, Depressed Mood, and Anxiety From Admission to Spinal Cord Injury Rehabilitation to 1 Year After Discharge. Arch Phys Med Rehabil 2021; 102:1939-1946. [PMID: 34038709 DOI: 10.1016/j.apmr.2021.04.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/07/2021] [Accepted: 04/25/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Self-efficacy (SE) is an important determinant for the psychological adjustment of people with spinal cord injury (SCI). However, little is known about the course of SE during inpatient rehabilitation up to 1 year after discharge. The aim of this study was to determine latent trajectory classes of SE, depressive mood, and anxiety in people with SCI, as well as the interrelationships between these trajectories. DESIGN Longitudinal inception cohort study. SETTING Eight specialized SCI rehabilitation centers. PARTICIPANTS The participants (N=268) were mainly men 183 of 268 (68.3%) with a mean age of 55.6 years. Almost half had a traumatic SCI 135 of 268 (50.4%) and tetraplegia (53.7%), and the minority had a motor complete SCI (32.2%). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES SE was measured using the University of Washington Self-Efficacy Scale. In addition, the Hospital Anxiety and Depression Scale was used to asses distress and perform dual trajectory modeling analyses. RESULTS Three trajectories of SE, indicating low, middle, and high SE, could be distinguished. Furthermore, a 2-class trajectory solution for depressive mood and a 4-class solution for anxiety were found to be most suitable. All trajectories were stable over time. Developmental connections between SE and depressive mood and between SE and anxiety were revealed. In particular, participants who adjusted well, reporting low scores on depressive mood and anxiety, could be identified by their high SE scores. However, the group of participants with high depressive mood scores and anxiety scores could not always be identified based on their SE trajectory. CONCLUSIONS In accordance with our hypotheses, distinct trajectories of SE, depressive mood, and anxiety were identified and high probabilities that SE trajectories were interrelated to the trajectories from depressive mood and anxiety were confirmed. Concurrent screening for SE and distress might best detect people at risk for adjustment problems.
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Affiliation(s)
- Tijn van Diemen
- Department of Spinal Cord Injury Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands.
| | - Yvonne Tran
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Janneke M Stolwijk-Swuste
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Ellen H Roels
- Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Ilse J W van Nes
- Department of Spinal Cord Injury Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands; Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Jörgensen S, Hedgren L, Sundelin A, Lexell J. Global and domain-specific life satisfaction among older adults with long-term spinal cord injury. J Spinal Cord Med 2021; 44:322-330. [PMID: 31099721 PMCID: PMC7952060 DOI: 10.1080/10790268.2019.1610618] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Although life expectancy after spinal cord injury (SCI) has increased, knowledge of life satisfaction and associated factors among older adults with long-term SCI is still very limited. The objective of this study was, therefore, to assess global and domain-specific life satisfaction among older adults with long-term SCI and investigate the association with sociodemographics, injury characteristics and secondary health conditions. DESIGN Cross-sectional cohort study. Data from the Swedish Aging with Spinal Cord Injury Study (SASCIS). SETTING Community settings in southern Sweden. PARTICIPANTS Seventy-eight individuals (32% women, injury levels C1-L3, American Spinal Injury Association Impairment Scale (AIS) A-D) mean age 68 years, mean time since injury 31 years. INTERVENTIONS Not applicable. OUTCOME MEASURES The Life Satisfaction Questionnaire (LiSat-11). RESULTS The participants were at least rather satisfied with most of the 11 life domains. They rated the lowest satisfaction with sexual life, activities of daily living and somatic health. Having a partner and being vocationally active was associated with greater satisfaction with life as a whole and with several other life domains. Participants with AIS D injuries were less satisfied with their somatic health than those with tetraplegia AIS A-C and paraplegia AIS A-C injuries. More secondary health conditions were negatively associated with satisfaction in five life domains. CONCLUSION Life satisfaction can be affected many years after SCI. The social context, participation in meaningful activities and minimizing secondary health conditions seem to be important for maintaining life satisfaction in older adults with a long-term injury.
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Affiliation(s)
- Sophie Jörgensen
- Department of Health Sciences, Lund University, Lund, Sweden
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Linn Hedgren
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Anna Sundelin
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Jan Lexell
- Department of Health Sciences, Lund University, Lund, Sweden
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
- Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden
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van Diemen T, Craig A, van Nes IJW, Stolwijk-Swuste JM, Geertzen JHB, Middleton J, Post MWM. Enhancing our conceptual understanding of state and trait self-efficacy by correlational analysis of four self-efficacy scales in people with spinal cord injury. BMC Psychol 2020; 8:108. [PMID: 33076995 PMCID: PMC7574195 DOI: 10.1186/s40359-020-00474-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/28/2020] [Indexed: 11/10/2022] Open
Abstract
Background Self-efficacy is an important determinant of adjustment following spinal cord injury. Self-efficacy is defined as the belief that one can successfully execute behavior required to produce the desired outcomes. In its original conceptualization, self-efficacy refers to the confidence that people have in their ability to accomplish specific tasks and behaviors within a specific context. Over the years these situation specific aspects have been unconfined and multiple constructs of self-efficacy have been proposed. The most common is a division in trait and state self-efficacy. Another used division that is utilized is between general, domain-specific and task-specific self-efficacy. The scientific support for these constructs is to date still unclear. The objective of this study was to enhance the understanding of the self-efficacy construct by comparing four self-efficacy scales designed to measure three aspects of self-efficacy (general versus domain-specific versus task-specific) in people with spinal cord injury. Methods Dutch and Australian adults with spinal cord injury (N = 140) completed four frequently used self-efficacy scales; the Moorong Self-efficacy Scale, General Self-efficacy Scale, University of Washington Self-efficacy Scale and a Self-care Self-efficacy Scale approximately 6 months after their inpatient rehabilitation. Pearson correlations examined inter-relationships between the scales. Results Hypothesized strong correlations between scales measuring similar aspects of self-efficacy were found (correlations 0.50–0.65). However, the hypothesized weak to moderate correlations between scales measuring diverging aspects of self-efficacy were only partly found (correlations 0.31–0.74), with 7 out of 12 correlations being strong instead of moderate. Conclusions The expected distinctions between the three aspects of self-efficacy was not demonstrated. All four scales measure a common latent construct, most likely general self-efficacy aspects. Further research is necessary to find ways to improve the measurement of domain-specific and task-specific aspects of SE, so that they are sensitive enough to capture change over time, and thus enhance clinical outcomes of people with SCI as they adjust to their disability.
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Affiliation(s)
- Tijn van Diemen
- Department of spinal cord injury Rehabilitation, Sint Maartenskliniek, P.O. box 9011, 6500, GM, Nijmegen, The Netherlands. .,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands. .,University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands.
| | - Ashley Craig
- John Walsh Center for Rehabilitation Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Kolling Institute, St Leonards, NSW, Australia
| | - Ilse J W van Nes
- Department of spinal cord injury Rehabilitation, Sint Maartenskliniek, P.O. box 9011, 6500, GM, Nijmegen, The Netherlands
| | | | - Janneke M Stolwijk-Swuste
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,Department of spinal cord injury, De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Jan H B Geertzen
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands
| | - James Middleton
- John Walsh Center for Rehabilitation Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Kolling Institute, St Leonards, NSW, Australia.,Spinal Outreach Service, Royal Rehab, Sydney, Australia
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands
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