Development of the Parent Forum: An in-person approach to supporting caregivers of youth with spinal cord injury

The voice of caregivers of children and adolescents with spinal cord injuries: A scoping review

CONTEXT

Participation in SCI research with caregivers of children and adolescents with spinal cord injury (SCI) can occur in a range of different ways. This review explores the extent to which caregivers' participation is connected to what might be called a voice.

OBJECTIVES

To explore the voice of caregivers by collating available research with the participation of caregivers of children and adolescents with SCI, and synthesizing how the research has been conducted.

METHODS

The databases CINAHL, ERIC, MEDLINE, PsycInfo, and Scopus were searched for articles published between January 2008 and March 2022. Descriptive and narrative information was extracted and factors describing how caregivers participated were identified using an inductive approach.

RESULTS

Twenty-nine articles were identified, of which 28 had affiliations connected to the USA, and 25 to Shriners Hospitals for Children. In most of the articles, the caregivers were invited to participate in the research to complete or develop measures. Information from the caregivers was often captured using close-structured questions and summarized quantitatively with little or no exploration of the perspectives of the caregivers.

CONCLUSION

The voice of caregivers of children and adolescents with SCI in research is limited by representativeness, the pre-determined emphasis, a lack of involvement in the process, and the reported narrative. By reflecting on voice, caregivers can have their experiences and perspectives acted upon to a greater extent to bring change, ultimately leading to improved care and health for children and adolescents with SCI.

A qualitative study on psycho-social needs of the family caregivers of persons with spinal cord injury

Background

Spinal cord injury is a high-cost long-lasting disability and a life-changing experience for family caregivers (FCGs). The current study aimed to explore the psycho-social needs of the FCGs of persons with spinal cord injury (PwSCI).

Materials and Methods

An exploratory qualitative approach was used, and sixteen FCGs of PwSCI participated in the face-to-face interviews. All the interviews were audio-recorded, and session notes were added to the existing data and later transcribed. Thematic analysis was used to identify the main themes.

Results

Three main themes have emerged, namely, awareness needs, resource needs, and personal care needs, from the data as a result of the qualitative analysis: The main themes have been categorised into nine sub-themes, such as want to know, alternative ways of contacting, the helpful or conducive environment of arrangements, sources to get money, pension certificate needs, resources for livelihood, resources for continuing the treatment, need my own time, and controlling of feelings.

Conclusion

The findings of this research aid in designing or developing need-based tailor-made psychosocial interventions for the FCGs of PwSCI in India. Multidisciplinary team professionals involved in managing spinal cord injury and other stakeholders should understand the importance of meeting the mentioned psycho-social needs of FCGs of PwSCI and delivering such tailor-made psycho-social interventions in a timely.

Lived experiences of caregivers and survivors of paediatric spinal cord injury: A scoping review of qualitative studies

CONTEXT

Paediatric Spinal Cord Injury (SCI) has an impact on a child's dynamic development, disrupting their participation in school, community, and social relationships while simultaneously causing repercussions on their caregiver's life. The rare nature of paediatric SCI calls for a detailed inspection of the literature from the perspective of children and their caregivers.

OBJECTIVE

This scoping review of qualitative research determines the extent of literature from perspective of caregivers and individuals with paediatric SCI.

METHODS

9351 full-text published articles were identified from CINAHL, Ovid, PubMed, and Scopus between 2001 and 2021. After duplicate deletion, 8354 articles were left, and 103 full-text articles were assessed for their eligibility. Finally, eight articles were assessed for their relevance. Key themes that emerged from the data were summarized, compared, and synthesized.

RESULTS

Six studies were from the perspectives of individuals with SCI and two from caregiver's perspective. Three major themes were identified from caregivers' opinion studies: "Obstacles to community participation"; "Unmet needs related to a child with SCI"; and "Radiating effect on caregivers' lives"; whereas five were obtained from individuals with paediatric SCI opinion studies: "Adjusting to life with SCI"; "Hardships & hardiness"; "Peers & family/emotional support"; "Perception of self & body-image post injury"; and "Transitioning into post-traumatic life".

CONCLUSION

There is a need for more specialized rehabilitation centers and an accessible environment in public spaces. Also, the review sheds some light on the discriminatory attitude of society as a whole, which can be improved by providing proper knowledge and awareness of SCI.

Research Priorities of the Pediatric Spinal Cord Injury Population: An International Insight for Rehabilitation Care

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.

Problem solving and collaborative involvement among adolescents with spinal cord injury and their caregivers

Objective

To determine the relationship between constructive adolescent problem solving (positive problem-solving orientation and rational problem-solving style) and caregiver problem solving and collaborative involvement with primary caregiver among adolescents with spinal cord injuries (SCIs). Positive constructive adolescent problem solving was hypothesized to be predicted by more effective caregiver problem solving and higher collaborative involvement.

Methods

Participants in this cross-sectional study were 79 adolescent and primary caregiver dyads recruited from a pediatric rehabilitation care system in North America. All participants completed a standardized problem-solving instrument and adolescent participants completed an adapted measure of collaborative parent involvement.

Results

More effective caregiver problem solving and adolescent perceptions of more collaboration with caregivers around SCI care were significantly associated with higher positive problem-solving orientation and higher rational problem-solving style among adolescents.

Conclusions

Results underscore the importance of caregiver problem-solving skills and their collaboration with adolescents with SCI when addressing care needs. Clinically, findings highlight opportunities for parent involvement and skill-building as an important factor of rehabilitation for adolescents with SCI.

Coping, Social Support, and Caregiver Well-Being With Families Living With SCI: A Mixed Methods Study

OBJECTIVES

To explore coping, problem solving, social support, and well-being among family caregivers of adults with spinal cord injury (SCI).

METHODS

This was a mixed methods study (qualitative interviews and standardized surveys) with a diverse sample of 39 adults with SCI and their caregivers from four rehabilitation hospitals in the United States, including one Veterans Affairs (VA) hospital. Cluster analysis was used to explore whether distinct profiles of caregivers could be identified, and it was used in conjunction with qualitative data to explore patterns in well-being. Measures of well-being included leisure time satisfaction, social integration, anxiety, depression, physical health complaints, caregiver burden, and quality of life.

RESULTS

The importance of individual and extra-individual resources, namely coping and social support, emerged from early qualitative analyses and guided subsequent mixed methods examination of the data. A cluster analysis yielded three caregiver profiles: (1) effective problem solvers with moderate satisfaction with social support, (2) mixed problem solvers with stronger negative orientations and mixed satisfaction with social support, and (3) low endorsers overall. Profiles helped us explore patterns across our data set and efficiently identify differences in caregiver social support, coping, well-being, and unmet needs.

CONCLUSION

Data echo the need for multimodal interventions aimed at skill development, respite options, and screening, support, information, and referral around mental health and burden. SCI care and rehabilitation programs should consider incorporating strategies for bolstering effective caregiver problem-solving skills, reducing negativity and ambivalence, and enhancing social support.

Health and LifeDomain ResearchPriorities in Children, Adolescents and Young Adults With Pediatric-Onset Spinal Cord Injury: A National Cross-Sectional Survey in England

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.