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Pallerla S, Krishnareddy SR, Parthasarathy NB, Navaneetham J, Gupta A. A qualitative study on psycho-social needs of the family caregivers of persons with spinal cord injury. J Family Med Prim Care 2024; 13:1262-1270. [PMID: 38827726 PMCID: PMC11142019 DOI: 10.4103/jfmpc.jfmpc_1349_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 06/04/2024] Open
Abstract
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.
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Affiliation(s)
- Srikanth Pallerla
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Shanivaram Reddy Krishnareddy
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Nirmala Berigai Parthasarathy
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Janardhana Navaneetham
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Anupam Gupta
- Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Morgan KA, Paton S, Patten A, Tucker S, Walker K. Community-based exercise goals of persons with spinal cord injury: Interpreted using the International Classification of Functioning, Disability, and Health. J Spinal Cord Med 2024; 47:229-238. [PMID: 34698620 PMCID: PMC10885771 DOI: 10.1080/10790268.2021.1970896] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To identify goals for exercising among community-dwelling persons with spinal cord injury (PwSCI). DESIGN Qualitative descriptive study. SETTING Community-based exercise facility for persons with a disability. PARTICIPANTS Fifty-five PwSCI identified their exercise goals prior to participation in a community-based exercise intervention. INTERVENTIONS None. OUTCOME MEASURES A modified version of the Canadian Occupational Performance Measure was used to ask about exercise goals. The International Classification of Functioning, Disability, and Health (ICF) was used to code the goals for themes. RESULTS The participants were predominantly male (76%) and Black (56%) with thoracic-level injury (51%) and a mean age of 39.44 (standard deviation [SD] 13.62). A total of 231 goals (mean 4.2 goals per participant; SD 1.25) were identified. Participants rated their performance and satisfaction with their goals as 4.256 (SD 1.55) and 3.57 (SD 1.67), respectively. Participants most frequently reported goals related to endurance, muscle strengthening, weight loss, activities of daily living, transferring, and home and community mobility. The most commonly reported goals fell into five ICF domains: Functions of Cardiovascular, Hematological, Immunological, and Respiratory Systems; Neuromusculoskeletal and Movement-Related Functions; Structures Related to Movement; Mobility; and Self-Care. CONCLUSION PwSCI have goals they would like to achieve through participation in exercise. The goals are multifaceted and encompass improving health and fitness as well as improving performance in everyday activities such as transferring and mobility. Identifying themes of goals for PwSCI to achieve through exercise is an important step in developing programs and interventions needed to support PwSCI living in the community.
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Affiliation(s)
- Kerri A. Morgan
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Samantha Paton
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Anna Patten
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Susan Tucker
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Kimberly Walker
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
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Kovacs Burns K, Bhatia Z, Gill B, van der Nest D, Knox J, Mouneimne M, Buck T, Charbonneau R, Aiello K, Loyola Sanchez A, Kamran R, Olayinka O, Ho C. Measures for Persons with Spinal Cord Injury to Monitor Their Transitions in Care, Health, Function, and Quality of Life Experiences and Needs: A Protocol for Co-Developing a Self-Evaluation Tool. Healthcare (Basel) 2024; 12:527. [PMID: 38470643 PMCID: PMC10930772 DOI: 10.3390/healthcare12050527] [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: 12/21/2023] [Revised: 01/30/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Evaluating the experiences of persons with spinal cord injury (PwSCI) regarding their transitions in care and changes in health, function, and quality of life is complex, fragmented, and involves multiple tools and measures. A staged protocol was implemented with PwSCI and relevant expert stakeholders initially exploring and selecting existing measures or tools through a modified Delphi process, followed by choosing one of two options. The options were to either support the use of the 10 selected tools from the Delphi method or to co-develop one unique condensed tool with relevant measures to evaluate all four domains. The stakeholders chose to co-develop one tool to be used by persons with SCI to monitor their transition experiences across settings and care providers. This includes any issues with care or support they needed to address at the time of discharge from acute care or rehabilitation and in the community at 3, 6, and 12 months or longer post-discharge. Once developed, the tool was made available online for the final stage of the protocol, which proposes that the tool be reliability tested prior to its launch, followed by validation testing by PwSCI.
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Affiliation(s)
- Katharina Kovacs Burns
- Clinical Quality Metrics/Primary Data Support, Data & Analytics, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Zahra Bhatia
- Spinal Cord Injury Alberta, Calgary, AB T2H 1H7, Canada
| | - Benveet Gill
- ReYu Paralysis Recovery Centre, Edmonton, AB T5S 1G8, Canada
| | - Dalique van der Nest
- Slave Lake Healthcare Centre (North Zone), Alberta Health Services, Slave Lake, AB T0G 2A2, Canada
| | - Jason Knox
- Tertiary Neurorehabilitation, Foothills Medical Centre, Calgary, AB T2N 2T9, Canada
| | - Magda Mouneimne
- Tertiary Neurorehabilitation, Foothills Medical Centre, Calgary, AB T2N 2T9, Canada
| | - Taryn Buck
- Glenrose Rehabilitation Hospital, Edmonton, AB T5G 0B7, Canada
| | - Rebecca Charbonneau
- Physical Medicine and Rehabilitation, Foothills Medical Centre, Calgary, AB T2N 2T9, Canada
| | - Kasey Aiello
- Patient Liaison to Neurosciences, Foothills Medical Centre, Calgary, AB T2N 2T9, Canada
| | - Adalberto Loyola Sanchez
- Division of Physical Medicine & Rehabilitation, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2S2, Canada
- Department of Clinical Neurosciences, Glenrose Rehabilitation Hospital, Edmonton, AB T5G 0B7, Canada
| | - Rija Kamran
- Rehabilitation Sciences, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T2N 1N4, Canada
| | - Olaleye Olayinka
- Division of Physical Medicine & Rehabilitation, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2S2, Canada
| | - Chester Ho
- Glenrose Rehabilitation Hospital, Edmonton, AB T5G 0B7, Canada
- Division of Physical Medicine & Rehabilitation, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2S2, Canada
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Colamarino E, Lorusso M, Pichiorri F, Toppi J, Tamburella F, Serratore G, Riccio A, Tomaiuolo F, Bigioni A, Giove F, Scivoletto G, Cincotti F, Mattia D. DiSCIoser: unlocking recovery potential of arm sensorimotor functions after spinal cord injury by promoting activity-dependent brain plasticity by means of brain-computer interface technology: a randomized controlled trial to test efficacy. BMC Neurol 2023; 23:414. [PMID: 37990160 PMCID: PMC10662594 DOI: 10.1186/s12883-023-03442-w] [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: 10/12/2023] [Accepted: 10/19/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Traumatic cervical spinal cord injury (SCI) results in reduced sensorimotor abilities that strongly impact on the achievement of daily living activities involving hand/arm function. Among several technology-based rehabilitative approaches, Brain-Computer Interfaces (BCIs) which enable the modulation of electroencephalographic sensorimotor rhythms, are promising tools to promote the recovery of hand function after SCI. The "DiSCIoser" study proposes a BCI-supported motor imagery (MI) training to engage the sensorimotor system and thus facilitate the neuroplasticity to eventually optimize upper limb sensorimotor functional recovery in patients with SCI during the subacute phase, at the peak of brain and spinal plasticity. To this purpose, we have designed a BCI system fully compatible with a clinical setting whose efficacy in improving hand sensorimotor function outcomes in patients with traumatic cervical SCI will be assessed and compared to the hand MI training not supported by BCI. METHODS This randomized controlled trial will include 30 participants with traumatic cervical SCI in the subacute phase randomly assigned to 2 intervention groups: the BCI-assisted hand MI training and the hand MI training not supported by BCI. Both interventions are delivered (3 weekly sessions; 12 weeks) as add-on to standard rehabilitation care. A multidimensional assessment will be performed at: randomization/pre-intervention and post-intervention. Primary outcome measure is the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP) somatosensory sub-score. Secondary outcome measures include the motor and functional scores of the GRASSP and other clinical, neuropsychological, neurophysiological and neuroimaging measures. DISCUSSION We expect the BCI-based intervention to promote meaningful cortical sensorimotor plasticity and eventually maximize recovery of arm functions in traumatic cervical subacute SCI. This study will generate a body of knowledge that is fundamental to drive optimization of BCI application in SCI as a top-down therapeutic intervention, thus beyond the canonical use of BCI as assistive tool. TRIAL REGISTRATION Name of registry: DiSCIoser: improving arm sensorimotor functions after spinal cord injury via brain-computer interface training (DiSCIoser). TRIAL REGISTRATION NUMBER NCT05637775; registration date on the ClinicalTrial.gov platform: 05-12-2022.
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Affiliation(s)
- Emma Colamarino
- Department of Computer, Control, and Management Engineering "Antonio Ruberti", Sapienza University of Rome, Via Ariosto, 25, 00185, Rome, Italy.
- IRCCS Fondazione Santa Lucia, Via Ardeatina, 306, 00179, Rome, Italy.
| | - Matteo Lorusso
- IRCCS Fondazione Santa Lucia, Via Ardeatina, 306, 00179, Rome, Italy
| | | | - Jlenia Toppi
- Department of Computer, Control, and Management Engineering "Antonio Ruberti", Sapienza University of Rome, Via Ariosto, 25, 00185, Rome, Italy
- IRCCS Fondazione Santa Lucia, Via Ardeatina, 306, 00179, Rome, Italy
| | | | - Giada Serratore
- IRCCS Fondazione Santa Lucia, Via Ardeatina, 306, 00179, Rome, Italy
| | - Angela Riccio
- IRCCS Fondazione Santa Lucia, Via Ardeatina, 306, 00179, Rome, Italy
| | - Francesco Tomaiuolo
- Department of Clinical and Experimental Medicine, University of Messina, Piazza Pugliatti, 1, 98122, Messina, Italy
| | | | - Federico Giove
- IRCCS Fondazione Santa Lucia, Via Ardeatina, 306, 00179, Rome, Italy
- Museo Storico Della Fisica E Centro Studi E Ricerche Enrico Fermi, Via Panisperna, 89a, 00184, Rome, Italy
| | | | - Febo Cincotti
- Department of Computer, Control, and Management Engineering "Antonio Ruberti", Sapienza University of Rome, Via Ariosto, 25, 00185, Rome, Italy
- IRCCS Fondazione Santa Lucia, Via Ardeatina, 306, 00179, Rome, Italy
| | - Donatella Mattia
- IRCCS Fondazione Santa Lucia, Via Ardeatina, 306, 00179, Rome, Italy
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Pallerla S, Krishnareddy SR, Parthasarathy NB, Navaneetham J, Gupta A. Rehabilitation Professionals' Perspectives on Psychosocial Needs of Family Caregivers of Persons with Spinal Cord Injury: A Qualitative Study from India. Korean J Fam Med 2023; 44:168-176. [PMID: 37225442 DOI: 10.4082/kjfm.22.0096] [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: 05/20/2022] [Accepted: 07/28/2022] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND This study explored the psychosocial needs of family caregivers of persons with spinal cord injuries from the perspective of rehabilitation professionals. METHODS An exploratory qualitative approach was used, and a total of 14 rehabilitation professionals from various backgrounds participated in face-to-face interviews. All interviews were audio recorded, and session notes were added to the existing data and later transcribed. Thematic analysis was used to identify key themes. RESULTS Nine need themes emerged: informational, psychological, personal care, financial, social support, welfare, vocational, telemedicine, and referral. CONCLUSION The findings of this study will aid the design or development of need-based customized psychosocial interventions for family caregivers of persons with spinal cord injuries in India. Multiple stakeholders involved in spinal cord injury management should understand the importance of meeting the needs of family caregivers of persons with spinal cord injuries and the timely delivery of customized psychosocial interventions.
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Affiliation(s)
- Srikanth Pallerla
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | | | | | - Janardhana Navaneetham
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Anupam Gupta
- Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bengaluru, India
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Brady J, Mouneimne M, Milaney K. Environmental and systems experiences of persons with spinal cord injury and their caregivers when transitioning from acute care to community living during the COVID-19 pandemic: a comparative case study. Spinal Cord Ser Cases 2023; 9:8. [PMID: 36906673 PMCID: PMC10006547 DOI: 10.1038/s41394-023-00561-x] [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: 08/29/2022] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 03/13/2023] Open
Abstract
STUDY DESIGN Comparative case study OBJECTIVES: To elevate the voices of and capture the lived environmental and systems experiences of persons with spinal cord injury (PWSCI) and their caregivers, in transitions from inpatient rehabilitation to the community. Also, to examine the perceived and actual availability and accessibility of services and programs for this group. SETTING Inpatient rehabilitation unit and community in Calgary, Alberta, Canada METHODS: As a comparative case study, this research included multiple sources of data including brief demographic surveys, pre- and post-discharge semi-structured interviews, and conceptual mapping of services and programs for PWSCI and caregivers in Calgary, Canada (dyads). Three dyads (six participants) were recruited from an inpatient rehabilitation unit at an acute care facility, from October 2020 to January 2021. Interviews were analyzed using the Interpretative Phenomenological Analysis approach. RESULTS Dyads described transition experiences from inpatient rehabilitation to community as uncertain and unsupported. Breakdowns in communication, COVID-19 restrictions, and challenges in navigating physical spaces and community services were identified by participants as concerns. Concept mapping of programs and services showed a gap in identification of available resources and a lack of services designed for both PWSCI and their caregivers together. CONCLUSIONS Areas for innovation were identified that may improve discharge planning and community reintegration for dyads. There is an intensified need for PWSCI and caregiver engagement in decision-making, discharge planning and patient-centered care during the pandemic. Novel methods used may provide a framework for future SCI research in comparable settings.
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Affiliation(s)
- Jocelyn Brady
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | | | - Katrina Milaney
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
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Spinal Cord Injury Patient's Physical and Psychological Care Needs at Home from Patients’ and Caregivers’ Perspectives: A Qualitative Study. ARCHIVES OF NEUROSCIENCE 2022. [DOI: 10.5812/ans-123462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Limited studies have attempted to identify the care needs of patients with spinal cord injury (SCI) and their professional caregivers at home and after discharge from the hospital. However, little information about these needs has led to increased physical and psychological complications and thus a reduced quality of life in SCI patients. Objectives: This study aimed to explain the experiences of patients and their caregivers regarding physical and psychological care needs at home. Method: This qualitative descriptive study was conducted on 24 SCI patients and their professional caregivers using the conventional content analysis. Data were collected through unstructured and semi-structured interviews. Purposeful sampling was continued until data saturation was reached. The conventional content analysis approach proposed by Graneheim and Lundman (continuous comparison) was used to analyze the data. Results: The age range of the participants was 29 - 48 years, with an average age of 37.8 years. Seven of the participants had paraplegia, and three of them had tetraplegia. The results of data analysis led to the extraction of two main categories, including physical and psychological care needs. Conclusions: By identifying the real needs of patients after discharge from the hospital, we emphasize the need to remove barriers to home health care services and provide more financial support to meet patients' needs. Therefore, policymakers are encouraged to use the results of this study to plan at-home patient care services.
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Reliability of the Nepali Version of the Spinal Cord Independence Measure Self-Report. Rehabil Res Pract 2022; 2022:9983464. [PMID: 35720259 PMCID: PMC9203215 DOI: 10.1155/2022/9983464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/13/2022] [Indexed: 12/04/2022] Open
Abstract
A self-report measure is considered a practical alternative tool for longitudinal monitoring and for community models of disability. Spinal Cord Independence Measure Self-Report (SCIM-SR) was developed to measure the functional independence of the spinal cord injury (SCI) population. For the application of this questionnaire in Nepali setting, the cross-cultural adaptation and reliability of the Nepali version of the SCIM-SR were also warranted. The aim of the study was to cross-culturally adapt the Nepali version of the SCIM-SR and determine its reliability. The English version of the SCIM-SR was translated into the Nepali language with cross-cultural adaptations following the Beaton guidelines. A total of 45 community-dwelling individuals with SCI administered the Nepali version of the SCIM-SR two times, with an interval of one week. The intraclass correlation coefficient (ICC) and Cronbach's alpha (α) were used to assess the test-retest reliability and internal consistency, respectively. Cross-cultural equivalence was achieved between the English version and the Nepali version of the SCIM-SR. The test-retest reliability was excellent, with ICCs for the total score 0.968 (95% confidence interval 0.941–0.982), self-care subscale 0.964 (0.934–0.980), respiration and sphincter management subscale 0.941 (0.893–0.968), and mobility subscale 0.966 (0.938–0.981). The internal consistency reached an acceptable range for the total score and most of the subscales except for those of respiration and sphincter management. Cronbach's α coefficients for the total score, self-care subscale, respiration and sphincter management subscale, and mobility subscale were 0.801, 0.959, 0.506, and 0.838, respectively. The Nepali version of the SCIM-SR was cross-culturally adapted and can be used as a reliable self-report instrument to assess functional independence among the community-dwelling SCI population in Nepal.
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Stoica SI, Anghelescu A, Onose G. Effectiveness of the multi-/interdisciplinary neurorehabilitati-on program in young patients with incomplete myeloradicualar injuries after spinal cord injury. BALNEO AND PRM RESEARCH JOURNAL 2022. [DOI: 10.12680/balneo.2022.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Nowadays young persons may be frequent victims of traumatic cervical spinal cord injury (CSCI). Material and methods A retrospective study (January 2019-March 2021) we conducted with the approval of the Ethics Commission of THEBA, to assess the results of the complex me-dical rehabilitation program during the subacute period. A selected group of 23 young tetraple-gic patients with traumatic CSCI, were admitted to the THEBA Neuromuscular Rehabilitation Clinic with incomplete (AIS-B, -C, -D) myeloradicular injuries. All patients were males, aged between 19 and 57 years (with a mean of 44.35 years, SD 12.9). Patients came from urban areas 11 (48%) and the remaining 12 (52%) from rural areas. Results The spine lesion location was located at C2 vertebral level (4 men), C3 (4 men), C4 (3 men), C5 (6 men); C6 (in 2 patients); C7 (in 2 men); T6 and T7 in 1 patient each. The patients' neurological levels of injury were: C1 (in 2 pati-ents), C2 (in 2 patients), C3 (in 4 patients), C5 (in 7 patients), C6 (in 4 patients) and C7 (in 2 pati-ents). The AIS/ Frankel degree at admission was: incomplete lesion AIS-B 3 patients, AIS-C 11 pa-tients, AIS-D 9 men. The average muscle strength at admission was 60.72 (SD 25.74). In the study group 20 patients were operated: anterior osteosynthesis was performed in 16 patients and pos-terior vertebral approach in 4 patients. The neurological evolution was favorable: at discharge there were only patients with incomplete AIS-C (8 men), respectively AIS-D (15 men) grade type of lesions, and their average muscle strength at discharge was 71.97 (SD 22.30). The following comorbidities were associated: arterial hypertension (in 2 patients), traumatic brain injury (in 14 patients), alcoholism (in 9 patients), pneumonia (in 6 patients), neoplastic disorders (in 1 pati-ent), gastric ulcer (in 2 patients), depression (in 2 patients). Complications of the immobilization syndrome were: enterocolitis (in 3 men), bronchopneumonia (in 3 patients), urinary tract infec-tions (in 13 patients) and bedsores (in 2 patients). Discussion Effectiveness of the final therapeutic approach was assessed (in percentage) by evaluating the progress of the muscle strength (quanti-fied and compared at discharge vs. admission) reported to the number of days of treatment. The external-internal variations of the numeric scores of the quality of life, FIM, Ashworth and Penn were evaluated. Statistics was performed for small groups (Anova and Pearson) to establish the effectiveness of the rehabilitation program, evaluating the level of correlation between the sco-res quantified with the aforementioned the scales. An inversely proportional relationship was found between spasticity and efficacy of physical therapy (F 0.000, Pearson -0.35), between the scores of Penn scale and the effectiveness of physical therapy (F test 0.000, Pearson -0.18), respec-tively directly proportional relationship between the kinetic therapy and FIM (F test 0.000, Pear-son 0.74), similar to the relationship between physical therapy and the scores assessing the quali-ty of life (F test 0.01, Pearson 0.02). Conclusions These results underline the importance of a multi-interdisciplinary team approach in the management of the tetraplegic patients after CSCI during the subacute post-lesional/ post-operative stage.
Keywords: neurorehabilitation program, incomplete myeloradicualar injuries, spinal cord injury
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Affiliation(s)
- Simona Isabelle Stoica
- 1 “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, 2 Teaching Emergency Hospital “Bagdasar-Arseni” (TEHBA), Bucharest, Romania
| | - Aurelian Anghelescu
- 1 “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, 2 Teaching Emergency Hospital “Bagdasar-Arseni” (TEHBA), Bucharest, Romania
| | - Gelu Onose
- 1 “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, 2 Teaching Emergency Hospital “Bagdasar-Arseni” (TEHBA), Bucharest, Romania
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Nevin S, Melby V. Talking about post-injury sexual functioning: The views of people with spinal cord injuries-A qualitative interview study. Int J Nurs Pract 2021; 28:e12977. [PMID: 34034357 DOI: 10.1111/ijn.12977] [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: 10/13/2020] [Revised: 04/12/2021] [Accepted: 05/09/2021] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to explore perceptions of people with spinal cord injuries regarding the information they received during their rehabilitation programme on post-injury sexual functioning. BACKGROUND Spinal cord injury is a traumatic, life-altering event that is associated with loss of motor and sensory function and sexual impairment. Existing evidence suggests that sexual issues are poorly handled during the rehabilitation phase of the patient's journey. DESIGN A descriptive qualitative design was utilized in this study. METHODS Twenty-nine people with spinal cord injury participated in qualitative in-depth interviews between November 2017 and April 2018, and data were analysed using the Burnard (1991, https://doi.org/10.1016/0260-6917(91)90009-y) thematic analysis framework. RESULTS Some participants indicated they were sexually inactive prior to their spinal cord injury. They testified that they had not received information on post-injury sexual functioning. Many participants who received post-injury information on sexual functioning reported dissatisfaction with the content and timing of this information. CONCLUSION Personal conversations between spinal cord injured patients and dedicated members of the interdisciplinary health team can enhance the quality of rehabilitation care and patients' satisfaction with rehabilitation care. Nurses are central clinicians in the rehabilitation programme of spinal cord injured patients and should engage in individually designed conversations about post-injury sexual functioning.
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Affiliation(s)
- Sheila Nevin
- The Spinal Cord Injuries Unit, Belfast Health & Social Care Trust, Belfast, UK
| | - Vidar Melby
- School of Nursing and Institute of Nursing and Health Research, Ulster University, Derry-Londonderry, UK
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Canori A, Kumar A, Hiremath SV. Factors associated with multiple hospital readmissions for individuals with spinal cord injury. ACTA ACUST UNITED AC 2021; 1:57-61. [PMID: 33554212 DOI: 10.15367/ch.v1i2.399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Objective To identify patient-level and clinical factors associated with multiple hospital readmissions in individuals with spinal cord injury (SCI). Design Retrospective cohort analysis of the publicly available dataset from the SCI Rehabilitation (SCIRehab) study. Setting Six rehabilitation centers in the U.S. that participated in the SCIRehab study. Participants: Individuals with traumatic SCI (N=1371) who were consecutively enrolled in the SCIRehab study. Outcome measures The primary outcome was all-cause hospital readmission within 1 year of discharge from a rehabilitation center. The patient-level and clinical factors include employment status, depression, caregiver support, state-funded insurance, functional status, and rehabilitation services. Results Of the 1170 participants included in the study, 228 were readmitted once and 120 were readmitted multiple times. In our study, 34.2% and 10.8% were readmitted more than once due to genitourinary and respiratory conditions, respectively. Lower utilization of rehabilitation services, lower functional status, unemployment, and depression were associated with higher odds of being readmitted multiple times within one year of discharge from inpatient rehabilitation facility. Conclusion Psychosocial and clinical factors were associated with increased risk for multiple readmissions in individuals with SCI. In order to reduce recurrent readmissions in individuals with SCI, further research is necessary to maximize efficacy of risk factor modification and prevention strategies.
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Affiliation(s)
- Alexandra Canori
- Department of Health and Rehabilitation Sciences, College of Public Health, Temple University
| | - Amit Kumar
- Center for Health Equity Research, Department of Physical Therapy and Athletic Training, Northern Arizona University
| | - Shivayogi V Hiremath
- Department of Health and Rehabilitation Sciences, College of Public Health, Temple University
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Scientific and Clinical Abstracts From WOCNext 2020 Reimagined. J Wound Ostomy Continence Nurs 2020. [DOI: 10.1097/won.0000000000000650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mahooti F, Raheb G, Alipour F, Hatamizadeh N. Psychosocial challenges of social reintegration for people with spinal cord injury: a qualitative study. Spinal Cord 2020; 58:1119-1127. [PMID: 32203067 DOI: 10.1038/s41393-020-0449-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 03/03/2020] [Accepted: 03/09/2020] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Qualitative study, using in-depth, and semi-structured interviews. OBJECTIVE To identify the psychosocial challenges of social reintegration for people with spinal cord injury (SCI) in Iran. SETTING People with SCI living in the community in Iran. METHOD Eleven individuals with SCI with a median time since injury of 12 years (between 9 and 20 years), two family members, and three specialists (two social workers and one physiotherapist) were selected by purposive sampling with maximum variation. In-depth and semi-structured interviews were conducted and finally the data analyzed through qualitative content methodology. RESULTS The psychosocial challenges were categorized into four main categories and twelve subcategories: early crises (denial and disbelief; feelings of isolation and depression; dependency crisis; and a sudden change in the normal course of life), disabling society (stigma; discrimination; employment challenges; and educational restriction), environmental barriers to access (lack of barrier-free environments and transportation challenges), and inappropriate services delivery (incomprehensive rules and lack of specialized training). CONCLUSIONS Providing various psychosocial services is essential for the social reintegration of people with SCI. This goal could be achieved by the provision of medical and physical rehabilitation services. The ultimate purpose of rehabilitation is to reintegrate individuals into society after injury or illness; thus, psychosocial issues must also be considered to ensure effective rehabilitation.
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Affiliation(s)
- Fariba Mahooti
- Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Ghoncheh Raheb
- Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fardin Alipour
- Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Nikta Hatamizadeh
- Department of Rehabilitation Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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14
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Wan FJ, Chien WC, Chung CH, Yang YJ, Tzeng NS. Association between traumatic spinal cord injury and affective and other psychiatric disorders-A nationwide cohort study and effects of rehabilitation therapies. J Affect Disord 2020; 265:381-388. [PMID: 32090763 DOI: 10.1016/j.jad.2020.01.063] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/06/2020] [Accepted: 01/14/2020] [Indexed: 02/09/2023]
Abstract
BACKGROUND This study aimed to investigate the association between traumatic spinal cord injury (TSCI) and the risk of affective and other psychiatric disorders, and the role of the rehabilitation therapies. METHODS In this population-based, retrospective cohort study, we used Taiwan's National Health Insurance Research Database to analyze the patients who were newly diagnosed with TSCI between 2000 and 2015 were included, with a 1:3 ratio by age, sex, and index year matched in the non-TSCI comparison group, for the risk of affective and other psychiatric disorders. RESULTS In total, 5375 out of 16,151 patients with TSCI developed psychiatric disorders, and 1467 out of 48,543 patients in the non-TSCI group developed psychiatric disorders (2930.88 vs 2823.29 per 100,000 persons/year). The Kaplan-Meier analysis showed that the TSCI cohort had a significantly higher risk of psychiatric disorders (log-rank, p < 0.001). Fine and Gray's survival analysis revealed that the adjusted hazard ratio was 1.977 (95% CI: 1.914-2.042, p < 0.001). Rehabilitation therapies, including physical and occupational therapies, within 90 days after the injury, was associated with a lowered risk of psychiatric disorders, including anxiety, depression, and bipolar disorder, in the TSCI cohort (adjusted HR = 0.702 [95% CI: 0.661-0.746, p < 0.001]). In the subgroups with low, medium, and high intensity, rehabilitation therapies were associated with a lowered risk of psychiatric disorders. CONCLUSIONS TSCI was associated with the risk of affective and other psychiatric disorders, and rehabilitation therapies were associated with a lowered risk of these in the TSCI cohort.
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Affiliation(s)
- Fang-Jung Wan
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC; School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC; School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, ROC
| | - Yun-Ju Yang
- Department of Neurological Surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC; Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, ROC.
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15
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Riegel B, Dunbar SB, Fitzsimons D, Freedland KE, Lee CS, Middleton S, Stromberg A, Vellone E, Webber DE, Jaarsma T. Self-care research: Where are we now? Where are we going? Int J Nurs Stud 2019; 116:103402. [PMID: 31630807 DOI: 10.1016/j.ijnurstu.2019.103402] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/04/2019] [Accepted: 08/10/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND OBJECTIVE The beneficial effects of self-care include improved well-being and lower morbidity, mortality, and healthcare costs. In this article we address the current state of self-care research and propose an agenda for future research based on the inaugural conference of the International Center for Self-Care Research held in Rome, Italy in June 2019. The vision of this Center is a world where self-care is prioritized by individuals, families, and communities and is the first line of approach in every health care encounter. The mission of the Center is to lead the self-care research endeavor, improving conceptual clarity and promoting interdisciplinary work informed by a shared vision addressing knowledge gaps. A focused research agenda can deepen our theoretical understanding of self-care and the mechanisms underlying self-care, which can contribute to the development of effective interventions that improve outcomes. METHODS During conference discussions, we identified seven major reasons why self-care is challenging, which can be grouped into the general categories of behavior change and illness related factors. We identified six specific knowledge gaps that, if addressed, may help to address these challenges: the influence of habit formation on behavior change, resilience in the face of stressful life events that interfere with self-care, the influence of culture on self-care behavioral choices, the difficulty performing self-care with multiple chronic conditions, self-care in persons with severe mental illness, and the influence of others (care partners, family, peer supporters, and healthcare professionals) on self-care. PLANS TO ACHIEVE RESULTS To achieve the vision and mission of the Center, we will lead a collaborative program of research that addresses self-care knowledge gaps and improves outcomes, create a supportive international network for knowledge transfer and support of innovations in self-care research, and support and train others in self-care research. Beyond these specific short-term goals, important policy implications of this work are discussed.
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Affiliation(s)
- Barbara Riegel
- School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, PA 19104-4217, USA; Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
| | | | | | | | | | - Sandy Middleton
- Nursing Research Institute, St Vincent's Health Australia & Australian Catholic University, Australia.
| | - Anna Stromberg
- Department of Medical and Health Sciences and Department of Cardiology, Linkoping University, Sweden.
| | | | | | - Tiny Jaarsma
- Julius Center, University Medical Center Utrecht, the Netherlands; Faculty of Medical and Health Sciences, Linkoping University, Sweden.
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Merritt CH, Taylor MA, Yelton CJ, Ray SK. Economic impact of traumatic spinal cord injuries in the United States. ACTA ACUST UNITED AC 2019; 6. [PMID: 33869674 PMCID: PMC8052100 DOI: 10.20517/2347-8659.2019.15] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Individuals having sustained traumatic spinal cord injury (TSCI) in the United States are living longer as compared to historical trends, thanks to an ever-evolving understanding of the nature of this injury. Despite this, multiple barriers to care for TSCI patients remain including variations in government-issued veteran insurance, privatized insurance, and among uninsured individuals. The United States alone experiences 12,000 new TSCI cases every year, many of these are found to occur in a growing proportion of elderly individuals. It is crucial to understand both the short-term direct costs as wells as the long-term rehabilitation costs required by these TSCI patients. The lifetime financial burden for those having sustained a TSCI can be immense for patients, insurance companies, and hospital systems alike. Among those with TSCI, re-hospitalization rates are high, leading to increased healthcare resource utilization within this specific patient population. Costs can quickly balloon into hundreds of thousands of dollars and cause a profound financial burden for these patients. This review article seeks to communicate an understanding of the current financial landscape surrounding TSCI patients. The authors will also examine the costs of acute emergency room surgical care such as American spinal injury association grade, hospital length of stay, as well as the timing delay between injury and surgical decompression. Long-term costs associated with TSCI such as rehabilitation, care of secondary comorbidities, and post-injury employment prospects will be examined as well. These costs will be framed from the patient’s perspective as well as from both the hospital and insurance company’s perspectives. It is hoped a complete understanding as to what makes TSCI such a medically and financially burdensome injury will allow for improved healthcare resource utilization in this population.
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Affiliation(s)
- Christopher H Merritt
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, SC 29209, USA
| | - Matthew A Taylor
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, SC 29209, USA
| | - Caleb J Yelton
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, SC 29209, USA
| | - Swapan K Ray
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, SC 29209, USA
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Trezzini B, Brach M, Post M, Gemperli A. Prevalence of and factors associated with expressed and unmet service needs reported by persons with spinal cord injury living in the community. Spinal Cord 2019; 57:490-500. [DOI: 10.1038/s41393-019-0243-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 01/11/2019] [Accepted: 01/11/2019] [Indexed: 11/09/2022]
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