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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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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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Mohan M, Singh VV, Deb R. Relational Empathy, Holistic Care, and Quality of Life in Persons With Spinal Cord Injuries: A Cross-sectional Study. Am J Phys Med Rehabil 2023; 102:1000-1007. [PMID: 37104645 DOI: 10.1097/phm.0000000000002261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
INTRODUCTION High-quality health systems are built on the concept of patient-centered approach, which includes holistic care and empathy. With time, this has progressively been recognized as a valuable paradigm for better health outcomes, particularly in chronic diseases. OBJECTIVES The study aims to determine the patients' perception during their consultation and to assess the relationship between Consultation and Relational Empathy measure with demographic/injury variables and quality of life. METHODS The present cross-sectional study was conducted among 226 individuals with spinal cord injuries. Data were collected via structured questionnaire, World Health Organization-Quality of life BREF, and Consultation and Relational Empathy measure. Independent t test is used to compare World Health Organization-Quality of life BREF domains with two groups of Consultation and Relational Empathy measure. Logistic regression was used to determine the significant factors of Consultation and Relational Empathy measure. RESULTS In the logistic regression analysis, it was observed that higher quality of life score has significantly higher odds of getting higher Consultation and Relational Empathy score with a remarkable odds ratio (odds ratio = 1.0264, 95% confidence interval = 1.0121-1.0261, P = 0.0001, 0.0472, 0.0001). CONCLUSIONS The quality of life of the present population is closely associated with greater perceptions of holistic care and empathy in the therapeutic patient-provider relationship. Lack of coordination, poor quality of life, and limited communication between patient and provider may arise when the latter focuses only on treating disease rather than treating a patient as a "whole person."
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Affiliation(s)
- Meenakshi Mohan
- From the Amity Institute of Anthropology, Amity University, Noida, India (MM, RD); and Kusum Spine and Neuro Rehabilitation (KSNR), Vasant Kunj, New Delhi, India (VVS)
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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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Kifley A, Arora M, Nunn A, Marshall R, Geraghty T, Weber G, Urquhart S, Craig A, Cameron ID, Middleton JW. Australian arm of the International Spinal Cord Injury (Aus-InSCI) Community Survey: 3. Drivers of quality of life in people with spinal cord injury. Spinal Cord 2023; 61:185-193. [PMID: 35995988 PMCID: PMC10023557 DOI: 10.1038/s41393-022-00845-3] [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: 12/14/2021] [Revised: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional population-based survey for the Australian cohort of the International Spinal Cord Injury (InSCI) Community Survey. OBJECTIVES To differentiate subgroups of people with spinal cord injury (SCI) who self-report good and poor overall quality of life (QoL) using domains of the International Classification of Functioning (ICF), and to evaluate how these factors contribute to QoL when considered together, while controlling confounders. SETTING Australian survey data from four state-wide SCI services, one government insurance agency, and three not-for-profit consumer organisations. METHODS Explanatory factors for QoL were compared between participants reporting poor vs. good QoL. Path models estimated total, direct and mediated contributions from each explanatory factor to QoL ratings after accounting for confounders. RESULTS Most participants (62%) reported good or very good QoL, 12% reported poor or very poor QoL. When explanatory factors were considered together, the strongest total effects on QoL involved social integration (+0.36 SDs), subjective social position (+0.29), secondary health condition burden (-0.28), activity/participation problem burden (-0.26), day-to-day assistance (-0.26), mental health (+0.18), pain (-0.16), self-efficacy (+0.15), vitality (+0.14) and environmental barriers (-0.11). Effects of social integration, mental health, vitality, self-efficacy, pain and activity/participation problems were partly or wholly direct. CONCLUSION Opportunities to improve QoL in people with SCI exist at every level of the health system. Virtually all aspects of the ICF framework make a substantive difference to QoL outcomes. Social and psychological factors and ability to complete desired activities have key direct effects and influence effects of secondary health condition burden and environmental barriers.
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Affiliation(s)
- Annette Kifley
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia.
- Sydney Medical School-Northern, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Mohit Arora
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia
- Sydney Medical School-Northern, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Andrew Nunn
- Victorian Spinal Cord Service, Austin Health, Heidelberg, VIC, Australia
| | - Ruth Marshall
- South Australian Spinal Cord Injury Service, Central Adelaide Local Health Network, Adelaide, SA, Australia
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Timothy Geraghty
- Queensland Spinal Cord Injuries Service, Division of Rehabilitation, Princess Alexandra Hospital, Brisbane, QLD, Australia
- The Hopkins Centre, Griffith University, Brisbane, QLD, Australia
| | - Gerard Weber
- Spinal Injury Unit, Royal Rehab, Ryde, NSW, Australia
| | - Sue Urquhart
- Queensland Spinal Cord Injury Service, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Ashley Craig
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia
- Sydney Medical School-Northern, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia
- Sydney Medical School-Northern, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - James W Middleton
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia
- Sydney Medical School-Northern, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- State Spinal Cord Injury Service, Agency for Clinical Innovation, St Leonards, NSW, Australia
- Spinal Outreach Service, Royal Rehab, Ryde, NSW, Australia
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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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Treatment patterns of in-patient spasticity medication use after traumatic spinal cord injury: a prospective cohort study. Spinal Cord 2018; 56:1176-1183. [PMID: 29904191 DOI: 10.1038/s41393-018-0165-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/16/2018] [Accepted: 05/21/2018] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Prospective cohort study using the Rick Hansen SCI Registry (RHSCIR) and retrospective medical chart review. OBJECTIVE To describe treatment patterns of in-patient anti-spasticity medication use following traumatic spinal cord injury (SCI) in acute and rehabilitation hospital settings in British Columbia, Canada. SETTING Quaternary trauma center, rehabilitation center. METHODS Individuals with traumatic SCI between 2005 and 2014 enrolled in the Vancouver RHSCIR site (N = 917) were eligible for inclusion. Oral and injectable anti-spasticity medication use were the main outcome measures. RESULTS In 769 participants, higher neurological level and injury severity were associated with in-patient anti-spasticity medication use (p < 0.001 for both). Of individuals with cervical and thoracic injuries (n = 589), 37% were prescribed anti-spasticity medication during hospital admission. Baclofen was the most commonly used first line oral therapy. Mean (SD) and median time from injury to Baclofen initiation was 70 (69) and 50 days, respectively. The probability of having initiated an in-patient anti-spasticity medication was 55% (95% CI (49, 60)) for individuals 6 months post-injury, and 71% (95% CI (62, 79)) for individuals 12 months post-injury. At community discharge, the prevalence of oral and injectable anti-spasticity medication use was 26 and 5%. Practice patterns of anti-spasticity medication use (2005-2009 vs. 2010-2014) have not changed significantly over time. CONCLUSIONS This is the first large prospective cohort study of in-patient anti-spasticity medication use following traumatic SCI. Results from our study inform clinicians and individuals of "real world" anti-spasticity medication use among individuals with traumatic SCI and may help guide care for this population in the community.
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Sweet SN, Rocchi M, Arbour-Nicitopoulos K, Kairy D, Fillion B. A Telerehabilitation Approach to Enhance Quality of Life Through Exercise Among Adults With Paraplegia: Study Protocol. JMIR Res Protoc 2017; 6:e202. [PMID: 29051134 PMCID: PMC5668635 DOI: 10.2196/resprot.8047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 08/16/2017] [Accepted: 09/06/2017] [Indexed: 11/28/2022] Open
Abstract
Background Despite compelling evidence linking physical activity and quality of life among adults with spinal cord injury (SCI), exercise participation rates are extremely low in this population. Unfortunately, a lack of behavioral exercise interventions, in particular theory-based randomized controlled trials (RCT), exists within the SCI literature. A pilot RCT is needed to first examine the feasibility to conduct such interventions and determine the appropriate effect size to inform future full-scale interventions. Objective The overall goal of this pilot RCT is to test an 8-week innovative, video-based telerehabilitation intervention based on self-determination theory and aimed at enhancing the basic psychological needs, motivation, exercise participation, and quality of life‒related outcomes of adults with paraplegia. The objectives are to (1) determine if individuals in the intervention group have greater increases in their basic psychological needs and autonomous motivation and a decrease in controlled motivation compared to the control group, (2) determine whether the intervention group reports greater increases in exercise participation and quality of life‒related variables (eg, life satisfaction, participation in daily/social activities, depressive symptoms) compared to the control group, and (3) examine if adults with paraplegia who received the intervention report improved scores on psychosocial predictors of exercise (eg, action planning) and well-being (eg, positive affect) compared to the control group. We also aimed to examine the implementation characteristics of the intervention (eg, satisfaction with the technology, counselor’s ability to foster the psychological needs). Methods Adults with paraplegia (N=24) living in the community will be recruited. All participants will be invited to complete assessments of their psychological needs, motivation, exercise, and quality of life‒related variables at three time points (baseline, 6, and 10 weeks). Following the baseline assessment, participants will be randomly assigned to the intervention or control group. Participants in the intervention group will participate in 8 weekly, 1-hour video-based telerehabilitation sessions with a trained physical activity counselor, while participants in the control group will be asked to continue with their regular routine. Results We expect higher ratings of the basic psychological needs and autonomous motivation and lower scores for controlled motivation for the intervention group compared to the control group (Objective 1). We also expect that our video-based intervention will have moderate effects on exercise participation, as well as small-to-moderate positive effects on the quality of life‒related variables (Objective 2). Finally, we expect the intervention to have a small positive effect on psychosocial predictors of physical activity and well-being (Objective 3). Conclusions We anticipate that the results will show that the intervention is appropriate for adults with paraplegia and feasible to test in a full-scale RCT. Trial Registration ClinicalTrials.gov NCT02833935; https://clinicaltrials.gov/ct2/show/NCT02833935 (Archived by WebCite at http://www.webcitation.org/6u8U9x2yt)
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Affiliation(s)
- Shane Norman Sweet
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | - Meredith Rocchi
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | | | - Dahlia Kairy
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), École de réadaptation, Université de Montréal, Montreal, QC, Canada
| | - Brigitte Fillion
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Centre de réadaptation Lucie-Bruneau, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
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Noonan VK, Chan E, Santos A, Soril L, Lewis R, Singh A, Cheng CL, O'Connell C, Truchon C, Paquet J, Christie S, Ethans K, Tsai E, Ford MH, Drew B, Linassi AG, Bailey CS, Fehlings MG. Traumatic Spinal Cord Injury Care in Canada: A Survey of Canadian Centers. J Neurotrauma 2017; 34:2848-2855. [PMID: 28367684 PMCID: PMC5653141 DOI: 10.1089/neu.2016.4928] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Specialized centers of care for persons sustaining a traumatic spinal cord injury (tSCI) have been established in many countries, but the ideal system of care has not been defined. The objective of this study was to describe care delivery, with a focus on structures and services, for persons with tSCI in Canada. A survey was sent to 26 facilities (12 acute, 11 rehabilitation, and three integrated) from eight provinces participating in the Access to Care and Timing project. The survey included questions about: 1) care provision; 2) structural attributes and; 3) service availability. Survey completion rate was 100%. Data sources used to complete the survey were the Rick Hansen Spinal Cord Injury Registry, other hospital databases, clinical protocols, and subject matter experts. Acute and rehabilitation care provided by integrated facilities were described separately, resulting in data from 15 acute and 14 rehabilitation facilities. The number of admissions for tSCI over a 12-month period between 2009-2011 ranged from 17 to 104 (median 39), and 11 to 96 (median 32), for acute and rehabilitation facilities, respectively. Grouping of patients was reported by 8/15 acute and 10/14 rehabilitation facilities. Criteria for admission to the inpatient rehabilitation facilities varied among facilities (25 different criteria reported). Results from the survey revealed similarities in the basic structure and the provision of general services, but also some differences in the degree of specialization of care for persons with tSCI. Continued work on the impact of specialized care for both the patient and healthcare system is needed.
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Affiliation(s)
| | - Elaine Chan
- Rick Hansen Institute, Vancouver, British Columbia, Canada
| | - Argelio Santos
- Rick Hansen Institute, Vancouver, British Columbia, Canada
| | - Lesley Soril
- Rick Hansen Institute, Vancouver, British Columbia, Canada
| | - Rachel Lewis
- Centre for Operations Excellence, Sauder School of Business, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anoushka Singh
- Spinal Cord Injury Clinical Research Unit, Toronto Western Hospital, Toronto, Ontario, Canada
| | | | - Colleen O'Connell
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Catherine Truchon
- Trauma and Critical Care Evaluation Unit, Institut national d'excellence en santé et en services sociaux, Québec City, Québec, Canada
| | - Jérôme Paquet
- Department of Surgery, Université Laval, Québec City, Québec, Canada
| | - Sean Christie
- Division of Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Karen Ethans
- Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Eve Tsai
- Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Michael H. Ford
- Orthopedic Spine and Trauma, Integrated Spine Unit, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - Brian Drew
- Department of Orthopedic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - A. Gary Linassi
- Department of Physical Medicine and Rehabilitation, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Moreno A, Zidarov D, Raju C, Boruff J, Ahmed S. Integrating the perspectives of individuals with spinal cord injuries, their family caregivers and healthcare professionals from the time of rehabilitation admission to community reintegration: protocol for a scoping study on SCI needs. BMJ Open 2017; 7:e014331. [PMID: 28780539 PMCID: PMC5724190 DOI: 10.1136/bmjopen-2016-014331] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION There is fragmented information about the different needs following a spinal cord injury (SCI). Expressed SCI needs can be met or unmet, they change along the rehabilitation continuum (eg, acute, rehabilitation and reintegration into the community) and can be different for traumatic and non traumatic SCI. The general objective of this scoping study is to evaluate and integrate the needs of individuals with traumatic and non-traumatic SCI, their family caregivers and those reported by rehabilitation professionals from the time of rehabilitation admission to community reintegration. The specific objectives are to: (A) synthesise the needs of individuals with SCI as perceived by themselves, their family caregivers and rehabilitation professionals using two theoretical models, (B) classify needs as met and unmet, (C) explore the evolution of met/unmet needs from the time of rehabilitation admission to community reintegration and (D) provide recommendations to improve SCI care. METHODS AND ANALYSIS: (A) identifying the most frequent met and unmet needs reported by adults with traumatic and non-traumatic SCI, their family caregivers and their rehabilitation professionals from the time of rehabilitation admission to community reintegration; (B) identifying relevant studies with a search in electronic databases; (C) charting the data based on categories refined and adjusted with a stakeholder group; (D) collating, summarising and reporting the results using two analytical frameworks (Maslow's hierarchical model of human needs and the Ferrans et al's model of health-related quality of life) and (E) a stakeholder consultation phase. ETHICS AND DISSEMINATION The results of this scoping study will allow understanding SCI needs from the time of rehabilitation admission to community reintegration from the perspective of different stakeholders. An integrated master report combining the needs of individuals with SCI from the perspectives of different stakeholders from the time of rehabilitation admission to community reintegration will follow the consultation meetings.
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Affiliation(s)
- Alexander Moreno
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Diana Zidarov
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Chandhana Raju
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Jill Boruff
- Schulich Library of Science and Engineering, McGill University, Montreal, Canada
| | - Sara Ahmed
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
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LaVela SL, Heinemann AW, Etingen B, Miskovic A, Locatelli SM, Chen D. Relational empathy and holistic care in persons with spinal cord injuries. J Spinal Cord Med 2017; 40:30-42. [PMID: 26833180 PMCID: PMC5376142 DOI: 10.1080/10790268.2015.1114227] [Citation(s) in RCA: 14] [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: 10/22/2022] Open
Abstract
OBJECTIVE Describe perceptions of persons with SCI on their receipt of holistic care and relational empathy during health care encounters. DESIGN Mailed survey. PARTICIPANTS/SETTING Individuals with SCI who received care from the largest suppliers of SCI care and rehabilitation (Veterans Health Administration and SCI Model Systems). OUTCOME MEASURES Using a survey and administrative databases, we collected demographic and injury characteristics, health status, health conditions, and the main outcome: Consultation and Relational Empathy (CARE) measure. RESULTS The sample included 450 individuals with SCI (124 Veterans and 326 civilians). Response rate was 39% (450/1160). Analyses were conducted on patients with complete data (n = 389). Veterans and civilians with SCI differed across many demographic characteristics, age at injury, and etiology, but mean CARE scores were equivalent. Fewer than half of the full SCI cohort had CARE scores above the normative value of 43. Having a recent pressure ulcer showed a trend for lower odds of having a normative or higher CARE score. Odds of having an above-normative CARE score were nearly 2 times greater for individuals with tetraplegia, and odds were higher for those with higher physical and mental health status. CONCLUSIONS Higher physical and mental health status and tetraplegia were each independently associated with greater perceptions of holistic care and empathy in the therapeutic patient-provider relationship. Limited empathy, communication, and holistic care may arise when providers focus on disease/disease management, rather than on patients as individuals. Frequent health care use and secondary conditions may affect empathy and holistic care in encounters, making it essential to understand and employ efforts to improve the therapeutic relationship between patients with SCI and their providers.
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Affiliation(s)
- Sherri L. LaVela
- Department of Veterans Affairs (VA), Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr. VA Hospital, Hines, IL, USA
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA
- Center for Healthcare Studies, Institute for Public Health and Medicine, General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Allen W. Heinemann
- Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL, USA
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Bella Etingen
- Department of Veterans Affairs (VA), Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr. VA Hospital, Hines, IL, USA
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA
| | - Ana Miskovic
- Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL, USA
| | - Sara M. Locatelli
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA
| | - David Chen
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Rehabilitation Institute of Chicago, Chicago, IL, USA
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Prevalence of secondary medical complications and risk factors for pressure ulcers after traumatic spinal cord injury during acute care in South Africa. Spinal Cord 2015; 54:535-9. [DOI: 10.1038/sc.2015.189] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 09/06/2015] [Accepted: 09/16/2015] [Indexed: 11/09/2022]
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Post MW, Charlifue S, Biering-Sørensen F, Catz A, Dijkers MP, Horsewell J, Noonan VK, Noreau L, Tate DG, Sinnott KA. Development of the International Spinal Cord Injury Activities and Participation Basic Data Set. Spinal Cord 2015; 54:530-4. [PMID: 26481708 DOI: 10.1038/sc.2015.188] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 05/23/2015] [Accepted: 05/27/2015] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Consensus decision-making process. OBJECTIVES The objective of this study was to develop an International Spinal Cord Injury (SCI) Activities and Participation (A&P) Basic Data Set. SETTING International working group. METHODS A committee of experts was established to select and define A&P data elements to be included in this data set. A draft data set was developed and posted on the International Spinal Cord Society (ISCoS) and American Spinal Injury Association websites and was also disseminated among appropriate organizations for review. Suggested revisions were considered, and a final version of the A&P Data Set was completed. RESULTS Consensus was reached to define A&P and to incorporate both performance and satisfaction ratings. Items that were considered core to each A&P domain were selected from two existing questionnaires. Four items measuring activities were selected from the Spinal Cord Independence Measure III to provide basic data on task execution in activities of daily living. Eight items were selected from the Craig Handicap Assessment and Reporting Technique to provide basic data on the frequency of participation. An additional rating of satisfaction on a three-point scale for each item completes the total of 24 A&P variables. CONCLUSION Collection of the International SCI A&P Basic Data Set variables in all future research on SCI outcomes is advised to facilitate comparison of results across published studies from around the world. Additional standardised instruments to assess activities of daily living or participation can be administered, depending on the purpose of a particular study.
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Affiliation(s)
- M W Post
- Brain Center Rudolf Magnus and Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation Centre, Utrecht, The Netherlands.,Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - F Biering-Sørensen
- Department for Spinal Cord Injuries, Rigshospitalet and Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark
| | - A Catz
- Loewenstein Rehabilitation Hospital, Raanana, and Tel-Aviv University, Tel-Aviv, Israel
| | - M P Dijkers
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Horsewell
- The European Spinal Cord Injury Federation, Copenhagen, Denmark
| | - V K Noonan
- The Rick Hansen Institute, Vancouver, BC, Canada
| | - L Noreau
- Université Laval and Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, QC, Canada
| | - D G Tate
- University of Michigan, Department of Physical Medicine and Rehabilitation, Ann Arbor, MI, USA
| | - K A Sinnott
- Burwood Academy of Independent Living, Christchurch, New Zealand
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