1
|
Mourits BMP, den Hartog SJ, de Graaf JA, Roozenbeek B, Post MWM, Visser-Meily JMA, Scholten EWM. Exploring patients' experience using PROMs within routine post-discharge follow-up assessment after stroke: a mixed methods approach. J Patient Rep Outcomes 2024; 8:46. [PMID: 38668901 PMCID: PMC11052975 DOI: 10.1186/s41687-024-00724-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 04/17/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Patient Reported Outcomes Measures (PROMs) are being used increasingly to measure health problems in stroke clinical practice. However, the implementation of these PROMs in routine stroke care is still in its infancy. To understand the value of PROMs used in ischemic stroke care, we explored the patients' experience with PROMs and with the consultation at routine post-discharge follow-up after stroke. METHODS In this prospective mixed methods study, patients with ischemic stroke completed an evaluation questionnaire about the use of PROMs and about their consultation in two Dutch hospitals. Additionally, telephone interviews were held to gain in-depth information about their experience with PROMs. RESULTS In total, 63 patients completed the evaluation questionnaire of which 10 patients were also interviewed. Most patients (82.2-96.6%) found completing the PROMs to be feasible and relevant. Half the patients (49.2-51.6%) considered the PROMs useful for the consultation and most patients (87.3-96.8%) reported the consultation as a positive experience. Completing the PROMs provided 51.6% of the patients with insight into their stroke-related problems. Almost 75% of the patients found the PROMs useful in giving the healthcare provider greater insight, and 60% reported discussing the PROM results during the consultation. Interviewed patients reported the added value of PROMs, particularly when arranging further care, in gaining a broader insight into the problems, and in ensuring all important topics were discussed during the consultation. CONCLUSIONS Completing PROMs appears to be feasible for patients with stroke attending post-discharge consultation; the vast majority of patients experienced added value for themselves or the healthcare provider. We recommend that healthcare providers discuss the PROM results with their patients to improve the value of PROMs for the patient. This could also improve the willingness to complete PROMs in the future.
Collapse
Affiliation(s)
- B M P Mourits
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
| | - S J den Hartog
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - J A de Graaf
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center, Utrecht, The Netherlands
| | - B Roozenbeek
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - M W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - J M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center, Utrecht, The Netherlands
| | - E W M Scholten
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| |
Collapse
|
2
|
de Groot S, Adriaansen JJE, Stolwijk-Swüste JM, Osterthun R, van den Berg-Emons RJG, Post MWM. Obesity in wheelchair users with long-standing spinal cord injury: prevalence and associations with time since injury and physical activity. Spinal Cord 2024:10.1038/s41393-024-00995-6. [PMID: 38649757 DOI: 10.1038/s41393-024-00995-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024]
Abstract
STUDY DESIGN Secondary analysis of cross-sectional data from the ALLRISC cohort study. OBJECTIVES To investigate the prevalence of obesity and its association with time since injury (TSI) and physical activity (PA) in wheelchair users with long-standing (TSI > 10 years) spinal cord injury (SCI). SETTING Community, The Netherlands. METHODS Wheelchair users with SCI (N = 282) in TSI strata (10-19, 20-29, and ≥30 years) and divided in meeting SCI-specific exercise guidelines or not. Waist circumference (WC) and body mass index (BMI) were assessed. Participants were classified as being obese (WC > 102 cm for men, WC > 88 cm for women; BMI ≥ 25 kg/m2) or not. Logistic regression analyses were performed to investigate the associations between obesity and TSI and PA. RESULTS Almost half of the participants (45-47%) were classified as obese. TSI was significantly associated with obesity, the odds of being obese were 1.4 higher when having a 10 years longer TSI. Furthermore, the odds of being obese were 2.0 lower for participants who were meeting the exercise guidelines. CONCLUSIONS The prevalence of obesity is high in people with long-standing SCI. Those with a longer TSI and individuals who do not meet the exercise guidelines are more likely to be obese and need to be targeted for weight management interventions.
Collapse
Affiliation(s)
- Sonja de Groot
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands.
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
| | | | - Janneke M Stolwijk-Swüste
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Rutger Osterthun
- Rijndam Rehabilitation, Rotterdam, The Netherlands
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Rita J G van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marcel W M Post
- De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Centre for Rehabilitation, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| |
Collapse
|
3
|
van Leeuwen CMC, Papazoglou E, van Eersel JHW, Stolwijk-Swüste JM, Post MWM. Associations between personality traits and depressive and anxiety symptoms among persons with spinal cord injury in first inpatient rehabilitation. Spinal Cord 2024; 62:178-182. [PMID: 38388760 DOI: 10.1038/s41393-024-00964-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/12/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024]
Abstract
STUDY DESIGN Retrospective analysis of medical records. OBJECTIVE To assess personality traits in persons with spinal cord injury (SCI) and compare these with the general population group. Moreover, to explore associations between personality traits and depressive and anxiety symptoms among persons with SCI in first inpatient rehabilitation. SETTING Specialized rehabilitation center in The Netherlands. METHODS Data were used from a routine psychological screening, administered in the first weeks of admission (N = 67). Measures included the Hospital Anxiety and Depression Scale and the Dutch Personality Questionnaire, which includes subscales measuring neuroticism, social inadequacy, rigidity, hostility, egoism, dominance, and self-esteem. Correlational and regression analyses were conducted. RESULTS Mean age of the participants was 58 (SD 17) years. The majority (63%) were male, and had a low lesion (57%). The participants scored significantly higher on dominance and lower on social inadequacy, hostility, and egoism in comparison with the general population. In the bivariate regression analyses, high neuroticism (β = 0.42 and β = 0.53) and low self-esteem (β = -0.25 and β = -0.29) were significantly associated with increased depressive and anxiety symptoms. In the hierarchical regression analyses, only high neuroticism was significantly associated with increased depressive (β = 0.42, p < 0.05) and anxiety (β = 0.55, p < 0.001) symptoms. CONCLUSIONS Personality traits are not the same between the SCI population and the general population. Assessment of personality traits early in inpatient rehabilitation can help to identify individuals at risk of mood problems and, thereby, facilitate interventions. Future research with a larger, representative SCI sample, is required to confirm these findings.
Collapse
Affiliation(s)
- Christel M C van Leeuwen
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
- Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
| | - Erika Papazoglou
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | | | - Janneke M Stolwijk-Swüste
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- University of Groningen, University Medical Centre Groningen, Centre for Rehabilitation, Groningen, The Netherlands
| |
Collapse
|
4
|
Sadiqi S, de Gendt EEA, Muijs SPJ, Post MWM, Benneker LM, Holas M, Tee JW, Albers CE, Häckel S, Svac J, Bransford RJ, El-Sharkawi MM, Kandziora F, Rajasekaran S, Schnake KJ, Vaccaro AR, Oner FC. Validation of the AO Spine CROST (Clinician Reported Outcome Spine Trauma) in the clinical setting. Eur Spine J 2024; 33:1607-1616. [PMID: 38367026 DOI: 10.1007/s00586-024-08145-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/19/2023] [Accepted: 01/13/2024] [Indexed: 02/19/2024]
Abstract
PURPOSE To evaluate feasibility, internal consistency, inter-rater reliability, and prospective validity of AO Spine CROST (Clinician Reported Outcome Spine Trauma) in the clinical setting. METHODS Patients were included from four trauma centers. Two surgeons with substantial amount of experience in spine trauma care were included from each center. Two separate questionnaires were administered at baseline, 6-months and 1-year: one to surgeons (mainly CROST) and another to patients (AO Spine PROST-Patient Reported Outcome Spine Trauma). Descriptive statistics were used to analyze patient characteristics and feasibility, Cronbach's α for internal consistency. Inter-rater reliability through exact agreement, Kappa statistics and Intraclass Correlation Coefficient (ICC). Prospective analysis, and relationships between CROST and PROST were explored through descriptive statistics and Spearman correlations. RESULTS In total, 92 patients were included. CROST showed excellent feasibility results. Internal consistency (α = 0.58-0.70) and reliability (ICC = 0.52 and 0.55) were moderate. Mean total scores between surgeons only differed 0.2-0.9 with exact agreement 48.9-57.6%. Exact agreement per CROST item showed good results (73.9-98.9%). Kappa statistics revealed moderate agreement for most CROST items. In the prospective analysis a trend was only seen when no concerns at all were expressed by the surgeon (CROST = 0), and moderate to strong positive Spearman correlations were found between CROST at baseline and the scores at follow-up (rs = 0.41-0.64). Comparing the CROST with PROST showed no specific association, nor any Spearman correlations (rs = -0.33-0.07). CONCLUSIONS The AO Spine CROST showed moderate validity in a true clinical setting including patients from the daily clinical practice.
Collapse
Affiliation(s)
- Said Sadiqi
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Erin E A de Gendt
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sander P J Muijs
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marcel W M Post
- Rehabilitation Center 'De Hoogstraat', Utrecht, The Netherlands
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, Groningen, The Netherlands
| | - Lorin M Benneker
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital Bern, University Bern, Bern, Switzerland
| | - Martin Holas
- Department of Trauma Surgery, Slovak Medical University, F. D. Roosevelt University General Hospital, Banska Bystrica, Slovakia
| | - Jin W Tee
- Department of Neurosurgery, Alfred Hospital, Melbourne, VIC, Australia
- Department of Surgery, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Christoph E Albers
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital Bern, University Bern, Bern, Switzerland
| | - Sonja Häckel
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital Bern, University Bern, Bern, Switzerland
| | - Juraj Svac
- Department of Trauma Surgery, Slovak Medical University, F. D. Roosevelt University General Hospital, Banska Bystrica, Slovakia
| | - Richard J Bransford
- Department of Orthopaedics and Sports Medicine, University of Washington/Harborview Medical Center, Seattle, WA, USA
| | - Mohammad M El-Sharkawi
- Department of Orthopaedic and Trauma Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
| | | | | | - Klaus J Schnake
- Center for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien, Erlangen, Germany
| | - Alexander R Vaccaro
- Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA
| | - F Cumhur Oner
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
5
|
Postma K, van Diemen T, Post MWM, Stolwijk-Swüste JM, van den Berg-Emons RJG, Osterthun R. Correlates of physical activity in ambulatory people with spinal cord injury during the first year after inpatient rehabilitation. Spinal Cord 2024:10.1038/s41393-024-00982-x. [PMID: 38509176 DOI: 10.1038/s41393-024-00982-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 03/22/2024]
Abstract
STUDY DESIGN Longitudinal cohort study. OBJECTIVES Examine the longitudinal association between mobility and level of physical activity (PA) and explore which other factors are also associated with level of PA in ambulatory people with Spinal Cord Injury (SCI) during the first-year post-inpatient rehabilitation. SETTING Three SCI-specialized rehabilitation centers and the Dutch community. METHODS Forty-seven adults with recent SCI and ambulatory function were included. All had motor incomplete lesions, 49% had tetraplegia, and the mean age was 55 ± 13 years. Duration of accelerometry-based all-day PA and self-reported level of mobility, exertion of walking, pain, fatigue, depressive mood symptoms, fear of falling, exercise self-efficacy, and attitude toward PA were measured just before discharge from inpatient rehabilitation and 6 and 12 months after discharge. All data were longitudinally analyzed using generalized estimating equations analyses. Models were corrected for age, lesion level, and time since injury. RESULTS Mobility was longitudinally associated with level of PA (beta: 4.5, P < 0.001, R2: 41%). In addition, lower levels of exertion of walking (beta: -5.6, P < 0.001), fear of falling (beta: -34.1, P < 0.001), and higher levels of exercise self-efficacy (beta: 2.3, P = 0.038) were associated with higher levels of PA. Exertion of walking and fear of falling were associated with level of PA independent of mobility. CONCLUSIONS Mobility, exertion of walking, fear of falling, and exercise self-efficacy seem to be correlates of level of PA in ambulatory people with SCI during the first year after inpatient rehabilitation. Targeting these factors using an interdisciplinary approach may enhance levels of PA in this population.
Collapse
Affiliation(s)
- Karin Postma
- Rijndam Rehabilitation, Rotterdam, The Netherlands.
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Tijn van Diemen
- Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- University of Groningen, University Medical Centre Groningen, Centre for Rehabilitation, Groningen, The Netherlands
| | - Janneke M Stolwijk-Swüste
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | | | - Rutger Osterthun
- Rijndam Rehabilitation, Rotterdam, The Netherlands
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
6
|
Hakbijl-van der Wind AJ, Rohn EJ, Tate DG, van Leeuwen CMC, Forchheimer M, Stolwijk-Swüste JM, Charlifue S, Greve JMD, New PW, Post MWM. The social dimension of quality of life following spinal cord injury or disease: an international ICF-linking study. Spinal Cord 2024; 62:104-109. [PMID: 38158409 DOI: 10.1038/s41393-023-00954-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/21/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
STUDY DESIGN International Classification of Functioning, Disability and Health (ICF) linking study. OBJECTIVE Analyze cognitive interview data using the ICF as an analytic framework, to examine aspects of social life relevant to quality of life (QoL) according to people with spinal cord injury or disease (SCI/D). This study builds upon results of an international study about the cross-cultural validity of the International SCI QoL Basic Data Set (QoL-BDS). SETTING Four specialized outpatient clinics in SCI/D rehabilitation, from the US, Brazil and Australia. METHODS Analysis of qualitative data from 39 cognitive interviews with SCI/D patients at least one year post onset. Participants were asked to define their concept of QoL, overall life satisfaction, physical health and psychological health, and other relevant matters. Four independent researchers coded text fragments related to the items, and fragments were linked to ICF chapters d6-d9, following established linking rules. RESULTS The proportion of text referring to social life was 35.8% (definition QoL), 24.9% (QoL life as whole), 6.0% (physical health) and 34.9% (psychological health). The most frequent ICF categories were d760 Family relationships, d770 Intimate relationships and d920 Recreation and leisure. Most frequent responded social topics to the 'other issues' item were d770 Intimate relationships, d760 Formal relationships, and d870 Economic self-sufficiency. CONCLUSION The importance of social life aspects to the QoL was highlighted based on responses of SCI/D patients, clearly demonstrated through the ICF linking process. Adding a satisfaction with social life item to the QoL-BDS has made this instrument a more comprehensive measure.
Collapse
Affiliation(s)
- Aline J Hakbijl-van der Wind
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
| | - Edward J Rohn
- Department of Interdisciplinary Health Sciences, Oakland University, Rochester, MI, USA
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Denise G Tate
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Christel M C van Leeuwen
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Martin Forchheimer
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Janneke M Stolwijk-Swüste
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | | | - Julia M D Greve
- Department of Orthopedics and Traumatology, Medical School of University of São Paulo, São Paulo, Brazil
| | - Peter W New
- Spinal Rehabilitation Service, Caulfield Hospital, Alfred Health, Melbourne, VIC, Australia
- Epworth-Monash Rehabilitation Medicine Unit, Monash University, Melbourne, VIC, Australia
- Department of Epidemiology and Preventative Medicine, School of Public Health & Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - Marcel W M Post
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| |
Collapse
|
7
|
Escorpizo R, Naud S, Post MWM, Schwegler U, Engkasan J, Halvorsen A, Geraghty T, Sadowsky C. Relationship between employment and quality of life and self-perceived health in people with spinal cord injury: an international comparative study based on the InSCI Community Survey. Spinal Cord 2024; 62:110-116. [PMID: 38160224 DOI: 10.1038/s41393-023-00953-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/08/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES Work-related disability is common in persons with spinal cord injury (SCI). The aims of this study are to examine the associations of employment with self-perceived health (SPH) and quality of life (QoL) across 22 countries and to explore the covariates around employment and SPH and QoL. SETTING Community. METHODS We analyzed 9494 community-dwelling persons with SCI aged 18-65. We performed an adjusted regression and path analysis. The independent variable was 'employment' and the dependent variables were two single items: QoL (very poor to very good) and SPH (excellent to poor). Covariates included the Gross Domestic Product (GDP), education, time since SCI, age, gender, years of employment after SCI, SCI level (paraplegia, tetraplegia), and completeness of SCI. RESULTS Participants' mean age was 47, 74% were male, and 63% had paraplegia. We found an association between employment and QoL and SPH. While the magnitude of the effect of employment on QoL did not differ across GDP quartiles, its perceived effect on QoL was found to be significant in the highest GDP quartile. Employment was predictive of good SPH in two GDP quartiles (Q1 and Q4), but significant across all quartiles when predicting poor perceptions, with the magnitude of effect varying significantly. CONCLUSIONS Employment is closely related to QoL and SPH depending on the GDP. We may positively influence the QoL and SPH in the SCI population to promote better employment outcomes by considering the infrastructure and economy.
Collapse
Affiliation(s)
- Reuben Escorpizo
- The University of Vermont, Department of Rehabilitation and Movement Science, Burlington, VT, USA.
- Swiss Paraplegic Research, Nottwil, Switzerland.
| | - Shelly Naud
- The University of Vermont, Department of Rehabilitation and Movement Science, Burlington, VT, USA
| | - Marcel W M Post
- Centre of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- University of Groningen, University Medical Centre Groningen, Centre for Rehabilitation, Groningen, The Netherlands
| | - Urban Schwegler
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | | | - Annette Halvorsen
- Clinic of Rehabilitation, Department of Spinal Cord Injuries, St Olavs hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Medical Quality Registries, St Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Timothy Geraghty
- Division of Rehabilitation, Princess Alexandra Hospital, and The Hopkins Centre, Metro South Health and Griffith University, Brisbane, Australia
| | - Cristina Sadowsky
- Kennedy Krieger Institute / Johns Hopkins School of Medicine, Baltimore, MD, USA
| |
Collapse
|
8
|
Slenders JPL, de Graaf JA, Post MWM, van Heugten CM, Van den Berg-Vos RM, Kwa VIH, Visser-Meily JMA. Participation in daily life activities at two months after stroke predicts long-term health-related quality of life. Top Stroke Rehabil 2024; 31:11-20. [PMID: 37056169 DOI: 10.1080/10749357.2023.2202017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/09/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND After stroke, many patients experience problems with participation in daily activities. Improving participation is the main goal in stroke rehabilitation. However, the longitudinal relationship between participation and health-related quality of life (HRQoL) remains unclear. OBJECTIVES This study aimed to examine (1) the predictive value of participation at two months on long-term HRQoL and (2) the longitudinal relationship between participation and HRQoL. METHODS In this multicenter, prospective cohort study, patients were assessed at two and 12 months after stroke. Participation was measured with the Restriction subscale of the Utrecht Scale for Evaluation of Rehabilitation - Participation. HRQoL was assessed with the three-level version of the EuroQoL five dimensions questionnaire index score. RESULTS This study included 291 patients. Mean age was 66.6 ± 12.4 years, 64.3% were male and mean National Institutes of Health Stroke Scale (NIHSS) was 2.5 ± 2.9. Multivariable linear regression, adjusted for demographic characteristics, stroke characteristics, physical and cognitive impairment, showed that a higher level of participation at two months correlated with a higher HRQoL at one year (B = .004; 95% CI =.002-.005). Patients whose participation improved had a greater increase in HRQoL, compared to patients without improvement (0.080 ± .21 versus -.054 ± .21; p < .001). CONCLUSIONS The level of participation at two months post-stroke predicts HRQoL at one year. Improvement in participation during the first year after stroke is associated with improvement in HRQoL. We recommend including the assessment of participation in daily activities at follow-up visits.
Collapse
Affiliation(s)
| | - Joris A de Graaf
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Caroline M van Heugten
- School for Mental Health & Neuroscience, Maastricht University Medical Center, Maastricht, Netherlands
- Department of Neuropsychology & Psychopharmacology, Maastricht University, Maastricht, Netherlands
| | - Renske M Van den Berg-Vos
- Department of Neurology, OLVG, Amsterdam, Netherlands
- Department of Neurology, Amsterdam UMC, Amsterdam, Netherlands
| | | | - Johanna M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| |
Collapse
|
9
|
DeShazo JM, Kouwijzer I, de Groot S, Post MWM, Valent LJM, van Leeuwen CMC, Wen H, Cowan RE. Effect of Training for an Athletic Challenge on Illness Cognition in Individuals with Chronic Disability: A Prospective Cohort Study. Int J Environ Res Public Health 2023; 21:58. [PMID: 38248523 PMCID: PMC10815898 DOI: 10.3390/ijerph21010058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/19/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024]
Abstract
Illness cognitions (IC) influence how a patient adapts to a chronic disease. The aim was (1) to determine if training for a handcycling mountain time trial (HandbikeBattle) improves IC and (2) to identify factors associated with IC change scores. Persons with a chronic disability (N = 220; including N = 151 with spinal cord disorder) trained 5 months and participated in the time trial. The IC Questionnaire measured helplessness, acceptance, perceived benefits and was assessed before training (T1), after training (T2), and four months after the event (T3). Age, sex, body mass index (BMI), time since injury (TSI), disability characteristics, self-efficacy, mental health (MH) and musculoskeletal pain were obtained at T1. Multilevel regression analyses showed that helplessness decreased (from 11.96 to 11.28, p < 0.01) and perceived benefits increased (from 16.91 to 17.58, p < 0.01) from T1 to T2. For helplessness this decrease persisted during follow-up (11.16 at T3). Changes in helplessness were associated with self-efficacy (p = 0.02), MH (p = 0.02) and lesion completeness (p = 0.02), and were independent of disability type (p = 0.66), lesion level (p = 0.30) and demographics such as sex (p = 0.29) and age (p = 0.67). Training with peers may improve helplessness and perceived benefits in individuals with a chronic disability. Especially individuals with MH problems might benefit from training for an athletic challenge with peers to improve illness cognitions, and ultimately, quality of life.
Collapse
Affiliation(s)
- Joy M. DeShazo
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (J.M.D.); (H.W.); (R.E.C.)
| | - Ingrid Kouwijzer
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands;
- Amsterdam Rehabilitation Research Center|Reade, 1054 HW Amsterdam, The Netherlands
| | - Sonja de Groot
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands;
- Amsterdam Rehabilitation Research Center|Reade, 1054 HW Amsterdam, The Netherlands
| | - Marcel W. M. Post
- Center of Excellence for Rehabilitation Medicine, UMCU Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, 3583 TM Utrecht, The Netherlands; (M.W.M.P.); (C.M.C.v.L.)
- Center for Rehabilitation, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Linda J. M. Valent
- Research and Development, Heliomare Rehabilitation Center, 1949 EC Wijk aan Zee, The Netherlands;
| | - Christel M. C. van Leeuwen
- Center of Excellence for Rehabilitation Medicine, UMCU Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, 3583 TM Utrecht, The Netherlands; (M.W.M.P.); (C.M.C.v.L.)
| | - Huacong Wen
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (J.M.D.); (H.W.); (R.E.C.)
| | - Rachel E. Cowan
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (J.M.D.); (H.W.); (R.E.C.)
| | | |
Collapse
|
10
|
Poublon CG, Scholten EWM, Wyndaele MIA, Post MWM, Stolwijk-Swüste JM. Changes in bladder emptying during inpatient rehabilitation after spinal cord injury and predicting factors: data from the Dutch Spinal Cord Injury Database. Spinal Cord 2023; 61:624-631. [PMID: 37608226 DOI: 10.1038/s41393-023-00925-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 07/24/2023] [Accepted: 08/02/2023] [Indexed: 08/24/2023]
Abstract
STUDY DESIGN Secondary analysis of multicentre prospective observational data. OBJECTIVES To describe methods of bladder emptying at admission and discharge in patients with recently acquired spinal cord injury (SCI) and to describe predictors of bladder emptying methods at discharge. SETTING First inpatient rehabilitation in specialised rehabilitation centres in the Netherlands. METHODS Data from the Dutch Spinal Cord Injury Database collected between 2015 and 2019 were used. McNemar-Bowker test was used to evaluate if bladder emptying methods differed over time; One-Way ANOVA and Chi-Square tests to see if bladder emptying methods differed by demographic and injury-related characteristics. Binary logistic regression was used to predict the type of bladder emptying at discharge with demographic and injury-related characteristics measured at admission. RESULTS Of 1403 patients, 44.1% had cervical, 38.4% thoracic and 17.5% lumbosacral lesions at admission. AIS classification was mostly D (63.8%). The method of bladder emptying changed significantly (p < 0.001) from admission to discharge: decrease of clean intermittent assisted catheterisation (17.1% to 4.1%) and indwelling catheter (33.4% to 16.3%) and increase in clean intermittent self-catheterisation (CISC, 7.8% to 22.2%) and normal voiding (40.2% to 56.1%). Age, sex, SCI level, AIS classification and level of independence predicted the method of bladder emptying at discharge (all p < 0.001). CONCLUSIONS During first inpatient rehabilitation, the method of bladder emptying changed resulting in more patients discharged with normal voiding and CISC. Age, sex, SCI level, AIS classification and level of independence in self-care were all confirmed as factors playing a role in this change.
Collapse
Affiliation(s)
- Claire G Poublon
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Eline W M Scholten
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Michel I A Wyndaele
- Department of Urology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marcel W M Post
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- University of Groningen, University Medical Centre Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Janneke M Stolwijk-Swüste
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
| |
Collapse
|
11
|
Kuiper H, Leeuwen CMCV, Stolwijk-Swüste JM, Post MWM. Does the disposition of passive coping mediate the association between illness perception and symptoms of anxiety and depression in patients with spinal cord injury during first inpatient rehabilitation? Disabil Rehabil 2023:1-9. [PMID: 37909296 DOI: 10.1080/09638288.2023.2272714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/14/2023] [Indexed: 11/03/2023]
Abstract
PURPOSE To examine associations between illness perception, also called illness cognitions or appraisals, disposition of passive coping, and symptoms of anxiety and depression, and to test whether passive coping mediates the associations between illness perception and symptoms of anxiety and depression. MATERIALS AND METHODS Longitudinal, multicentre study. Participants were inpatients of spinal cord injury (SCI) rehabilitation. Measures included the Brief Illness Perception Questionnaire (B-IPQ), the Utrecht Coping List passive coping subscale (UCL-P), and the Hospital Anxiety and Depression Scale (HADS). Mediation was tested with the PROCESS tool. RESULTS The questionnaires were completed by 121 participants at admission and at discharge. Of them, 70% were male, 58% had a paraplegia, and 82% an incomplete lesion. Weak to strong (0.294-0.650) significant associations were found between each pair of study variables. The use of passive coping strategies mediated the associations between illness perception and symptoms of anxiety and depression. CONCLUSION Symptoms of anxiety and depression were more frequent in people who have a threatening illness perception combined with a lower use of passive coping strategies. Therefore, it is advised that patients are screened and treated for threatening illness perception and high use of passive coping strategies during rehabilitation after SCI.
Collapse
Affiliation(s)
- Heleen Kuiper
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Centre for Rehabilitation, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Christel M C van Leeuwen
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Janneke M Stolwijk-Swüste
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marcel W M Post
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Centre for Rehabilitation, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
12
|
Tsoy N, Langewitz W, Müri S, Notter S, Pannek J, Post MWM, Rednic LN, Rubinelli S, Scheel-Sailer A. Quality of life from the patient perspective at the end of the first rehabilitation after the onset of spinal cord injury/disorder - A qualitative interview-based study. J Spinal Cord Med 2023:1-12. [PMID: 37819653 DOI: 10.1080/10790268.2023.2263235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
CONTEXT At present, there is a lack of information concerning patients' perspectives on their quality of life (QoL) after a recently acquired spinal cord injury/disorder (SCI/D). OBJECTIVE To explore patients' perspectives on their QoL during their first inpatient rehabilitation after the onset of SCI/D. METHODS Qualitative study. Semi-structured face-to-face interviews were conducted with 20 participants aged 18 years or older at least three months after the onset of SCI/D and two weeks before they were discharged from their first rehabilitation. Audio-recorded interviews were transcribed and analyzed according to the thematic content analysis. Interviewees rated their QoL with the SCI QoL data set. RESULTS The interviewees judged their satisfaction with life as a whole, their physical and mental health, as relatively high with values between six and eight (with 10 meaning complete satisfaction). They highlighted social aspects, health topics, and the experience of autonomy as relevant to their concept of QoL. The aspects that positively influenced QoL included the level of well-being in the current social and institutional environment, the increased level of energy, strength, and autonomy in daily life, and an improved mental state derived from general positive personal attitudes. In contrast, the social restrictions during the COVID-19 pandemic, physical issues including pain, a lack of progress associated with psychological dissatisfaction, and limitations in personal independence decreased patients' QoL. CONCLUSION Since the interviewees described different aspects from the areas of social, health and autonomy as important for their QoL, exploring and addressing these areas should be used to achieve an individualized first rehabilitation.
Collapse
Affiliation(s)
| | - Wolf Langewitz
- Basel University Hospital, Psychosomatic Medicine - Communication in Medicine, Basel, Switzerland
| | - Selina Müri
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Seraina Notter
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Jürgen Pannek
- Swiss Paraplegic Centre, Nottwil, Switzerland
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marcel W M Post
- University of Groningen, University Medical Centre Groningen, Department of rehabilitation medicine, Groningen, the Netherlands
- Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | | | - Sara Rubinelli
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Anke Scheel-Sailer
- Swiss Paraplegic Centre, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| |
Collapse
|
13
|
Dorton MC, Kramer JK, de Groot S, Post MWM, Claydon VE. Relationships between cardiovascular disease risk, neuropathic pain, mental health, and autonomic function in chronic spinal cord injury. Spinal Cord 2023; 61:548-555. [PMID: 37749189 DOI: 10.1038/s41393-023-00933-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 08/28/2023] [Accepted: 09/06/2023] [Indexed: 09/27/2023]
Abstract
STUDY DESIGN Multicentre, cross-sectional study. OBJECTIVES To determine if clinical measures of poor mental health (MH-) and neuropathic pain (NP) are related to increased CVD risk in individuals with chronic spinal cord injury (SCI), and further elucidate the relationships between CVD risk, autonomic function, NP, and MH-. SETTING Eight SCI rehabilitation centres in the Netherlands. METHODS Individuals (n = 257) with a traumatic, chronic (≥10 yrs) SCI, with age at injury between 18-35 years, completed a self-report questionnaire and a one-day visit to a rehabilitation centre for testing. CVD risk was calculated using Framingham risk score. NP was inferred using The Douleur Neuropathique 4 clinical examination, and MH- was assessed using the five-item Mental Health Inventory questionnaire. Cardiovascular autonomic function was determined from peak heart rate during maximal exercise (HRpeak). RESULTS There was a high prevalence of both NP (39%) and MH- (45%) following SCI. MH- was significantly correlated with an adverse CVD risk profile (r = 0.174; p = 0.01), increased the odds of adverse 30-year CVD risk by 2.2 (CI 0.92-2.81, p = 0.02), and is an important variable in determining CVD risk (importance=0.74, p = 0.05). Females (p = 0.05) and those with a higher HRpeak (p = 0.046) tended to be more likely to have NP. CONCLUSIONS Clinical measures of MH-, but not NP, are important factors for increased CVD risk following SCI. NP tended to be more prevalent in those with more preserved cardiovascular autonomic function. The interrelationships between secondary consequences of SCI are complex and need further exploration.
Collapse
Affiliation(s)
- Matthew C Dorton
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
- International Collaboration on Repair and Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - John K Kramer
- International Collaboration on Repair and Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Sonja de Groot
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marcel W M Post
- Center of Excellence in Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and de Hoogstraat Rehabilitation, Utrecht, The Netherlands
- University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Victoria E Claydon
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.
- International Collaboration on Repair and Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.
| |
Collapse
|
14
|
Post MWM, Forchheimer M, Charlifue S, D'Andréa Greve J, New P, Tate DG. Responsiveness of the International Spinal Cord Injury Quality of Life Basic Data Set V2.0: An international longitudinal study. J Spinal Cord Med 2023; 46:760-768. [PMID: 37133305 PMCID: PMC10446793 DOI: 10.1080/10790268.2023.2197820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
CONTEXT/OBJECTIVE Examine the sensitivity of the International Spinal Cord Injury Quality of Life Basic Data Set V2.0 (QoL-BDS V2.0) to reflect changes in mobility and secondary health conditions (SHCs) between inpatient rehabilitation and one-year follow-up. DESIGN International longitudinal study. Questionnaires were administered at baseline (Median 6 weeks, inter-quartile range 4-10 weeks post-onset) and after 12 months. SETTING Spinal cord rehabilitation institutions in the US, Brazil, Australia and the Netherlands. PARTICIPANTS : Individuals with recent onset of spinal cord injury or disease (SCI/SCD) admitted to inpatient rehabilitation. OUTCOME MEASURES The QoL-BDS V2.0, comprises four items on satisfaction with 'life as a whole', 'physical health', 'psychological health', and 'social life'. Mobility level was measured with a single item and SHCs with the SCI Secondary Conditions Scale (SCI-SCS). RESULTS Of the 160 participants, 61% had SCI, 48% had tetraplegia and 82% were wheelchair-users. Scores on 'life as a whole', 'physical health' and the total scale were significantly higher at follow-up compared to baseline in the total sample and the SCD subgroup, but not in the SCI subgroup. Increases in 'physical health', 'psychological health', 'social life' and the total score were significantly associated with improvements in the SCI-SCS or mobility scores. Participants with improved SCI-SCS and mobility at follow-up showed significantly more improvement in satisfaction with social life and the total score compared to participants without such favorable changes. CONCLUSION The results of this study provide partial evidence of responsiveness of the QoL-BDS V2.0 total score as a measure of QoL among individuals with SCI/SCD.
Collapse
Affiliation(s)
- Marcel W. M. Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Martin Forchheimer
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Julia D'Andréa Greve
- Orthopedic Department Medical School, University of São Paulo, São Paulo, Brazil
| | - Peter New
- Spinal Rehabilitation Service, Caulfield Hospital, Alfred Health, Melbourne, Victoria, Australia
- Epworth-Monash Rehabilitation Medicine Unit, Monash University, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Denise G. Tate
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
15
|
Kouwijzer I, de Groot S, van Leeuwen CMC, Valent LJM, Stolwijk-Swüste JM, van der Woude LHV, Post MWM. Changes in body satisfaction during and after a 5-month handcycle training period and associations with physical capacity and body composition in individuals with a physical impairment. Disabil Rehabil 2023:1-8. [PMID: 37431151 DOI: 10.1080/09638288.2023.2232732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
PURPOSE To investigate: (1) changes in body satisfaction during five months of handcycle training and one year after the training period; (2) whether longitudinal changes are dependent on sex, waist circumference and severity of the physical impairment; (3) associations between changes in physical capacity or body composition, and body satisfaction. MATERIALS AND METHODS Individuals (N = 143) with health conditions such as spinal cord injury filled out the Adult Body Satisfaction Questionnaire: at the start of the training (T1), directly after the training period (T2); and four months (T3) and one year after the training period (T4). At T1 and T2, physical capacity was determined with an upper-body graded exercise test, and waist circumference was measured. Handcycling classification was used as a proxy for the severity of impairment. RESULTS Multilevel regression analyses showed that body satisfaction significantly increased during the training period and significantly decreased back to pre-training levels at follow-up. Individuals with more severe impairments showed a larger decrease at T4. Improvements in physical capacity and waist circumference were significantly associated with improvements in body satisfaction. CONCLUSIONS Body satisfaction significantly increased during the training period, but significantly decreased during follow-up. Additional efforts might be necessary to keep individuals engaged in long-term exercise.
Collapse
Affiliation(s)
- Ingrid Kouwijzer
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands
- Amsterdam Rehabilitation Research Center I Reade, Amsterdam, The Netherlands
| | - Sonja de Groot
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands
- Amsterdam Rehabilitation Research Center I Reade, Amsterdam, The Netherlands
| | - Christel M C van Leeuwen
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Linda J M Valent
- Research and Development, Heliomare Rehabilitation Center, Amsterdam, The Netherlands
| | - Janneke M Stolwijk-Swüste
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Lucas H V van der Woude
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| |
Collapse
|
16
|
Hakbijl-van der Wind AJ, Post MWM, van Diemen T, Schnake KJ, Benneker LM, Kandziora F, Rajasekaran S, Schroeder GD, Vaccaro AR, Öner FC, Sadiqi S. Health professionals' perspective on the applicability of AO Spine PROST (patient reported outcome Spine trauma) in people with a motor-complete traumatic or non-traumatic spinal cord injury. Eur Spine J 2023:10.1007/s00586-023-07676-7. [PMID: 37031293 DOI: 10.1007/s00586-023-07676-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/02/2023] [Accepted: 03/22/2023] [Indexed: 04/10/2023]
Abstract
PURPOSE The AO Spine PROST (Patient Reported Outcome Spine Trauma) was developed for people with spine trauma and minor or no neurological impairment. The purpose is to investigate health professionals' perspective on the applicability of the AO Spine PROST for people with motor-complete traumatic or non-traumatic spinal cord injury (SCI), using a discussion meeting and international survey study. METHODS A discussion meeting with SCI rehabilitation physicians in the Netherlands was performed, followed by a worldwide online survey among the AO Spine International community, involved in the care of people with SCI. Participants rated the comprehensibility, relevance, acceptability, feasibility and completeness of the AO Spine PROST on a 1-5 point scale (5 most positive). Comments could be provided per question. RESULTS The discussion meeting was attended by 13 SCI rehabilitation physicians. The survey was completed by 196 participants. Comprehensibility (mean ± SD: 4.1 ± 0.8), acceptability (4.0 ± 0.8), relevance (3.9 ± 0.8), completeness (3.9 ± 0.8), and feasibility (4.1 ± 0.7) of the AO Spine PROST were rated positively for use in people with motor-complete traumatic or non-traumatic SCI. Only a few participants questioned the relevance of items on the lower extremities (e.g., walking) or missed items on pulmonary functioning and complications. Some recommendations were made for improvement in instructions, terminology and examples of the tool. CONCLUSION Health professionals found the AO Spine PROST generally applicable for people with motor-complete traumatic or non-traumatic SCI. This study provides further evidence for the use of the AO Spine PROST in spine trauma care, rehabilitation and research, as well as suggestions for its further development.
Collapse
Affiliation(s)
- Aline J Hakbijl-van der Wind
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, P.O. Box 85238, 3508 AE, Utrecht, The Netherlands.
| | - Marcel W M Post
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, P.O. Box 85238, 3508 AE, Utrecht, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Tijn van Diemen
- Department of spinal cord injury Rehabilitation, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Klaus J Schnake
- Center for Spine and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien, Erlangen, Germany
- Department of Orthopeadics and Traumatology, Paracelsus Private Medical University Nuremberg, Nuremberg, Germany
| | - Lorin M Benneker
- Center for Spine Surgery and Neurotraumatology, BG Unfallklinik Frankfurt am Main, Frankfurt, Germany
| | - Frank Kandziora
- Center for Spine Surgery and Neurotraumatology, BG Unfallklinik Frankfurt am Main, Frankfurt, Germany
| | | | - Gregory D Schroeder
- Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Alexander R Vaccaro
- Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - F Cumhur Öner
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Said Sadiqi
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
17
|
Tasiemski T, Kujawa J, Tederko P, Rubinelli S, Middleton JW, Craig A, Post MWM. Relationship between secondary health conditions and life satisfaction in persons with spinal cord injury: study across twenty-one countries. Qual Life Res 2023:10.1007/s11136-023-03376-3. [PMID: 36862301 DOI: 10.1007/s11136-023-03376-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE To determine the relationships between impact of secondary health conditions (SHCs), treatment of SHCs, and life satisfaction (LS) following spinal cord injury (SCI) across 21 countries. Hypotheses were as follows: (1) Persons with SCI and fewer SHCs report higher LS and (2) Persons who receive treatment for SHCs report higher LS than those who do not receive treatment. METHODS Cross-sectional survey, including 10,499 persons with traumatic or non-traumatic SCI aged 18 years or older and living in the community. To assess SHCs, 14 items adapted from the SCI-Secondary Conditions Scale were used (range 1-5). SHCs index was calculated as the mean of all 14 items. LS was assessed using a selection of 5 items from the World Health Organization Quality of Life Assessment. LS index was calculated as the mean of these 5 items. RESULTS South Korea, Germany, and Poland exhibited the highest (2.40-2.93) and Brazil, China, and Thailand the lowest (1.79-1.90) impact of SHCs. Indexes for LS and SHCs were inversely correlated (- 0.418; p < 0.001). Mixed Model Analysis showed that the fixed effect (key predictors of the study) of SHCs index (p < 0.001) and the positive interaction between SHCs index and treatment (p = 0.002) were significant determinants of LS. CONCLUSION Persons with SCI across the world are more likely to perceive better LS if they experience fewer SHCs and receive treatment for SHCs, in comparison to those who do not. Prevention and treatment of SHCs following SCI should be a high priority in order to improve the lived experience and enhance LS.
Collapse
Affiliation(s)
- Tomasz Tasiemski
- Department of Adapted Physical Activity, Faculty of Sport Sciences, Poznań University of Physical Education, ul. Królowej Jadwigi 27/39, 61-871, Poznań, Poland.
| | - Jolanta Kujawa
- Department of Medical Rehabilitation, Faculty of Health Sciences, Medical University of Łódź, Łódź, Poland
| | - Piotr Tederko
- Department of Rehabilitation, Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Sara Rubinelli
- Department of Health Science and Medicine, University of Lucerne and Swiss Paraplegic Research, Nottwil, Switzerland
| | - James W Middleton
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Ashley Craig
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat, Utrecht, The Netherlands.,Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
18
|
Crul TC, Post MWM, Visser-Meily JMA, Stolwijk-Swüste JM. Prevalence and Determinants of Pain in Spinal Cord Injury During Initial Inpatient Rehabilitation: Data From the Dutch Spinal Cord Injury Database. Arch Phys Med Rehabil 2023; 104:74-82. [PMID: 35914561 DOI: 10.1016/j.apmr.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 07/15/2022] [Accepted: 07/15/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To describe the prevalence and characteristics of spinal cord injury (SCI)-related pain during initial inpatient rehabilitation and to investigate relationships with demographic and lesion characteristics. DESIGN Cohort during inpatient rehabilitation. SETTING Eight specialized SCI rehabilitation centers in the Netherlands. PARTICIPANTS Patients with newly acquired SCI admitted for inpatient rehabilitation between November 2013 and August 2019 (N=1432). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Presence of pain at admission and discharge. Logistic regression analyses were used to study the prevalence of pain related to sex, age, etiology, completeness, and level of injury. RESULTS Data from 1432 patients were available. Of these patients 64.6% were male, mean age was 56.8 years, 59.9% had a nontraumatic SCI, 63.9% were classified as American Spinal Cord Injury Association Impairment Scale (AIS) D and 56.5% had paraplegia. Prevalence of pain was 61.2% at admission (40.6% nociceptive pain [NocP], 30.2% neuropathic pain [NeuP], 5.4% other pain) and 51.5% at discharge (26.0% NocP, 31.4% NeuP, 5.7% other pain). Having NocP at admission was associated with traumatic SCI. AIS B had a lower risk of NocP than AIS D at admission. Having NocP at discharge was associated with female sex and traumatic SCI. AIS C had a lower risk of NocP at discharge than AIS D. Having NeuP at admission was associated with female sex. Having NeuP at discharge was associated with female sex, age younger than 65 years vs age older than 75 years and tetraplegia. CONCLUSIONS SCI-related pain is highly prevalent during inpatient rehabilitation. Prevalence of NocP decreased during inpatient rehabilitation, and prevalence of NeuP stayed the same. Different patient and lesion characteristics were related to the presence of SCI-related pain. Healthcare professionals should be aware of these differences in screening patients on presence and development of pain during inpatient rehabilitation.
Collapse
Affiliation(s)
- Tim C Crul
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht; De Hoogstraat Rehabilitation, Utrecht
| | - Marcel W M Post
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht; De Hoogstraat Rehabilitation, Utrecht; University of Groningen, University Medical Centre Groningen, Centre for Rehabilitation, Groningen
| | - Johanna M A Visser-Meily
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht; De Hoogstraat Rehabilitation, Utrecht; Department of Rehabilitation, Physical Therapy Science, and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht
| | - Janneke M Stolwijk-Swüste
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht; De Hoogstraat Rehabilitation, Utrecht; Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, Utrecht, the Netherlands.
| |
Collapse
|
19
|
Mol TI, van Bennekom CAM, Scholten EWM, Visser-Meily JMA, Reneman MF, Riedstra A, de Groot V, Meijer JWG, Bult MK, Post MWM. Self-regulation as rehabilitation outcome: what is important according to former patients? Disabil Rehabil 2022; 44:7484-7490. [PMID: 34747280 DOI: 10.1080/09638288.2021.1998663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Self-regulation refers to self-management and self-control, with or without disability. Outcomes of rehabilitation with respect to self-regulation are unclear. This study aims to identify elements of self-regulation that former patients consider important in the context of medical rehabilitation. MATERIALS AND METHODS Qualitative exploration based on focus group discussions (FGDs). Transcripts were analysed using thematic analysis as well as open coding. Forty individuals participated in seven diagnosis-related FGDs. RESULTS Six subthemes were raised in the FGDs which could be merged into three main themes. Two main themes are conditional for regaining self-regulation: 1) having insight into one's condition and abilities (i.e., insight into impairments. consequences of impairments. abilities); 2) to know how to cope with the consequences of the condition (be able to communicate limitations; have to trust in body and functioning). The subject of the last theme 3) is how to apply self-regulation in one's own life (to make use of abilities and optimize functioning). CONCLUSIONS Three main themes of self-regulation in the context of medical rehabilitation were identified by former patients, partly relating to the ability to self-regulate and partly to the execution of self-regulation. This knowledge can be used to define specific rehabilitation goals and further develop rehabilitation outcome measurement.IMPLICATIONS FOR REHABILITATIONAwareness of the fundamental subthemes of self-regulation in rehabilitation will positively contribute to theory building and improve clinical practice (e.g., goal setting).Paying explicit attention to the six subthemes as standard elements of rehabilitation will help to provide a comprehensive view concerning self-regulation.The conceptual model of self-regulation, based on patient perspectives, can contribute to the measurement of rehabilitation outcomes.
Collapse
Affiliation(s)
- T I Mol
- Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht, UMC Utrecht Brain Centre, Utrecht, the Netherlands.,Department of Rehabilitation Medicine, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - C A M van Bennekom
- Research and Development Division, Heliomare Rehabilitation Centre, Wijk aan Zee, the Netherlands.,Coronel Institute of Occupational Health, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - E W M Scholten
- Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht, UMC Utrecht Brain Centre, Utrecht, the Netherlands
| | - J M A Visser-Meily
- Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht, UMC Utrecht Brain Centre, Utrecht, the Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Centre Utrecht, UMC Utrecht Brain Centre, Utrecht, the Netherlands
| | - M F Reneman
- Department of Rehabilitation Medicine, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - A Riedstra
- Research Committee Dutch Spinal Cord Association, Utrecht, the Netherlands
| | - V de Groot
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - J W G Meijer
- Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht, UMC Utrecht Brain Centre, Utrecht, the Netherlands.,De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - M K Bult
- Cerebral Palsy Netherlands/Spina Bifida & Hydrocephalus Netherlands, Utrecht, The Netherlands
| | - M W M Post
- Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht, UMC Utrecht Brain Centre, Utrecht, the Netherlands.,Department of Rehabilitation Medicine, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
20
|
de Graaf JA, Wondergem R, Kooijmans ECM, Pisters MF, Schepers VPM, Veenhof C, Visser-Meily JMA, Post MWM. The longitudinal association between movement behavior patterns and the course of participation up to one year after stroke. Disabil Rehabil 2022:1-9. [PMID: 35944521 DOI: 10.1080/09638288.2022.2109071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE (1) To investigate the differences in the course of participation up to one year after stroke between distinct movement behavior patterns identified directly after discharge to the home setting, and (2) to investigate the longitudinal association between the development of movement behavior patterns over time and participation after stroke. MATERIALS AND METHODS 200 individuals with a first-ever stroke were assessed directly after discharge to the home setting, at six months and at one year. The Participation domain of the Stroke Impact Scale 3.0 was used to measure participation. Movement behavior was objectified using accelerometry for 14 days. Participants were categorized into three distinct movement behavior patterns: sedentary exercisers, sedentary movers and sedentary prolongers. Generalized estimating equations (GEE) were performed. RESULTS People who were classified as sedentary prolongers directly after discharge was associated with a worse course of participation up to one year after stroke. The development of sedentary prolongers over time was also associated with worse participation compared to sedentary exercisers. CONCLUSIONS The course of participation after stroke differs across distinct movement behavior patterns after discharge to the home setting. Highly sedentary and inactive people with stroke are at risk for restrictions in participation over time.Implications for rehabilitationThe course of participation in people with a first-ever stroke up to one year after discharge to the home setting differed based on three distinct movement behavior patterns, i.e., sedentary exercisers, sedentary movers and sedentary prolongers.Early identification of highly sedentary and inactive people with stroke after discharge to the home setting is important, as sedentary prolongers are at risk for restrictions in participation over time.Supporting people with stroke to adapt and maintain a healthy movement behavior after discharge to the home setting could prevent potential long-term restrictions in participation.
Collapse
Affiliation(s)
- Joris A de Graaf
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Roderick Wondergem
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, The Netherlands.,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, The Netherlands.,Department of Health Innovations and Technology, Research Group Empowering Healthy Behaviour, Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Eline C M Kooijmans
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Martijn F Pisters
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, The Netherlands.,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, The Netherlands.,Department of Health Innovations and Technology, Research Group Empowering Healthy Behaviour, Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Vera P M Schepers
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Cindy Veenhof
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, The Netherlands.,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, The Netherlands.,Expertise Center Healthy Urban Living, Research Group Innovation of Human Movement Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Johanna M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Department of Rehabilitation Medicine, Groningen, The Netherlands
| |
Collapse
|
21
|
Hakbijl AJ, van Diemen T, Dompeling S, Oner FC, Post MWM, Sadiqi S. Applicability of the AO Spine Patient Reported Outcome Spine Trauma (PROST) in people with motor-complete spinal cord injury: a cognitive interview study. Spinal Cord 2022; 60:911-916. [PMID: 35798872 PMCID: PMC9261216 DOI: 10.1038/s41393-022-00829-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN This is a cognitive interview study. OBJECTIVES To examine the applicability of the Patient Reported Outcome Spine Trauma (AO Spine PROST) in people with motor-complete traumatic or non-traumatic spinal cord injury (SCI). SETTING Two rehabilitation centers in The Netherlands. METHOD Semi-structured cognitive interviews were conducted with 29 adults with a motor-complete SCI (AISA Impairment Scale A or B). Participants were asked to complete the AO Spine PROST and four additional evaluation questions rated on a 1-5-point Likert scale (5 most positive), while verbalizing their thoughts about their answers. Interviews were audio-recorded and transcribed. Codes were identified and linked to a coding scheme. Qualitative data were used to interpret the quantitative results. RESULTS Almost three-quarters of the participants (71.4%) had a traumatic SCI. Positive ratings of the measure were obtained regards comprehensibility (mean 4.0), non-offensiveness (4.6), relevance (4.2), and completeness (3.6). A question about the emotional impact of SCI was indicated to be missing. How using an assistive device should weigh in the score was a recurring topic. The use of multiple examples per item raised uncertainty, mostly solved by averaging their score. Some individuals indicated that the possibility to express even better function compared to before the onset of injury would be valuable. CONCLUSIONS Overall, the AO Spine PROST appears applicable in adults with a motor-complete traumatic or non-traumatic SCI. Recommendations are made for improvement in instructions, terminology, and examples used in the tool. This study contributes to the further development of the AO Spine PROST in spine trauma care and research.
Collapse
Affiliation(s)
- Aline J Hakbijl
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
| | - Tijn van Diemen
- Department of Spinal Cord Injury Rehabilitation, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Stephanie Dompeling
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - F Cumhur Oner
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marcel W M Post
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Said Sadiqi
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
22
|
Mol TI, van Bennekom CAM, Scholten EWM, Post MWM. Measures of self-regulation used in adult rehabilitation populations: A systematic review and content screening. Clin Rehabil 2022; 36:1120-1138. [PMID: 35473388 PMCID: PMC9284405 DOI: 10.1177/02692155221091510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Objective We aimed to identify generic measures of self-regulation and to examine the
degree to which these measures fit a recently developed conceptual model of
self-regulation in a rehabilitation context. Data sources Pubmed, Embase, PsycInfo, and CINAHL were searched. Review methods Articles were included if they were published between January 2015 and August
2020 and reported on empirical studies (trials and observational studies)
using a measure of self-regulation or a related concept, in an adult
rehabilitation population. Main content was analysed by linking all items of
the selected measures to one or more of the six sub-themes of
self-regulation: (1) insight into physical and cognitive impairments, (2)
insight into the consequences of the impairments, (3) insight into
abilities, (4) to be able to communicate limitations, (5) trust in body and
functioning, and (6) make use of abilities. Results Two reviewers independently screened 7808 abstracts, resulting in the
inclusion of 236 articles. In these articles, 80 different measures were
used to assess self-regulation or related concept. Nineteen of these
measures met the inclusion criteria and were included for the content
analyses. Nine of these were self-efficacy measures. No measures covered
four or more of the six sub-themes of self-regulation. The three sub-themes
on gaining insights were covered less compared to the sub-domains ‘trust’
and ‘make use of abilities’. Conclusions Many measures on self-regulation exist None of these measures cover all six
sub-themes of self-regulation considered important to measure
self-regulation as a rehabilitation outcome.
Collapse
Affiliation(s)
- T I Mol
- Center of Excellence for Rehabilitation Medicine, 526115UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,84792Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - C A M van Bennekom
- 100506Heliomare Rehabilitation Center, Research and Development, Wijk aan Zee, the Netherlands.,522567Amsterdam University Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam, the Netherlands
| | - E W M Scholten
- Center of Excellence for Rehabilitation Medicine, 526115UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - M W M Post
- Center of Excellence for Rehabilitation Medicine, 526115UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,84792Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| |
Collapse
|
23
|
Welten JJE, Cox VCM, Kruithof WJ, Visser-Meily JMA, Post MWM, van Heugten CM, Schepers VPM. Intra- and interpersonal effects of coping style and self-efficacy on anxiety, depression and life satisfaction in patient-partner couples after stroke. Neuropsychol Rehabil 2022; 33:849-870. [PMID: 35297736 DOI: 10.1080/09602011.2022.2051564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Many stroke patients and partners suffer from anxiety, depression, and low life satisfaction. Psychological factors such as coping style and self-efficacy can be protective factors within individuals. The close relationship between stroke patients and partners suggests that there may be interdependence in psychological functioning. The aim of this study was to examine intra- and interpersonal effects of coping style and self-efficacy on anxiety, depression, and life satisfaction in patient-partners couples. In this prospective cohort study, pro-active coping (UPCC), general self-efficacy (GSES), anxiety (HADS-A), depression (HADS-D), and life satisfaction (1-6 scale) were assessed in 215 couples at 2 and 12 months post-stroke. Effects within couples were assessed using structural equation modelling. Several intra- and interpersonal effects of coping style and self-efficacy at 2 months post-stroke were related to emotional health at 12 months post-stroke. Most effects were intrapersonal effects. The interpersonal effects were small but showed that pro-active coping by the patient was associated with lower anxiety of the partner. Higher self-efficacy of the partner was associated with lower depression scores and higher life satisfaction of the patient. This study underscores the importance of a dyadic approach to post-stroke functioning. It supports a family-based approach for treating post-stroke emotional problems.
Collapse
Affiliation(s)
- J J E Welten
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - V C M Cox
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - W J Kruithof
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - C M van Heugten
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - V P M Schepers
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
24
|
Rohn EJ, Hakbijl-van der Wind AJ, Post MWM, Forchheimer M, Charlifue S, New PW, Greve JMD, Tate DG. A cross-cultural mixed methods validation study of the spinal cord injury quality of life basic dataset (SCI QoL-BDS). Spinal Cord 2022; 60:177-186. [DOI: 10.1038/s41393-021-00742-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 12/16/2021] [Accepted: 12/19/2021] [Indexed: 11/09/2022]
|
25
|
Roels EH, Schneider CCI, Reneman MF, Post MWM. Content validity of the Work Rehabilitation Questionnaire (WORQ) for persons with spinal cord injury: A mixed methods study. Spinal Cord 2022; 60:354-360. [PMID: 35046539 DOI: 10.1038/s41393-021-00738-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 11/27/2021] [Accepted: 12/08/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Mixed methods. OBJECTIVES The aim of our study was to investigate the content validity of the Work Rehabilitation Questionnaire (WORQ) for use in persons with post-acute and chronic spinal cord injury (SCI). SETTING A university-based Rehabilitation Center in The Netherlands. METHODS Contents of the WORQ, brief ICF core sets for SCI for post-acute care and for chronic situation were compared with semi-guided interviews with persons with SCI and controlled for relevance by SCI rehabilitation professionals in two group meetings. RESULTS Fourteen interviews with persons with SCI were performed. Two group meetings with 8 and 9 SCI rehabilitation professionals were held. Thirty seven of the 46 ICF categories (80%) of the WORQ were confirmed by both sources: mentioned in interviews with persons with SCI and considered important by the SCI professionals. The remaining 9 categories (20%) were confirmed by either the persons with SCI or the SCI professionals. Fourteen ICF categories that are part of the brief ICF core set for SCI for acute care and/or chronic situation, however are not part of the WORQ, have revealed importance by persons with SCI and SCI professionals. CONCLUSION Our study confirms that most categories of the WORQ are important to consider for VR in persons with SCI, however, there are ICF categories that are absent in the WORQ and deemed relevant for use in VR in persons with SCI. Consequently, the content validity of the WORQ without additional items is insufficient for persons with SCI.
Collapse
Affiliation(s)
- Ellen H Roels
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, The Netherlands.
| | - Charlotte C I Schneider
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, The Netherlands
| | - Michiel F Reneman
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, The Netherlands
| | - Marcel W M Post
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, The Netherlands.,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| |
Collapse
|
26
|
Tasiemski T, Kujawa J, Tederko P, Rubinelli S, Middleton JW, Craig A, Post MWM. Comparison of life satisfaction in persons with spinal cord injury living in 22 countries with different economic status. Arch Phys Med Rehabil 2021; 103:1285-1293. [PMID: 34922932 DOI: 10.1016/j.apmr.2021.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To analyze and compare life satisfaction (LS) in persons with spinal cord injury (SCI) living in 22 countries participating in the International SCI (InSCI) community survey. The study tested the hypothesis that there are differences in LS across InSCI countries according to the countries' economic status specified as gross domestic product per capita purchased power parity (GDP-PPP). DESIGN Cross-sectional survey. SETTING Community setting (22 countries representing all 6 World Health Organization regions). PARTICIPANTS Persons (N=12,108) with traumatic or non-traumatic SCI aged at least 18 years, living in the community and able to respond to one of the available language versions of the questionnaire. INTERVENTIONS Not applicable. MAIN OUTCOMES Life satisfaction measured by 5 items selected from the World Health Organization Quality of Life Assessment-BREF (WHOQOL-5): satisfaction with overall quality of life, health, daily activities, relationships, and living conditions. LS index was calculated as the mean of these 5 items. RESULTS The highest level of LS was reported by persons with SCI living in USA, Malaysia, and Switzerland (mean range: 3.76-3.80), and the lowest by persons with SCI living in South Korea, Japan and Morocco (mean range: 2.81-3.16). There was a significant cubic association between LS index and GDP-PPP. Regression Trees analysis revealed the main variables differentiating LS index were GDP-PPP and monthly income, followed by time since injury and education. CONCLUSIONS Life satisfaction reported by persons with SCI related mainly to their country economic situation expressed by GDP-PPP and monthly income. The results of this study underscore the need for policy dialogues to avoid inequalities and improve the life experience in persons with SCI.
Collapse
Affiliation(s)
- Tomasz Tasiemski
- Department of Adapted Physical Activity, Faculty of Sport Sciences, Poznan University of Physical Education, Poland.
| | - Jolanta Kujawa
- Department of Medical Rehabilitation, Faculty of Health Sciences, Medical University of Lodz, Poland
| | - Piotr Tederko
- Department of Rehabilitation, Faculty of Medicine, Medical University of Warsaw, Poland
| | - Sara Rubinelli
- Department of Health Science and Medicine, University of Lucerne and Swiss Paraplegic Research
| | - James W Middleton
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Royal North Shore Hospital, NSW Australia and Faculty of Medicine and Health, The University of Sydney, Australia
| | - Ashley Craig
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Royal North Shore Hospital, NSW Australia and Faculty of Medicine and Health, The University of Sydney, Australia
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat, Utrecht, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| |
Collapse
|
27
|
Roels EH, Reneman MF, Post MWM. Measurement Properties of the Full and Brief Version of the Work Rehabilitation Questionnaire in Persons with Physical Disabilities. J Occup Rehabil 2021; 31:886-894. [PMID: 33844131 PMCID: PMC8558184 DOI: 10.1007/s10926-021-09973-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/17/2021] [Indexed: 06/12/2023]
Abstract
Purpose The Work Rehabilitation Questionnaire (WORQ) is a self-report vocational rehabilitation assessment. A comprehensive (WORQ-FULL) and a brief version (WORQ-BRIEF) are available. The purpose of this study was to investigate measurement properties of both versions in persons with physical disabilities. Methods Cross sectional and test-retest design. Adults with physical disabilities in vocational rehabilitation were included. Internal consistency (Cronbach's alpha), test-retest reliability (intra-class correlation; ICC), agreement between sessions (Bland-Altman Plots), criterion validity (ICC and agreement with Bland-Altman Plots between WORQ-FULL and WORQ-BRIEF) and convergent validity with the Work Ability Index -Single item (WAS) and the EuroQOL 5D-5L were analyzed. Results Out of the 91 individuals who agreed to participate, 74 (81%) returned questionnaire T1 and 49 (54%) participants returned questionnaire T2 within the maximum time interval (= 27 days). At T2, 28 (57%) participants reported no medical changes compared to T1. Median age was 49 (IQR 40-60), 57% were male, 47% had experienced a stroke and 27% a spinal cord injury (n = 49). Internal consistency was good: 0.95/0.95/0.94 for the WORQ-FULL and 0.88/0.89/0.85 for the WORQ-BRIEF (n = 74/n = 48/n = 28, respectively). Test-retest reliabilitywas good: ICC = 0.86/0.85 for the WORQ-FULL and ICC = 0.87/0.86 for the WORQ-BRIEF (n = 49/ n = 28). Bland Altman plots suggested a higher score at T1. As for criterion validity of the WORQ-FULL versus the WORQ-BRIEF, ICC was good (ICC = 0.84; n = 74), however Bland Altman plots indicated potential bias. Correlations with the WAS/EuroQOL 5D-5L were variable: r = -0.24/r = -0.57 (WORQ-FULL) and r = -0.28/-0.65 (WORQ-BRIEF). Conclusions The WORQ showed good internal consistency and test-retest reliability. Agreement demonstrated large score differences are needed to indicate change beyond random chance at individual level, whereas small changes are sufficient at group level. Criterion validity of the WORQ-FULL versus the WORQ-BRIEF was supported, however, agreement demonstrated moderate to large score differences are needed to indicate change beyond random chance at individual level, whereas small changes are sufficient at group level. This indicates the WORQ-FULL and WORQ-BRIEF are better not used interchangeably. Correlation analyses provided better insight in the validity of the WORQ. Convergent validity was supported for the WORQ-BRIEF with the EuroQoL 5D-5L (r = -0.65).
Collapse
Affiliation(s)
- Ellen H Roels
- Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Michiel F Reneman
- Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marcel W M Post
- Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| |
Collapse
|
28
|
Kuiper H, van Leeuwen CMC, Stolwijk-Swüste JM, Post MWM. Reliability and validity of the Brief Illness Perception Questionnaire (B-IPQ) in individuals with a recently acquired spinal cord injury. Clin Rehabil 2021; 36:550-557. [PMID: 34818113 DOI: 10.1177/02692155211061813] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the reliability and validity of the Brief Illness Perception Questionnaire (B-IPQ) and possible subscales, and to interpret Brief Illness Perception Questionnaire (B-IPQ) total scores, in individuals with a spinal cord injury. DESIGN Cross-sectional. SETTING Seven Dutch rehabilitation centres. SUBJECTS Individuals with a recently acquired traumatic or non-traumatic spinal cord injury at the start of inpatient spinal cord injury rehabilitation (N = 270). MAIN MEASURE The Brief Illness Perception Questionnaire (B-IPQ) consists of eight items on an individual's cognitive and emotional representation of one's health conditions. Principal component analysis was performed to identify possible Brief Illness Perception Questionnaire (B-IPQ) subscales. Validity was assessed by testing hypotheses on correlations between the Brief Illness Perception Questionnaire (B-IPQ) and other measures. Cut-off points of the Brief Illness Perception Questionnaire (B-IPQ) total score were determined. RESULTS Mean (SD) age of participants was 60.1 (16.5) years, 188 (71%) were male, and 119 (44%) had tetraplegia. Three potential subscales were revealed. Cronbach's alpha was acceptable for only one subscale. This subscale was named 'consequences' and included the items 'consequences', 'symptom burden', 'concern', and 'emotions'. The Brief Illness Perception Questionnaire (B-IPQ) total and the consequence subscale showed the expected strong correlations (>.50) with symptoms of anxiety and depression. Mean (SD) scores were 40.9 (12.3) on the 8-item Brief Illness Perception Questionnaire (B-IPQ) (range 0-80) and 25.1 (8.1) on the consequences subscale (range 0-40). Cut-off points for the Brief Illness Perception Questionnaire (B-IPQ) total score were determined as follows: <42 indicating low experienced threat, 42-49 indicating moderate experienced threat, and ≥50 indicating high experienced threat. CONCLUSION The Brief Illness Perception Questionnaire (B-IPQ) total and consequences subscale seem applicable in individuals with a spinal cord injury in the rehabilitation practice and research.
Collapse
Affiliation(s)
- Heleen Kuiper
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- University of Groningen, University Medical Centre Groningen, Centre for Rehabilitation, Groningen, The Netherlands
| | - Christel M C van Leeuwen
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Spinal Cord Injury and Orthopedics, 84896De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Janneke M Stolwijk-Swüste
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Spinal Cord Injury and Orthopedics, 84896De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marcel W M Post
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- University of Groningen, University Medical Centre Groningen, Centre for Rehabilitation, Groningen, The Netherlands
| |
Collapse
|
29
|
Adegeest CY, van Gent JAN, Stolwijk-Swüste JM, Post MWM, Vandertop WP, Öner FC, Peul WC, Wengel PVT. Influence of severity and level of injury on the occurrence of complications during the subacute and chronic stage of traumatic spinal cord injury: a systematic review. J Neurosurg Spine 2021; 36:632-652. [PMID: 34767527 DOI: 10.3171/2021.7.spine21537] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/19/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Secondary health conditions (SHCs) are long-term complications that frequently occur due to traumatic spinal cord injury (tSCI) and can negatively affect quality of life in this patient population. This study provides an overview of the associations between the severity and level of injury and the occurrence of SHCs in tSCI. METHODS A systematic search was conducted in PubMed and Embase that retrieved 44 studies on the influence of severity and/or level of injury on the occurrence of SHCs in the subacute and chronic phase of tSCI (from 3 months after trauma). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. RESULTS In the majority of studies, patients with motor-complete tSCI (American Spinal Injury Association [ASIA] Impairment Scale [AIS] grade A or B) had a significantly increased occurrence of SHCs in comparison to patients with motor-incomplete tSCI (AIS grade C or D), such as respiratory and urogenital complications, musculoskeletal disorders, pressure ulcers, and autonomic dysreflexia. In contrast, an increased prevalence of pain was seen in patients with motor-incomplete injuries. In addition, higher rates of pulmonary infections, spasticity, and autonomic dysreflexia were observed in patients with tetraplegia. Patients with paraplegia more commonly suffered from hypertension, venous thromboembolism, and pain. CONCLUSIONS This review suggests that patients with a motor-complete tSCI have an increased risk of developing SHCs during the subacute and chronic stage of tSCI in comparison with patients with motor-incomplete tSCI. Future studies should examine whether systematic monitoring during rehabilitation and the subacute and chronic phase in patients with motor-complete tSCI could lead to early detection and potential prevention of SHCs in this population.
Collapse
Affiliation(s)
- Charlotte Y Adegeest
- 1Department of Neurosurgery, Leiden University Medical Center, Leiden.,2Department of Neurosurgery, Haaglanden Medical Center, The Hague
| | - Jort A N van Gent
- 1Department of Neurosurgery, Leiden University Medical Center, Leiden
| | - Janneke M Stolwijk-Swüste
- 3Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht
| | - Marcel W M Post
- 3Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht.,4Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen
| | - William P Vandertop
- 5Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam
| | - F Cumhur Öner
- 6Department of Orthopedic Surgery, University Medical Center Utrecht; and
| | - Wilco C Peul
- 1Department of Neurosurgery, Leiden University Medical Center, Leiden.,2Department of Neurosurgery, Haaglanden Medical Center, The Hague.,7Department of Neurosurgery, University Neurosurgical Center Holland, Leiden University Medical Center Leiden, Haaglanden Medical Center and Haga Teaching Hospital, The Hague, The Netherlands
| | - Paula V Ter Wengel
- 2Department of Neurosurgery, Haaglanden Medical Center, The Hague.,7Department of Neurosurgery, University Neurosurgical Center Holland, Leiden University Medical Center Leiden, Haaglanden Medical Center and Haga Teaching Hospital, The Hague, The Netherlands
| |
Collapse
|
30
|
Galvis Aparicio M, Carrard V, Kunz S, Morselli D, Post MWM, Peter C. Longitudinal changes in psychological adaptation outcomes during spinal cord injury inpatient rehabilitation. Rehabil Psychol 2021; 66:491-506. [PMID: 34735207 DOI: 10.1037/rep0000396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To determine average changes and individuals' patterns of change in depressive symptoms, anxiety symptoms, general distress, and life satisfaction between admission to spinal cord injury inpatient rehabilitation and discharge; and to identify factors associated with change. METHOD Longitudinal data collection as part of a national cohort study (N = 281). Changes in the psychological adaptation outcomes were analyzed using latent change score models. Reliable change indexes were calculated for each outcome to identify individuals' patterns of change. Biopsychosocial factors were examined as covariates of change. RESULTS On average, depressive symptoms, anxiety symptoms, and general distress decreased between admission and discharge, while life satisfaction increased. According to the reliable change indexes, several adaptation patterns were identified. The proportion of individuals following each pattern varied depending on the analyzed outcome: resilience (absence of clinically relevant symptoms at admission and discharge) was the most common for symptoms of depression (61.57%) and anxiety (66.55%), whereas vulnerability (clinically relevant symptoms at both measurement times) was the most common for distress (57.32%). Improvement patterns (statistically significant decreases) were identified for 6.41%, 4.27%, and 7.83% of participants in depressive symptoms, anxiety symptoms and distress, respectively. For life satisfaction, improvement (statistically significant increases) was found for 8.54%. Male sex, tetraplegia, self-efficacy, optimism, and social support were associated with average changes in the psychological adaptation outcomes. CONCLUSIONS On average, participants showed improvement in all analyzed outcomes. Still, there is substantial variability in change. Self-efficacy, social support, and optimism are potential intervention targets during inpatient rehabilitation to promote a favorable psychological adaptation process. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
| | | | - Simon Kunz
- Department of Health Sciences and Medicine
| | | | | | | |
Collapse
|
31
|
Kunz S, Carrard V, Galvis Aparicio M, Scheel-Sailer A, Fekete C, Lude P, Post MWM, Westphal M. Longitudinal measurement invariance of the international spinal cord injury quality of life basic data set (SCI-QoL-BDS) during spinal cord injury/disorder inpatient rehabilitation. Qual Life Res 2021; 31:1247-1256. [PMID: 34734353 PMCID: PMC8960613 DOI: 10.1007/s11136-021-03027-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2021] [Indexed: 12/04/2022]
Abstract
Purpose This study aimed at testing the internal consistency and longitudinal measurement invariance of a brief quality of life questionnaire—the spinal cord injury quality of life basic data set (SCI-QoL-BDS)—among individuals with spinal cord injury/disorder undergoing first inpatient rehabilitation.
Methods Longitudinal data from the Swiss spinal cord injury inception cohort study were used. Participants (n = 218) completed the SCI-QoL-BDS at one and three months post injury and at discharge. The SCI-QoL-BDS consists of three items assessing satisfaction with life as a whole, physical health, and psychological health. Internal consistency was examined at each time point and longitudinal measurement invariance was tested using longitudinal confirmatory factor analysis. Results Internal consistency coefficients ranged between .82 and .90. The confirmatory factor analysis revealed invariance of the factor structure and of all factor loadings across time. Additionally, all item intercepts except the one of satisfaction with physical health were invariant across time, suggesting partial intercept invariance of the SCI-QoL-BDS. Indeed, a response shift was observed in satisfaction with physical health. This item was evaluated more negatively in the early phase of inpatient rehabilitation, indicating the change of the evolving physical situation after the onset of a spinal cord injury. Conclusion The SCI-QoL-BDS is a consistent and valid measure to assess quality of life among individuals undergoing first spinal cord injury/disorder inpatient rehabilitation. However, we recommend using latent variable frameworks instead of mean scores when examining longitudinal changes in the measure to account for potential response shift. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-03027-5.
Collapse
Affiliation(s)
- Simon Kunz
- Swiss Paraplegic Research (SPF), Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Valerie Carrard
- Swiss Paraplegic Research (SPF), Nottwil, Switzerland. .,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland. .,Psychiatric Liaison Service, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue de Beaumont 23, 1011, Lausanne, Switzerland.
| | - Mayra Galvis Aparicio
- Swiss Paraplegic Research (SPF), Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Anke Scheel-Sailer
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Center, Nottwil, Switzerland
| | - Christine Fekete
- Swiss Paraplegic Research (SPF), Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Peter Lude
- Swiss Paraplegic Research (SPF), Nottwil, Switzerland.,Department of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, Zurich, Switzerland.,School of Applied Psychology, Zurich University of Applied Sciences (ZHAW), Zurich, Switzerland
| | - Marcel W M Post
- Department of Rehabilitation Medicine, University of Groningen, Groningen, The Netherlands.,Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Maren Westphal
- Department of Psychology, Pace University, Pleasantville, USA.,Department of Psychiatry, Columbia University, New York, USA
| |
Collapse
|
32
|
Galvis Aparicio M, Kunz S, Morselli D, Post MWM, Peter C, Carrard V. Adaptation during spinal cord injury rehabilitation: The role of appraisal and coping. Rehabil Psychol 2021; 66:507-519. [PMID: 34618508 DOI: 10.1037/rep0000410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To test the spinal cord injury adjustment model (SCIAM) by examining whether primary appraisals (threat or loss) and coping strategies (approach-oriented and denial) sequentially mediate the impact of functional independence, psychological resources, and social support on depressive and anxiety symptoms among individuals with spinal cord injury during inpatient rehabilitation. METHOD Path analyses of longitudinal data from a Swiss inception cohort study (N = 207). Models were implemented separately for depressive and anxiety symptoms. RESULTS The initial models based on the SCIAM yielded poor fit and were respecified. Different from the SCIAM's assumptions, psychological resources and threat appraisal showed direct effects on depressive symptoms (β = -.28, SE = .07, p < .001 and β = .33, SE = .07, p < .001, respectively), while social support and threat appraisal showed direct effects on anxiety symptoms (β = -.23, SE = .06, p < .001 and β = .42, SE = .06, p < .001, respectively). Primary appraisals and coping strategies partially mediated the effects of psychological resources on depressive symptoms and fully mediated their effect on anxiety symptoms. However, this did not only happen via the SCIAM's sequential double mediation, since indirect effects were also observed via threat appraisal only. The final models explained 40 and 30% of the variance of depressive and anxiety symptoms, respectively. CONCLUSIONS The findings only partially supported the SCIAM's sequential double mediation mechanism. Psychological resources, social support, and primary appraisals can have direct effects on psychological adaptation outcomes and may be suitable intervention targets during inpatient rehabilitation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Simon Kunz
- Department of Health Sciences and Medicine
| | | | | | | | | |
Collapse
|
33
|
de Graaf JA, Volkers EJ, Schepers VPM, Visser-Meily JMA, Post MWM. Validity of the Utrecht scale for evaluation of rehabilitation-participation restrictions scale in a hospital-based stroke population 3 months after stroke. Top Stroke Rehabil 2021; 29:516-525. [PMID: 34315356 DOI: 10.1080/10749357.2021.1956047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background:The Utrecht Scale for Evaluation of Rehabilitation-Participation Restrictions scale (USER-P-R) is a promising patient-reported outcome measure, but has currently not been validated in a hospital-based stroke population. Objective:To examine psychometric properties of the USER-P-R in a hospital-based stroke population 3 months after stroke onset. Methods:Cross-sectional study including 359 individuals with stroke recruited through 6 Dutch hospitals. The USER-P-R, EuroQol 5-dimensional 5-level questionnaire (EQ-5D-5 L), Patient Reported Outcomes Measurement Information System 10-Question Global Health Short Form (PROMIS-10), modified Rankin Scale (mRS) and two items on perceived decrease in health and activities post-stroke were administered in a telephone interview 3 months after stroke. The internal consistency, distribution, floor/ceiling effects, convergent validity and discriminant ability of the USER-P-R were calculated. Results:Of all participants, 96.9% were living at home and 50.9% experienced no or minimal disabilities (mRS 0-1). The USER-P-R showed high internal consistency (α = 0.90) and a non-normal left-skewed distribution with a ceiling effect (21.4% maximum scores). A substantial proportion of participants with minimal disabilities (mRS 1) experienced restrictions on USER-P-R items (range 11.9-48.5%). The USER-P-R correlated strongly with the EQ-5D-5 L, PROMIS-10 and mRS. The USER-P-R showed excellent discriminant ability in more severely affected individuals with stroke, whereas its discriminant ability in less affected individuals was moderate. Conclusions:The USER-P-R shows good measurement properties and provides additional patient-reported information, proving its usefulness as an instrument to evaluate participation after 3 months in a hospital-based stroke population.
Collapse
Affiliation(s)
- Joris A de Graaf
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Eline J Volkers
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Vera P M Schepers
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, The Netherlands
| | - Johanna M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, The Netherlands
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Department of Rehabilitation Medicine, Groningen, The Netherlands
| |
Collapse
|
34
|
Halvorsen A, Pape K, Post MWM, Biering-Sørensen F, Mikalsen S, Hansen AN, Steinsbekk A. Participation and quality of life in persons living with spinal cord injury in Norway. J Rehabil Med 2021; 53:jrm00217. [PMID: 34232321 PMCID: PMC8638721 DOI: 10.2340/16501977-2858] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objectives To describe the association between sociodemographic and spinal cord injury characteristics, of people living with spinal cord injury, and participation and quality of life, and to study the association between participation and quality of life in this group of people. Design Persons registered in the Norwegian Spinal Cord Injury Registry after post-acute rehabilitation between 2011 and 2017 were invited to participate in a survey in 2019 when they were in a community setting. Subjects A total of 339 people living with spinal cord injury. Methods The Frequency scale and Restrictions scale of the Utrecht Scale for Evaluation of Rehabilitation-Participation were used to measure participation. Quality of life was measured as life satisfaction with the World Health Organization Quality of life assessment (WHOQoL-5) and mental health was measured using the Mental Health subscale (MHI-5). Results Overall, sociodemographic characteristics were more prominently associated with quality of life and participation than were spinal cord injury characteristics. Currently working as main activity and having a family income in the highest quartile were associated with higher scores on all 4 measures of participation and quality of life. There was a strong gradient between higher level of participation (frequency and restrictions) and better quality of life. Conclusion Participation was strongly associated with life satisfaction and mental health in people living with spinal cord injury. This indicates that participation issues should be given greater priority during post-acute rehabilitation, follow-up and subsequent care efforts provided in the community.
Collapse
Affiliation(s)
- Annette Halvorsen
- Department of Medical Quality Registries, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway. E-mail:
| | | | | | | | | | | | | |
Collapse
|
35
|
Nijsse B, Verberne DPJ, Visser-Meily JMA, Post MWM, de Kort PLM, van Heugten CM. Temporal evolution and predictors of subjective cognitive complaints up to 4 years after stroke. J Rehabil Med 2021; 53:jrm00205. [PMID: 33948672 PMCID: PMC8814883 DOI: 10.2340/16501977-2840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective To examine the temporal evolution of subjective cognitive complaints in the long-term after stroke, and to identify predictors of long-term subjective cognitive complaints. Methods Prospective cohort study including 395 stroke patients. Subjective cognitive complaints were assessed at 2 months, 6 months and 4 years post-stroke, using the Checklist for Cognitive and Emotional consequences following stroke (CLCE-24). The temporal evolution of subjective cognitive complaints was described using multilevel growth modelling. Associations between CLCE-24 cognition score at 4 years post-stroke and baseline characteristics, depression, anxiety, cognitive test performance, and adaptive and maladaptive psychological factors were examined. Significant predictors were entered in a multivariate multilevel model. Results A significant increase in subjective cognitive complaints from 2 months up to 4 years (mean 3.7 years, standard deviation (SD) 0.6 years) post-stroke was observed (p≤0.001). Two months post-stroke, 76% of patients reported at least one cognitive complaint, 72% at 6 months, and 89% at 4 years post-stroke. A higher level of subjective cognitive complaints at 2 months and lower scores on adaptive and maladaptive psychological factors were significant independent predictors of a higher level of subjective cognitive complaints at 4 years post-stroke. Conclusion Post-stroke subjective cognitive complaints increase over time and can be predicted by the extent of subjective cognitive complaints and the presence of adaptive and maladaptive psychological factors in the early phases after stroke.
Collapse
Affiliation(s)
- Britta Nijsse
- Neurology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | | | | | | | | | | |
Collapse
|
36
|
van Diemen T, Tran Y, Stolwijk-Swuste JM, Roels EH, van Nes IJW, Post MWM. Trajectories of Self-Efficacy, Depressed Mood, and Anxiety From Admission to Spinal Cord Injury Rehabilitation to 1 Year After Discharge. Arch Phys Med Rehabil 2021; 102:1939-1946. [PMID: 34038709 DOI: 10.1016/j.apmr.2021.04.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/07/2021] [Accepted: 04/25/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Self-efficacy (SE) is an important determinant for the psychological adjustment of people with spinal cord injury (SCI). However, little is known about the course of SE during inpatient rehabilitation up to 1 year after discharge. The aim of this study was to determine latent trajectory classes of SE, depressive mood, and anxiety in people with SCI, as well as the interrelationships between these trajectories. DESIGN Longitudinal inception cohort study. SETTING Eight specialized SCI rehabilitation centers. PARTICIPANTS The participants (N=268) were mainly men 183 of 268 (68.3%) with a mean age of 55.6 years. Almost half had a traumatic SCI 135 of 268 (50.4%) and tetraplegia (53.7%), and the minority had a motor complete SCI (32.2%). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES SE was measured using the University of Washington Self-Efficacy Scale. In addition, the Hospital Anxiety and Depression Scale was used to asses distress and perform dual trajectory modeling analyses. RESULTS Three trajectories of SE, indicating low, middle, and high SE, could be distinguished. Furthermore, a 2-class trajectory solution for depressive mood and a 4-class solution for anxiety were found to be most suitable. All trajectories were stable over time. Developmental connections between SE and depressive mood and between SE and anxiety were revealed. In particular, participants who adjusted well, reporting low scores on depressive mood and anxiety, could be identified by their high SE scores. However, the group of participants with high depressive mood scores and anxiety scores could not always be identified based on their SE trajectory. CONCLUSIONS In accordance with our hypotheses, distinct trajectories of SE, depressive mood, and anxiety were identified and high probabilities that SE trajectories were interrelated to the trajectories from depressive mood and anxiety were confirmed. Concurrent screening for SE and distress might best detect people at risk for adjustment problems.
Collapse
Affiliation(s)
- Tijn van Diemen
- Department of Spinal Cord Injury Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands.
| | - Yvonne Tran
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Janneke M Stolwijk-Swuste
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Ellen H Roels
- Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Ilse J W van Nes
- Department of Spinal Cord Injury Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands; Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| |
Collapse
|
37
|
Ferdiana A, Post MWM, Bültmann U, van der Klink JJL. Barriers and facilitators for work and social participation among individuals with spinal cord injury in Indonesia. Spinal Cord 2021; 59:1079-1087. [PMID: 33828246 DOI: 10.1038/s41393-021-00624-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Qualitative study using in-depth interviews. OBJECTIVES To describe experienced barriers and facilitators for work and social participation among individuals with spinal cord injury (SCI). SETTING Vocational rehabilitation (VR) center in Yogyakarta Province, Indonesia. METHODS Semi-structured interviews were conducted with 12 participants (8 males, 4 females) aged 24-67 years. Five participants still underwent vocational rehabilitation, while seven participants lived in the community. Thematic analysis was used. RESULTS None of the participants who worked before the injury returned to her/his previous occupation, most participants became self-employed. The frequency of participation in social activities decreased substantially. Barriers for work and social participation included health conditions and environmental barriers, including inaccessibility, stigma and discrimination and limited institutional support and services. Identified facilitators for work and social participation were perceived importance of work and social participation, adaptations to disability condition, and social support. CONCLUSION Barriers to engage in work and social activities for individuals with SCI in Indonesia are combination of physical limitations, lack of accessibility, stigma, and institutional barriers. The capacity of social networks such as family in facilitating participation should be strengthened during the VR processes. VR should provide marketing skills and link self-employed clients with the market, in collaboration with the private sector and industries. Immediate policy and programmatic action is needed to enable these individuals to enhance sustainable work and social participation.
Collapse
Affiliation(s)
- Astri Ferdiana
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, The Netherlands. .,Department of Public Health, Faculty of Medicine, University of Mataram, Mataram, Indonesia.
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMCU Brain Center, University Medical Center Utrecht and De Hoogstraat, Utrecht, The Netherlands.,University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Ute Bültmann
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, The Netherlands
| | - Jac J L van der Klink
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo, Tilburg, The Netherlands.,Optentia, North-West University, Vanderbijlpark, South Africa
| |
Collapse
|
38
|
Kruitwagen-Van Reenen ET, Scholten EWM, van Groenestijn A, Van Den Berg LH, Post MWM, Visser-Meily J. Participation and autonomy in the first 10 months after diagnosis of ALS: a longitudinal study. Amyotroph Lateral Scler Frontotemporal Degener 2021; 22:459-466. [PMID: 33683160 DOI: 10.1080/21678421.2021.1893335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: More insight is needed into participation in daily activities and autonomy among patients with amyotrophic lateral sclerosis (ALS). Aims of this study were (1) to describe the course of participation restrictions and autonomy in participation during the first 10 months after diagnosis; (2) to study the influence of the rate of ALS progression on the course of participation. Methods: Secondary analysis of data from the longitudinal multicenter FACTS-2-ALS study. Self-report questionnaires were administered at inclusion (T0; n = 71), at 4 months (T1), 7 months (T2), 10 months (T3) after inclusion. Median duration of follow-up was 10.0 months. Participation restrictions were assessed using the sum of the Mobility Range and Social Behavior subscales of the Sickness Impact profile-68 (SIPSOC). Autonomy in participation was assessed using the Impact on Participation and Autonomy (IPA) Questionnaire. Fast disease progression was defined as an increase of 1.1 points per month or more on the ALS Functional Rating Scale. Results: Patients reported participation restrictions in all subscales while having mild physical limitations. There was a decrease of participation over time (restrictions and autonomy). This decrease was greatest in patients with fast disease progression. Disease progression negatively influenced movement-related participation more than social interaction domains. Rate of disease progression was more strongly related to SIPSOC scores compared to IPA scores. Discussion: Preserving participation may be an important determinant of quality of care for patients with ALS. Rate of progression of the disease should be taken into account as it was found to be significantly associated with the level of participation.
Collapse
Affiliation(s)
- Esther T Kruitwagen-Van Reenen
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands.,Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands.,De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Eline W M Scholten
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands.,De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Annerieke van Groenestijn
- Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Leonard H Van Den Berg
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands, and
| | - Marcel W M Post
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands.,De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Johanna Visser-Meily
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands.,Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands.,De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| |
Collapse
|
39
|
Kuiper H, van Leeuwen CCM, Kopsky DJ, Stolwijk-Swüste JM, Post MWM. Post-traumatic stress disorder symptoms and pain intensity in persons with spinal cord injury. Spinal Cord 2021; 59:328-335. [PMID: 33495577 DOI: 10.1038/s41393-020-00599-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/19/2020] [Accepted: 11/23/2020] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional. OBJECTIVES To examine the association between post-traumatic stress disorder (PTSD) symptoms and pain intensity, taking symptoms of anxiety and depression into account within persons with spinal cord injury (SCI). SETTING Persons with SCI, who visited a Dutch rehabilitation centre between 2005 and 2010, were invited to complete a survey. METHODS PTSD symptoms were measured with the Trauma Screening Questionnaire (TSQ), pain intensity with an 11-point Numerical Rating Scale (NRS), and symptoms of anxiety and depression with the Hospital Anxiety and Depression Scale (HADS). To determine associations between PTSD symptoms and pain intensity, linear regression analyses were performed. Confounding variables representing anxiety and depression were added to the final model. RESULTS In total, 175 participants (55.8% traumatic, 29.1% complete) were included (response rate of 31.7%). Of them, 11.4% had clinically relevant symptoms of probable PTSD (TSQ score ≥ 6) 69.8% experienced moderate to severe pain levels (NRS ≥ 4), 14.9% had symptoms of anxiety and 20.8% symptoms of depression (HADS scores ≥ 11). Levels of PTSD symptoms were strongly associated with symptoms of anxiety (0.54) and depression (0.49). Bivariate analyses showed a moderate significant association (0.30) between PTSD symptoms and pain intensity. This association became small (0.10) when anxiety and depression comorbidity were factored into the final regression model. CONCLUSIONS No independent association between PTSD symptoms and pain intensity was shown when adjusted for anxiety and depression. Results of this study suggest the usefulness of screening for PTSD in persons with SCI (regardless of injury cause or type/level) who score high on symptoms of anxiety/depression.
Collapse
Affiliation(s)
- Heleen Kuiper
- Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,University of Groningen, University Medical Centre Groningen, Centre for Rehabilitation, Groningen, The Netherlands
| | - Christel C M van Leeuwen
- Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - David J Kopsky
- Institute for Neuropathic Pain, Amsterdam, The Netherlands
| | - Janneke M Stolwijk-Swüste
- Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marcel W M Post
- Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands. .,University of Groningen, University Medical Centre Groningen, Centre for Rehabilitation, Groningen, The Netherlands.
| |
Collapse
|
40
|
Niemeyer MJS, Lokerman RD, Sadiqi S, van Heijl M, Houwert RM, van Wessem KJP, Post MWM, van Koppenhagen CF. Epidemiology of Traumatic Spinal Cord Injury in the Netherlands: Emergency Medical Service, Hospital, and Functional Outcomes. Top Spinal Cord Inj Rehabil 2021; 26:243-252. [PMID: 33536729 DOI: 10.46292/sci20-00002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background Evaluating treatment of traumatic spinal cord injuries (TSCIs) from the prehospital phase until postrehabilitation is crucial to improve outcomes of future TSCI patients. Objective To describe the flow of patients with TSCI through the prehospital, hospital, and rehabilitation settings and to relate treatment outcomes to emergency medical services (EMS) transport locations and surgery timing. Method Consecutive TSCI admissions to a level I trauma center (L1TC) in the Netherlands between 2015 and 2018 were retrospectively identified. Corresponding EMS, hospital, and rehabilitation records were assessed. Results A total of 151 patients were included. Their median age was 58 (IQR 37-72) years, with the majority being male (68%) and suffering from cervical spine injuries (75%). In total, 66.2% of the patients with TSCI symptoms were transported directly to an L1TC, and 30.5% were secondarily transferred in from a lower level trauma center. Most injuries were due to falls (63.0%) and traffic accidents (31.1%), mainly bicycle-related. Most patients showed stable vital signs in the ambulance and the emergency department. After hospital discharge, 71 (47.0%) patients were admitted to a rehabilitation hospital, and 34 (22.5%) patients went home. The 30-day mortality rate was 13%. Patients receiving acute surgery (<12 hours) compared to subacute surgery (>12h, <2 weeks) showed no significance in functional independence scores after rehabilitation treatment. Conclusion A surge in age and bicycle-injuries in TSCI patients was observed. A substantial number of patients with TSCI were undertriaged. Acute surgery (<12 hours) showed comparable outcomes results in subacute surgery (>12h, <2 weeks) patients.
Collapse
Affiliation(s)
- Menco J S Niemeyer
- University Medical Center Utrecht, Department of Trauma Surgery, Utrecht, the Netherlands
| | - R D Lokerman
- University Medical Center Utrecht, Department of Trauma Surgery, Utrecht, the Netherlands
| | - S Sadiqi
- University Medical Center Utrecht, Department of Orthopedics, Utrecht, the Netherlands
| | - M van Heijl
- Diakonessenhuis Hospital, Department of Surgery, Utrecht, the Netherlands
| | - R M Houwert
- University Medical Center Utrecht, Department of Trauma Surgery, Utrecht, the Netherlands
| | - K J P van Wessem
- University Medical Center Utrecht, Department of Trauma Surgery, Utrecht, the Netherlands
| | - M W M Post
- University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Groningen, the Netherlands.,University Medical Center Utrecht, Department of Rehabilitation, Physical Therapy Science and Sports, UMCU Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - C F van Koppenhagen
- University Medical Center Utrecht, Center of Excellence for Rehabilitation Medicine, UMCU Brain Center and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| |
Collapse
|
41
|
Kouwijzer I, Valent LJM, van Bennekom CAM, Post MWM, van der Woude LHV, de Groot S. Training for the HandbikeBattle: an explorative analysis of training load and handcycling physical capacity in recreationally active wheelchair users. Disabil Rehabil 2020; 44:2723-2732. [PMID: 33147423 DOI: 10.1080/09638288.2020.1839974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE (1) to analyze training characteristics of recreationally active wheelchair users during handcycle training, and (2) to examine the associations between training load and change in physical capacity. METHODS Former rehabilitation patients (N = 60) with health conditions such as spinal cord injury or amputation were included. Participants trained for five months. A handcycling/arm crank graded exercise test was performed before and after the training period. Outcomes: peak power output per kg (POpeak/kg) and peak oxygen uptake per kg (VO2peak/kg). Training load was defined as Training Impulse (TRIMP), which is rating of perceived exertion (sRPE) multiplied by duration of the session, in arbitrary units (AU). Training intensity distribution (TID) was also determined (time in zone 1, RPE ≤4; zone 2, RPE 5-6; zone 3, RPE ≥7). RESULTS Multilevel regression analyses showed that TRIMPsRPE was not significantly associated with change in physical capacity. Time in zone 2 (RPE 5-6) was significantly associated with ΔVO2peak, %ΔVO2peak, ΔVO2peak/kg and %ΔVO2peak/kg. CONCLUSION Training at RPE 5-6 was the only determinant that was significantly associated with improvement in physical capacity. Additional controlled studies are necessary to demonstrate causality and gather more information about its usefulness, and optimal handcycle training regimes for recreationally active wheelchair users.IMPLICATIONS FOR REHABILITATIONMonitoring of handcycle training load is important to structure the training effort and intensity over time and to eventually optimize performance capacity. This is especially important for relatively untrained wheelchair users, who have a low physical capacity and a high risk of overuse injuries and shoulder pain.Training load can be easily calculated by multiplying the intensity of the training (RPE 0-10) with the duration of the training in minutes.Results on handcycle training at RPE 5-6 intensity in recreationally active wheelchair users suggests to be promising and should be further investigated with controlled studies.
Collapse
Affiliation(s)
- Ingrid Kouwijzer
- Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands.,University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands.,Amsterdam Rehabilitation Research Center
- Reade, Amsterdam, The Netherlands
| | - Linda J M Valent
- Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands
| | - Coen A M van Bennekom
- Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands.,Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | | | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMCU Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Groningen, The Netherlands
| | - Lucas H V van der Woude
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Groningen, The Netherlands
| | - Sonja de Groot
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands.,Amsterdam Rehabilitation Research Center
- Reade, Amsterdam, The Netherlands.,Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, The Netherlands
| |
Collapse
|
42
|
van Diemen T, Craig A, van Nes IJW, Stolwijk-Swuste JM, Geertzen JHB, Middleton J, Post MWM. Enhancing our conceptual understanding of state and trait self-efficacy by correlational analysis of four self-efficacy scales in people with spinal cord injury. BMC Psychol 2020; 8:108. [PMID: 33076995 PMCID: PMC7574195 DOI: 10.1186/s40359-020-00474-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/28/2020] [Indexed: 11/10/2022] Open
Abstract
Background Self-efficacy is an important determinant of adjustment following spinal cord injury. Self-efficacy is defined as the belief that one can successfully execute behavior required to produce the desired outcomes. In its original conceptualization, self-efficacy refers to the confidence that people have in their ability to accomplish specific tasks and behaviors within a specific context. Over the years these situation specific aspects have been unconfined and multiple constructs of self-efficacy have been proposed. The most common is a division in trait and state self-efficacy. Another used division that is utilized is between general, domain-specific and task-specific self-efficacy. The scientific support for these constructs is to date still unclear. The objective of this study was to enhance the understanding of the self-efficacy construct by comparing four self-efficacy scales designed to measure three aspects of self-efficacy (general versus domain-specific versus task-specific) in people with spinal cord injury. Methods Dutch and Australian adults with spinal cord injury (N = 140) completed four frequently used self-efficacy scales; the Moorong Self-efficacy Scale, General Self-efficacy Scale, University of Washington Self-efficacy Scale and a Self-care Self-efficacy Scale approximately 6 months after their inpatient rehabilitation. Pearson correlations examined inter-relationships between the scales. Results Hypothesized strong correlations between scales measuring similar aspects of self-efficacy were found (correlations 0.50–0.65). However, the hypothesized weak to moderate correlations between scales measuring diverging aspects of self-efficacy were only partly found (correlations 0.31–0.74), with 7 out of 12 correlations being strong instead of moderate. Conclusions The expected distinctions between the three aspects of self-efficacy was not demonstrated. All four scales measure a common latent construct, most likely general self-efficacy aspects. Further research is necessary to find ways to improve the measurement of domain-specific and task-specific aspects of SE, so that they are sensitive enough to capture change over time, and thus enhance clinical outcomes of people with SCI as they adjust to their disability.
Collapse
Affiliation(s)
- Tijn van Diemen
- Department of spinal cord injury Rehabilitation, Sint Maartenskliniek, P.O. box 9011, 6500, GM, Nijmegen, The Netherlands. .,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands. .,University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands.
| | - Ashley Craig
- John Walsh Center for Rehabilitation Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Kolling Institute, St Leonards, NSW, Australia
| | - Ilse J W van Nes
- Department of spinal cord injury Rehabilitation, Sint Maartenskliniek, P.O. box 9011, 6500, GM, Nijmegen, The Netherlands
| | | | - Janneke M Stolwijk-Swuste
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,Department of spinal cord injury, De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Jan H B Geertzen
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands
| | - James Middleton
- John Walsh Center for Rehabilitation Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Kolling Institute, St Leonards, NSW, Australia.,Spinal Outreach Service, Royal Rehab, Sydney, Australia
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands
| |
Collapse
|
43
|
Postma K, Bussmann JBJ, van Diemen T, Post MWM, Dekkers J, van Nes IJW, Osterthun R, van den Berg-Emons RJG. Physical Activity and Sedentary Behavior From Discharge to 1 Year After Inpatient Rehabilitation in Ambulatory People With Spinal Cord Injury: A Longitudinal Cohort Study. Arch Phys Med Rehabil 2020; 101:2061-2070. [PMID: 32750374 DOI: 10.1016/j.apmr.2020.06.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 04/23/2020] [Accepted: 06/29/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate changes in duration of physical activity (PA) and sedentary behavior (SB) from discharge to 1 year after inpatient rehabilitation in ambulatory people with spinal cord injury (SCI). DESIGN Longitudinal cohort study with objective measurements of physical behavior at discharge and at 6 and 12 months post discharge. SETTING Three rehabilitation centers and the participant's home environment. PARTICIPANTS Participants (N=47) with ambulatory function were consecutively recruited from the self-management and self-efficacy in patients with SCI cohort (age 18 years or older, recent SCI, expected inpatient stay ≥4wk). Mean age was 54.5±12.9 years, all had incomplete lesions, 53% were men, 49% had tetraplegia, and 51% were community ambulators at discharge. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Duration (min) of PA (summed duration of walking, cycling, running, and wheeling) and SB (sitting/lying). RESULTS Mean duration of PA increased by 21 min/d (95% confidence interval, 7-35) and SB decreased by 64 min/d (95% confidence interval, -94 to -35) from discharge to 6 months after inpatient rehabilitation. No changes were found in the second half-year. One year after discharge mean PA was 116±59 min/d and mean SB was 665±121 min/d. The increase in PA was the result of an almost doubling of time spent walking. Variability in physical behavior and its change was large. Older age and lower ambulation level were associated with lower PA, lower ambulation level with higher SB, and tetraplegia was associated with a reduced increase in PA. CONCLUSIONS At group level, duration of PA and SB improved following inpatient rehabilitation in ambulatory people with SCI. However, there were large differences between individuals. Levels 1 year after discharge were still unfavorable, particularly regarding SB.
Collapse
Affiliation(s)
- Karin Postma
- Rijndam Rehabilitation, Rotterdam; Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam.
| | - Johannes B J Bussmann
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam
| | - Tijn van Diemen
- Department of Rehabilitation, Sint Maartenskliniek, Nijmegen; Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht; Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen
| | - Jos Dekkers
- Dutch Spinal Cord Injury Association, Nijkerk, The Netherlands
| | | | - Rutger Osterthun
- Rijndam Rehabilitation, Rotterdam; Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam
| | | |
Collapse
|
44
|
Scholten EWM, Ketelaar M, Visser-Meily JMA, Stolwijk-Swüste J, van Nes IJW, Gobets D, Post MWM. Self-Efficacy Predicts Personal and Family Adjustment Among Persons With Spinal Cord Injury or Acquired Brain Injury and Their Significant Others: A Dyadic Approach. Arch Phys Med Rehabil 2020; 101:1937-1945. [PMID: 32585170 DOI: 10.1016/j.apmr.2020.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/15/2020] [Accepted: 06/17/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To investigate whether the combination of self-efficacy levels of individuals with spinal cord injury (SCI) or acquired brain injury (ABI) and their significant others, measured shortly after the start of inpatient rehabilitation, predict their personal and family adjustment 6 months after inpatient discharge. DESIGN Prospective longitudinal study. SETTING Twelve Dutch rehabilitation centers. PARTICIPANTS Volunteer sample consisting of dyads (N=157) of adults with SCI or ABI who were admitted to inpatient rehabilitation and their adult significant others. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Self-efficacy (General Competence Scale) and personal and family adjustment (Hospital Anxiety and Depression Scale and McMaster Family Assessment Device General Functioning). RESULTS In 20 dyads, both individuals with SCI or ABI and their significant others showed low self-efficacy at baseline. In 67 dyads, both showed high self-efficacy. In the low-self-efficacy dyads, 61% of the individuals with SCI or ABI and 50% of the significant others showed symptoms of anxiety 6 months after discharge, vs 23% and 30%, respectively, in the high-self-efficacy dyads. In the low-self-efficacy dyads, 56% of individuals with SCI or ABI and 50% of the significant others reported symptoms of depression, vs 20% and 27%, respectively, in the high-self-efficacy dyads. Problematic family functioning was reported by 53% of the individuals with SCI or ABI and 42% of the significant others in the low-self-efficacy dyads, vs 4% and 12%, respectively, in the high-self-efficacy dyads. Multivariate analysis of variance analyses showed that the combination of levels of self-efficacy of individuals with SCI or ABI and their significant others at the start of inpatient rehabilitation predict personal (V=0.12; F6,302=2.8; P=.010) and family adjustment (V=0.19; F6,252=4.3; P<.001) 6 months after discharge. CONCLUSIONS Low-self-efficacy dyads appear to be more at risk for personal and family adjustment problems after discharge. Screening for self-efficacy may help healthcare professionals to identify and support families at risk for long-term adjustment problems.
Collapse
Affiliation(s)
- Eline W M Scholten
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Johanna M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands; Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, The Netherlands
| | - Janneke Stolwijk-Swüste
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Ilse J W van Nes
- Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - David Gobets
- Rehabilitation Centre, Heliomare, Wijk aan Zee, The Netherlands
| | | | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands; University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Department of Rehabilitation Medicine, Groningen, The Netherlands.
| |
Collapse
|
45
|
Fekete C, Brach M, Ehrmann C, Post MWM, Stucki G. Cohort Profile of the International Spinal Cord Injury Community Survey Implemented in 22 Countries. Arch Phys Med Rehabil 2020; 101:2103-2111. [PMID: 32533933 DOI: 10.1016/j.apmr.2020.01.022] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To detail the methodological features of the first International Spinal Cord Injury (InSCI) Community Survey by describing recruitment and data collection procedures, and to report on the recruitment results and basic characteristics of participants by country and income setting. DESIGN Cross-sectional survey. SETTING Community setting in 22 countries representing all 6 World Health Organization regions. PARTICIPANTS Individuals (N=12,591) with traumatic or non-traumatic spinal cord injury (SCI) aged over 18 years. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Recruitment and data collection procedures, recruitment results, and basic sociodemographic and lesion characteristics of participants. RESULTS Eight countries used predefined sampling frames and 14 countries applied convenience sampling for recruitment. Most countries recruited participants through specialized rehabilitation facilities, patient organizations, or acute and general hospitals. Modes of approaching potential participants depended on the sampling strategy and multiple response modes were offered to maximize participation. Contact rates ranged from 33% to 98%, cooperation rates ranged from 29% to 90%, and response rates ranged from 23% to 54%. The majority of participants were men (73%), the median age was 52 years (interquartile range, 40-63y), 60% had a partner, 8% reported that they were born in another country than where they were currently residing, and the median length of education was 12 years (interquartile range, 9-15y). Paraplegia was the main diagnosis (63%), traumatic etiologies were the major cause of injury (81%), and the median time since injury (TSI) was 9 years (interquartile range, 4-19y). Compared with participants from lower income settings, participants from higher income settings were over-represented and, in general, were older, more often diagnosed with tetraplegia, had a longer TSI, higher education, and were more often born in a country different than their current residence country. CONCLUSIONS The successful implementation of the InSCI survey enables the comparison of the situation of individuals with SCI around the world and constitutes a crucial starting point for an international learning experience.
Collapse
Affiliation(s)
- Christine Fekete
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
| | - Mirjam Brach
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Cristina Ehrmann
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Marcel W M Post
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, the Netherlands; Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | | | - Gerold Stucki
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; ICF Research Branch, Swiss Paraplegic Research, Nottwil, Switzerland
| |
Collapse
|
46
|
de Graaf JA, Nijsse B, Schepers VPM, van Heugten CM, Post MWM, Visser-Meily JMA. Which approach to measure cognitive functioning should be preferred when exploring the association between cognitive functioning and participation after stroke? Neuropsychol Rehabil 2020; 31:1207-1223. [PMID: 32496877 DOI: 10.1080/09602011.2020.1769687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A variety of approaches are currently used to explore the relationship between cognitive functioning and participation after stroke. We aimed to gain insight into the preferred approach to measure cognitive functioning when exploring the association between cognitive functioning and participation in the long term after stroke. In this inception cohort study 128 individuals with stroke participated and were assessed at a single time point three to four years after the event. Participation was measured using the Restrictions subscale of the Utrecht Scale for Evaluation of Rehabilitation-Participation. Subjective cognitive complaints were assessed using the Cognition subscale of the Checklist for Cognitive and Emotional Consequences (CLCE-24-C). Objective cognitive performance was measured using the Montreal Cognitive Assessment (MoCA) and a neuropsychological test battery (NTB) testing multiple cognitive domains. Participation showed a strong correlation (r = 0.51) with the CLCE-24-C and moderate correlations with the domains of visuospatial perception (r = 0.37) and mental speed (r = 0.36). Backward linear regression analyses showed that participation restrictions were best explained by the combination of the CLCE-24-C and a test for visuospatial perception (R2 = 0.31). Our findings suggest the use of a combination of subjective cognitive complaints and objective cognitive performance to explore the relationship between cognitive functioning and participation after stroke.
Collapse
Affiliation(s)
- J A de Graaf
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - B Nijsse
- Department of Neurology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | - V P M Schepers
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, The Netherlands
| | - C M van Heugten
- Faculty of Psychology and Neuroscience, Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands.,Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - M W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - J M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, The Netherlands
| |
Collapse
|
47
|
Scholten EWM, Simon JDHP, van Diemen T, Hillebregt CF, Ketelaar M, Woldendorp KH, Osterthun R, Visser-Meily JMA, Post MWM. Appraisals and coping mediate the relationship between resilience and distress among significant others of persons with spinal cord injury or acquired brain injury: a cross-sectional study. BMC Psychol 2020; 8:51. [PMID: 32434585 PMCID: PMC7238738 DOI: 10.1186/s40359-020-00419-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 05/08/2020] [Indexed: 11/21/2022] Open
Abstract
Background Many significant others of persons with serious conditions like spinal cord injury (SCI) and acquired brain injury (ABI) report high levels of psychological distress. In line with the stress-coping model, the aim of the present study was to investigate the relationship between personal resource resilience and psychological distress, and whether appraisals of threat and loss, and passive coping mediate this relationship. Methods Significant others (n = 228) of persons with SCI or ABI completed questionnaires shortly after admission to first inpatient rehabilitation after onset of the condition. The questionnaire included measures to assess psychological distress (Hospital Anxiety and Depression Scale), resilience (Connor-Davidson Resilience Scale-10), appraisals (Appraisals of Life Events scale, threat and loss) and passive coping (Utrecht Coping List). The PROCESS tool was used to test the presence of mediation. Confounding and differences between SCI and ABI were investigated. Results High levels of psychological distress among significant others were found (34–41%). Fifty-five percent of the variance in psychological distress was explained by the relationship between resilience and psychological distress. This relationship was mediated by appraisals of threat and loss, and passive coping. The relationship between resilience and psychological distress was similar in the SCI and ABI groups. Conclusions The results of our study indicate that appraisals of threat and loss and passive coping are mediating factors in the relationship between resilience and psychological distress. It seems useful to investigate if interventions focussing on psychological factors like resilience, appraisal and coping are effective to prevent or reduce psychological distress among significant others of persons with SCI or ABI. Trial registration Dutch trial register NTR5742. Registered January 9, 2016.
Collapse
Affiliation(s)
- Eline W M Scholten
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.
| | - Julia D H P Simon
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Tijn van Diemen
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,Sint Maartenskliniek, Department of Rehabilitation, Nijmegen, the Netherlands.,University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Chantal F Hillebregt
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Kees Hein Woldendorp
- "Revalidatie Friesland" Center for Rehabilitation, Beetsterzwaag, the Netherlands
| | - Rutger Osterthun
- Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, the Netherlands.,Rijndam Rehabilitation Center, Rotterdam, the Netherlands
| | - Johanna M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands. .,University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Department of Rehabilitation Medicine, Groningen, the Netherlands.
| |
Collapse
|
48
|
Fekete C, Siegrist J, Post MWM, Tough H, Brinkhof MWG. Does engagement in productive activities affect mental health and well-being in older adults with a chronic physical disability? Observational evidence from a Swiss cohort study. Aging Ment Health 2020; 24:732-739. [PMID: 30789009 DOI: 10.1080/13607863.2019.1576158] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: To investigate type and load of productive activities as potential determinants of mental health and well-being in elderly persons with a physical disability.Methods: We used data from a Swiss population-based sample of 314 adults at or past the legal retirement age (65 for men, 64 for women) who live with a chronic physical disability, spinal cord injury. Engagement in housework, volunteering, and paid work were dichotomized (no; some engagement) and three groups of engagement types were constructed (none; housework only; volunteering and/or paid work). Load of engagement was appraised using a sumscore on the overall frequency as well as the total number of performed activities. We used regression modelling to draw causal inference regarding the associations of type and load of engagement with general mental health (Mental Health Inventory, SF-36), self-reported depression (Self-Administered Comorbidity Questionnaire, SCQ), and well-being (WHOQoL-BREF items).Results: Engagement in volunteering was positively related to well-being. Persons engaged only in housework reported better well-being and lower prevalence of depression than non-engaged persons, however, persons engaged in volunteering or paid work reported the highest well-being and the lowest prevalence of depression. The productivity sumscore tertiles and the number of performed activities were both positively linked to well-being and negatively linked to depression, while their association with general mental health was less pronounced.Conclusion: Strengthening the engagement in productive activities among the elderly with a chronic physical disability is suggested as a promising strategy to promote well-being and reduce the prevalence of depression.
Collapse
Affiliation(s)
- Christine Fekete
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland.,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Johannes Siegrist
- Senior Professorship 'Work Stress Research', Faculty of Medicine, University of Duesseldorf, Life-Science-Center, Duesseldorf, Germany
| | - Marcel W M Post
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, CG Utrecht, the Netherlands
| | - Hannah Tough
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland.,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Martin W G Brinkhof
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland.,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | | |
Collapse
|
49
|
Kruitwagen-van Reenen ETH, Post MWM, van Groenestijn A, van den Berg LH, Visser-Meily JMA. Associations between illness cognitions and health-related quality of life in the first year after diagnosis of amyotrophic lateral sclerosis. J Psychosom Res 2020; 132:109974. [PMID: 32155469 DOI: 10.1016/j.jpsychores.2020.109974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 02/17/2020] [Accepted: 02/19/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To describe illness cognitions among patients with amyotrophic lateral sclerosis (ALS), to study cross-sectional associations between illness cognitions and health-related quality of life (HRQoL) and to study the predictive value of illness cognitions measured shortly after the diagnosis for HRQoL at follow-up. METHODS Prospective longitudinal design. We administered Self-report questionnaires at study onset (n = 72) and follow-up (n = 48). Median follow-up period was 10.0 months. At baseline median ALS Functional Rating Scale-Revised was 43, median time since onset of symptoms was 13.6 months, 79% of patients presented with spinal onset. Illness cognitions Helplessness, Acceptance and Disease Benefits were measured with the Illness Cognitions Questionnaire (ICQ) and HRQoL with the ALS Assessment Questionnaire (ALSAQ-40). Correlational and regression analyses were used. RESULTS Patients experienced more Helplessness at follow-up. We found no significant changes in Acceptance or Disease Benefits at follow-up. In cross-sectional analyses, Helplessness was independently related to worse HRQoL at baseline (β = 0.44; p = .001) and Acceptance and Disease Benefits were independently related to worse HRQoL at follow-up (β = -0.17, p = .045) and (β = -0.186, p = .03 respectively). Longitudinal analyses showed that, adjusted for disease severity at baseline, Helplessness at baseline was a predictor of worse HRQoL at follow-up (β = 0.43; p = .006). None of the illness cognitions were a significant predictor of HRQoL with adjustment for baseline HRQoL. CONCLUSION Helplessness was independently associated with HRQoL in the cross-sectional and longitudinal analyses. These results can help us identify patients shortly after diagnosis who might benefit from psychological interventions.
Collapse
Affiliation(s)
- E T H Kruitwagen-van Reenen
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, the Netherlands; Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.
| | - M W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - A van Groenestijn
- Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - L H van den Berg
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - J M A Visser-Meily
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, the Netherlands; Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| |
Collapse
|
50
|
de Graaf JA, Kuijpers MMT, Visser-Meily JMA, Kappelle LJ, Post MWM. Validity of an enhanced EQ-5D-5L measure with an added cognitive dimension in patients with stroke. Clin Rehabil 2020; 34:545-550. [DOI: 10.1177/0269215520907990] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Objective: The 5-level EuroQoL (EQ-5D-5L) is a patient-reported outcome measure frequently used in stroke research. However, it does not assess the cognitive problems many patients with stroke experience. The aim of this article is to compare the content validity, internal consistency and discriminative ability of the EQ-5D-5L with and without an additional cognitive domain (EQ-5D-5L+C), administered three months post-stroke. Design: Cross-sectional study. Setting: Six general hospitals in the Netherlands. Subjects: In all, 360 individuals with stroke three months after the event. Interventions: Not applicable. Main measures: The modified Rankin Scale and EQ-5D-5L+C were administered in telephone interviews three months post-stroke. Results: A total of 360 patients with stroke were included. Mean age was 68.8 years (standard deviation (SD) = 11.7), 143 (40%) were female, 334 (93%) had had an ischemic stroke, 165 (46%) had a National Institutes of Health Stroke Scale (NIHSS) score ⩽ 4 at presentation and the Barthel Index was 17.2 (SD = 4) four days post-stroke. Cognitive problems were reported by 199 (55%) patients three months post-stroke. Internal consistencies of the EQ-5D-5L and EQ-5D-5L+C were 0.75 and 0.77, respectively. Adding a cognitive domain resulted in a decrease of the ceiling effect from 22% to 14%. Both EQ-5D-5L and EQ-5D-5L+C showed good discriminative ability, but differences between patients with different modified Rankin Scale scores and with/without reported decrease in health and daily activities were slightly larger with the EQ-5D-5L+C compared to the EQ-5D-5L. Conclusions: The EQ-5D-5L+C, which includes a cognitive domain that is highly significant for stroke patients, showed increased content validity and good discriminative ability, without losing internal consistency.
Collapse
Affiliation(s)
- JA de Graaf
- Center of Excellence for Rehabilitation Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht University, Utrecht, The Netherlands
| | - MMT Kuijpers
- Center of Excellence for Rehabilitation Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht University, Utrecht, The Netherlands
| | - JMA Visser-Meily
- Center of Excellence for Rehabilitation Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht University, Utrecht, The Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - LJ Kappelle
- UMC Utrecht Brain Center and Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - MWM Post
- Center of Excellence for Rehabilitation Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht University, Utrecht, The Netherlands
- Center for Rehabilitation, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| |
Collapse
|