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O’Connell C, Armstrong J, De la Cerna-Luna R, Ganvir S, Arnillas Brigneti P. Perspective of the World Rehabilitation Alliance: Global Strategies to Strengthen Spinal Cord Injury Rehabilitation Services in Health Systems. Healthcare (Basel) 2024; 12:2313. [PMID: 39595510 PMCID: PMC11593608 DOI: 10.3390/healthcare12222313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Revised: 11/14/2024] [Accepted: 11/15/2024] [Indexed: 11/28/2024] Open
Abstract
BACKGROUND/OBJECTIVES Spinal cord injury (SCI) is a disabling condition prevalent worldwide, requiring rehabilitation services from injury through community living. This study, conducted by representatives of the World Rehabilitation Alliance (WRA), aims to identify strategies for strengthening SCI rehabilitation services globally, with particular attention to settings where resources are limited. METHODS Three focus groups were held between 2023 and 2024 with WRA representatives specializing in SCI rehabilitation. Discussions focused on four key areas: workforce and education, health policy and systems research, primary care, and emergency response. Perspectives were developed taking into account frameworks from the World Health Organization (WHO). RESULTS Key insights into SCI rehabilitation services emphasize workforce and education as critical areas, underscoring the importance of specialized training, certification, and ongoing support to build capacity. In health systems and policy research, significant gaps in evidence-based practices were highlighted, emphasizing the need for comprehensive data collection and national registries to guide policy and align SCI care with global standards. The integration into primary care systems is recommended to improve access and address common complications in low- and middle-income countries (LMICs). For emergency response, this study stresses the importance of preparedness and establishing multi-disciplinary teams capable of managing SCI cases in resource-limited settings, reducing preventable complications, and improving patient outcomes. CONCLUSIONS SCI rehabilitation services are essential to global health, with a need for workforce development, research, national registries, and integration into primary and emergency care. Such efforts should improve accessibility and align with global best practices, ensuring comprehensive and accessible rehabilitation for all.
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Affiliation(s)
- Colleen O’Connell
- Stan Cassidy Centre for Rehabilitation, Dalhousie Medicine New Brunswick, Faculty of Medicine, Dalhousie University, Fredericton, NB E3B 0C7, Canada
| | - Jo Armstrong
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Bucks HP21 8AL, UK;
| | - Roger De la Cerna-Luna
- Physical Medicine and Rehabilitation Department, Hospital Nacional Edgardo Rebagliati Martins, Lima 15072, Peru; (R.D.l.C.-L.); (P.A.B.)
| | - Suvarna Ganvir
- DVVPF’s College of Physiotherapy, Maharashtra University of Health Sciences, Ahmednagar 414111, Maharashtra, India;
- Primary Care Task Force, Indian Federation of Neurorehabilitation (IFNR), Mumbai 400020, Maharashtra, India
| | - Paula Arnillas Brigneti
- Physical Medicine and Rehabilitation Department, Hospital Nacional Edgardo Rebagliati Martins, Lima 15072, Peru; (R.D.l.C.-L.); (P.A.B.)
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Acosta-Santillán PL, Toro-Sashida MF, Rosas-Mendoza AV, Fuentes-Orozco C, Jasso-García K, García de León-Flores P, Mellado-Téllez MP, Ibarra-Camargo SA, Chejfec-Ciociano JM, Barbosa-Camacho FJ, Flores-Prado JA, Cervantes-Guevara G, Cervantes-Pérez E, Cevantes-Cardona GA, Alvarez-Villaseñor AS, González-Ojeda A. Quality of sexual life in Mexican men after spinal cord injury. J Rehabil Med 2023; 55:jrm11641. [PMID: 38124428 PMCID: PMC10802783 DOI: 10.2340/jrm.v55.11641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 10/24/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To evaluate the quality of sexual life in men with spinal cord injury. DESIGN Cross-sectional analytical study. PATIENTS Males with a history of spinal cord injury who attended an outpatient rehabilitation service. METHODS An analytical study examined adult male patients with complete spinal cord injury in rehabilitation. A modified Sexual Life Quality Questionnaire (SLQQ) examined quality of sexual life, with scores below 50 suggesting significant sexual dysfunction and dissatisfaction. The assessment evaluated age, occupation, marital status, comorbidities, and treatment methods. RESULTS A total of 80 patients were included; 33 (41%) had a thoracic spinal cord injury, and 47 (59%) had a lumbar spinal cord injury. Thirty-seven patients (46%) were dissatisfied with the quality of their sexual life; 29 patients (88%) with thoracic spinal cord injury and 8 patients (17%) with lumbar spinal cord injury were dissatisfied with the quality of their sexual life (p = 0.001). Patients with higher education level experienced less sexual dissatisfaction (p = 0.03). CONCLUSION Human sexuality involves numerous interconnected elements that impact on general health. Sexual pleasure, self-esteem, and personal relationships are crucial for patients with spinal cord injury to identify rehabilitation needs. These results indicate the importance of supporting sexual well-being in recovery. Further studies of sexual enjoyment and quality of life for patients with spinal cord injury are needed, using larger and more diverse populations.
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Affiliation(s)
- Paulina Lucia Acosta-Santillán
- Department of Physical Rehabilitation, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Maria Fernanda Toro-Sashida
- Department of Physical Rehabilitation, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Alejandra Viridiana Rosas-Mendoza
- Department of Physical Rehabilitation, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Clotilde Fuentes-Orozco
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Kelvin Jasso-García
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Paulina García de León-Flores
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Mel Paul Mellado-Téllez
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Silvia Alejandra Ibarra-Camargo
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Jonathan Matías Chejfec-Ciociano
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Francisco José Barbosa-Camacho
- Department of Psychiatry, Civil Hospital of Guadalajara Fray Antonio Alcalde, University Center of Health Sciences, University of Guadalajara, Guadalajara, Jalisco, México
| | - Juan Armando Flores-Prado
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Gabino Cervantes-Guevara
- Department of Wellbeing and Sustainable Development, Centro Universitario del Norte, University of Guadalajara, Guadalajara, Jalisco, México
| | - Enrique Cervantes-Pérez
- Department of Internal Medicine, Civil Hospital of Guadalajara Fray Antonio Alcalde, University Center of Health Sciences, University of Guadalajara, Guadalajara, Jalisco. México
| | - Guillermo Alonso Cevantes-Cardona
- Department of Philosophical, Methodological and Instrumental Disciplines, University Center of Health Sciences, University of Guadalajara, Guadalajara, Jalisco, México
| | | | - Alejandro González-Ojeda
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México.
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