Post-clinical follow-up of spinal patients through domestic check-ups. (Koblenz model)

Problems in the health management of persons with spinal cord injury

This study was conducted to clarify the features of complications attending spinal cord injury (SCI). A comparison was made of the prevalence of disease among patients with SCI (SCIP) with that in the general population in Japan (National Livelihood Basic Survey). For this purpose, a survey was conducted on 244 males at 8 Rosai Rehabilitation Centers (Workman's Accident Compensation Rehabilitation Workshops). The average age was 49.6 years. To eliminate age effects on this parameter, the prevalence rates were expressed as standardized outpatient morbidity ratios (SOMRs), with the value for the general population set at 100. The SOMR data for cystitis were particularly high (16,278, p < 0.01). The SOMRs for other diseases were also high: renal diseases, 2,642; disorders of the skin, 361; gastritis, 339; and hepatic disorders, 381 (p < 0.01). These disorders may be regarded as primary or secondary lesions associated with SCI. SCIP with diseases associated with aging, such as hypertension and diabetes mellitus, are on the increase in Japan. The SOMR for hypertension was 250 (p < 0.01), and for diabetes mellitus it was 323 (p < 0.01).

Sequelae of SCI after discharge from the initial rehabilitation program

The purpose of this study was to identify sequelae that occurred in persons with spinal cord injuries 11 weeks to 5 years after discharge from two initial rehabilitation programs. The investigator-developed instrument was first administered to a convenience sample of 21 subjects (Adamski, 1983). The modified version of the instrument was administered to a probability sample of 19 subjects in the present study. The results demonstrated that respondents experienced a higher incidence of medical sequelae than has been documented in the literature. These findings have important implications for nursing practice in developing and evaluating educational programs for persons with spinal cord injuries.