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Ghai S, Hitzig SL, Eberlin L, Melo J, Mayo AL, Blanchette V, Habra N, Zucker-Levin A, Zidarov D. Reporting of Rehabilitation Outcomes in the Traumatic Lower Limb Amputation Literature: A Systematic Review. Arch Phys Med Rehabil 2024; 105:1158-1170. [PMID: 37708929 DOI: 10.1016/j.apmr.2023.08.028] [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: 03/09/2023] [Revised: 08/09/2023] [Accepted: 08/28/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVE To synthesize the outcomes reported in the rehabilitation and community literature for adults with traumatic lower limb amputation (LLA). DATA SOURCES The search strategy was conducted in 3 databases (Medline, EMBASE, and CINAHL) from inception to April 2022. STUDY SELECTION To be eligible, articles could be of any design but were required to have at least 50% adult individuals with traumatic LLA and had to report on interventions and outcomes in either a rehabilitation or community setting. DATA EXTRACTION The extracted outcomes were classified using Dodd's framework, which is designed for organizing research outcomes. Heterogeneity was observed in the outcome measures (OMs) used for evaluation. Two reviewers independently conducted the data extraction, which was verified by a third reviewer. DATA SYNTHESIS Of the 7,834 articles screened, 47 articles reporting data on 692 individuals with traumatic LLA, met our inclusion criteria. Four core areas encompassing 355 OMs/indicators were identified: life effect (63.4%), physiological/clinical (30.1%), resource use (5.1%), and adverse events (1.4%). Physical functioning (eg, gait, mobility) was the most frequently reported outcome domain across studies, followed by nervous system outcomes (eg, pain) and psychiatric outcomes (eg, depression, anxiety). Domains such as global quality of life and role/emotional functioning were seldomly reported. CONCLUSION The study provides a list of outcome indicators explicitly published for adults with traumatic LLA, highlighting inconsistent reporting of outcome indicators. The lack of a standardized set of OMs is a barrier to performing meta-analyses on interventions, preventing the identification of effective care models and clinical pathways. Developing a core outcome set that includes OMs relevant to the needs of the traumatic LLA population may address these issues.
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Affiliation(s)
- Shashank Ghai
- Department of Political, Historical, Religious and Cultural Studies, Karlstads Universitet, Karlstad, Sweden; Centre for Societal Risk Research, Karlstads Universitet, Karlstad, Sweden; Psychology of Learning and Instruction, Department of Psychology, School of Science, Technische Universität Dresden, Dresden, Germany; Centre for Tactile Internet with Human-in-the-loop (CeTI), Technische Universität Dresden, Dresden, Germany.
| | - Sander L Hitzig
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Lindsay Eberlin
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Joshua Melo
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Amanda L Mayo
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada; Division of Physical Medicine and Rehabilitation, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada; Centre for Quality Improvement and Patient Safety (CQuIPS), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Virginie Blanchette
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Québec, Canada; Department of Human Kinetics and Podiatric Medicine, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Natalie Habra
- Faculté de Médecine, Université de Montréal, Montréal, Canada; Centre de Recherche Interdisciplinaire en Réadaptation (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada
| | - Audrey Zucker-Levin
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Canada
| | - Diana Zidarov
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada; École de readaptation, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada.
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Barth CA, Wladis A, Blake C, Bhandarkar P, Aebischer Perone S, O'Sullivan C. Retrospective observational study of characteristics of persons with amputations accessing International Committee of the Red Cross (ICRC) rehabilitation centres in five conflict and postconflict countries. BMJ Open 2021; 11:e049533. [PMID: 34853101 PMCID: PMC8638157 DOI: 10.1136/bmjopen-2021-049533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 11/05/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Limb amputation incidence is particularly high in fragile contexts due to conflict, accidents and poorly managed diabetes. The study aim was to analyse (1) demographic and amputation characteristics of persons with any type of acquired amputation (PwA) and (2) time between amputation and first access to rehabilitation in five conflict and postconflict countries. DESIGN A retrospective, observational study analysing differences in demographic and clinical factors and time to access rehabilitation between users with traumatic and non-traumatic amputations. SETTING Five countries with the highest numbers of PwA in the global International Committee of the Red Cross database (Afghanistan, Cambodia, Iraq, Myanmar, Sudan). Cleaned and merged data from 2009 to 2018 were aggregated by sex; age at amputation and registration; cause, combination and anatomical level of amputation(s); living environment. PARTICIPANTS All PwA newly attending rehabilitation. RESULTS Data for 28 446 individuals were included (4329 (15.2%) female). Most were traumatic amputations (73.4%, 208 90); of these, 48.6% (138 01) were conflict related. Average age at traumatic amputation for men and women was 26.9 and 24.1 years, respectively; for non-traumatic amputation it was 49.1 years and 45.9 years, respectively. Sex differences in age were statistically significant for traumatic and non-traumatic causes (p<0.001, p=0.003). Delay between amputation and rehabilitation was on average 8.2 years for those with traumatic amputation, significantly higher than an average 3 years for those with non-traumatic amputation (p<0.001). CONCLUSIONS Young age for traumatic and non-traumatic amputations indicates the devastating impact of war and fragile health systems on a society. Long delays between amputation and rehabilitation reveal the mismatch of needs and resources. For rehabilitation service providers in fragile settings, it is an enormous task to manage the diversity of PwA of various causes, age, sex and additional conditions. Improved collaboration between primary healthcare, surgical and rehabilitation services, a prioritisation of rehabilitation and increased resource provision are recommended to ensure adequate access to comprehensive rehabilitation care for PwA.
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Affiliation(s)
- Cornelia Anne Barth
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
- Cochrane Switzerland, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Andreas Wladis
- Department of Biomedical and Clinical Sciences (BKV), Linköping University, Linköping, Sweden
| | - Catherine Blake
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Prashant Bhandarkar
- BARC Hospital, WHO collaborating centre for research in surgical needs in LMICs, Mumbai, India
- School of Health Systems Studies, Tata Institute of Social Sciences, Deonar, India
| | - Sigirya Aebischer Perone
- Health Unit, International Committee of the Red Cross, Geneva, Switzerland
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Cliona O'Sullivan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Lindner H, Montgomery S, Hiyoshi A. Risk of depression following traumatic limb amputation—a general population-based cohort study. Scand J Public Health 2019; 48:289-293. [DOI: 10.1177/1403494819868038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Individuals with traumatic limb amputation (TLA) may be at risk of depression, but evidence of increased depression after TLA from longitudinal studies has been limited. It is also unknown whether physical function, cognitive function, and employment prior to amputation affects depression risk. We aimed to examine longitudinal associations between TLA and depression in working age men, and to explore the role of pre-amputation occupational and individual characteristics. Methods: A Swedish national register-based cohort of 189,220 men born between 1952 and 1956, and who attended conscription assessments in adolescence, was followed from 1985 to 2009. Physical, cognitive, and psychological characteristics were measured at the conscription examination, and occupational information was obtained from the 1985 census. Main outcome measures were hospital inpatient and outpatient admissions for depression. Results: In total, 401 men underwent TLA; mean age at amputation was 42.5 years (SD 7.4). Cox regression produced an unadjusted hazard ratio (95% confidence interval) of 2.61 (1.62–4.21) for risk of subsequent depression associated with TLA compared with the general population. Adjustment for occupational, physical, cognitive, and psychological characteristics did not change the association much, producing a hazard ratio of 2.53 (1.57–4.08). Conclusions: TLA is associated with an increased risk of depression in men over more than two decades of follow up. Occupational and individual characteristics prior to amputation did not greatly change depression risk following amputation. We speculate that a coordinated combination of social support and medical management may help reduce persistent depression risk in men who experience amputation.
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Affiliation(s)
- Helen Lindner
- Institution for Health Sciences, Örebro University, Sweden
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Sweden
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Epidemiology and Public Health, University College London, UK
| | - Ayako Hiyoshi
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Sweden
- Department of Public Health Sciences, Stockholm University, Sweden
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Heszlein-Lossius HE, Al-Borno Y, Shaqqoura S, Skaik N, Giil LM, Gilbert M. Does pain, psychological distress and deteriorated family economy follow traumatic amputation among war casualties? A retrospective, cross-sectional study from Gaza. BMJ Open 2019; 9:e029892. [PMID: 31217319 PMCID: PMC6589021 DOI: 10.1136/bmjopen-2019-029892] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The aim of this study was to explore determinants of psychosocial distress and pain in patients who have survived severe extremity amputation in Gaza. SETTING This study was conducted in a secondary care rehabilitation centre in Gaza, Palestine. The clinic is Gaza's sole provider of artificial limbs. PARTICIPANTS We included 254 civilian Palestinians who had survived but lost one or more limb(s) during military incursions from 2006 to 2016. We included patients with surgically treated amputation injuries who attended physical rehabilitation at a specialist prosthesis centre in Gaza. Amputees with injuries prior to 2006 or non-military related injuries were excluded.We assessed their pain and psychological stress using the General Health Questionnaire (GHQ-12). We used income, amputation severity scored by proximity to torso, current employment status, loss of family members and loss of home as independent variables. RESULTS The amputees median age was 23 years at the time of trauma, while a median of 4.3 years had passed from trauma to study inclusion. Nine of 10 were male, while 43 were children when they were amputated (17%≤18 years). One hundred and ninety-one (75%) were unemployed and 112 (44%) reported unemployment caused by being amputated. Pain was the most frequent problem, and 80 amputees (32%) reported to suffer from daily pain. Family income was significantly correlated with the physical pain (OR=0.54, CI 0.36 to 0.80, p=0.002). Psychological distress was higher among unemployed amputees (OR=1.36, CI 1.07 to 1.72, p=0.011). We found no association between psychological distress (GHQ-scores) and the extent of the initial amputation. CONCLUSION Pain and psychological distress following war-related extremity amputation of one or more limbs correlated stronger with deteriorated family economy and being unemployed than with the anatomical and medical severity of extremity amputations.
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Affiliation(s)
| | - Yahya Al-Borno
- Surgical department, Al-Shifa Hospital, Gaza City, Palestine
| | - Samar Shaqqoura
- Surgical department, Al-Shifa Hospital, Gaza City, Palestine
| | - Nashwa Skaik
- Surgical department, Al-Shifa Hospital, Gaza City, Palestine
| | - Lasse Melvaer Giil
- Department of Internal medicine, Haraldsplass Diakonale Sykehus AS, Bergen, Norway
| | - Mads Gilbert
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway
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Abstract
BACKGROUND Alongside physical impairment, psychosocial health issues may arise after amputation, impacting quality of life. Traditional psychosocial care models provide services in a linear fashion, with limited supports upon discharge. A novel program entitled Amputees Unanimous is a 12-step program provided for amputees by amputees. OBJECTIVE To shape the final content of Amputees Unanimous by identifying personal beliefs and opinions of healthcare professionals and amputees. STUDY DESIGN Qualitative design utilizing a phenomenological approach. METHOD Five focus groups were held: four with amputees and one with healthcare providers. A phenomenological approach shaped the inquiry of the lived experience of limb loss in relation to the content of Amputees Unanimous. RESULTS Three themes emerged: (1) accepting limb loss, (2) peer inspiration, and (3) regaining prior level of function. CONCLUSION Limb loss may alter one's self-image, both physically and psychologically, having a profound effect on how an individual copes throughout his or her lifetime. The content and delivery format of Amputees Unanimous could be tested for effectiveness as a program tailored to facilitate coping after limb loss and to provide encouragement, support, and hope for the future of amputees. CLINICAL RELEVANCE A dynamic, amputee-led, mutual help program may provide individuals with limb loss a place for encouragement, support, and optimism for the future.
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Affiliation(s)
- Catrinna Amorelli
- 1 Specialty Care Services, Vilseck Army Health Clinic, Vilseck, Germany
| | - Kathleen Yancosek
- 2 Department of Rehabilitation Medicine, Center for the Intrepid, Brooke Army Medical Center, San Antonio, TX, USA
| | - Ruth Morris
- 3 University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Herrera-Moreno D, Carvajal-Ovalle D, Cueva-Nuñez MA, Acevedo C, Riveros-Munévar F, Camacho K, Fajardo-Tejada DM, Clavijo-Moreno MN, Lara-Correa DL, Vinaccia-Alpi S. Body image, perceived stress, and resilience in military amputees of the internal armed conflict in Colombia. Int J Psychol Res (Medellin) 2018; 11:56-62. [PMID: 32612779 PMCID: PMC7110278 DOI: 10.21500/20112084.3487] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The objective of this study was to determine the levels and the relationship between body image satisfaction, perceived stress and resilience in soldier amputee victims of the internal armed conflict in Colombia. It was a quantitative, cross-sectional study of correlational scope, with the participation of 22 Colombian soldiers who were victims of the internal armed conflict and with some degree of amputation. For each soldier, the Multidimensional Body Self-relations Questionnaire (MBSRQ), Perceived Stress (EEP-14) and the Connor-Davidson Resilience Scale (CD-RISC 10) were applied. The results show high scores in behaviors aimed at maintaining physical fitness, self-assessed physical attractiveness and physical appearance, low scores in stress and scores with high trends in resilience, as well as a negative correlation between stress and conducts aimed to maintain physical fitness.
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Affiliation(s)
- Daniela Herrera-Moreno
- Universidad de San Buenaventura, Bogotá, Colombia. Universidad de San Buenaventura Universidad de San Buenaventura Bogotá Colombia
| | - Diego Carvajal-Ovalle
- Universidad de San Buenaventura, Bogotá, Colombia. Universidad de San Buenaventura Universidad de San Buenaventura Bogotá Colombia
| | - María Angélica Cueva-Nuñez
- Universidad de San Buenaventura, Bogotá, Colombia. Universidad de San Buenaventura Universidad de San Buenaventura Bogotá Colombia
| | - Camila Acevedo
- Universidad de San Buenaventura, Bogotá, Colombia. Universidad de San Buenaventura Universidad de San Buenaventura Bogotá Colombia
| | - Fernando Riveros-Munévar
- Universidad de San Buenaventura, Bogotá, Colombia. Universidad de San Buenaventura Universidad de San Buenaventura Bogotá Colombia
| | - Katherin Camacho
- Universidad de San Buenaventura, Bogotá, Colombia. Universidad de San Buenaventura Universidad de San Buenaventura Bogotá Colombia
| | - Diana Milena Fajardo-Tejada
- Ministerio de defensa-Dirección Centro de Rehabilitación Inclusiva, Colombia. Ministerio de defensa-Dirección Centro de Rehabilitación Inclusiva Colombia
| | - Mauricio Noel Clavijo-Moreno
- Ministerio de defensa-Dirección Centro de Rehabilitación Inclusiva, Colombia. Ministerio de defensa-Dirección Centro de Rehabilitación Inclusiva Colombia
| | - Dary Luz Lara-Correa
- Ministerio de defensa-Dirección Centro de Rehabilitación Inclusiva, Colombia. Ministerio de defensa-Dirección Centro de Rehabilitación Inclusiva Colombia
| | - Stefano Vinaccia-Alpi
- Universidad del Sinú, Montería, Colombia. Universidad del Sinú Universidad del Sinú Montería Colombia
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Ryken KO, Hogue M, Marsh JL, Schweizer M. Long-term consequences of landmine injury: A survey of civilian survivors in Bosnia-Herzegovina 20 years after the war. Injury 2017; 48:2688-2692. [PMID: 29102043 DOI: 10.1016/j.injury.2017.08.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 08/07/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Bosnia-Herzegovina is one of the most landmine-contaminated countries in Europe. Since the beginning of the war in 1992, there have been 7968 recorded landmine victims, with 1665 victims since the end of the war in 1995. While many of these explosions result in death, a high proportion of these injuries result in amputation, leading to a large number of disabled individuals. OBJECTIVE The purpose of this study is to conduct a survey of civilian landmine victims in Bosnia-Herzegovina in order to assess the effect of landmine injuries on physical, mental, and social well-being. METHODS Civilian survivors of landmine injuries were contacted while obtaining care through local non-governmental organizations (NGOs) throughout Bosnia-Herzegovina to inquire about their current level of independence, details of their injuries, and access to healthcare and public space. The survey was based upon Physicians for Human Rights handbook, "Measuring Landmine Incidents & Injuries and the Capacity to Provide Care." RESULTS 42 survivors of landmines completed the survey, with an average follow up period of 22.0 years (±1.7). Of civilians with either upper or lower limb injuries, 83.3% underwent amputations. All respondents had undergone at least one surgery related to their injury: 42.8% had at least three total operations and 23.8% underwent four or more surgeries related to their injury. 26.2% of survivors had been hospitalized four or more times relating to their injury. 57.1% of participants reported they commonly experienced anxiety and 47.6% reported depression within the last year. On average, approximately 3% of household income each year goes towards paying medical bills, even given governmental and non-governmental assistance. Most survivors relied upon others to take care of them: only 41.5% responded they were capable of caring for themselves. 63.4% of respondents reported their injury had limited their ability to gain training, attend school, and go to work. CONCLUSION The majority of civilian landmine survivors report adverse health effects due to their injuries, including anxiety, depression, multiple surgeries, and hospitalizations. The majority also experience loss of independence, either requiring care of family members for activities of daily living, disability, and inability to be employed. Further research is required to determine effective interventions for landmine survivors worldwide.
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Affiliation(s)
- Katherine O Ryken
- University of Iowa Carver College of Medicine, 375 Newton Road, Iowa City, IA, 52242, United States.
| | - Matthew Hogue
- Department of Orthopedics, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - J Lawrence Marsh
- Department of Orthopedics, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Marin Schweizer
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
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Kornhaber R, Mclean L, Betihavas V, Cleary M. Resilience and the rehabilitation of adult spinal cord injury survivors: A qualitative systematic review. J Adv Nurs 2017; 74:23-33. [PMID: 28726274 DOI: 10.1111/jan.13396] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2017] [Indexed: 11/28/2022]
Abstract
AIM To synthesize the qualitative research evidence that explored how survivors of adult spinal cord injury experience and make sense of resilience. BACKGROUND Spinal cord injury is often a sudden and unexpected life-changing event requiring complex and long-term rehabilitation. The development of resilience is essential in determining how spinal cord injury survivors negotiate this injury and rehabilitation. DESIGN A qualitative systematic review and thematic synthesis of the research evidence. DATA SOURCES CINAHL, PubMed, Embase, Scopus and PsycINFO were searched, no restriction dates were used. REVIEW METHODS Methodological quality was assessed using the Critical Appraisal Skills Programme checklist. Thematic synthesis focused on how survivors of adult spinal cord injury experience and make sense of resilience. RESULTS Six qualitative research articles reported the experiences of 84 spinal cord injury survivors. Themes identified were: uncertainty and regaining independence; prior experiences of resilience; adopting resilient thinking; and strengthening resilience through supports. CONCLUSION Recovery and rehabilitation following spinal cord survivors is influenced by the individual's capacity for resilience. Resilience may be influenced by previous life experiences and enhanced by supportive nursing staff encouraging self-efficacy. Survivors identified the need for active involvement in decision-making about their care to enable a sense of regaining control of their lives. This has the potential to have a significant impact on their self-efficacy and in turn health outcomes.
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Affiliation(s)
- Rachel Kornhaber
- School of Health Sciences, Faculty of Health, University of Tasmania, Sydney, NSW, Australia
| | - Loyola Mclean
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.,Consultation and Liaison Psychiatry, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia
| | | | - Michelle Cleary
- School of Health Sciences, Faculty of Health, University of Tasmania, Sydney, NSW, Australia
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Shultz JM, Garcia-Vera MP, Santos CG, Sanz J, Bibel G, Schulman C, Bahouth G, Dias Guichot Y, Espinel Z, Rechkemmer A. Disaster complexity and the Santiago de Compostela train derailment. DISASTER HEALTH 2017; 3:11-31. [PMID: 28229012 DOI: 10.1080/21665044.2015.1129889] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 05/23/2015] [Accepted: 05/26/2015] [Indexed: 10/22/2022]
Abstract
This disaster complexity case study examines Spain's deadliest train derailment that occurred on July 24, 2013 on the outskirts of Santiago de Compostela, Galicia, Spain. Train derailments are typically survivable. However, in this case, human error was a primary factor as the train driver powered the Alvia train into a left curve at more than twice the posted speed. All 13 cars came off the rails with many of the carriages careening into a concrete barrier lining the curve, leading to exceptional mortality and injury. Among the 224 train occupants, 80 (36%) were killed and all of the remaining 144 (4%) were injured. The official investigative report determined that this crash was completely preventable.
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Affiliation(s)
- James M Shultz
- Center for Disaster & Extreme Event Preparedness (DEEP Center), University of Miami Miller School of Medicine , Miami, FL, USA
| | - Maria Paz Garcia-Vera
- Universidad Complutense de Madrid, Psychosocial Team, Military Disaster Relief Unit, Spanish Ministry of Defense , Madrid, Spain
| | - Clara Gesteira Santos
- Department of Personality, Assessment, and Clinical Psychology, Universidad Complutense de Madrid , Madrid, Spain
| | - Jesús Sanz
- Department of Personality, Assessment, and Clinical Psychology, Universidad Complutense de Madrid , Madrid, Spain
| | - George Bibel
- Department of Mechanical Engineering, College of Engineering and Mines, University of North Dakota , Grand Forks, ND, USA
| | - Carl Schulman
- William Lehman Injury Research Center, Surgical Residency Program, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine , Miami, FL, USA
| | | | - Yasmin Dias Guichot
- WalkSafe Program, KiDZ Neuroscience Center, The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine , Miami, FL, USA
| | - Zelde Espinel
- Department of Psychiatry and Behavioral Health, University of Miami Miller School of Medicine and Jackson Memorial Hospital , Miami, FL, USA
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Malavera A, Silva FA, Fregni F, Carrillo S, Garcia RG. Repetitive Transcranial Magnetic Stimulation for Phantom Limb Pain in Land Mine Victims: A Double-Blinded, Randomized, Sham-Controlled Trial. THE JOURNAL OF PAIN 2016; 17:911-8. [PMID: 27260638 PMCID: PMC4969102 DOI: 10.1016/j.jpain.2016.05.003] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 04/21/2016] [Accepted: 05/06/2016] [Indexed: 02/07/2023]
Abstract
UNLABELLED We evaluated the effects of repetitive transcranial magnetic stimulation (rTMS) in the treatment of phantom limb pain (PLP) in land mine victims. Fifty-four patients with PLP were enrolled in a randomized, double-blinded, placebo-controlled, parallel group single-center trial. The intervention consisted of real or sham rTMS of M1 contralateral to the amputated leg. rTMS was given in series of 20 trains of 6-second duration (54-second intertrain, intensity 90% of motor threshold) at a stimulation rate of 10 Hz (1,200 pulses), 20 minutes per day, during 10 days. For the control group, a sham coil was used. The administration of active rTMS induced a significantly greater reduction in pain intensity (visual analogue scale scores) 15 days after treatment compared with sham stimulation (-53.38 ± 53.12% vs -22.93 ± 57.16%; mean between-group difference = 30.44%, 95% confidence interval, .30-60.58; P = .03). This effect was not significant 30 days after treatment. In addition, 19 subjects (70.3%) attained a clinically significant pain reduction (>30%) in the active group compared with 11 in the sham group (40.7%) 15 days after treatment (P = .03). The administration of 10 Hz rTMS on the contralateral primary motor cortex for 2 weeks in traumatic amputees with PLP induced significant clinical improvement in pain. PERSPECTIVE High-frequency rTMS on the contralateral primary motor cortex of traumatic amputees induced a clinically significant pain reduction up to 15 days after treatment without any major secondary effect. These results indicate that rTMS is a safe and effective therapy in patients with PLP caused by land mine explosions.
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Affiliation(s)
- Alejandra Malavera
- Neurovascular Science Group, Fundación Cardiovascular de Colombia, Floridablanca, Colombia; Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | - Federico Arturo Silva
- Neurovascular Science Group, Fundación Cardiovascular de Colombia, Floridablanca, Colombia
| | - Felipe Fregni
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sandra Carrillo
- Neurovascular Science Group, Fundación Cardiovascular de Colombia, Floridablanca, Colombia
| | - Ronald G Garcia
- Neurovascular Science Group, Fundación Cardiovascular de Colombia, Floridablanca, Colombia; MASIRA Research Institute, School of Medicine, Universidad de Santander, Bucaramanga, Colombia; Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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Zounon O, Hans-Moevi Akué A, Cohovi Quenum G, Clay Sorum P, Mullet E. Why people in Benin are reluctant to undergo amputations? A systematic inventory of motives. J Health Psychol 2016; 21:2753-2761. [PMID: 26009569 DOI: 10.1177/1359105315586212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We made an inventory of the reasons for inhabitants of Benin are reluctant to undergo the amputation of a limb. A robust six-factor structure of motives was found: Change in Appearance, Lack of Information, Fear of Hospitals and Medical Staff, Loss of Others' Consideration and Affection, Denial of Necessity, and Spiritual and Religious Concerns. The first three motives were the most strongly endorsed. To improve people's timely acceptance, it is important to attack the main emotional-motivational barriers by using artificial limbs imitating real ones, by providing complete information on post-operative care and rehabilitation, and by strengthening family support.
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Washington ED, Williams AE. An exploratory phenomenological study exploring the experiences of people with systemic disease who have undergone lower limb amputation and its impact on their psychological well-being. Prosthet Orthot Int 2016; 40:44-50. [PMID: 25406231 DOI: 10.1177/0309364614556838] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 09/17/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND Amputation is a life-changing event accompanied by challenges for the affected person with time-dependent depression often used to quantify its level of impact on their psychological well-being. There are varied factors that contribute to this and its persistence. The aim of this study was to explore the experiences over time of people with diabetes and/or peripheral vascular disease following an amputation and the impact on their psychological well-being. OBJECTIVES To develop an understanding of the experience of living with an amputation and a chronic condition in order to help clinicians identify those in need of counselling support. STUDY DESIGN A qualitative study utilising an iterative approach in line with the philosophy of interpretive phenomenology. METHODS Six participants who had experienced a lower limb amputation associated with peripheral vascular disease/diabetes were interviewed on two occasions (baseline and 4 months). An interpretative phenomenological approach was utilised for both data collection and analysis. RESULTS For these participants, amputation was part of the chronology of their chronic disease. It was the individual's variable experience of health which impacted their psychological well-being rather than the length of time since amputation. CONCLUSIONS The multivariable experience of amputation means that individually tailored counselling/psychological support is recommended. CLINICAL RELEVANCE An understanding of how the experience of living with an amputation and a chronic condition may change over time will help clinicians to identify the ongoing need for counselling support.
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Affiliation(s)
- Elaine D Washington
- Directorate of Prosthetics, Orthotics and Podiatry, School of Health Sciences, University of Salford, UK
| | - Anita E Williams
- Directorate of Prosthetics, Orthotics and Podiatry, School of Health Sciences, University of Salford, UK
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Bonnan-White J, Yep J, Hetzel-Riggin MD. Voices from the past: Mental and physical outcomes described by American Civil War amputees. J Trauma Dissociation 2016; 17:13-34. [PMID: 26158228 DOI: 10.1080/15299732.2015.1041070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Studies of trauma commonly concentrate on the psychological and physiological effects of recent violent events. Although today connections are becoming more explicitly drawn, early studies of the aftermath of amputation serve to shed light on modern understanding of the interaction of the physical and emotional. The study of combat amputation, dissociation, and related posttraumatic stress largely began with the work of 19th-century Philadelphia physician Silas Weir Mitchell, who brought attention to the phenomenon of phantom limb pain. Less known, however, are the data he and his son, John K. Mitchell, also collected on the mental outcomes of trauma. Using an archived collection of original surveys of double-amputee patients dating largely from 1893 housed at the Historical Medical Library at the College of Physicians of Philadelphia, an interdisciplinary team explored the historical, anthropological, and psychological background of the study of combat trauma. Almost 30 years following the end of hostilities, the majority of the sample of U.S. Civil War veterans indicated that their general disposition, general health, and sleeping or eating patterns had changed following limb amputation. More telling, possibly, are the written comments on the surveys and letters that indicate frustration with the continuous suffering and the knowledge of their mental and physical changes. These data illustrate the value of historical archives in documenting the development of the study of trauma and modern concepts of combat experiences.
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Affiliation(s)
- Jess Bonnan-White
- a School of Social and Behavioral Sciences , Stockton University , Galloway , New Jersey , USA
| | - Jewelry Yep
- b School of Health Sciences , Stockton University , Galloway , New Jersey , USA
| | - Melanie D Hetzel-Riggin
- c School of Humanities and Social Sciences , Penn State Erie, The Behrend College , Erie , Pennsylvania , USA
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Stough LM. World Report on Disability, Intellectual Disabilities, and Disaster Preparedness: Costa Rica as a Case Example. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2015. [DOI: 10.1111/jppi.12116] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hemmati MA, Shokoohi H, Masoumi M, Khateri S, Soroush M, Modirian E, Poor Zamany Nejat Kermany M, Hosseini M, Mousavi B. Mental health disorders in child and adolescent survivors of post-war landmine explosions. Mil Med Res 2015; 2:30. [PMID: 26568841 PMCID: PMC4644284 DOI: 10.1186/s40779-015-0052-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 09/24/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To describe the mental health status of 78 child and adolescent survivors of post-war landmine explosions. METHODS Child and adolescent survivors of landmine explosions who were younger than 18 years old at the time of the study were identified and enrolled in this study. The mental health status of the participants was assessed by general health assessment and psychiatric examinations. Psychiatric assessment and diagnosis were undertaken using the Diagnostic and Statistical Manual for mental disorders (DSM-IV) criteria. A psychiatrist visited and interviewed each survivor and identified psychiatric disorders. RESULTS Seventy-eight child and adolescent survivors with a mean age of 16.11 ± 2 years old were identified and agreed to participate in the study. The mean age of the victims at the time of injury was 8.2 ± 3.12 years old (range 2-15). Thirty-seven (47.4 %) of the adolescent survivors suffered from at least one psychiatric disorder. Twenty-nine survivors (37.1 %) were newly diagnosed and needed to start medication and psychiatric treatment. The most common findings were anxiety disorders (34.6 %), including posttraumatic stress disorder (PTSD) in 20 (25.6 %), and generalized anxiety disorder (GAD) in 7 (9 %) subjects. Mild-Moderate depression was found in 5 (6.4 %) subjects. No personality disorders were observed, and two patients suffered from mental retardation. The study results revealed a significant association between age of casualty, duration of injury and limb amputation, and types of psychological disorders. CONCLUSION Child and adolescent survivors of landmine explosions had a high prevalence of psychiatric disorders.
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Affiliation(s)
| | - Hamid Shokoohi
- Department of Emergency Medicine, George Washington University, Washington, DC USA
| | - Mehdi Masoumi
- Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
| | - Shahriar Khateri
- Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
| | - Mohammadreza Soroush
- Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran ; NO.25, Farrokh St., Moghaddas Ardebily Ave., Chamran Highway, Tehran, Iran
| | - Ehsan Modirian
- Emergency Department, Medical Faculty, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Maryam Hosseini
- Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
| | - Batool Mousavi
- Community and Preventive Medicine, Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
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Kreniske JS, Harris A, Safadi W. Landmines in the Golan Heights: a patient's perspective. BMJ Case Rep 2014; 2014:bcr-2014-205756. [PMID: 25155496 DOI: 10.1136/bcr-2014-205756] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Fifteen years after the Ottawa Mine Ban Treaty, landmines continue to negatively impact global public health. Recent estimates attribute 11-12 daily casualties to landmines and explosive remnants of war. The majority of these casualties are civilians. Children are disproportionately affected by landmine injuries. In this report, we examine the case and recovery of a child severely injured in a 1982 Golan Heights landmine accident, illustrating the danger landmines pose to civilians and their long-term health implications.
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Affiliation(s)
| | - Asaf Harris
- Ben Gurion University, Medical School for International Health, Beer Sheva, Israel
| | - Wajdi Safadi
- Department of Surgery, Ziv Medical Center, Safed, Galilee, Israel
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Barbic SP, Mayo NE, White CL, Bartlett SJ. Emotional vitality in family caregivers: content validation of a theoretical framework. Qual Life Res 2014; 23:2865-72. [PMID: 24853533 DOI: 10.1007/s11136-014-0718-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE Emotional vitality may play an important role in determining whether informal caregivers are able to successfully adopt and persist in their roles. This study describes a content validation of a conceptual model of emotional vitality in informal caregivers. METHODS A secondary content analysis was performed on transcripts of 30 caregivers who were interviewed about their quality of life in relation to assuming the role of informal caregiver for a family member who had experienced a recent stroke. Caregivers discussed changes in their own health, relationships, roles, finances, participation, and mood after assuming the caregiving role. Using a thematic inductive approach, two raters independently coded the presence and frequency of physical, emotional, and social impacts associated with the caregiving role in order to further develop and validate a conceptual model of caregiver emotional vitality. RESULTS The interviews provided information that affirmed the relevance of four themes relevant to caregiver emotional vitality previously identified: physical health and well-being; mood regulation; sense of control/mastery of new skills; and participation in meaningful activity. An additional theme of support and recognition from others also emerged. CONCLUSIONS Adopting the informal caregiving role results in major impacts to the caregiver's physical, emotional, and social health. Five core domains appear to meaningfully contribute to emotional vitality of caregivers and may influence their ability to persist in this role over time. Many of the factors that influence emotional vitality in caregivers are potentially modifiable. This new model offers new opportunities for rehabilitation specialists and allied health professionals to develop skill-building interventions that may help caregivers successfully adapt and thrive in the caregiving role.
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Affiliation(s)
- Skye P Barbic
- Social Aetiology of Mental Illness Program, Centre for Addiction and Mental Health, 33 Russell, Suite 1111, Toronto, ON, M5S 2G8, Canada,
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Southivong B, Ichikawa M, Nakahara S, Southivong C. A cross-sectional community study of post-traumatic stress disorder and social support in Lao People's Democratic Republic. Bull World Health Organ 2013; 91:765-72. [PMID: 24115800 DOI: 10.2471/blt.12.115311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 06/09/2013] [Accepted: 06/22/2013] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To estimate post-traumatic stress disorder (PTSD) symptoms in those injured and not injured by landmines or unexploded ordnance (UXO) in rural Lao People's Democratic Republic and to determine whether the perception of social support was associated with PTSD symptom severity. METHODS A community survey was conducted among 190 people injured by landmines or UXO and 380 age-, sex- and neighbourhood-matched non-injured individuals in the Sepone district of Savannakhet Province, the part of the Lao People's Democratic Republic most heavily bombed during the Viet Nam War. Using the Harvard Trauma Questionnaire and the Medical Outcomes Study Social Support Survey, trained health-care workers conducted face-to-face interviews to assess PTSD symptoms and level of perceived social support. Multiple linear regression was performed to explore the association between social support and other factors and PTSD. FINDINGS The prevalence of PTSD was higher among the injured (10%) than among the non-injured (4%), but the level of perceived social support was not significantly different between the two groups. A higher level of perceived social support was associated with milder symptoms of PTSD. Women, older people and those with a formal education were more often and more severely affected by PTSD. CONCLUSION The perception of strong social support might help to alleviate the symptoms of PTSD among people injured by landmines or UXO in rural parts of the Lao People's Democratic Republic. Psychosocial interventions should be incorporated in assistance for the injured because they have more severe and longer-lasting symptoms of PTSD than the non-injured.
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Bodde MI, Schrier E, Krans HK, Geertzen JH, Dijkstra PU. Resilience in patients with amputation because of Complex Regional Pain Syndrome type I. Disabil Rehabil 2013; 36:838-43. [DOI: 10.3109/09638288.2013.822023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Machida M, Irwin B, Feltz D. Resilience in competitive athletes with spinal cord injury: the role of sport participation. QUALITATIVE HEALTH RESEARCH 2013; 23:1054-1065. [PMID: 23771633 DOI: 10.1177/1049732313493673] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Individuals who experience loss of their physical abilities often face the challenges of adapting to a new way of life. Past research has shown that sport participation can assist the physical and psychological adaptation to acquired physical disabilities. The purposes of our study were to examine the following: (a) the resilience process of sport participants with acquired spinal cord injury, and (b) the role of sport participation in the resilience process. We conducted semistructured phenomenological interviews with 12 male quadriplegic wheelchair rugby players. Results show that the development of resilience is a multifactorial process involving pre-existing factors and pre-adversity experiences, disturbance/disturbing emotions, various types and sources of social support, special opportunities and experiences, various behavioral and cognitive coping strategies, motivation to adapt to changes, and learned attributes or gains from the resilience process. We discuss implications for future research and practice.
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Affiliation(s)
- Moe Machida
- Juntendo University, School of Health and Sports Science, Inzai, Chiba, Japan.
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Shin JI, Chae JH, Min JA, Lee CU, Hwang SI, Lee BS, Han SH, Ju HI, Lee CY. Resilience as a possible predictor for psychological distress in chronic spinal cord injured patients living in the community. Ann Rehabil Med 2012; 36:815-20. [PMID: 23342314 PMCID: PMC3546184 DOI: 10.5535/arm.2012.36.6.815] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 08/28/2012] [Indexed: 01/08/2023] Open
Abstract
Objective To investigate whether higher resilience level predicts low levels of psychological distress in chronic SCI patients living in the community. Method Thirty seven patients (mean age 41.5±10.9, male : female=28 : 9) with chronic spinal cord injury (duration 8.35±7.0 years) living in the community are included, who were hospitalized for annual checkups from November, 2010 to May, 2011. First, their spinal cord injury level, completeness and complications were evaluated. The patients completed questionnaires about their educational status, religion, employment status, marital status, medical and psychological history and also the following questionnaires: Hospital Anxiety and Depression Scale (HADS), Connor-Davidson Resilience Scale (CD-RISC), Alcohol Use Disorders Identification Test-alcohol consumption questions (AUDIT-C) and Health-related quality of life (EQ-5D). The patients were divided into two subgroups: patients with HADS ≥13 are classified as high psychological distress group and others as low psychological distress group. We compared the two groups to find statistically significant differences among the variables. Results CD-RISC, EQ-5D and employment status are significantly different between two groups (p<0.05). In a forward stepwise regression, we found that EQ-5D had a greater contribution than CD-RISC to the psychological distress level. Conclusion In addition to health-related quality of life, resilience can be suggested as a possible predictor of psychological distress in chronic SCI patients.
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Affiliation(s)
- Jung-In Shin
- Department of Rehabilitation Medicine, National Rehabilitation Hospital, Seoul 142-884, Korea
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The “Trauma Signature:” Understanding the Psychological Consequences of the 2010 Haiti Earthquake. Prehosp Disaster Med 2011; 26:353-66. [DOI: 10.1017/s1049023x11006716] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThe 2010 Haiti earthquake was one of the most catastrophic episodes in history, leaving 5% of the nation’s population killed or injured, and 19% internally displaced. The distinctive combination of earthquake hazards and vulnerabilities, extreme loss of life, and paralyzing damage to infrastructure, predicts population-wide psychological distress, debilitating psychopathology, and pervasive traumatic grief. However, mental health was not referenced in the national recovery plan. The limited MHPSS services provided in the first eight months generally lacked coordination and empirical basis.There is a need to customize and coordinate disaster mental health assessments, interventions, and prevention efforts around the novel stressors and consequences of each traumatic event. An analysis of the key features of the 2010 Haiti earthquake was conducted, defining its “Trauma Signature” based on a synthesis of early disaster situation reports to identify the unique assortment of risk factors for post-disaster mental health consequences. This assessment suggests that multiple psychological risk factors were prominent features of the earthquake in Haiti. For rapid-onset disasters, Trauma Signature (TSIG) analysis can be performed during the post-impact/pre-deployment phase to target the MHPSS response in a manner that is evidence-based and tailored to the event-specific exposures and experiences of disaster survivors. Formalization of tools to perform TSIG analysis is needed to enhance the timeliness and accuracy of these assessments and to extend this approach to human-generated disasters and humanitarian crises.
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Liu F, Williams RM, Liu HE, Chien NH. The lived experience of persons with lower extremity amputation. J Clin Nurs 2010; 19:2152-61. [DOI: 10.1111/j.1365-2702.2010.03256.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sjödahl C, Gard G, Jarnlo GB. Transfemoral amputees' experiences of the first meeting and subsequent interactions with hospital staff. Disabil Rehabil 2009; 30:1192-1203. [PMID: 17852247 DOI: 10.1080/09638280701521683] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To describe, by use of a phenomenological approach, how transfemoral amputees experience their first meeting and subsequent interaction with hospital staff in the acute phase, in the long term and suggestions for future care-giving. METHOD Eleven transfemoral amputees, median age 33.5 years, were interviewed. The amputations, performed in median 7.5 years before the interview, were caused by tumour, motorcycle accidents or work-related traumas. The participants were community dwelling and managed well indoors. All, except one, worked or studied full time. The interviews were tape-recorded and transcribed verbatim. RESULTS Three themes emerged: (i) Communication/information - limitations in preparing the patient for the new situation, (ii) empathy and emotional support, and (iii) ability to meet the need of individually tailored rehabilitation. For future care-giving three categories emerged: (i) Individually tailored communication/information, (ii) rehabilitation to be prepared to adapt to one's new situation, and (iii) support in regaining control. CONCLUSION The participants expressed a need for both professional and emotional support in the acute phase. Over time they preferred a patient-centred approach which improved coping skills and facilitated their own ability to gain control. Increased awareness of how meeting and interacting with hospital staff influences rehabilitation processes may further improve patient satisfaction and outcomes.
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Affiliation(s)
- Catharina Sjödahl
- Department of Health Sciences, Division of Physical Therapy, Lund University, Sweden.
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Rumpler CH. How do you intervene in posttraumatic stress disorder symptoms associated with traumatic injury? Rehabil Nurs 2008; 33:187-91. [PMID: 18767399 DOI: 10.1002/j.2048-7940.2008.tb00226.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Combalbert N, Lançon JM. Les spécificités du débriefing psychologique en milieu professionnel. PRAT PSYCHOL 2006. [DOI: 10.1016/j.prps.2006.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Daniel HC, Van der Merwe JD. Chapter 58 Cognitive behavioral approaches and neuropathic pain. HANDBOOK OF CLINICAL NEUROLOGY 2006; 81:855-868. [PMID: 18808880 DOI: 10.1016/s0072-9752(06)80062-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Abstract
INTRODUCTION Review of the literature about evaluation of amputees. MATERIALS AND METHODS A search of the Medline and Reedoc databases with the key words lower limb amputee, upper limb amputee, evaluation of lower limb amputee, evaluation of upper limb amputee, survey of lower limb amputee, survey of upper limb and the same words in French for reports on the evaluation of amputees. RESULTS Evaluations of amputees differ according to the level of amputation (lower or upper limb) and age (adult or child). They concern standing balance, walking (lower limb) and the mono- or bimanual prehensile capacities with or without prostheses in daily living activities and leisure (upper limb) as well as quality of life, personal satisfaction, psychological impact and, in particular, coping strategies. DISCUSSION For lower-limb amputees, tools to evaluate include scales of deambulation, of which few are valid in French, and global scales (on locomotor capacities, quality of life and satisfaction), which have been recently validated, but only one of them is valid in French. For upper-limb amputees, specific and valid tools are not available for adults; however, for children some functional capacity scales in daily activities have been validated and take into account psychomotor development. None of these tools are valid in French, and their use is scattered and limited to validation studies. CONCLUSION Only a few tools to evaluate amputees are valid in French for adults, and they concern lower-limb amputees only. Validating some of these tools in French is necessary.
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Affiliation(s)
- I Loiret
- Institut régional de réadaptation, faculté de médecine, université de Nancy 1, IFR 25, 35, rue Lionnois, 54500 Nancy, France
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