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Fultz C, Nussbaum R, Schroth SL, Tuakli-Wosornu YA, Schroeder AN. Document analysis of adaptive sport opportunities at Division-1 universities in the United States. Disabil Health J 2024:101646. [PMID: 38853094 DOI: 10.1016/j.dhjo.2024.101646] [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: 01/09/2024] [Revised: 04/19/2024] [Accepted: 06/01/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Individuals with disabilities are less likely to participate in physical activity, with the greatest decline in participation during college years. Despite known health benefits, there are significant barriers that limit sport and exercise participation for students with disabilities, including adaptive access. To our knowledge, there has been no comprehensive review conducted to examine the number of adaptive sport offerings on a collegiate level. OBJECTIVE Assess the availability of adaptive sport opportunities for students at National Collegiate Athletic Association (NCAA) Division-1 Universities to better understand university-affiliated adaptive sport opportunity for students. METHODS Website document analysis was conducted by systematically querying the general homepage, athletics page, and campus recreation websites of each NCAA Division-1 University in the United States (US). Institutional and sport-related characteristics were recorded. RESULTS Of the 358 NCAA Division-1 Universities, 20.4 % (73/358) marketed adaptive sport opportunities (recreational, club, and/or intercollegiate), with 3.9 % (11/358) acknowledging intercollegiate adaptive sport programs on their websites. Five percent (6/121) of private institutions, and 28.3 % (67/237) of public institutions reported adaptive sport opportunities. The Northeast region had the fewest number of institutions reporting adaptive sport offerings (4/67, 6.0 %). The most commonly offered sport was adaptive recreation (36/358, 10.2 %), followed by wheelchair basketball (26/358, 7.4 %). CONCLUSION Over three-quarters of Division-1 Universities in the US lack an online description of adaptive sport opportunity, highlighting the need for expanded resourcing and marketing of adaptive sport at the university level. Future studies are necessary to identify appropriate strategies to effectively promote sport, maximize participation and improve social inclusion.
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Affiliation(s)
- Connor Fultz
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Ryan Nussbaum
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Saarimäki SM, Reiterä P, Täckman A, Arokoski J, Vainionpää A, Kallinen M, Tallqvist S, Koskinen E, Hämäläinen H, Kauppila AM, Anttila H, Hiekkala S. Environmental barriers perceived by the Finnish population with spinal cord injury: a cross-sectional survey. Spinal Cord 2024:10.1038/s41393-024-00990-x. [PMID: 38654113 DOI: 10.1038/s41393-024-00990-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 03/26/2024] [Accepted: 04/05/2024] [Indexed: 04/25/2024]
Abstract
STUDY DESIGN Cross-sectional survey of the Finnish population with spinal cord injury (SCI). OBJECTIVES To explore the frequencies of perceived environmental barriers (EB) that made participation harder for the Finnish population with SCI and to compare the occurrence of perceived EBs by gender, age, time since injury, and injury severity. SETTING Participants were recruited from the registers of the three SCI outpatient clinics responsible for the lifelong care of people with SCI in Finland. METHODS The self-administered Nottwil Environmental Factors Inventory Short Form (NEFI-SF) collected in the Finnish Spinal Cord Injury Study (FinSCI) (n = 1772) was used. Nonparametric tests and multinomial logistic regression models were utilized. RESULTS 880 individuals responded to the NEFI-SF items (response rate 50%). Climate was perceived as a barrier by 72% and a serious one by 44% of the respondents. The rates regarding public access were 59% and 24%, private home access 46% and 18%, and long-distance transport 45% and 20%. Four out of ten respondents reported that finances, lack of assistive devices for short-distance transport, and political decisions restricted their participation. The NEFI-SF total scores were higher (meaning more perceived restrictions by EBs) for those more severely injured. CONCLUSIONS Climate, access to public and private places, challenges with transport, finances, and political decisions were the EBs most frequently perceived to restrict participation by the Finnish population with SCI. Most EBs that were prominent causes of restrictions are modifiable. Greater accessibility to the built environment, equal services to all, and positive special treatment could reduce their effects.
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Grants
- HUS/53/2017, §9 9.6.2017 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/76/2018, §11 18.4.2018 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/174/201, §1 12.4.2019 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/53/2017, §9 9.6.2017 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/76/2018, §11 18.4.2018 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/174/201, §1 12.4.2019 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/53/2017, §9 9.6.2017 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/76/2018, §11 18.4.2018 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/174/201, §1 12.4.2019 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/53/2017, §9 9.6.2017 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/76/2018, §11 18.4.2018 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/174/201, §1 12.4.2019 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/53/2017, §9 9.6.2017 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/76/2018, §11 18.4.2018 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/174/201, §1 12.4.2019 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/53/2017, §9 9.6.2017 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/76/2018, §11 18.4.2018 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/174/201, §1 12.4.2019 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/53/2017, §9 9.6.2017 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/76/2018, §11 18.4.2018 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/174/201, §1 12.4.2019 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/53/2017, §9 9.6.2017 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/76/2018, §11 18.4.2018 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/174/201, §1 12.4.2019 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/53/2017, §9 9.6.2017 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/76/2018, §11 18.4.2018 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/174/201, §1 12.4.2019 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/53/2017, §9 9.6.2017 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/76/2018, §11 18.4.2018 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/174/201, §1 12.4.2019 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/53/2017, §9 9.6.2017 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/76/2018, §11 18.4.2018 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/174/201, §1 12.4.2019 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/53/2017, §9 9.6.2017 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/76/2018, §11 18.4.2018 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
- HUS/174/201, §1 12.4.2019 Helsingin ja Uudenmaan Sairaanhoitopiiri (Helsinki University Central Hospital)
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Affiliation(s)
- Sanna-Mari Saarimäki
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - Paula Reiterä
- Biostatistics Unit, Department of Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anni Täckman
- The Finnish Association of Spinal Cord Injured Akson, Helsinki, Finland
| | - Jari Arokoski
- Department of Internal Medicine and Rehabilitation / Spinal Cord Injury Outpatient Clinic, Helsinki University Hospital, Helsinki, Finland
| | - Aki Vainionpää
- Department of Rehabilitation, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Mauri Kallinen
- Department of Rehabilitation Medicine, Hospital Nova of Central Finland, Central Finland Health Care District, Jyväskylä, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | | | - Eerika Koskinen
- Department of Sensory, Neural, and Musculoskeletal Medicine, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Harri Hämäläinen
- Department of Internal Medicine and Rehabilitation / Spinal Cord Injury Outpatient Clinic, Helsinki University Hospital, Helsinki, Finland
| | - Anna-Maija Kauppila
- Department of Medical Rehabilitation / Spinal Cord Injury Outpatient Clinic, Oulu University Hospital, Oulu, Finland
| | - Heidi Anttila
- Public Health and Welfare Department, Finnish Institute for Health and Welfare (THL), Knowledge Management and Co-creation Unit, Helsinki, Finland
| | - Sinikka Hiekkala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- The Finnish Association of People with Physical Disabilities, Helsinki, Finland
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3
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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] [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.
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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
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4
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Ríos-León M, Onal B, Arango-Lasprilla JC, Augutis M, Civicos-Sanchez N, Graham A, Kelly EH, López-Dolado E, Scheel-Sailer A, Subiñas-Medina P, Taylor J. Pediatric health and life domain priorities: A national survey of people with spinal cord injury and their parents and caregivers. J Spinal Cord Med 2024; 47:155-167. [PMID: 35776093 PMCID: PMC10795593 DOI: 10.1080/10790268.2022.2087140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
CONTEXT/OBJECTIVE No information is available regarding priorities for pediatric-onset spinal cord injury (SCI). This study described the Health and Life (H&L) domain priorities of youth with pediatric-onset SCI and their parents/caregivers living in Spain. DESIGN A cross-sectional survey. SETTING Two SCI rehabilitation centers. PARTICIPANTS Sixty participants, youth with pediatric-onset SCI (n = 26) and parents/caregivers (n = 34). INTERVENTIONS Not applicable. OUTCOME MEASURES Median overall priorities calculated on the basis of importance, unhappiness, and research measured with a new survey of pediatric H&L domains and rated using a 5-point Likert Scale. RESULTS A total of 60 surveys were received providing information on 35 individuals with SCI: 2-7-year-olds (25.7%), 8-12-year-olds (22.9%), 13-17-year-olds (31.4%), and 18-25-year-olds (20.0%). The top three overall H&L priorities reported by parents/caregivers of 2-12-year-olds were "parenthood expectations" (84%), "leg/foot movement" (83%), and "bladder" function (83%), compared to "dressing/undressing" (78%), "walking/ability to move" (77%) and "bladder" function (77%) rated for 13-25-year-olds. "Sit-to-stand" (79%), "leg/foot movement" (78%) and "arm/hand movement" (77%) were reported as priorities by 13-25-year-olds. The 13-25-year-olds highlighted "sit-to-stand" (100%), "eating/drinking" (54%), and "physical function" (94%) as their top unhappiness, importance, and research priorities, respectively. Significant differences between tetraplegia and paraplegia were found in "mobility in the community" (unhappiness item) for 13-25-years-old. CONCLUSION Health domains were considered the top overall H&L priorities by parents/caregivers of 13-25-year-olds, compared to life domains reported for their 2-12-year-olds. This survey will aid rehabilitation professionals to engage stakeholders to implement a comprehensive SCI management program for the pediatric population.
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Affiliation(s)
- Marta Ríos-León
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
| | - Bashak Onal
- NHS Buckinghamshire Clinical Commissioning Group, Aylesbury, UK
| | - Juan Carlos Arango-Lasprilla
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country, Leioa, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Marika Augutis
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | | | - Allison Graham
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK
| | | | - Elisa López-Dolado
- Rehabilitation Department, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
| | - Anke Scheel-Sailer
- Swiss Paraplegic Centre, Nottwil, Switzerland
- Department of Health Science and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Patricia Subiñas-Medina
- Servicio de Atención Temprana, Asociación de Familias de Personas con Discapacidad Intelectual y del Desarrollo (APANAS), Toledo, Spain
| | - PEPSCI Collaboration
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
- NHS Buckinghamshire Clinical Commissioning Group, Aylesbury, UK
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country, Leioa, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
- Unidad de Lesionados Medulares, Hospital de Cruces, Barakaldo, Spain
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK
- American Academy of Pediatrics, Itasca, Illinois, USA
- Rehabilitation Department, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
- Swiss Paraplegic Centre, Nottwil, Switzerland
- Department of Health Science and Medicine, University of Lucerne, Lucerne, Switzerland
- Servicio de Atención Temprana, Asociación de Familias de Personas con Discapacidad Intelectual y del Desarrollo (APANAS), Toledo, Spain
- Harris Manchester College, University of Oxford, Oxford, UK
| | - Julian Taylor
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
- Harris Manchester College, University of Oxford, Oxford, UK
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Bezuidenhout L, Rhoda A, Moulaee Conradsson D, Mothabeng J, Joseph C. The Role of Environmental Factors on Health Conditions, General Health and Quality of Life in Persons with Spinal Cord Injuries in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095709. [PMID: 37174227 PMCID: PMC10178437 DOI: 10.3390/ijerph20095709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE The objective was to describe the individual items of the environmental factors and to investigate the relationship between the environmental factors to health conditions, general health and quality of life in people with SCI in South Africa. METHODS Two hundred persons with SCI participated in a cross-sectional survey design. This study formed part of the International Spinal Cord Injury (InSCI) Community Survey. Four major domains, environmental factors, health conditions, general health and quality of life of the survey questionnaire responses, were used for the analysis. Regression models were used to determine the association between the independent variable, which consisted of the specific environmental factors items, and the dependent variables comprising health conditions, general health and quality of life. RESULTS The commonly reported environmental barriers were public access, lack of short- and long-distance transport and finances. Environmental factors such as public access (p < 0.001), short- (p < 0.001) and long-distance transport (p = 0.001), and friends' (p = 0.003) and colleagues' (p < 0.001) attitudes and communication (p = 0.042) were significantly associated with the presence of secondary health conditions. Finances (p = 0.026), family attitudes (p = 0.037) and communication (p = 0.039) had a significant association with worsened mental health. Services (p = 0.022) and communication (p = 0.042) were also significantly associated with decreased general health. CONCLUSION The results provide insight into modifiable environmental factors policymakers need to consider or adapt to improve the lives of people with SCI in South Africa with respect to health (secondary health conditions), as well as general and mental health.
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Affiliation(s)
- Lucian Bezuidenhout
- Faculty of Community and Health Sciences, University of Western Cape, Cape Town 7701, South Africa
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Anthea Rhoda
- Faculty of Community and Health Sciences, University of Western Cape, Cape Town 7701, South Africa
| | - David Moulaee Conradsson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 17177 Stockholm, Sweden
- Department of Health and Rehabilitation Sciences, Division of Physiotherapy, Stellenbosch University, Cape Town 7602, South Africa
- Medical Unit Occupational Therapy & Physiotherapy, Theme Women's Health and Allied Health Professional, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Joyce Mothabeng
- Department of Physiotherapy, University of Pretoria, Pretoria 0028, South Africa
| | - Conran Joseph
- Department of Health and Rehabilitation Sciences, Division of Physiotherapy, Stellenbosch University, Cape Town 7602, South Africa
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6
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Jeon M, Kim O, Lee BS, Kim W, Kim JH, Kim EJ, Kim J. Influence of Sociodemographic Factors, Health Conditions, and Activity on Participation in People With Spinal Cord Injury in South Korea. Arch Phys Med Rehabil 2023; 104:52-62. [PMID: 36028101 DOI: 10.1016/j.apmr.2022.08.004] [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: 03/11/2022] [Revised: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To verify the causal relationship between sociodemographic factors, health conditions, and activities that influence the participation of people with spinal cord injury (SCI) using International Spinal Cord Injury (InSCI) Survey data and to investigate the moderation effects of environmental restrictions and health care system concerns. DESIGN Cross-sectional community survey and structural equation model. SETTING SCI databases of the Korea National Rehabilitation Center and Korea Spinal Cord Injury Association. PARTICIPANTS Community-dwelling adults (N=890) with SCI. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The InSCI questionnaire domains included sociodemographic factors, health conditions, activity, participation, environmental restrictions, and health system concerns. Sociodemographic factors included age, education, and income. Health conditions included bowel dysfunction, respiratory problems, and pain, among others. Activity included "daily routine" and "using hands," among others. Participation included "interacting with people" and "intimate relationships," among others. Environmental restrictions included "public places" and "negative attitudes," among others. Health care system concerns included "nursing care" and "experience of being treated," among others. RESULTS The hypothesis that health conditions would have a significant effect on activity was supported because 51% of the total variance in activity factors was explained by health condition factors. The hypothesis that activity would have a significant effect on participation was also supported because 63.4% of total variance in participation factors was explained by activity factors. The moderation effect tests supported the hypotheses that health conditions, activity, and participation would differ depending on the extent of environmental restrictions as well as the extent of health system concerns. CONCLUSIONS When formulating policies and recommendations to promote the participation of people with SCI living in the South Korean community, the influence of environmental restrictions and health systems as well as the causal influence of health conditions and activity should be considered.
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Affiliation(s)
- Minjae Jeon
- Department of Healthcare and Public Health Research, Rehabilitation Research Institute, Korea National Rehabilitation Center, Seoul
| | - Onyoo Kim
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Korea National Rehabilitation Center, Seoul.
| | - Bum-Suk Lee
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Korea National Rehabilitation Center, Seoul.
| | - Wanho Kim
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Korea National Rehabilitation Center, Seoul
| | - Jung Hwan Kim
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Korea National Rehabilitation Center, Seoul
| | - Eun-Joo Kim
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Korea National Rehabilitation Center, Seoul
| | - Jiin Kim
- Department of Community Reintegration Service, Rehabilitation Hospital, Korea National Rehabilitation Center, Seoul, Republic of Korea
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7
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Gurung S, Jenkins HT, Chaudhury H, Ben Mortenson W. Modifiable Sociostructural and Environmental Factors That Impact the Health and Quality of Life of People With Spinal Cord Injury: A Scoping Review. Top Spinal Cord Inj Rehabil 2022; 29:42-53. [PMID: 36819929 PMCID: PMC9936894 DOI: 10.46292/sci21-00056] [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] [Indexed: 11/19/2022]
Abstract
Objective The objective of this scoping review was to identify the modifiable factors that impact the health and quality of life (QOL) of community-dwelling people with spinal cord injury (SCI). Methods Empirical journal articles were identified using three academic databases: CINAHL Complete, MEDLINE with Full Text, and PsycINFO. Full-text journal articlesincluded studies of participants who were community-dwelling with traumatic or nontraumatic SCI and were over the age of 18 years without cognitive impairment; published between 2000 and 2021; focused on modifiable factors impacting health and QOL; and conducted inAustralia, Europe, orNorth America. A data table was used to extract article information including authors, year of publication, country, sample, design and methods, purpose/objectives, and main findings. Qualitative data analysis software was used to categorize major findings inductively through content analysis. Results Thirty-one peer-reviewed articles consisting of qualitive, quantitative, and mixed-methods study design were included. This scoping review revealed modifiable factors that impact the health and QOL of community-dwelling people with SCI: sociostructural factors (social attitudes, health care access, information access, and funding and policies) and environmental factors (built environment, housing, transportation, assistive technology, and natural environment). Conclusion Future research should examine the influence of the modifiable factors on health and QOL using qualitative inquiry, adopting a community-based participatory research approach, and considering the implications of individual characteristics and resources.
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Affiliation(s)
- Shreemouna Gurung
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Hailey-Thomas Jenkins
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
| | - W. Ben Mortenson
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, Canada
- International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada
- GF Strong Rehabilitation Research Program, Vancouver, British Columbia, Canada
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Developing a consensus on the core educational content to be acquired by people with spinal cord injuries during rehabilitation: findings from a Delphi study followed by a Consensus Conference. Spinal Cord 2021; 59:1187-1199. [PMID: 34108615 DOI: 10.1038/s41393-021-00652-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/28/2021] [Accepted: 05/28/2021] [Indexed: 02/05/2023]
Abstract
STUDY DESIGN Three-round Delphi study followed by a Consensus Conference with selected stakeholders. OBJECTIVES To identify a set of core educational content that people with spinal cord injury (SCI) need to acquire during rehabilitation. SETTING The Delphi study was performed electronically. The Consensus Conference was held at the Città della Salute e della Scienza University Hospital of Turin, Italy. METHODS A panel of 20 experts (healthcare professionals and SCI survivors) participated in a three-round Delphi study. In round 1, arguments for core educational content were solicited and reduced into items. In rounds 2 and 3, a five-point Likert scale was used to find consensus on and validate core educational content items (threshold for consensus and agreement: 60% and 80%, respectively). A Consensus Conference involving 32 stakeholders was held to discuss, modify (if appropriate) and approve the list of validated items. RESULTS The 171 arguments proposed in round 1 were reduced into 74 items; 67 were validated in round 3. The Consensus Conference approved a final list of 72 core educational content items, covering 16 categories, which were made into a checklist. CONCLUSIONS Consensus was achieved for a set of core educational content for people with SCI. The resultant checklist could serve as an assessment tool for both healthcare professionals and SCI survivors. It can also be used to support SCI survivors' education, streamline resource use and bridge the gap between information provided during rehabilitation and information SCI survivors need to function in the community.
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Tomas V, Srinivasan R, Kulkarni V, Teplicky R, Anaby D, Khetani M. A guiding process to culturally adapt assessments for participation-focused pediatric practice: the case of the Participation and Environment Measures (PEM). Disabil Rehabil 2021; 44:6497-6509. [PMID: 34410207 DOI: 10.1080/09638288.2021.1960645] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE There is unprecedented opportunity to evaluate children's participation in diverse cultural contexts, to enhance cross-cultural research, advance the delivery of culturally responsive pediatric rehabilitation, and translate new knowledge on a global scale. The participation concept is complex and heavily influenced by a child's context. Therefore, effectively capturing the participation concept requires valid, reliable, and culturally sensitive participation-focused measures. This perspective paper proposes a structured process for culturally adapting measures of participation for children and youth with disabilities. METHODS Elements of the Applied Cultural Equivalence Framework and Beaton and colleagues' six-step process were used to create a guiding process for culturally adapting a Participation and Environment Measure (PEM) while drawing on two distinct cultural contexts. This process included forward and back language translations, and semi-structured cognitive interviews, to develop adapted versions of the PEM that are ready for psychometric validation. RESULTS Common challenges to culturally adapting PEM content and administration are identified and methodological strategies to mitigate these challenges are proposed. CONCLUSIONS The proposed process can guide rehabilitation specialists and researchers in adapting participation measures that are suitable for their culture. Such a process can facilitate scalable implementation of evidence-based tools to support participation-based practice in the rehabilitation field.Implications for RehabilitationThe use of a systematic process can harmonize efforts by rehabilitation researchers and service providers to effectively culturally adapt pediatric participation measures to optimize its impact for culturally sensitive research and practice targeting participation.Two distinct, yet complementary, illustrative exemplars showcase the range of considerations and strategies, such as by conducting consecutive rounds of cognitive interviews, when teams use this systematic process to cultural adapt a pediatric participation measure.The systematic process outlined in this paper promotes rigor in achieving all elements of cultural equivalency, when feasible, to best ensure that the participation measure is suitable for use in the target cultural context.
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Affiliation(s)
- Vanessa Tomas
- Rehabilitation Science Institute, University of Toronto, Toronto, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | | | | | - Rachel Teplicky
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Dana Anaby
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Mary Khetani
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada.,Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
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Media portrayal of spinal cord injury and its impact on lived experiences: a phenomological study. Spinal Cord 2021; 59:504-511. [PMID: 33837298 DOI: 10.1038/s41393-021-00630-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN This is a qualitative, phenomenological study. OBJECTIVE To investigate media portrayal of spinal cord injury (SCI) as perceived by people with SCI and explore its impact on their lived experience. SETTING People with SCI living in Australia. METHOD Twenty-four participants, recruited using purposive and snowball sampling, completed in-depth, semi-structured interviews. Thematic data analysis followed an inductive, iterative process. RESULTS Participants perceived media portrayed SCI through a narrow lens, describing how people with SCI were 'absent' or portrayed as either 'pity or pedestal'. Participants said media portrayed an inaccurate picture of their lived experience that perpetuated misunderstandings of SCI. This portrayal fostered unreasonable public expectations and assumptions about living with SCI, which presented in the participant's lives as uncomfortable interactions and inappropriate remarks. The impact for participants was a burden to explain SCI and justify what it meant for them. People with SCI would like media to portray a broader, more authentic representation of SCI to improve public understanding and to reduce the negative impact on their lives. CONCLUSION People with SCI perceived a narrow and inaccurate portrayal of SCI in media that overlooked potential quality of life, overshadowed health and life domains they considered important and reinforced the idea that SCI can be overcome. People with SCI were mostly concerned with what was absent in media portrayal of SCI rather than what was present. Action for change lies in promoting information, expanding narratives and raising awareness to diverse abilities of people with SCI.
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Converging Robotic Technologies in Targeted Neural Rehabilitation: A Review of Emerging Solutions and Challenges. SENSORS 2021; 21:s21062084. [PMID: 33809721 PMCID: PMC8002299 DOI: 10.3390/s21062084] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/05/2021] [Accepted: 03/11/2021] [Indexed: 11/17/2022]
Abstract
Recent advances in the field of neural rehabilitation, facilitated through technological innovation and improved neurophysiological knowledge of impaired motor control, have opened up new research directions. Such advances increase the relevance of existing interventions, as well as allow novel methodologies and technological synergies. New approaches attempt to partially overcome long-term disability caused by spinal cord injury, using either invasive bridging technologies or noninvasive human-machine interfaces. Muscular dystrophies benefit from electromyography and novel sensors that shed light on underlying neuromotor mechanisms in people with Duchenne. Novel wearable robotics devices are being tailored to specific patient populations, such as traumatic brain injury, stroke, and amputated individuals. In addition, developments in robot-assisted rehabilitation may enhance motor learning and generate movement repetitions by decoding the brain activity of patients during therapy. This is further facilitated by artificial intelligence algorithms coupled with faster electronics. The practical impact of integrating such technologies with neural rehabilitation treatment can be substantial. They can potentially empower nontechnically trained individuals-namely, family members and professional carers-to alter the programming of neural rehabilitation robotic setups, to actively get involved and intervene promptly at the point of care. This narrative review considers existing and emerging neural rehabilitation technologies through the perspective of replacing or restoring functions, enhancing, or improving natural neural output, as well as promoting or recruiting dormant neuroplasticity. Upon conclusion, we discuss the future directions for neural rehabilitation research, diagnosis, and treatment based on the discussed technologies and their major roadblocks. This future may eventually become possible through technological evolution and convergence of mutually beneficial technologies to create hybrid solutions.
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Conti A, Sperlinga R, Luciani M, Crenna MF, Piovan C, Scavino E, Campagna S. Association between sleep quality and participation in people with spinal cord injury: A preliminary study. J Spinal Cord Med 2021; 46:477-484. [PMID: 33606607 PMCID: PMC10114967 DOI: 10.1080/10790268.2021.1876818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To explore the association between perceived sleep quality and participation in people with spinal cord injury (SCI). DESIGN Cross-sectional study. SETTING Spinal unit at the Città della Salute e della Scienza University Hospital of Turin, Italy. PARTICIPANTS From May to July 2019, 55 consecutive outpatients were recruited. OUTCOME MEASURES A set of structured questionnaires was administered. It included sociodemographic data, the Pittsburgh Sleep Quality Index, the Utrecht Scale for Evaluation of Rehabilitation-Participation, the Spinal Cord Independence Measure Self-Report, the Short Form version 12.2, and the Hospital Anxiety and Depression Scale. T-tests were used to highlight differences between participation and participant characteristics. Bivariate analyses and linear regressions were performed to identify associations between sleep quality and participation. RESULTS Differences in participation occurred mainly in individuals with a higher level of injury, caregiver dependency, and lower functional level. Participants reporting better sleep quality had more frequent (r = -0.36, P < 0.01), less restricted (r = -0.32, P < 0.05), and more satisfactory participation (r = -0.33, P < 0.01). Linear regression analyses showed that poor sleep quality was significantly associated with reduced participation frequency (β = -0.30, P = 0.03) and less satisfaction with participation (β = -0.49, P < 0.001). Moreover, age, number of hours slept at night, and time since injury were associated with satisfaction with participation. CONCLUSIONS An association was found between sleep quality and participation in people with SCI. Given the high prevalence of sleep problems and their association with all dimensions of participation, the promotion of sleep quality should be encouraged because it may positively affect participation.
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Affiliation(s)
- Alessio Conti
- Department of Public Health and Paediatric Sciences, University of Torino, Torino, Italy
| | - Riccardo Sperlinga
- School of Nursing, Catholic University of the Sacred Heart, Torino, Italy
| | - Michela Luciani
- Department of Public Health and Paediatric Sciences, University of Torino, Torino, Italy
| | | | - Chiara Piovan
- Department of Physical Medicine and Rehabilitation, Spinal Unit, A.O.U. Città della Salute e della Scienza University Hospital, Torino, Italy
| | - Enrica Scavino
- School of Nursing, Catholic University of the Sacred Heart, Torino, Italy
| | - Sara Campagna
- Department of Public Health and Paediatric Sciences, University of Torino, Torino, Italy
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Change in environmental barriers experienced over a 5-year period by people living with spinal cord injury in Switzerland: a prospective cohort study. Spinal Cord 2020; 59:441-451. [PMID: 33230271 DOI: 10.1038/s41393-020-00580-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 09/27/2020] [Accepted: 09/29/2020] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Cohort study with two measurement occasions. OBJECTIVES To investigate change in environmental barriers experienced by people living with spinal cord injury (SCI) over a 5-year period. SETTING Community, Switzerland. METHODS Data were from the Swiss spinal cord injury (SwiSCI) survey. Main outcome measure was the Nottwil Environmental Factors Inventory-Short Form. Random-effects Poisson regression featuring between-within estimation was used to examine predictors of the number of environmental barriers and of its change over time. RESULTS One thousand five hundred and forty-nine persons participated in Survey 2012 and 1530 participated in Survey 2017; 761 participated in both surveys. In both surveys most participants reported at least three barriers. Leading issues were unfavorable climate, inaccessibility of buildings and public spaces, and lack of or insufficiently adapted means of transportation. Reporting of barriers related to climate, finances, and state services declined over time. Between subjects, having more health problems, lesser physical independence, poorer mental health, and a lower household income were related to a higher number of barriers experienced. Within subjects, improvements in income, physical independence, and mental health over time were related to a reduction in barriers. CONCLUSIONS Inaccessibility of buildings and places and problems with transportation remained major barriers over a 5-year period and should be priorities of Swiss disability policy. People with reduced mental and physical health, and those with lower income are vulnerable groups deserving specific attention. Policies targeting income and life-long rehabilitation targeting health promotion and maintenance may be suitable means to reduce the experience of environmental barriers.
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Dorjbal D, Prodinger B, Zanini C, Avirmed B, Stucki G, Rubinelli S. Living with spinal cord injury in Mongolia: A qualitative study on perceived environmental barriers. J Spinal Cord Med 2020; 43:518-531. [PMID: 30633693 PMCID: PMC7480610 DOI: 10.1080/10790268.2019.1565707] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Context: Environmental factors play a key role in the lives of individuals with a spinal cord injury (SCI). This study identifies environmental barriers and their impacts on daily lives as perceived by individuals living with SCI in Mongolia. Design: A qualitative study with semi-structured interviews was conducted. A topic guide for the interviews was structured around the components of the International Classification of Functioning, Disability, and Health. Setting: Urban and rural areas of Mongolia. Participants: A purposive sample of 16 persons with traumatic SCI. Interventions: Not applicable. Outcome Measures: Not applicable. Results: Seven categories of environmental barriers were mentioned, such as poor access to the physical environment, absence of wheelchair-friendly transportation, negative societal attitudes, inadequate health and rehabilitation services, lack of access to assistive devices and medicines, limited financial resources for healthcare, and inaccurate categorization of disabilities in laws. These barriers were claimed to have an impact on physical and psychological health, limit activities, and restrict participation in almost all areas of life. Conclusion: This study contributes to the identification of targets for interventions aimed at improving the lived experience of persons with SCI in a low-resource context. The findings reveal that while the Mongolian government already has laws and policies in place to improve access to the physical environment, transportation, assistive devices and employment, much more has to be done in terms of enforcement. Specialized SCI care and rehabilitation services are highly demanded in Mongolia.
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Affiliation(s)
- Delgerjargal Dorjbal
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of LucerneLucerne, Switzerland
| | - Birgit Prodinger
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of LucerneLucerne, Switzerland
- Faculty of Applied Health and Social Sciences, University of Applied Sciences Rosenheim, Rosenheim, Germany
| | - Claudia Zanini
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of LucerneLucerne, Switzerland
| | - Baljinnyam Avirmed
- Department of Rehabilitation Medicine, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Gerold Stucki
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of LucerneLucerne, Switzerland
| | - Sara Rubinelli
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of LucerneLucerne, Switzerland
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Reinhardt JD, Middleton J, Bökel A, Kovindha A, Kyriakides A, Hajjioui A, Kouda K, Kujawa J. Environmental Barriers Experienced by People With Spinal Cord Injury Across 22 Countries: Results From a Cross-Sectional Survey. Arch Phys Med Rehabil 2020; 101:2144-2156. [PMID: 32502565 DOI: 10.1016/j.apmr.2020.04.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 04/21/2020] [Accepted: 04/26/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate the experience of environmental barriers by people with spinal cord injury (SCI) across 22 countries. Specific aims were to describe and compare the prevalence of environmental barriers experienced across countries, and to analyze determinants of environmental barriers at individual and country level. DESIGN Cross-sectional community survey. PARTICIPANTS Individuals (N=12,591) living with SCI in the community. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Nottwil Environmental Factors Inventory-Short Form. RESULTS Most barriers were experienced in relation to accessibility, climate, transportation, finances, and state services. More severe barriers were experienced in settings with lower gross domestic product (GDP), which especially refers to medical supplies (gamma=-0.38; P<.001) and finances (gamma=-0.37; P<.001) in this study. However, in a multivariable negative binomial regression using within-between estimation of the number of barriers experienced on the selected predictors, the effect of GDP was reversed when it was adjusted for covariates. On the individual level, the number of experienced barriers decreased with better mental health and greater self-care ability. People with low income, with paraplegia, complete lesions, and more health problems reported more barriers. On the country level, fewer barriers were reported in countries with higher average age, better mental health, and greater self-care ability, as well as in those with a higher percentage of traumatic SCI, paraplegia, and complete lesions. More barriers were reported in countries with a higher percentage of married individuals, lower average household income, higher average time since injury, higher mean vitality scores, and greater income inequality. CONCLUSIONS Study participants reported a significant number of environmental barriers, many of which are modifiable. Complementary interventions are recommended. Within and between country effects of covariates sometimes pointed in different directions, suggesting that countries with a different composition of SCI population also differed in environmental contexts.
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Affiliation(s)
- Jan D Reinhardt
- Institute for Disaster Management and Reconstruction, Sichuan University and Hong Kong Polytechnic University, Chengdu, China; Swiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
| | - James Middleton
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical School, The University of Sydney, Sydney Australia
| | - Andrea Bökel
- Department of Rehabilitation Medicine, Hannover Medical School, Germany
| | - Apichana Kovindha
- Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Athanasios Kyriakides
- Spinal Cord Injuries Rehabilitation Department, Medical University of Patras, Patras, Greece
| | - Abderrazak Hajjioui
- Department of Rehabilitation Medicine, Clinical Neuroscience Laboratory, Faculty of Medicine, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - Ken Kouda
- Department of Rehabilitation Medicine, Wakayama Medical University, School of Medicine, Wakayama, Japan
| | | | - Jolanta Kujawa
- Medical Rehabilitation Clinic, Medical University of Lodz, Lodz, Poland
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Zanini C, Fiordelli M, Amann J, Brach M, Gemperli A, Rubinelli S. Coping strategies of family caregivers in spinal cord injury: a qualitative study. Disabil Rehabil 2020; 44:243-252. [PMID: 32449426 DOI: 10.1080/09638288.2020.1764638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: To identify the coping strategies used by family caregivers of persons with spinal cord injury (SCI) in Switzerland in order to develop tailored support programs.Materials and methods: Purposive sample of >18 years participants, speaking an official Swiss language fluently, being family caregivers of persons with SCI for at least 4 years, and perceiving either a high or low burden in relation to caregiving. Data were collected through face-to-face semi-structured interviews (N = 22). Thematic analysis was performed.Results: Four main coping strategies were identified: reappraisal, active acceptance, setting limits to the caregiver role, and seeking support. These strategies can be used one at a time or combined, and at different times of a caregiver pathway. Our analysis highlighted that caregivers need skills to implement these strategies (e.g., self-evaluation skills).Conclusions: Caregivers of persons with SCI develop cognitive coping strategies to make sense of the situation and establish a "new normal" and problem-focused coping strategies to deal with their new tasks and role. These strategies do not seem to be typical only of SCI caregivers. Hence, interventions that worked for caregivers in other fields could be adapted. Rehabilitation centers should systematically integrate programs targeted to caregivers into their offerings.IMPLICATIONS FOR REHABILITATIONHealthcare systems need to develop educational and support measures for both persons with a health condition and their caregivers.Caregivers should become long-term partners in rehabilitation and a regular and structured needs assessment should be offered.Interventions that worked for caregivers in other fields can be adapted to support also caregivers in SCI.Educational and support programs dedicated to caregivers should teach not only how to perform caregiving tasks but also how to balance between responding to the care recipient's needs and their own needs.
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Affiliation(s)
- Claudia Zanini
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Maddalena Fiordelli
- Swiss Paraplegic Research, Nottwil, Switzerland.,Institute of Communication and Health, Università della Svizzera italiana, Lugano, Switzerland
| | - Julia Amann
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Technology, Health Ethics and Policy Lab, ETH, Zurich, Switzerland
| | - Mirjam Brach
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Armin Gemperli
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Sara Rubinelli
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Mahooti F, Raheb G, Alipour F, Hatamizadeh N. Psychosocial challenges of social reintegration for people with spinal cord injury: a qualitative study. Spinal Cord 2020; 58:1119-1127. [PMID: 32203067 DOI: 10.1038/s41393-020-0449-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 03/03/2020] [Accepted: 03/09/2020] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Qualitative study, using in-depth, and semi-structured interviews. OBJECTIVE To identify the psychosocial challenges of social reintegration for people with spinal cord injury (SCI) in Iran. SETTING People with SCI living in the community in Iran. METHOD Eleven individuals with SCI with a median time since injury of 12 years (between 9 and 20 years), two family members, and three specialists (two social workers and one physiotherapist) were selected by purposive sampling with maximum variation. In-depth and semi-structured interviews were conducted and finally the data analyzed through qualitative content methodology. RESULTS The psychosocial challenges were categorized into four main categories and twelve subcategories: early crises (denial and disbelief; feelings of isolation and depression; dependency crisis; and a sudden change in the normal course of life), disabling society (stigma; discrimination; employment challenges; and educational restriction), environmental barriers to access (lack of barrier-free environments and transportation challenges), and inappropriate services delivery (incomprehensive rules and lack of specialized training). CONCLUSIONS Providing various psychosocial services is essential for the social reintegration of people with SCI. This goal could be achieved by the provision of medical and physical rehabilitation services. The ultimate purpose of rehabilitation is to reintegrate individuals into society after injury or illness; thus, psychosocial issues must also be considered to ensure effective rehabilitation.
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Affiliation(s)
- Fariba Mahooti
- Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Ghoncheh Raheb
- Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fardin Alipour
- Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Nikta Hatamizadeh
- Department of Rehabilitation Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Moshi H, Sundelin G, Sahlen KG, Sörlin A. Quality of life of persons with traumatic spinal cord injury in rural Kilimanjaro, Tanzania: a community survey. Disabil Rehabil 2020; 43:2838-2845. [PMID: 32003248 DOI: 10.1080/09638288.2020.1718780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIM To describe the quality of life of persons with traumatic spinal cord injury (TSCI) in a rural area of a low-income country. METHODS This was a cross-sectional descriptive study in which snowballing was used to identify persons with TSCI in their homes. A Kiswahili version of the short version of the World Health Organization quality of life questionnaire was used for data collection. Data were analyzed descriptively and independent samples t-tests were used to calculate the difference in the mean scores between groups. RESULTS Eighty persons with TSCI with a mean age of 42.29 ± 11.4 years were identified, 68.8% of whom were males. The highest scoring domains were psychological (12.76 ± 2.55) and social relationships (12.62 ± 2.95). The lowest scores were for physical (11.48 ± 2.74) and environment (9.59 ± 2.68) domains. Significantly higher scores were associated with younger age in: physical (0.05), social relationships (0.01), and environment (0.02) domains (p value < 0.05). CONCLUSIONS Persons with TSCI in the Kilimanjaro rural area registered a relatively low quality of life in which the most affected domains are physical health and environment.Implications for rehabilitationQuality of life is the ultimate goal in the rehabilitation of persons with any irreversible disability such as spinal cord injury.It is important for rehabilitation professionals to know which domains of quality of life are most affected among persons with spinal cord injury.Rehabilitation professionals ought to understand and address physical health and environmental issues that affect persons with traumatic spinal cord injury in rural resource-constrained areas.Addressing physical health and environmental challenges for persons with spinal cord injury in resource-constrained rural areas require involvement of the family, rehabilitation personnel, policy makers, and the community.
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Affiliation(s)
- Haleluya Moshi
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.,Physiotherapy Department, Faculty of Rehabilitation Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Gunnevi Sundelin
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Klas-Göran Sahlen
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden.,Department of Epidemiology and Global Health, Umea University, Umea, Sweden
| | - Ann Sörlin
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
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Bökel A, Egen C, Gutenbrunner C, Weidner N, Moosburger J, Abel FR, Rupp R, Kalke YB, Liebscher T, Kurze I, Sauer M, Geng V, Sturm C. [Spinal Cord Injury in Germany - a Survey on the Living and Care Situation of People with Spinal Cord Injury]. REHABILITATION 2020; 59:205-213. [PMID: 31962349 DOI: 10.1055/a-1071-5935] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Multiple organizations like UN and WHO call for the collection of internationally comparable data on living and supply conditions of people with disabilities. Furthermore, reliable national data are necessary for ensuring appropriate care. Regarding patients with Spinal Cord Injury (SCI) in Germany, only data on diagnostics or therapeutic interventions is currently available. The International Spinal Cord Injury Survey aims at collecting reliable data of people with SCI in 21 countries and developing recommendations for actions to be taken by policy-makers and other decision-makers. METHODS In 2017, eight specialized SCI-centers across Germany sent a standardized questionnaire to their patients who had diagnosis of SCI, and were older than 18 years (n=5,598). The questionnaire could be completed paper-based or online. RESULTS 1,479 patients participated in the study and were included in data analysis. On average, participants were 55.3 years (SD=14.6) old, ¾ were male. The mean time of onset of paralysis was 13.9 years. Two thirds of the spinal cord injury causes were traumatic. In 51.2% SCI was classified as paraplegia. The most frequently cited health problem was sexual dysfunction. Medical treatment for this problem was rarely used. Serious environmental barriers were the inadequate accessibility of private households and public places. 42.5% of the respondents in working age were employed, which is 10% less than in Switzerland. DISCUSSION Serious problems in environmental barriers, medical care and labor market participation were identified for people with SCI. The results will be reported to and discussed with political decision makers and further actors to create solutions. This requires extensive efforts, like modification in building law and home support.
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Affiliation(s)
- Andrea Bökel
- Klinik für Rehabilitationsmedizin, Medizinische Hochschule
| | - Christoph Egen
- Klinik für Rehabilitationsmedizin, Medizinische Hochschule
| | | | | | - Jürgen Moosburger
- Medizinisches Rehabilitationszentrum für Querschnittgelähmte Heinrich-Sommer-Klinik Bad Wildbad
| | | | - Rüdiger Rupp
- Klinik für Paraplegiologie Universitätsklinikum Heidelberg
| | - York-Bernhard Kalke
- Querschnittgelähmtenzentrum der Universitäts- und Rehabilitationskliniken Ulm
| | - Thomas Liebscher
- Behandlungszentrum für Rückenmarkverletzte des Unfallkrankenhauses Berlin
| | - Ines Kurze
- Querschnittgelähmten-Zentrum/Klinik für Paraplegiologie und Neuro-Urologie Zentralklinikum Bad Berka
| | - Marion Sauer
- Zentrum für Tetra- und Paraplegie der Orthopädischen Klinik Hessisch Lichtenau
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Cole S, Svetina Valdivia D. Developing a Facilitators Scale in the Context of Travel: ReTRIP. Arch Rehabil Res Clin Transl 2020; 2:100042. [PMID: 33543071 PMCID: PMC7853389 DOI: 10.1016/j.arrct.2020.100042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective To develop a scale for measuring factors that facilitate participation of people with spinal cord injury (SCI) in travel-related activities: Removing Travel Restrictions Influencing Participation (ReTRIP). Design A mixed-method approach where in the qualitative phase, items were developed and written based on results of interviewers with different stakeholder groups and in the quantitative phase, survey data were collected to examine the psychometric properties of the scale. Setting Home, work, and community settings. Participants People living with SCI, caregivers or family members, therapists, travel professionals (N=333). Interventions None. Main Outcome Measures An 11-item ReTRIP scale that measures the facilitators that enhance the travel participation of people with SCI. Results In the qualitative phase of the study, 5 categories of travel facilitators were identified based on semistructured in-depth interviews with 83 respondents from 4 stakeholder groups. Initial items of the ReTRIP scale were written based on the travel facilitators identified. Items in the scale were then revised based on results of cognitive interviews and an expert panel review. In the quantitative phase, a total of 250 patients enrolled in a Spinal Cord Injury Model System were systematically selected to report their experience with each travel facilitator. Item-response theory-based Rasch analysis revealed that the 11-item ReTRIP has acceptable psychometric properties, containing 2 main dimensions: industry-oriented facilitators (6 items) and self-oriented facilitators (5 items). Conclusions The 11-item ReTRIP scale demonstrates promising psychometric properties, allowing researchers and clinicians to potentially use self-reported environmental factors that are beneficial for people's participation in travel after SCI to properly design client-centered interventions. Future studies using a larger sample are needed to validate the scale.
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Key Words
- CFA, confirmatory factor analysis
- DIF, differential item functioning
- EF, environmental factor
- Environment
- ICF, International Classification of Functioning, Disability and Health
- PCA, principal component analysis
- PCM, partial credit model
- RSM, Rasch-Andrich rating scale model
- ReTRIP, Removing Travel Restrictions Influencing Participation
- Rehabilitation
- SCI, spinal cord injury
- Spinal cord injuries
- Travel
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Affiliation(s)
- Shu Cole
- Indiana University School of Public Health-Bloomington, Bloomington, Indiana
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Cole M, Froehlich-Grobe K, Driver S, Shegog R, McLaughlin J. Website Redesign of a 16-Week Exercise Intervention for People With Spinal Cord Injury by Using Participatory Action Research. JMIR Rehabil Assist Technol 2019; 6:e13441. [PMID: 31845902 PMCID: PMC6938595 DOI: 10.2196/13441] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 08/21/2019] [Accepted: 10/22/2019] [Indexed: 01/20/2023] Open
Abstract
Background People with spinal cord injury (SCI) are at higher risk for numerous preventable chronic conditions. Physical activity is a protective factor that can reduce this risk, yet those with SCI encounter barriers to activity and are significantly less likely to be active. Limited evidence supports approaches to promote increased physical activity for those with SCI. Objective Building upon our previous theory- and evidence-based approach to increase participation in regular physical activity for those with SCI, this study aimed to use a participatory action research approach to translate a theory-based intervention to be delivered via the Web to individuals with SCI. Methods A total of 10 individuals with SCI were invited to participate in consumer input meetings to provide the research team with iterative feedback on an initial website designed as a platform for delivering a theory-based exercise intervention. Results A total of 7 individuals with SCI whose average age was 43.6 years (SD 13.4) and lived an average age of 12.5 years (SD 14.9) with SCI met on 2 occasions to provide their feedback of the website platform, both on the initial design and subsequently on the revamped site. Their iterative feedback resulted in redesigning the website content, format, and functionality as well as delivery of the intervention program. Conclusions The substantially redesigned website offers an easier-to-navigate platform for people with SCI with greater functionality that delivers information using a module format with less text, short video segments, and presents more resources. Preliminary testing of the site is the next step.
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Affiliation(s)
- Maria Cole
- Baylor Scott and White Institute for Rehabilitation, Dallas, TX, United States
| | | | - Simon Driver
- Baylor Scott and White Institute for Rehabilitation, Dallas, TX, United States
| | - Ross Shegog
- University of Texas Health Science Center Houston, School of Public Health, Houston, TX, United States
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Dorjbal D, Zanini C, Tsegmid N, Stucki G, Rubinelli S. Toward an optimization of rehabilitation services for persons with spinal cord injury in Mongolia: the perspective of medical doctors. Disabil Rehabil 2019; 43:2200-2212. [PMID: 31790290 DOI: 10.1080/09638288.2019.1696415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE To explore medical doctors' views on what are barriers in providing rehabilitation services for persons with SCI in Mongolia. METHODS A qualitative study with semi-structured interviews was conducted with 12 medical doctors. Participants were purposely sampled. The World Health Organization (WHO)'s report International Perspectives on Spinal Cord Injury was chosen as a guide to structure the interviews. The study used inductive thematic analysis. RESULTS Five barriers in the provision of rehabilitation services were identified: low awareness and limited knowledge regarding SCI and rehabilitation issues, inadequate rehabilitation policies, deficiencies in infrastructure, deficiencies in equipment and medication, and a shortage of well-prepared rehabilitation workforce. CONCLUSIONS Based on WHO recommendations "Rehabilitation in health systems", this study provides suggestions on how to strengthen rehabilitation services in Mongolia to better respond to the needs of the SCI population. Our findings highlight that a core issue is the lack of awareness among policymakers regarding rehabilitation and its benefits at the micro, meso and macro levels of the health system. Actions are needed at the level of health policies to ensure, for instance, adequate financing and access to the services. Also, synergies between the Ministries of Education and Health can improve the training of the workforce.Implications for rehabilitationEvidence that rehabilitation services contribute to improving health outcomes and cost-effectiveness could raise awareness among Mongolian policymakers and inform their decisions on funding schemes.Health policies in Mongolia should be reformed to remove barriers in the provision of rehabilitation services for persons with complex and chronic health conditions.Rehabilitation services need to be included into the Mongolian health insurance scheme in order to improve the quality and accessibility of rehabilitation services.Synergies between the Ministry of Education and the Ministry of Health in Mongolia are needed to develop training standards for rehabilitation professionals.
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Affiliation(s)
- Delgerjargal Dorjbal
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Claudia Zanini
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Narantsetseg Tsegmid
- Department of Rehabilitation Medicine, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Gerold Stucki
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Sara Rubinelli
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Robinson-Whelen S, Hughes RB, Taylor HB, Markley R, Vega JC, Nosek TM, Nosek MA. Promoting psychological health in women with SCI: Development of an online self-esteem intervention. Disabil Health J 2019; 13:100867. [PMID: 31757776 DOI: 10.1016/j.dhjo.2019.100867] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 10/01/2019] [Accepted: 10/22/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND There are no known interventions addressing self-esteem in women following spinal cord injury (SCI). OBJECTIVES To test the feasibility of an online self-esteem intervention for women with disabilities, as modified for women with SCI. METHOD We conducted a randomized, controlled feasibility test of a self-esteem intervention (N = 21). Participants were randomly assigned to the intervention or control group that received intervention materials at the end of the study. Intervention participants met as avatars for 7 weekly real-time group sessions in Second Life (SL), a free online virtual world. Feasibility indicators were study engagement, acceptability of SL and the intervention, and improvements on measures of psychological health promoting behaviors, social support, self-efficacy, self-esteem, and depression. RESULTS Intervention participants (n = 10) were highly engaged, and most described the SL program as more enjoyable and more convenient than in-person programs. All rated the intervention as "good" (n = 4) or "very good" (n = 6), and all 10 rated themselves has having made positive life changes as a result of the program. Intervention participants experienced significantly greater change than controls on two measures of health-promoting behavior (Health Promoting Lifestyle Profile-II Spiritual Growth/Self-actualization; Interpersonal Relations). Examining change in the intervention group using regression analyses, we found medium-to-large effects of the intervention on these behaviors and measures of depression (CESD-10, PHQ-9). The intervention had small effects on remaining measures. CONCLUSION We found preliminary support for the feasibility of this modified self-esteem intervention offered in SL. Such programming may help circumvent barriers to community-based psychological services and may improve psychological health.
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Affiliation(s)
- Susan Robinson-Whelen
- Spinal Cord Injury and Disability Research Center, TIRR Memorial Hermann, Houston, TX, USA; Center for Research on Women with Disabilities, H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
| | - Rosemary B Hughes
- The Rural Institute for Inclusive Communities, University of Montana, Missoula, MT, USA; Department of Psychology, University of Montana, Missoula, MT, USA
| | - Heather B Taylor
- Spinal Cord Injury and Disability Research Center, TIRR Memorial Hermann, Houston, TX, USA; McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), USA
| | - Rachel Markley
- Spinal Cord Injury and Disability Research Center, TIRR Memorial Hermann, Houston, TX, USA
| | - José C Vega
- Spinal Cord Injury and Disability Research Center, TIRR Memorial Hermann, Houston, TX, USA
| | - Thomas M Nosek
- Department of Physiology and Biophysics, Case Western Reserve University, School of Medicine, Cleveland, OH, USA
| | - Margaret A Nosek
- Center for Research on Women with Disabilities, H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
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Selb M, Zampolini M, Delargy M, Kiekens C, Stucki G. Specifying clinical assessment schedules for the European framework of rehabilitation service types: the perspective of the physical and rehabilitation medicine Section and Board of the European Union of Medical Specialists. Eur J Phys Rehabil Med 2019; 55:834-844. [PMID: 31583877 DOI: 10.23736/s1973-9087.19.05961-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION In light of global mandates and in recognition of the value of data collection and reporting based on the International Classification of Functioning, Disability and Health (ICF), the UEMS PRM Section and Board established an action plan to implement the ICF in Physical and Rehabilitation Medicine, rehabilitation and health care at large. This includes, among other steps, the development of a framework of rehabilitation service types for Europe (European Framework) and corresponding clinical assessment schedules (CLASs) for each service type. A CLAS encompasses the recommendation for what aspects of functioning to document, for whom and when, and the data collection tools to use. The objective of this paper is to report on the development of the CLASs for the European Framework developed in Stockholm in 2018, with focus on what to document. METHODS Involving UEMS PRM delegates across European regions, a multistage Delphi process comprised the development of an initial proposal of the CLASs (i.e. default and optional ICF Sets to document), two feedback (pre- and post-Stockholm) rounds via e-mail, and a deliberation by the UEMS PRM during its March 2019 meeting in Budapest. In both Delphi rounds, participants were asked whether the initially proposed default and optional ICF Sets represent what is currently documented at an exemplary service provider in the country or in consideration of their own expertise. The European Framework was revised between the two Delphi rounds, requiring a revision of the CLAS proposal accordingly. Participants were additionally asked whether they support the suggested ICF Sets as the specification of the CLAS. Level of support (strong = ≥80%, moderate = between 80-60%, weak =≤59%) was calculated as the percentage of countries supporting the suggested CLAS over the number of responding countries. The results of the post-Stockholm round were presented for discussion, revision and approval at the Budapest meeting. RESULTS Pre-Stockholm Delphi round: due to low response rate only a summary of comments made by the responding countries was provided as reference information for the post-Stockholm round. Post-Stockholm Delphi round: results indicated moderate to strong support for the proposed CLASs. Deliberation Budapest Meeting - Motions for specific revisions to the CLASs based on the results of the Post-Stockholm round were predominately accepted. With additional minor revisions, the UEMS PRM General Assembly approved a version of the CLASs for the European Framework. CONCLUSIONS To kick-off the implementation of these CLASs, UEMS PRM plans demonstration projects in at least one rehabilitation facility in each delegate country that exemplifies the rehabilitation service types of the European Framework which exist in the respective country. The demonstration projects are intended to orient service providers and clinicians to the CLASs and illustrate how the CLASs can be implemented.
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Affiliation(s)
- Melissa Selb
- ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications in Germany, Nottwil, Switzerland - .,Swiss Paraplegic Research, Nottwil, Switzerland -
| | - Mauro Zampolini
- President, UEMS PRM Section, Brussels, Belgium.,USL Umbria 2, Hospital of Foligno, Perugia, Italy
| | - Mark Delargy
- Chair, Clinical Affairs Committee, UEMS PRM Section, Brussels, Belgium.,National Rehabilitation Hospital, Dublin, Ireland
| | - Carlotte Kiekens
- Chair, Professional Practice Committee, UEMS PRM Section, Brussels, Belgium.,University Hospitals of Leuven - KU Leuven, Leuven, Belgium
| | - Gerold Stucki
- ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications in Germany, Nottwil, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland.,Expert UEMS PRM Section and Board, Brussels, Belgium.,Swiss Delegate UEMS PRM Section and Board, Brussels, Belgium.,Department of Health Sciences and Health Policy, University of Luzern, Luzern, Switzerland
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