Manna M, Mortenson WB, Kardeh B, Douglas S, Marks C, Krauss EM, Berger MJ. Patient perspectives and self-rated knowledge of nerve transfer surgery for restoring upper limb function in spinal cord injury.
PM R 2022;
15:579-586. [PMID:
35352495 DOI:
10.1002/pmrj.12811]
[Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 02/06/2022] [Accepted: 03/16/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND
Nerve transfer surgery has the potential to restore upper limb function in patients with spinal cord injury (SCI); however, there has been limited exploration of patient perception of nerve transfer.
OBJECTIVE
To explore the perspectives of patients with chronic SCI (>2 years from injury) on nerve transfer surgery, and to determine if an educational intervention improved participants' perceived knowledge levels about the procedure.
DESIGN
Mixed-methods study including qualitative semi-structured interviews and self-reported rating scales. Pre- and post-interviews were completed following an educational presentation.
SETTING
Two local SCI clinics.
PARTICIPANTS
Ten patients with chronic traumatic SCI and neurological level of injury C3-C7 (motor complete or incomplete), recruited via snowball sampling (six male, four female).
INTERVENTION
An educational slide presentation on nerve transfer concepts.
MAIN OUTCOME MEASURES
The primary study outcome measure is the participants' responses to interview questions. The secondary study outcome measure is their self-reported knowledge levels of nerve transfer before and after education.
RESULTS
Regaining upper limb function was a priority for all participants. Although most participants had heard of nerve transfer, none were offered it at the time of their SCI, and only two stated that they had any peers who had undergone the procedure. The educational module significantly increased self-rated scores on understanding of nerve transfer (p < .05). Although all participants were open to nerve transfer after the educational module, they described weighing different factors, including (1) potential for loss versus gain of function, (2) inadequate knowledge about nerve transfer, (3) recovery time, and (4) determining their eligibility for the surgery.
CONCLUSIONS
These findings suggest that people with SCI have limited understanding of nerve transfer as a potential option and would benefit from educational opportunities to help them make informed decisions. This study may inform the development of patient resources to improve pre-surgical consultation and informed decision-making.
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