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Guilcher SJT, Cimino SR, Tadrous M, McCarthy LM, Riad J, Tricco AC, Hagens S, Lien J, Tharmalingam S, Gomes T. Experiences and Outcomes of Using e-Prescribing for Opioids: Rapid Scoping Review. J Med Internet Res 2023; 25:e49173. [PMID: 38153776 PMCID: PMC10784986 DOI: 10.2196/49173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/31/2023] [Accepted: 11/01/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND e-Prescribing is designed to assist in facilitating safe and appropriate prescriptions for patients. Currently, it is unknown to what extent e-prescribing for opioids influences experiences and outcomes. To address this gap, a rapid scoping review was conducted. OBJECTIVE This rapid scoping review aims to (1) explore how e-prescribing has been used clinically; (2) examine the effects of e-prescribing on clinical outcomes, the patient or clinician experience, service delivery, and policy; and (3) identify current gaps in the present literature to inform future studies and recommendations. METHODS A rapid scoping review was conducted following the guidance of the JBI 2020 scoping review methodology and the World Health Organization guide to rapid reviews. A comprehensive literature search was completed by an expert librarian from inception until November 16, 2022. Three databases were electronically searched: MEDLINE (Ovid), Embase (Ovid), and Scopus (Elsevier). The search criteria were as follows: (1) e-prescribing programs targeted to the use or misuse of opioids, including those that were complemented or accompanied by clinically focused initiatives, and (2) a primary research study of experimental, quasi-experimental, observational, qualitative, or mixed methods design. An additional criterion of an ambulatory component of e-prescribing (eg, e-prescribing occurred upon discharge from acute care) was added at the full-text stage. No language limitations or filters were applied. All articles were double screened by trained reviewers. Gray literature was manually searched by a single reviewer. Data were synthesized using a descriptive approach. RESULTS Upon completing screening, 34 articles met the inclusion criteria: 32 (94%) peer-reviewed studies and 2 (6%) gray literature documents (1 thesis study and 1 report). All 33 studies had a quantitative component, with most highlighting e-prescribing from acute care settings to community settings (n=12, 36%). Only 1 (3%) of the 34 articles provided evidence on e-prescribing in a primary care setting. Minimal prescriber, pharmacist, and clinical population characteristics were reported. The main outcomes identified were related to opioid prescribing rates, alerts (eg, adverse drug events and drug-drug interactions), the quantity and duration of opioid prescriptions, the adoption of e-prescribing technology, attitudes toward e-prescribing, and potential challenges with the implementation of e-prescribing into clinical practice. e-Prescribing, including key features such as alerts and dose order sets, may reduce prescribing errors. CONCLUSIONS This rapid scoping review highlights initial promising results with e-prescribing and opioid therapy management. It is important that future work explores the experience of prescribers, pharmacists, and patients using e-prescribing for opioid therapy management with an emphasis on prescribers in the community and primary care. Developing a common set of quality indicators for e-prescribing of opioids will help build a stronger evidence base. Understanding implementation considerations will be of importance as the technology is integrated into clinical practice and health systems.
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Affiliation(s)
- Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Stephanie R Cimino
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mina Tadrous
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Lisa M McCarthy
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Jessica Riad
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Andrea C Tricco
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health, Toronto, ON, Canada
| | | | | | | | - Tara Gomes
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health, Toronto, ON, Canada
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Cimino SR, Hitzig SL, Fung V, Dainty KN, MacKay C, Sale JEM, Mayo AL, Guilcher SJT. Quality of life following non-dysvascular lower limb amputation is contextualized through occupations: a qualitative study. Disabil Rehabil 2023:1-8. [PMID: 37731381 DOI: 10.1080/09638288.2023.2258340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/06/2023] [Accepted: 09/07/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE To understand how persons with non-dysvascular lower limb amputation (LLA) use occupations to contextualize their quality of life (QoL). METHODS A qualitative study using an interpretative description approach was conducted. Analysis of the interviews was guided by an occupational perspective, which considers the day-to-day activities that are important to an individual. RESULTS Twenty adults with an adult-acquired non-dysvascular amputation (e.g., trauma, cancer or infection) were interviewed. Following thematic analysis, two main themes were developed: (1) sense of self expressed through occupations; and (2) sense of belonging with others influenced by occupations. Participants expressed the way they felt about themselves through their activities and placed high value on whether they could participate in certain occupations. Participants also described how their sense of belonging was changed through the context of their changing occupations. CONCLUSION The findings from this work can be leveraged by clinicians and researchers alike to improve care for this population. Rehabilitation programs should consider interventions and programming that help to restore occupations or develop new ones given the importance placed on occupations by persons with non-dysvascular LLA.
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Affiliation(s)
- Stephanie R Cimino
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sander L Hitzig
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Occupational Therapy and Occupational Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Vera Fung
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Katie N Dainty
- North York General Hospital, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Crystal MacKay
- Westpark Health Care Centre, Toronto, ON, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Joanna E M Sale
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Amanda L Mayo
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sara J T Guilcher
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
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Hitzig SL, Donaghy S, Wang S, Tay C, Cimino SR, Szkudlarek S, Werle S, Lopez-Pollard W, Linkewich E. The influence of food packaging on independent eating in individuals with hand impairments. Disabil Rehabil 2023:1-8. [PMID: 37623427 DOI: 10.1080/09638288.2023.2247982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/30/2022] [Revised: 08/06/2023] [Accepted: 08/10/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE Hand function plays a major role in the successful performance of activities of daily living (ADLs), such as eating. There is a lack of data exploring how persons with hand impairment manage food packaging and its impact on eating. METHODS A convenience sample of 12 inpatients with hand impairments undergoing rehabilitation participated in a qualitative interview where they were asked questions about their experiences with food packaging and independent eating, and asked to open a set of commonly available hospital food packages, first without any tools/aids, and then with tools/aids if they desired to use them. Audio data were transcribed and cross-referenced with video data. Data were analyzed using codebook thematic analysis. RESULTS An overarching theme of "Messiness" along with four major themes were identified: a) Inaccessibility of food packaging; b) Lack of control; c) Eating avoidance; and d) Preferred packaging and strategies. CONCLUSIONS Inpatients with a hand impairment often experience several challenges with independent eating while in hospital as a result of their difficulties with hard to open food packaging. A greater consideration of universal design principles may be relevant for designers to make packaging more accessible.
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Affiliation(s)
- Sander L Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Siobhan Donaghy
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Susan Wang
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Candice Tay
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Stephanie R Cimino
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Stuart Werle
- Faculty of Design, OCAD University, Toronto, ON, Canada
| | - Wendy Lopez-Pollard
- St. John's Rehab, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Practice-Based Research, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Elizabeth Linkewich
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Practice-Based Research, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Guilcher SJ, Cadel L, He A, Cimino SR, Ahmed M, Ho CH, Hitzig SL, McCarthy LM, Patel T, Hahn-Goldberg S, Lofters AK, Packer TL. Medication self-management toolkits for adults with multiple sclerosis: A scoping review. Explor Res Clin Soc Pharm 2023; 10:100282. [PMID: 37396110 PMCID: PMC10314208 DOI: 10.1016/j.rcsop.2023.100282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/16/2023] [Accepted: 05/22/2023] [Indexed: 07/04/2023] Open
Abstract
Background Multiple sclerosis (MS) is an autoimmune disease that is often treated with multiple medications. Managing multiple medications, also known as polypharmacy, can be challenging for persons with MS. Toolkits are instructional resources designed to promote behaviour change. Toolkits may support medication self-management for adults with MS, as they have been useful in other populations with chronic conditions. Objective The main purpose of this review was to identify and summarize medication self-management toolkits for MS, as related to the design, delivery, components, and measures used to evaluate implementation and/or outcomes. Methods A scoping review was conducted following guidelines by JBI. Articles were included if they focused on adults (18 years or older) with MS. Results Six articles reporting on four unique toolkits were included. Most toolkits were technology-based, including mobile or online applications, with only one toolkit being paper-based. The toolkits varied in type, frequency, and duration of medication management support. Varying outcomes were also identified, but there were improvements reported in symptom management, medication adherence, decision-making, and quality of life. The six studies were quantitative in design, with no studies exploring the user experience from a qualitative or mixed-methods design. Conclusions There is limited research on medication self-management toolkits among adults with MS. Future development, implementation, and evaluation mixed-methods research are needed to explore user experiences and overall design of toolkits.
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Affiliation(s)
- Sara J.T. Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario M5S3M2, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario L5B1B8, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario M5G1V7, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario M2M2G1, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario M5T3M6, Canada
| | - Lauren Cadel
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario M5S3M2, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario L5B1B8, Canada
| | - Andrea He
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario M5S3M2, Canada
| | - Stephanie R. Cimino
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario M5S3M2, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario M5G1V7, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario M2M2G1, Canada
| | - Maham Ahmed
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario M5S3M2, Canada
| | - Chester H. Ho
- Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Alberta, Edmonton, Alberta T6G2G4, Canada
| | - Sander L. Hitzig
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario M5G1V7, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario M2M2G1, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario M5G1V7, Canada
| | - Lisa M. McCarthy
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario M5S3M2, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario L5B1B8, Canada
- School of Pharmacy, University of Waterloo, Kitchener, Ontario N2G 1C5, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario M5G1V7, Canada
- Women's College Research Institute, Toronto, Ontario M5G1N8, Canada
| | - Tejal Patel
- School of Pharmacy, University of Waterloo, Kitchener, Ontario N2G 1C5, Canada
- Schlegel-University of Waterloo Research Institute of Aging, Waterloo, Ontario N2J0E2, Canada
| | - Shoshana Hahn-Goldberg
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario M5S3M2, Canada
- OpenLab, University Health Network, Toronto, Ontario M5G2C4, Canada
| | - Aisha K. Lofters
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario M5G1V7, Canada
- Women's College Research Institute, Toronto, Ontario M5G1N8, Canada
| | - Tanya L. Packer
- Schools of Occupational Therapy and Health Administration, Dalhousie University, Halifax, Nova Scotia B3H4R2, Canada
- Department of Nursing, Umeå University, Umeå, Sweden
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Cimino SR, Cadel L, Guilcher SJT, Wasilewski M, Hitzig SL. Social disconnectedness and perceived social isolation in persons with spinal cord injury/dysfunction living in the community: A scoping review. J Spinal Cord Med 2023; 46:367-389. [PMID: 36269865 PMCID: PMC10116929 DOI: 10.1080/10790268.2022.2129170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Context: Persons with spinal cord injury/dysfunction (SCI/D) are particularly at risk for social disconnectedness and/or perceived social isolation, which are key components to overall well-being. However, there is limited evidence that aims to understand these phenomena in this population.Objective: To investigate what is known about social disconnectedness and perceived social isolation for adults with SCI/D living in the community.Methods: A scoping review was conducted. A computer assisted search of four online databases was completed on all articles published until May 18th, 2021. Gray literature and key agencies were also searched for relevant documents. Two key concepts (spinal cord injury/dysfunction and social disconnectedness/perceived social isolation) and associated terms were used. All articles were double screened for inclusion by two reviewers.Results: Following deduplication, title and abstract screening and full-text screening, 37 articles met the criteria for inclusion in this review. Most of the included articles were published in North America, used quantitative methods and a cross-sectional design. Articles identified several factors that influenced social disconnectedness and perceived social isolation including participant characteristics, social support, psychological well-being, participation in activities, the built environment and physical health.Conclusion: The current literature suggests that issues with social disconnectedness and perceived social isolation exist for persons living with SCI/D in the community. More work is needed to better understand the relationship between these constructs. A more nuanced understanding can inform targeted interventions to help mitigate the impact of these phenomena on the SCI/D population.
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Affiliation(s)
- Stephanie R. Cimino
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lauren Cadel
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Sara J. T. Guilcher
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Marina Wasilewski
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sander L. Hitzig
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Hitzig SL, Rios J, Devlin M, Guilcher SJT, MacKay C, Dilkas S, Payne MW, Viana R, Kayssi A, Cimino SR, Mayo AL. Health utility in community-dwelling adults with dysvascular lower limb loss. Qual Life Res 2023:10.1007/s11136-023-03357-6. [PMID: 36757573 DOI: 10.1007/s11136-023-03357-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2023] [Indexed: 02/10/2023]
Abstract
PURPOSE Adults with dysvascular lower extremity amputation (LEA) experience a large number of secondary health conditions yet there is a gap in the literature on health utility scores for this population. A health utility score relates to a person's state of well-being, and is a single metric anchored at 0 (death) and 1 (perfect health). This study aimed to provide a descriptive account of health utility scores in community-dwelling adults with dysvascular LEA. METHODS Participants were adults with dysvascular LEA who were 3 months post-amputation. Data collected included socio-demographic characteristics, the Special Interest Group in Amputee Medicine (SIGAM) grades, the dysvascular conditions scale (DCS), which is a scale developed for this study, and the Short Form-36 (SF-36). SF-6D health utility scores were derived from the SF-36 using a software algorithm. Participants were grouped into low-impact and high-impact groups based on self-reported severity of symptoms using the DCS. Health utility scores were compared between the low-impact and high-impact groups using independent t-tests. RESULTS A total of 231 participants were enrolled in the study. The mean SF-6D health utility score was 0.689 (0.127). A significant association was found between health utility score and SIGAM grade (p < 0.001, η2 = .09). Health utility was positively associated with age (r = 0.137, p = 0.037) and months post-amputation (r = 0.141, p = 0.032), and negatively associated with DCS severity (r = -0.526, p < 0.001). Health utility scores were lower for participants in the DCS high-impact groups for conditions such as diabetes mellitus, phantom limb pain, musculoskeletal pain, back pain, psychological distress, depression, vision problems, and other pain. CONCLUSION Cost-utility analyses rely on health utility estimates and our findings provide data for future economic evaluations that may assist policy makers in evidence informed allocation of healthcare resources for this population.
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Affiliation(s)
- Sander L Hitzig
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada. .,St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. .,Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Jorge Rios
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - Sara J T Guilcher
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Crystal MacKay
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,West Park Healthcare Centre, Toronto, ON, Canada.,Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Steven Dilkas
- West Park Healthcare Centre, Toronto, ON, Canada.,Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michael W Payne
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Ricardo Viana
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Ahmed Kayssi
- Schulich Heart Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Division of Vascular Surgery, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Stephanie R Cimino
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Amanda L Mayo
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,St. John's Rehab, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Cadel L, Cimino SR, Bradley-Ridout G, Hitzig SL, Packer TL, McCarthy LM, Patel T, Lofters AK, Hahn-Goldberg S, Ho CH, Guilcher SJT. A scoping review of medication self-management intervention tools to support persons with traumatic spinal cord injury. PLoS One 2023; 18:e0284199. [PMID: 37079514 PMCID: PMC10118177 DOI: 10.1371/journal.pone.0284199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/25/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Persons with traumatic spinal cord injury (SCI) use multiple medications (polypharmacy) to manage the high number of secondary complications and concurrent conditions. Despite the prevalence of polypharmacy and challenges associated with managing medications, there are few tools to support medication self-management for persons with SCI. OBJECTIVE The purpose of this scoping review was to identify and summarize what is reported in the literature on medication self-management interventions for adults with traumatic SCI. METHODS Electronic databases and grey literature were searched for articles that included an adult population with a traumatic SCI and an intervention targeting medication management. The intervention was required to incorporate a component of self-management. Articles were double screened and data were extracted and synthesized using descriptive approaches. RESULTS Three studies were included in this review, all of which were quantitative. A mobile app and two education-based interventions to address self-management of SCI, medication management, and pain management, respectively, were included. Only one of the interventions was co-developed with patients, caregivers, and clinicians. There was minimal overlap in the outcomes measured across the studies, but learning outcomes (e.g., perceived knowledge and confidence), behavioural outcomes (e.g., management strategies, data entry), and clinical outcomes (e.g., number of medications, pain scores, functional outcomes) were evaluated. Results of the interventions varied, but some positive outcomes were noted. CONCLUSIONS There is an opportunity to better support medication self-management for persons with SCI by co-designing an intervention with end-users that comprehensively addresses self-management. This will aid in understanding why interventions work, for whom, in what setting, and under what circumstances.
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Affiliation(s)
- Lauren Cadel
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Stephanie R Cimino
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - Sander L Hitzig
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tanya L Packer
- Schools of Occupational Therapy and Health Administration, Dalhousie University, Halifax, NS, Canada
- Department of Rehabilitation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Lisa M McCarthy
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
- Schlegel-University of Waterloo Research Institute of Aging, Waterloo, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Women's College Research Institute, Toronto, ON, Canada
| | - Tejal Patel
- Schlegel-University of Waterloo Research Institute of Aging, Waterloo, ON, Canada
- University of Waterloo School of Pharmacy, Kitchener, ON, Canada
| | - Aisha K Lofters
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Women's College Research Institute, Toronto, ON, Canada
| | - Shoshana Hahn-Goldberg
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- OpenLab, University Health Network, Toronto, ON, Canada
| | - Chester H Ho
- Division of Physical Medicine & Rehabilitation, Department of Clinical Neurosciences, Foothills Medical Centre, Calgary, AB, Canada
| | - Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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Cadel L, Cimino SR, Bradley-Ridout G, Hitzig SL, Patel T, Ho CH, Packer TL, Lofters AK, Hahn-Goldberg S, McCarthy LM, Guilcher SJT. Medication self-management interventions for persons with stroke: A scoping review. PLoS One 2023; 18:e0285483. [PMID: 37200316 DOI: 10.1371/journal.pone.0285483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/25/2023] [Indexed: 05/20/2023] Open
Abstract
The use of multiple medications is common following a stroke for secondary prevention and management of co-occurring chronic conditions. Given the use of multiple medications post-stroke, optimizing medication self-management for this population is important. The objective of this scoping review was to identify and summarize what has been reported in the literature on interventions related to medication self-management for adults (aged 18+) with stroke. Electronic databases (Ovid Medline, Ovid Embase, EBSCO CINAHL, Ovid PsycINFO, Web of Science) and grey literature were searched to identify relevant articles. For inclusion, articles were required to include an adult population with stroke undergoing an intervention aimed at modifying or improving medication management that incorporated a component of self-management. Two independent reviewers screened the articles for inclusion. Data were extracted and summarized using descriptive content analysis. Of the 56 articles that met the inclusion criteria, the focus of most interventions was on improvement of secondary stroke prevention through risk factor management and lifestyle modifications. The majority of studies included medication self-management as a component of a broader intervention. Most interventions used both face-to-face interactions and technology for delivery. Behavioural outcomes, specifically medication adherence, were the most commonly targeted outcomes across the interventions. However, the majority of interventions did not specifically or holistically target medication self-management. There is an opportunity to better support medication self-management post-stroke by ensuring interventions are delivered across sectors or in the community, developing an understanding of the optimal frequency and duration of delivery, and qualitatively exploring experiences with the interventions to ensure ongoing improvement.
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Affiliation(s)
- Lauren Cadel
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Stephanie R Cimino
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - Sander L Hitzig
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tejal Patel
- University of Waterloo School of Pharmacy, Kitchener, ON, Canada
- Schlegel-University of Waterloo Research Institute of Aging, Waterloo, ON, Canada
| | - Chester H Ho
- Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Tanya L Packer
- Schools of Occupational Therapy and Health Administration, Dalhousie University, Halifax, NS, Canada
- Department of Rehabilitation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Aisha K Lofters
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Women's College Research Institute, Toronto, ON, Canada
| | - Shoshana Hahn-Goldberg
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- OpenLab, University Health Network, Toronto, ON, Canada
| | - Lisa M McCarthy
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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9
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MacKay C, Lee L, Best K, Campbell J, Cimino SR, Cowley H, Delvin M, Dilkas S, Landry M, Marzolini S, Mayo A, Oh P, Payne M, Viana R, Totosy de Zepetnek J, Domingo A, King S, Miller WC, Robert M, Tang A, Zidarov D, Zucker-Levin A, Hitzig SL. Developing a research agenda on exercise and physical activity for people with limb loss in Canada. Disabil Rehabil 2022; 44:8130-8138. [PMID: 34843420 DOI: 10.1080/09638288.2021.2003877] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE There is a lack of high-quality evidence about the effects of exercise or physical activity interventions for adults with lower limb amputations (LLAs). A planning meeting involving stakeholders (i.e., people with LLA, community advocates, health care providers, researchers) was organized to identify key research priorities related to exercise and physical activity for people with LLAs. METHODS We used a collaborative prioritized planning process with a pre-meeting survey and 2-day virtual meeting that included: identification and prioritization of challenges or gaps; identification and consolidation of solutions; and action planning. This process integrated a modified Delphi approach, including anonymous feedback in two surveys. RESULTS Thirty-five stakeholders participated. Six challenges related to exercise and physical activity for people with LLA were prioritized. One solution was prioritized for each challenge. After consolidation of solutions, participants developed five research action plans for research including: developing an on-line interface; developing and evaluating peer-support programs to support physical activity; examining integration of people with LLA into cardiac rehabilitation; development and evaluation of health provider education; and determining priority outcomes related to physical activity and exercise. CONCLUSIONS This collaborative process resulted in an action plan for amputation research and fostered collaborations to move identified priorities into action.IMPLICATIONS FOR REHABILITATIONLower limb amputations impact mobility leading to lower levels of physical activity.There are research gaps in our understanding of the effects of exercise or physical activity interventions for adults with lower limb amputations.Through a collaborative planning process, participants prioritized research directions on physical activity and exercise for people with LLA to advance research in the field.Action plans for research focused on developing online resources, peer support, cardiac rehabilitation for people with LLA, health provider education and determining priority outcomes related to physical activity and exercise.
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Affiliation(s)
- Crystal MacKay
- West Park Healthcare Centre, Toronto, Canada.,Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Leanna Lee
- West Park Healthcare Centre, Toronto, Canada
| | - Krista Best
- Faculté de médecine, Universite Laval, Quebec City, Canada
| | | | - Stephanie R Cimino
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | | | | | - Steven Dilkas
- West Park Healthcare Centre, Toronto, Canada.,Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Mireille Landry
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Women's College Hospital, Toronto, Canada
| | - Susan Marzolini
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
| | - Amanda Mayo
- Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.,Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Paul Oh
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
| | - Michael Payne
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Canada.,Parkwood Institute, St. Joseph's Health Care, London, Canada
| | - Ricardo Viana
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Canada.,Parkwood Institute, St. Joseph's Health Care, London, Canada
| | | | | | | | - William C Miller
- GF Strong Rehab Centre, Vancouver, Canada.,Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Maxime Robert
- Faculté de médecine, Universite Laval, Quebec City, Canada
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Diana Zidarov
- Faculté de Médecine, École de réadaptation, Université de Montréal, Montréal, Canada.,Centre de Recherche Interdisciplinaire en Réadaptation (CRIR), Institut de réadaptation Gingras-Lindsay-de-Montréal, Montréal, Canada
| | - Audrey Zucker-Levin
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Canada
| | - Sander L Hitzig
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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10
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Cimino SR, Vijayakumar A, MacKay C, Mayo AL, Hitzig SL, Guilcher SJT. Sex and gender differences in quality of life and related domains for individuals with adult acquired lower-limb amputation: a scoping review. Disabil Rehabil 2022; 44:6899-6925. [PMID: 34546799 DOI: 10.1080/09638288.2021.1974106] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE To understand what is known about sex and gender differences in quality of life (QoL) and related domains for individuals with an adult acquired lower limb amputation (LLA). METHODS A computer-assisted literature search of four online databases was completed. Articles were included if they incorporated sex or gender as part of their data analysis with a focus on QoL-related domains. Data were analyzed using descriptive numerical analysis and thematic analysis. RESULTS One hundred and eleven articles were included in this review. Women were under-represented across studies, with most of the participants being men. No articles described the inclusion of trans or non-binary persons. Differences by sex or gender were reported by 66 articles. Articles reporting on gender seldom provided descriptions of how gender was defined. Overall, women/females seemed to have worse outcomes in terms of prosthesis-related outcomes, mental health, and return to occupations. CONCLUSION Articles included in this review were not clear with how gender was defined. In order for more targeted interventions that account for sex and gender differences, studies need to be more forthcoming about how they use and define gender. Future research should seek to include gender non-conforming participants to identify additional needs.Implications for rehabilitationSex and gender are important constructs that influence outcomes following lower limb amputation.Rehabilitation professionals should consider sex and gender-specific outcomes when tailoring programs to ensure ethical clinical care.
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Affiliation(s)
- Stephanie R Cimino
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | | | - Crystal MacKay
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,West Park Health Care Centre, Toronto, Canada.,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Amanda L Mayo
- St. John's Rehabilitation Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.,Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sander L Hitzig
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,St. John's Rehabilitation Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sara J T Guilcher
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada
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11
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Mayo AL, Viana R, Dilkas S, Payne M, Devlin M, MacKay C, Cimino SR, Guilcher SJT, Hitzig SL. Self-reported health condition severity and ambulation status postmajor dysvascular limb loss. Prosthet Orthot Int 2022; 46:239-245. [PMID: 35315834 DOI: 10.1097/pxr.0000000000000106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 01/04/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Individuals with dysvascular lower limb amputations (LLA) secondary to complications of peripheral arterial disease (PAD) and/or diabetes have high rates of co-morbidities. OBJECTIVES To describe self-reported health condition severity and their association with sociodemographic factors and ambulations status among individuals with major dysvascular LLA. STUDY DESIGN Cross sectional telephone and in person survey with adults with major dysvascular LLA living in the community setting in Ontario, Canada. METHODS Survey by phone/in person, and completion of the Dysvascular Conditions Scale and Special Interest in Amputee Medicine Mobility (SIGAM) Grade by each participant. RESULTS Two hundred thirty-one individuals with major dysvascular LLAs participated in the study. Most of them were male individuals (80.5%) and had undergone a transtibial amputation (74%). On average, participants were 3.4 years postlimb loss and had five identified Dysvascular Conditions Scale health conditions. The top five reported health conditions were diabetes, hypertension, phantom limb pain, musculoskeletal pain, and back pain. With the exclusion of hypertension, these conditions were also perceived by respondents to be quite severe for their impact. Vision impairment was also rated as being severe in nature. Lower mobility Special Interest Group in Amputee Medicine grades were associated with higher health condition severity scores. CONCLUSIONS Individuals with dysvascular limb loss experience high multimorbidity with perceived negative impact on their overall wellness and function. Rehabilitation and self-management strategies to help patients with dysvascular LLAs to manage chronic health conditions may improve outcomes.
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Affiliation(s)
- Amanda L Mayo
- St. John's Rehab, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Division of Physical Medicine & Rehabilitation, Temerty Faculty of Medicine, University of Toronto Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ricardo Viana
- Parkwood Institute, St. Joseph's Health Care London, London, Ontario, Canada
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Steven Dilkas
- Division of Physical Medicine & Rehabilitation, Temerty Faculty of Medicine, University of Toronto Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Michael Payne
- Parkwood Institute, St. Joseph's Health Care London, London, Ontario, Canada
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | | | - Crystal MacKay
- West Park Healthcare Centre, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie R Cimino
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sara J T Guilcher
- West Park Healthcare Centre, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Sander L Hitzig
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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12
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Hitzig SL, Dilkas S, Payne MW, MacKay C, Viana R, Devlin M, Cimino SR, Guilcher SJT, Mayo AL. Examination of social disconnectedness and perceived social isolation on health and life satisfaction in community-dwelling adults with dysvascular lower limb loss. Prosthet Orthot Int 2022; 46:155-163. [PMID: 35412523 DOI: 10.1097/pxr.0000000000000069] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 08/09/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND People with physical disabilities are at risk for social isolation, which has been shown to negatively influence health and well-being. OBJECTIVES The purpose of this study was to examine the association of social disconnectedness and perceived social isolation (PSI) on health-related quality of life (HrQoL) and life satisfaction in adults with dysvascular lower extremity amputation (LEA). STUDY DESIGN Cross-sectional survey. METHODS Data were collected from community-dwelling adults with dysvascular major LEA (N = 231). The main outcome measures were the Short-Form 36 and the Life Satisfaction-11. Other measures were used to quantify comorbidities/secondary health conditions, PSI, social disconnectedness, self-efficacy, social support, and social engagement. Three hierarchical regression models were conducted to predict (1) physical HrQoL, (2) mental HrQoL, and (3) life satisfaction. RESULTS Approximately one-third of the sample had high levels of social disconnectedness and PSI. The regression model predicting physical HrQoL accounted for 47% of the variance and only found that higher levels of mobility, lower perceived impact of comorbidities/conditions, and higher levels of social engagement and self-efficacy were associated with better physical HrQoL. A model predicting mental HrQoL accounted for 36% of the variance, with older age, lower PSI, and higher levels of self-efficacy being significant predictors. Finally, the model predicting life satisfaction accounted for 56% of the variance, with older age, lower perceived impact of comorbidities/conditions, and higher self-efficacy remaining as significant predictors. CONCLUSIONS These findings highlight that one-third of our sample were at risk for being socially isolated and that PSI was influential on mental HrQoL and life satisfaction. There is a need for approaches to address social isolation for people with dysvascular LEA living in the community to optimize their long-term health and well-being.
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Affiliation(s)
- Sander L Hitzig
- St John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Steven Dilkas
- West Park Healthcare Centre, Toronto, Ontario, Canada
- Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael W Payne
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Crystal MacKay
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- West Park Healthcare Centre, Toronto, Ontario, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ricardo Viana
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | | | - Stephanie R Cimino
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sara J T Guilcher
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, St Michael's Hospital, Toronto, Ontario, Canada
| | - Amanda L Mayo
- St John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- St John's Rehabilitation Hospital, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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13
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Wasilewski MB, Cimino SR, Kokorelias KM, Simpson R, Hitzig SL, Robinson L. Providing Rehabilitation to Patients Recovering from COVID-19: A Scoping Review. PM R 2021; 14:239-258. [PMID: 34240576 PMCID: PMC8441670 DOI: 10.1002/pmrj.12669] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 06/02/2021] [Accepted: 06/25/2021] [Indexed: 11/08/2022]
Abstract
Objective To synthesize the nature and extent of research on rehabilitation care provision to patients with COVID‐19. Specifically, we aimed to (1) describe the impact of COVID on patients and associated rehabilitation needs, (2) outline the adaptations and preparations required to enable the provision of COVID rehabilitation, (3) describe the types of rehabilitation services and treatments provided to COVID patients, and (4) identify barriers and facilitators to delivering COVID rehabilitation. Literature Survey We searched Medline, PsychINFO, Embase, and CINAHL on June 26, 2020 using key words such as “rehabilitation,” “physical medicine,” “allied health professionals,” and variations of “COVID.” The search was updated on October 13, 2020. We included articles published in English and that focused on some aspect of COVID rehabilitation for adults. We excluded articles focused on pediatric populations and those not focused (or minimally focused) on rehabilitation for COVID patients. Methodology Data were charted based on article type (ie, primary data, secondary data, guidelines). Key information extracted included (1) COVID sequelae; (2) rehabilitation adaptations; (3) structure, function, and content of rehabilitation services/programs; (4) facilitators and/or barriers to providing COVID rehabilitation; and (5) recommendations for COVID rehabilitation programming. Data were synthesized narratively. Synthesis In total, 128 articles were included in the review that reported primary data (n = 33), secondary data (n = 82), and clinical practice/patient self‐management guidelines (n = 13). Evidence begins to suggest that rehabilitation is necessary and valuable for addressing COVID‐related declines in health, function, and well‐being. Most articles recommended that an individualized rehabilitation program be provided across the continuum of care by an interdisciplinary team of professionals and that the nature and extent of rehabilitation be informed by the care setting and COVID severity. Most issues that challenged COVID rehabilitation delivery were directly addressed by the facilitators and adaptations identified. Conclusions Future recommendations include a greater emphasis on the psychosocial aspects of COVID rehabilitation, inclusion of families in rehabilitation planning, and the use of qualitative approaches to complement clinical data.
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14
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Hitzig SL, Cimino SR, Alavinia M, Bassett-Gunter RL, Craven BC, Guilcher SJT. Examination of the Relationships Among Social Networks and Loneliness on Health and Life Satisfaction in People with Spinal Cord Injury/Dysfunction. Arch Phys Med Rehabil 2021; 102:2109-2116.e1. [PMID: 33932359 DOI: 10.1016/j.apmr.2021.03.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 07/23/2020] [Revised: 02/12/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the associations among social networks and loneliness on health and life satisfaction in adults with chronic spinal cord injury/dysfunction (SCI/D). DESIGN Cross-sectional telephone survey study. SETTING Tertiary spinal cord injury rehabilitation center in Ontario, Canada. PARTICIPANTS Community-dwelling adults with chronic SCI/D (N=170). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The main outcome measures were the Short-Form 36 to assess health and the Life Satisfaction-11 to assess life satisfaction. RESULTS A hierarchical regression model predicting physical health accounted for 24% (P<.001) of the variance. The only social network variable to significantly contribute to the model was having a higher proportion of network members living in one's household (P<.05). A model predicting mental health accounted for 44% (P<.001) of the variance, with having a higher proportion of network members living in one's household (P<.05) and lower feelings of loneliness (P<.001) associated with better mental health. Finally, the model predicting life satisfaction accounted for 62% (P<.001) of the variance, with lower greater levels of social network intimacy (P<.01) and lower feelings of loneliness (P<.001) being significant predictors. CONCLUSIONS These findings highlight the importance of having access to network members in one's home for better physical and mental health after SCI/D as well as the negative association between loneliness and mental health and life satisfaction. There is a need for approaches to ensure that people with SCI/D in the community feel supported to mitigate feelings of loneliness to optimize their health and wellbeing.
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Affiliation(s)
- Sander L Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario; Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario.
| | - Stephanie R Cimino
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Mohammad Alavinia
- Neural Engineering & Therapeutics Team, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario; Division of Physiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario
| | | | - B Catharine Craven
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario; Neural Engineering & Therapeutics Team, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario; Division of Physiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
| | - Sara J T Guilcher
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
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15
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Cadel L, Cimino SR, Rolf von den Baumen T, James KA, McCarthy L, Guilcher SJT. Medication Management Frameworks in the Context of Self-Management: A Scoping Review. Patient Prefer Adherence 2021; 15:1311-1329. [PMID: 34163148 PMCID: PMC8216068 DOI: 10.2147/ppa.s308223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/29/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Many individuals take multiple prescribed and unprescribed medications, also known as polypharmacy, which can be problematic. Improving medication self-management is important; however, most medication management frameworks focus on adherence and limit the integration of the core components of self-management. Therefore, the objective of this scoping review was to identify what is reported in the literature on medication management frameworks or models within the context of self-management. METHODS Electronic databases (Medline, Embase, CINAHL and Cochrane Library) and grey literature (healthcare and government organization websites) were searched for articles that described a framework or model developed or adapted for medication management, included components of self-management and was published from January 2000 to January 2020. During the screening of titles and abstracts, 5668 articles were reviewed, 5242 were excluded and 426 were then assessed at the full-text level. Thirty-nine articles met the eligibility criteria and were included in the review. RESULTS About half of the frameworks were newly developed (n=20), while the other half were adapted from, or applied, a previous model or framework (n=19). The majority of frameworks focused on medication adherence and most of the self-management domains were categorized as medical management, followed by emotional and role management. CONCLUSION Medication self-management is a complex process and often impacts multiple areas of an individual's life. It is important for future frameworks to incorporate a comprehensive, holistic conceptualization of self-management that is inclusive of the three self-management domains - medical, emotional and role management.
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Affiliation(s)
- Lauren Cadel
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Stephanie R Cimino
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- St. John’s Rehab, Sunnybrook Health Sciences Centre, North York, Ontario, Canada
| | | | - Kadesha A James
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Lisa McCarthy
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
| | - Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Correspondence: Sara JT Guilcher Leslie Dan Faculty of Pharmacy, 144 College Street, Room 604, Toronto, ON, M5S 3M2, CanadaTel + 1-416-946-7020 Email
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16
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Cimino SR, Hitzig SL, Craven BC, Bassett-Gunter RL, Li J, Guilcher SJT. An exploration of perceived social isolation among persons with spinal cord injury in Ontario, Canada: a qualitative study. Disabil Rehabil 2020; 44:3400-3409. [PMID: 33356633 DOI: 10.1080/09638288.2020.1861485] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To advance the understanding of perceived social isolation among persons with spinal cord injury (SCI), the objectives of the present study were to explore: (1) experiences of perceived social isolation and (2) factors that contribute to perceived social isolation. METHODS Interpretive description qualitative methodology was used to conduct semi-structured interviews with 30 individuals with SCI from across Ontario (Canada) from November 2016 to August 2017. Data were analyzed using thematic analysis. RESULTS Participants identified disruption to social networks that seemed to impact perceived social isolation. Five major themes were identified: (1) impact on structure and frequency of social network; (2) importance of feeling heard; (3) importance of employment, hobbies, and sports; (4) need to improve physical accessibility and built environment; and (5) individual characteristics. Changes in quality of social networks, rather than size, contributed to greater feelings of perceived social isolation. The built environment, maintenance of employment, hobbies, and sports, social media, and technology use, as well as individual traits, were also found to impact perceived social isolation. CONCLUSION Future research should focus on the development of programs to help maintain or improve social network quality for persons with SCI to minimize the impact of perceived social isolation.IMPLICATIONS FOR REHABILITATIONPerceived social isolation, resulting from physical and environmental barriers, is a challenge that is faced by many individuals who are living in the community with a spinal cord injury (SCI).Rehabilitation and community programs should utilize an individualized approach to find solutions to challenges faced by this population to prevent the effects of perceived social isolation.Education on how to adapt to changes in social network, together with the provision of access to peer-to-peer support groups, and SCI specific return to work or leisure programs, is recommended as an essential component of rehabilitation.
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Affiliation(s)
- Stephanie R Cimino
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sander L Hitzig
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, Faculty of Medicine,, University of Toronto, Toronto, Canada
| | - B Catharine Craven
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,Neural Engineering & Therapeutics Team, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.,Division of Physiatry, Department of Medicine, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | | | - Joyce Li
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada
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MacKay C, Cimino SR, Guilcher SJT, Mayo AL, Devlin M, Dilkas S, Payne MW, Viana R, Hitzig SL. A qualitative study exploring individuals’ experiences living with dysvascular lower limb amputation. Disabil Rehabil 2020; 44:1812-1820. [DOI: 10.1080/09638288.2020.1803999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Crystal MacKay
- West Park Healthcare Centre, Toronto, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Stephanie R. Cimino
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sara J. T. Guilcher
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
- Leslie Dan Faculty of Pharmacy, Faculty of Medicine, University of Toronto, Toronto, Canada
- Institute of Health Policy Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Canada
- MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Canada
| | - Amanda L. Mayo
- St. John’s Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
- Sunnybrook Health Sciences Centre, Toronto, Toronto, Canada
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Toronto, Canada
| | | | - Steven Dilkas
- West Park Healthcare Centre, Toronto, Canada
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Toronto, Canada
| | - Michael W. Payne
- Parkwood Institute, St. Joseph’s Healthcare, London, Canada
- Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Ricardo Viana
- Parkwood Institute, St. Joseph’s Healthcare, London, Canada
- Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Sander L. Hitzig
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
- St. John’s Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
- Department of Occupational Science & Occupational Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
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18
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Everall AC, Cadel L, Lofters AK, Packer TL, Hitzig SL, Patel T, Cimino SR, Guilcher SJT. An exploration of attitudes and preferences towards medications among healthcare providers and persons with spinal cord injury/dysfunction: a qualitative comparison. Disabil Rehabil 2020; 44:1252-1259. [PMID: 32755402 DOI: 10.1080/09638288.2020.1799249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To compare the attitudes and preferences of persons with spinal cord injury/dysfunction (SCI/D) and healthcare providers regarding prescription medications, over-the-counter medications, and natural health products (NHPs). MATERIALS AND METHODS A qualitative study involving semi-structured interviews with healthcare providers (n = 32) and persons with SCI/D (n = 19) in Canada. Inductive descriptive and interpretive analyses were conducted using data display matrices and a constant comparative approach. RESULTS Participants described differing perceptions of therapeutic benefits based on medication type, with shared attitudes about the therapeutic benefits of prescription medications and differing views about the effectiveness of NHPs. Despite the perceived effectiveness of prescription medications, persons with SCI/D preferred to avoid them due to concerns about side effects, safety, and stigma. Persons with SCI/D were often concerned about the long-term safety of prescription medications, whereas providers focused more on medication-related addictions. Participants discussed stigma relating to prescription medications, NHPs, and medicinal marijuana. CONCLUSION Healthcare providers and persons with SCI/D described different attitudes about and preferences for pharmacotherapeutic products, contributing to challenges in optimizing medication management. Strategies to improve medication management include shared decision-making to incorporate patient preferences into care plans and explicit discussions about long-term medication safety. Further, steps are needed to combat the stigma associated with medication use.Implications for rehabilitationFollowing a person-centered approach to shared decision-making, prescribers should initiate explicit conversations about patient medication preferences, short and long-term prescription medication side effects, and alternative treatment options.Regarding prescription medication safety, persons with spinal cord injury/dysfunction focused on the long term impact of medications, while providers focused on medication-related addictions, highlighting a disconnect that should be discussed during initiation, continuation, or discontinuation of a medication.Providers should be mindful of the stigma associated with taking multiple prescription medications, including medicinal marijuana, as well as the stigma associated with over-the-counter medications and natural health products.Providers could benefit from education about spinal cord injury/dysfunction-specific prescription medications and could benefit from increased education about natural health products.
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Affiliation(s)
- Amanda C Everall
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Lauren Cadel
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Aisha K Lofters
- Department of Family and Community Medicine, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | - Tanya L Packer
- Schools of Occupational Therapy and Health Administration, Dalhousie University, Halifax, Canada
| | - Sander L Hitzig
- Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,St. John's Rehab Research Program, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Tejal Patel
- School of Pharmacy, University of Waterloo, Kitchener, Canada
| | - Stephanie R Cimino
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.,St. John's Rehab Research Program, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, Canada
| | - Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.,Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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Hitzig SL, Mayo AL, Kayssi A, Viana R, MacKay C, Devlin M, Dilkas S, Domingo A, Hebert JS, Miller WC, Andrysek J, Azhari F, Baltzer HL, de Mestral C, Dittmer DK, Dudek NL, Grad S, Guilcher SJT, Habra N, Hunter SW, Journeay WS, Katz J, King S, Payne MW, Underwood HA, Zariffa J, Aternali A, Atkinson SL, Brooks SG, Cimino SR, Rios J. Identifying priorities and developing strategies for building capacity in amputation research in Canada. Disabil Rehabil 2020; 43:2779-2789. [PMID: 32036731 DOI: 10.1080/09638288.2020.1720831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Compared to other patient population groups, the field of amputation research in Canada lacks cohesion largely due to limited funding sources, lack of connection among research scientists, and loose ties among geographically dispersed healthcare centres, research institutes and advocacy groups. As a result, advances in clinical care are hampered and ultimately negatively influence outcomes of persons living with limb loss. OBJECTIVE To stimulate a national strategy on advancing amputation research in Canada, a consensus-workshop was organized with an expert panel of stakeholders to identify key research priorities and potential strategies to build researcher and funding capacity in the field. METHODS A modified Delphi approach was used to gain consensus on identifying and selecting an initial set of priorities for building research capacity in the field of amputation. This included an anonymous pre-meeting survey (N = 31 respondents) followed by an in-person consensus-workshop meeting that hosted 38 stakeholders (researchers, physiatrists, surgeons, prosthetists, occupational and physical therapists, community advocates, and people with limb loss). RESULTS The top three identified research priorities were: (1) developing a national dataset; (2) obtaining health economic data to illustrate the burden of amputation to the healthcare system and to patients; and (3) improving strategies related to outcome measurement in patients with limb loss (e.g. identifying, validating, and/or developing outcome measures). Strategies for moving these priorities into action were also developed. CONCLUSIONS The consensus-workshop provided an initial roadmap for limb loss research in Canada, and the event served as an important catalyst for stakeholders to initiate collaborations for moving identified priorities into action. Given the increasing number of people undergoing an amputation, there needs to be a stronger Canadian collaborative approach to generate the necessary research to enhance evidence-based clinical care and policy decision-making.IMPLICATIONS FOR REHABILITATIONLimb loss is a growing concern across North America, with lower-extremity amputations occurring due to complications arising from diabetes being a major cause.To advance knowledge about limb loss and to improve clinical care for this population, stronger connections are needed across the continuum of care (acute, rehabilitation, community) and across sectors (clinical, advocacy, industry and research).There are new surgical techniques, technologies, and rehabilitation approaches being explored to improve the health, mobility and community participation of people with limb loss, but further research evidence is needed to demonstrate efficacy and to better integrate them into standard clinical care.
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Affiliation(s)
- Sander L Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Amanda L Mayo
- Physical Medicine and Rehabilitation, St. John's Rehab Hospital, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Ahmed Kayssi
- Division of Vascular Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Ricardo Viana
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | | | | | | | | | - Jacqueline S Hebert
- Department of Medicine, Faculty of Medicine and Dentistry, Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, Canada
| | - William C Miller
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Jan Andrysek
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
| | - Fae Azhari
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Canada
| | - Heather L Baltzer
- Division of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Charles de Mestral
- St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada
| | - Douglas K Dittmer
- Physical Medicine & Rehabilitation, Grand River Hospital, Kitchener, Canada
| | - Nancy L Dudek
- Division of Physical Medicine and Rehabilitation, University of Ottawa, Ottawa, Canada
| | - Sharon Grad
- Department of Physical Medicine and Rehabilitation, Hamilton Health Sciences, McMaster University, Hamilton, Canada
| | - Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Natalie Habra
- Division of Physical Medicine and Rehabilitation, Gingras-Lindsay Montreal Rehabilitation Institute, University of Montreal, Montreal, Canada
| | - Susan W Hunter
- School of Physical Therapy, Western University, London, Canada
| | | | - Joel Katz
- Department of Psychology, Faculty of Health, York University, Toronto, Canada
| | - Sheena King
- G.F. Strong Rehabilitation Centre, Vancouver, Canada
| | - Michael W Payne
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Heather A Underwood
- Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, Canada
| | - José Zariffa
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Andrea Aternali
- Department of Psychology, Faculty of Health, York University, Toronto, Canada
| | - Samantha L Atkinson
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Stephanie G Brooks
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Stephanie R Cimino
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Jorge Rios
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
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20
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Hitzig SL, Gotlib Conn L, Guilcher SJT, Cimino SR, Robinson LR. Understanding the role of the physiatrist and how to improve the continuum of care for trauma patients: a qualitative study. Disabil Rehabil 2020; 43:2846-2853. [DOI: 10.1080/09638288.2020.1719215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Sander L. Hitzig
- St. John’s Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Lesley Gotlib Conn
- Tory Trauma Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
- Department of Anthropology, Faculty of Arts and Science, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Sara J. T. Guilcher
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
- MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Canada
| | - Stephanie R. Cimino
- St. John’s Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Lawrence R. Robinson
- St. John’s Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Toronto, Toronto, Canada
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21
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Guilcher SJT, Everall AC, Patel T, Packer TL, Hitzig SL, Cimino SR, Lofters AK. "The strategies are the same, the problems may be different": a qualitative study exploring the experiences of healthcare and service providers with medication therapy management for individuals with spinal cord injury/dysfunction. BMC Neurol 2020; 20:20. [PMID: 31941437 PMCID: PMC6961330 DOI: 10.1186/s12883-019-1550-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 11/28/2019] [Indexed: 02/01/2023] Open
Abstract
Background Persons with spinal cord injury/dysfunction (SCI/D) often take multiple medications to treat their secondary complications and chronic conditions (multimorbidity). Multiple healthcare and service providers are often involved in care, which can result in increased risk of fragmentation of care. Optimal medication therapy management (MTM) is essential to ensure therapeutic benefit from medication regimens. However, little is known about the experiences of providers in supporting persons with SCI/D with MTM. Methods Telephone interviews were conducted to explore healthcare and service providers’ experiences with MTM for persons with SCI/D. Participants were recruited through clinical organizations and researchers’ personal contacts. Participants were purposefully selected for diversity in profession and were required to be English speaking and to have provided care to at least one person with SCI/D. The qualitative interviews followed a semi-structured interview guide. Data display matrices were used in a constant comparative process for descriptive and interpretive analysis. Results Thirty-two interviews were conducted from April to December 2018. Each profession had distinct views on their roles in facilitating MTM for persons with SCI/D, which aligned with their respective scopes of practice. Shared provider tasks included tailoring medications, providing education, and exploring medication alternatives. Most participants felt that the care they provided for persons with SCI/D was similar to the care that they provided to other patients, with some differences relating to the physical limitations and medical complexity associated with SCI/D. Five factors were identified that impacted participants’ abilities to provide MTM for persons with SCI/D: patient self-management skills, provider knowledge and confidence, provider-patient relationships, interprofessional collaboration, and provider funding models including the use of technology-supported consultations. Conclusion While participants described commonalities in the barriers and enablers associated with providing MTM to persons with SCI/D and other populations, there were unique considerations identified. These SCI/D-specific considerations resulted in recommendations for improvements in MTM for this population. Future research should include perspectives from persons with SCI/D.
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Affiliation(s)
- Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada. .,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada. .,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
| | - Amanda C Everall
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Tejal Patel
- School of Pharmacy, University of Waterloo, Kitchener, Canada.,Department of Family Medicine, DeGroote School of Medicine, McMaster University, Hamilton, Canada
| | - Tanya L Packer
- Schools of Occupational Therapy and Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Sander L Hitzig
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Stephanie R Cimino
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.,St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Aisha K Lofters
- Women's College Hospital, Family Practice Health Centre, Toronto, Canada
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Cimino SR, Rios JN, Godleski M, Hitzig SL. A Scoping Review on the Long-Term Outcomes in Persons with Adult-Acquired Burn Injuries. J Burn Care Res 2019; 41:472-502. [DOI: 10.1093/jbcr/irz146] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Abstract
Adult-acquired burn injuries are a life-altering event that can lead to debilitating functional or psychological impairments. With advancements in health care resulting in decreased mortality rates, survivors of burn injuries can expect to live longer. This warrants a shift in focus to better understand what happens to adults once they are discharged from the hospital into the community. Therefore, the purpose of this scoping review was to map the literature regarding the long-term outcomes of community-dwelling adult-acquired burn survivors. A computer-assisted literature search was conducted on literature from January 1, 2000 to August 31, 2018 utilizing four large databases (MEDLINE, EMBASE, CINHAL, and PsycINFO). Articles were included if they had a minimum of five individuals with a burn injury as a result of an accidental injury who were at least 18 years of age at the time of injury. Fifty-four articles were found suitable for inclusion in this review. The majority of studies were conducted in the United States and were longitudinal in design. Four themes were apparent from the articles: postburn complications, psychosocial outcomes, quality of life, and community participation. Data are lacking with respect to outcomes more than 5 years postburn as well as qualitative research. Furthermore, more literature is needed to understand the impact of postburn complications, coping strategies, and posttraumatic growth as well as barriers to community participation. Overall, there is an emerging body of literature that describes the long-term outcomes of adult-acquired burn survivors up to 5 years postburn.
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Affiliation(s)
- Stephanie R Cimino
- St. John’s Rehab, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Jorge N Rios
- St. John’s Rehab, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Matthew Godleski
- St. John’s Rehab, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sander L Hitzig
- St. John’s Rehab, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Abstract
PURPOSE Three-dimensional (3D) printing is an innovative technology being utilized to create prostheses for individuals with limb loss. However, there is a paucity of research on the feasibility of using this technology to fabricate prostheses. A scoping review was conducted to map the literature on 3D printing and its applications in the field of amputation. MATERIALS AND METHODS Using a scoping review framework, a systematic literature search was conducted in three electronic databases (MEDLINE, EMBASE and CINAHL) for all indexed literature up to 29 June 2018. RESULTS Twenty-eight articles met the inclusion criteria. The majority of studies had small sample sizes (five participants or less; n = 20) and used a case study design (n = 17). The benefits of 3D printing technology include higher levels of customization and lower production costs. However, the functionality of 3D printed prostheses is lacking. There is also a need for more robust research designs to obtain a better understanding of the advantages and disadvantages of 3D printed prostheses and its impact on end-user outcomes. CONCLUSIONS The use of 3D printing technology has a number of benefits for improving the manufacturing process of devices for people with lower and upper limb loss. However, more research and technological advancements are required to fully understand the impact of this technology on patients and how it will affect their daily life. The long-term effects of this technology will also need to be investigated in order to produce a more sustainable alternative to traditional prostheses.IMPLICATIONS FOR REHABILITATIONThe use of 3D printing technology for the fabrication of prosthetics for persons with limb-loss has a number of promising features to improve the fitting and customization of these devices for this patient population.Although the costs of producing 3D printed devices is less expensive and burdensome than traditional approaches to manufacturing techniques, there is a need for additional technological advancements to improve the functionality of these devices.Future research needs to adopt more robust research designs with larger sample sizes to provide a better understanding of the viability of using 3D printing technology to improve patient outcomes.
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Affiliation(s)
- Danielle Ribeiro
- Department of Electrical, Computer and Biomedical Engineering, Faculty of Engineering and Architectural Science, Ryerson University, Toronto, Canada
| | - Stephanie R Cimino
- St. John's Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
| | - Amanda L Mayo
- St. John's Rehabilitation Hospital, Sunnybrook Health Sciences Centre, Toronto, Canada.,Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Matt Ratto
- Faculty of Information, University of Toronto, Toronto, Canada
| | - Sander L Hitzig
- St. John's Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada.,Faculty of Information, University of Toronto, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
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24
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Guilcher SJT, Catharine Craven B, Bassett-Gunter RL, Cimino SR, Hitzig SL. An examination of objective social disconnectedness and perceived social isolation among persons with spinal cord injury/dysfunction: a descriptive cross-sectional study. Disabil Rehabil 2019; 43:69-75. [PMID: 31130020 DOI: 10.1080/09638288.2019.1616328] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE To describe objective social disconnectedness and perceived social isolation post-spinal cord injury/dysfunction (SCI/D), and to examine associations among social disconnectedness and social isolation by sociodemographic and clinical characteristics. MATERIALS AND METHODS A telephone-based questionnaire was administered to 170 community dwelling individuals with a SCI/D. Social disconnectedness was measured by social network size, composition, and frequency of contact. Social isolation was measured using the revised three item UCLA Loneliness Scale. RESULTS Of the 170 participants, the majority were men (n = 136, 80%), had a traumatic injury (n = 149, 87.6%), and had incomplete tetraplegia (n = 58, 34%). The mean network size was 3.86 (SD = 2.0) of a maximum seven. The mean loneliness score for the sample was 4.93 (SD = 1.87). Factors associated with lower feelings of loneliness included being married, living with a higher proportion of network members, and being employed. Size of networks was not significantly associated with feelings of loneliness. CONCLUSIONS This study highlights the vulnerability for perceived social isolation among persons with SCI/D. The size of network does not seem to matter as much as the frequency and quality of social interactions. Findings reinforce the complexity of social disconnectedness and the importance in understanding the various indicators of social disconnectedness as they relate to social isolation. IMPLICATIONS FOR REHABILITATION Social relationships have been shown to be a vital component of optimal health and well-being. Individuals with a spinal cord injury/dysfunction are faced with a number of challenges in developing and maintaining social relationships and community participation. Rehabilitation professionals should encourage opportunities for social inclusion, employment and community participation to optimize health and well-being for this population.
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Affiliation(s)
- Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada
| | - B Catharine Craven
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Neural Engineering & Therapeutics Team, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.,Division of Physiatry, Department of Medicine, University of Toronto, Toronto, Canada
| | | | - Stephanie R Cimino
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Sander L Hitzig
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
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25
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Lurie RC, Cimino SR, Gregory DE, Brown SHM. The effect of short duration low back vibration on pain developed during prolonged standing. Appl Ergon 2018; 67:246-251. [PMID: 29122196 DOI: 10.1016/j.apergo.2017.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/24/2017] [Accepted: 10/09/2017] [Indexed: 06/07/2023]
Abstract
The purpose of this study was to determine if vibration, a potential method of pain management, applied to the low back could alleviate pain developed during prolonged standing. Eighteen healthy individuals participated in a 2.5-h standing task during which vibration (3-min duration) was applied at the 2-h and 2.25-h marks. During the full 2.5 h, participants recorded their perceived pain scores every 15 min using a 10 cm visual analogue scale (VAS). Following each vibration bout, those who developed low back pain (LPB) reported statistically lower VAS scores compared to prior to the vibration; however, when the vibration ceased, LBP returned to pre-vibration levels. It appears that vibration may be an effective method of alleviating LBP caused by prolonged standing; however, the effects seem to be temporary. Further research is needed to investigate the optimal vibration frequency and time period to maximize pain management effectiveness.
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Affiliation(s)
- Renée C Lurie
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, Canada
| | - Stephanie R Cimino
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, Canada
| | - Diane E Gregory
- Department of Kinesiology & Physical Education/Health Sciences, Wilfrid Laurier University, Waterloo, Canada.
| | - Stephen H M Brown
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, Canada
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Cimino SR, Beaudette SM, Brown SHM. Kinesio taping influences the mechanical behaviour of the skin of the low back: A possible pathway for functionally relevant effects. J Biomech 2017; 67:150-156. [PMID: 29276069 DOI: 10.1016/j.jbiomech.2017.12.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 06/09/2017] [Revised: 11/24/2017] [Accepted: 12/04/2017] [Indexed: 10/18/2022]
Abstract
Despite claims of functional benefits of kinesio tape application, little mechanistic evidence exists to support physiological pathways to achieve these benefits. As kinesio tape is adhered directly to the skin, it can be supposed that any pathway needs to first achieve effects at this level. To address this, two layers of the skin, the combined epidermis and dermis, as well as the hypodermis were studied. Specifically, -kinematic measures of skin surface stretch and retraction, as well as ultrasound measures of skin thickness, were made along all edges of kinesio tape applied over the low back. Results demonstrated that the more superficial skin layer (combined epidermis and dermis), but not the deeper hypodermis, was significantly stretched (p = .0001) and thinner (p = .0016) at either end of the tape, and significantly retracted (p < .0001) and thicker (p = .0001) along the lateral edges of the tape. These results were partly dependent upon spine posture; skin retraction along the tape edges was only apparent in neutral and flexed (but not extended) spine postures, while skin thinning at the tape ends was only apparent in neutral and extended (but not flexed) spine postures. Hypodermal thickness was not affected by kinesio tape application at any location or in any posture. In summary, measured deformations at the skin surface and within the epidermal and dermal regions provide plausible pathways through which kinesio tape could achieve its claimed benefits.
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Affiliation(s)
- Stephanie R Cimino
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Shawn M Beaudette
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Stephen H M Brown
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada.
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