Quality of care indices AND spinal cord injury

Goal planning is core for the delivery of the biopsychosocial model of rehabilitation and is commonly practiced in spinal cord injury (SCI) and other physical health settings. Despite a strong theoretical basis from several branches of psychology, evidence regarding specific practice, interventions and impact has yet to be established, with no universal standards in this area. Study One outlines the standards used at the National Spinal Injuries Centre (NSIC), Stoke Mandeville Hospital since the inception of the SMS-NAC and goal planning programme in 1989...

BACKGROUND: Following acquired brain injury (ABI), cognitive and physical barriers can prevent access to a previously enjoyed lifestyle, reducing quality of life. OBJECTIVE: This study aimed to examine predictors of health-related quality of life (HRQoL) in adults with ABI receiving post-acute community-based rehabilitation and disability support services, using tools developed for this population. METHODS: Retrospective cross-sectional design...

STUDY DESIGN: Cohort comparative study. OBJECTIVE: Evaluate the suitability of satisfaction scores for the assessment of quality of care and service in spinal rehabilitation. SETTING: Spinal rehabilitation department. METHODS: Fifty-two inpatients participated anonymously in a large satisfaction survey, in 2017. A questionnaire containing the same questions was completed by 96 other inpatients, whose personal details were known, admitted to the same department between 2017 and 2019...

Disrupted descending supraspinal control results in a hyper-excitable sympathetic nervous system connectome after spinal cord injury (SCI). A condition termed "autonomic dysreflexia" (AD) results, which is characterized by severe elevations in blood pressure that are life-threatening. There are no effective therapies for AD. Long-term epidural stimulation below the level of the SCI can promote functionally-relevant plasticity of volitional motor circuits, and this paradigm may prevent the hyper-excitable sympathetic connectome after SCI...

STUDY DESIGN: Narrative review. OBJECTIVES: To evaluate the availability and quality of breastfeeding guidelines for women with spinal cord injury (SCI). SETTING: International Collaboration on Repair Discoveries (ICORD), Department of Medicine, Vancouver, BC. METHODS: An environmental scan restricted to English language literature was performed to identify existing postpartum and breastfeeding guidelines. Guidelines were evaluated using a structured, validated tool (AGREE II) by 13 appraisers [medical/research experts (n = 10) and those with lived experience (n = 3)] from Vancouver and two international sites...

PURPOSE/OBJECTIVE: Spinal cord injury (SCI) often represents a significant life change, yet most individuals with SCI show resilience and positive adjustment after injury. Social support, including support from health care providers, has been associated with increased resilience among the SCI population. This study aimed to further understand health care providers' perceptions of resilience in their SCI patients, as patient-provider relationships can impact health care outcomes and overall health and well-being...

BACKGROUND: The present investigation was designed to determine cognitive performance and quality of life (QoL) in a group of elite athletes who sustained spinal cord injury (SCI). METHODS: nine participants suffering a SCI participated in the study. Different cognitive functions were evaluated through the following tests: COWAT, Digit Span, Stroop color-word and QoL through the WHOQoL-BREF scale. RESULTS: Generally, participants positively assessed their overall quality of life and health status...

BACKGROUND: Parkinson disease (PD) is a progressive neurological disease resulting in motor impairments, postural instability, and gait alterations which may result in self-care limitations and loss of mobility reducing quality of life. OBJECTIVE: This study's purpose was to determine the impact of a community-based boxing program on gait parameters, dual task and backwards walking in individuals with PD. METHODS: This study included 26 community dwelling individuals with PD who participated in 12-week boxing classes (1 hour, 2 times a week)...

OBJECTIVE: To describe the development of structure, process, and outcome indicators aimed to advance the quality of Reaching, Grasping & Manipulation (RG&M) rehabilitation for Canadians living with spinal cord injury or disease (SCI / D). METHOD: Upper extremity rehabilitation experts developed a framework of indicators for evaluation of RG&M rehabilitation quality. A systematic search of the literature identified potential upper extremity indicators that influence RG&M outcomes...

CONTEXT: Although self-management is linked to reduced secondary health complications (SHCs) and enhanced overall quality of life post-spinal cord injury or disease (SCI/D), it is poorly integrated into the current rehabilitation process. Promoting self-management and assuring equity in care delivery is critical. Herein, we describe the selection of Self-Management structure, process and outcome indicators for adults with SCI/D in the first 18 months after rehabilitation admission. METHODS: Experts in self-management across Canada completed the following tasks: (1) defined the Self-Management construct; (2) conducted a systematic search of available outcomes and their psychometric properties; and (3) created a Driver diagram summarizing available evidence related to Self-Management...

Community participation following spinal cord injury/disease (SCI/D) can be challenging due to associated primary impairments and secondary health conditions as well as difficulties navigating both the built and social-emotional environment. To improve the quality of SCI/D rehabilitation care to optimize community participation, the SCI-High Project developed a set of structure, process and outcome indicators for adults with SCI/D in the first 18 months after rehabilitation admission. A pan-Canadian Working Group of diverse stakeholders: (1) defined the community participation construct; (2) conducted a systematic review of available outcomes and their psychometric properties; (3) constructed a Driver diagram summarizing available evidence associated with community participation; and (4) prepared a process map...

CONTEXT: Employment and Return to Work (RTW) rates following spinal cord injury/disease (SCI/D) are low due to individual and impairments characteristics, secondary health conditions, social and environmental barriers, prior work experience, workplace supports and resources, and physical or psychosocial work demands. To improve RTW, the SCI-High Project team developed a set of Employment structure, process, and outcome indicators for adults with SCI/D in the first 18 months after rehabilitation admission...

CONTEXT: Dedicated implementation efforts are critical to bridging the gaps between current practices and best practices. A quality improvement collaborative (QIC), the Spinal Cord Injury Implementation and Evaluation Quality Care Consortium (SCI IEQCC), was established to meet this need, bringing together a network of clinicians and administrators to systematically improve the quality and equity of tertiary spinal cord injury or disease (SCI/D) rehabilitation care in Ontario, Canada...

OBJECTIVE: Neuropathic pain is complex and often refractory. Clinical hypnosis has emerged as a viable treatment for pain. This scoping review is the first comprehensive review of hypnosis for chronic neuropathic pain. It critically assesses available evidence noting practice implications, literature gaps, and future research opportunities. SUBJECTS: Individuals with chronic neuropathic pain treated with hypnosis. METHODS: Following PRISMA guidelines, we searched PubMed, CINAHL, Embase, and PsycInfo for studies for which the intervention and primary outcome(s) were associated with hypnosis and neuropathic pain, respectively...

PURPOSE: To describe the usual bowel care regimes of people living in the community with spinal cord injury and factors important for integrating bowel care into everyday life. METHODS AND MATERIALS: Descriptive and interpretive thematic analysis of transcribed semi-structured interviews with 11 men living with spinal cord injury, aged 23-77 years, 8-45 years post injury. RESULTS: Participants had different levels and types of injuries...

OBJECTIVE: To investigate the effects of community transition programs for adults with traumatic spinal cord injury (tSCI) on hospital readmissions (HR) and quality of life (QOL). DATA SOURCES: Seven databases (PubMed, Embase, CINAHL, Google Scholar, the Joanna Briggs Institute database, OTseeker, and PEDro) and reference lists of relevant articles were searched from inception through March 2020. STUDY SELECTION: Original research studies were included that 1) evaluated interventions designed to support individuals ages 18-65 with newly acquired tSCI in navigating the transition from sub-acute care to the community and 2) reported data for QOL or HR outcomes...

BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has become the standard of care for thoracic aortic aneurysms and increasingly for blunt thoracic aortic injury (BTAI). Postoperative complications, including spinal cord ischemia and paraplegia, have been shown to be less common with elective TEVAR than with open thoracic or thoracoabdominal repair. Although small cohort studies exist, the postoperative complications of endovascular repair of traumatic aortic injury have not been described through large data set analysis...

CONTEXT: The COVID-19 pandemic has forced people to maintain social distance and to refrain from going out. As a result, home-based patients with spinal cord injuries (SCI) are not only less able to go out, but they may have difficulty in easily receiving long-term care services. There are concerns that their health-related quality of life (HRQOL) may have deteriorated. We aimed to clarify the effect of the COVID-19 pandemic on HRQOL in home-based patients with SCI.In June 2020, when the COVID-19 pandemic was finally settling down in Japan, we conducted a mail survey of 266 patients with SCI regarding changes in the frequency of going out, the long-term care services, and their HRQOL due to the COVID-19 pandemic...

OBJECTIVES: To describe the association between sociodemographic and spinal cord injury characteristics, of people living with spinal cord injury, and participation and quality of life, and to study the association between participation and quality of life in this group of people. DESIGN: Persons registered in the Norwegian Spinal Cord Injury Registry after post-acute rehabilitation between 2011 and 2017 were invited to participate in a survey in 2019 when they were in a community setting...

AIM: This study aimed to explore perceptions of people with spinal cord injuries regarding the information they received during their rehabilitation programme on post-injury sexual functioning. BACKGROUND: Spinal cord injury is a traumatic, life-altering event that is associated with loss of motor and sensory function and sexual impairment. Existing evidence suggests that sexual issues are poorly handled during the rehabilitation phase of the patient's journey. DESIGN: A descriptive qualitative design was utilized in this study...