scholarly journals Environmental factors influencing the prevention of secondary health conditions among people with spinal cord injury, South Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252280
Author(s):  
Sonti Pilusa ◽  
Hellen Myezwa ◽  
Joanne Potterton

Background The environment where people live, work or play can influence health and disability outcomes. People with spinal cord injury are at risk for secondary health conditions, with this increasing readmission rates and decreasing quality of life. Studies on preventative care for secondary health conditions and factors influencing the prevention of secondary health conditions are scarce in low to middle-income countries. Aim To explore environmental factors influencing the prevention of secondary health conditions in people with spinal cord injury. Setting This study was based at a public rehabilitation hospital, South Africa. Methods Explorative qualitative design was used. Semi-structured interviews were conducted with 21 therapists, 17 people with a spinal cord injury and six caregivers. The interviews were transcribed verbatim. Analysis was conducted using content analysis. Results The categories that emerged included the impact of social support, inaccessible built environment and transport system, and an inefficient health care system. Sub-categories for the inefficient health care systems were: Shortage of resources, health workers lack of knowledge on prevention of secondary health conditions and inadequate patient care approach. Conclusion Environmental factors influencing the prevention of secondary health conditions are complex and multifactorial. When developing rehabilitation and prevention programmes, environmental factors must be considered.

2019 ◽  
Author(s):  
SONTI PILUSA ◽  
Myezwa Hellen ◽  
Potterton Joanne

Abstract Background Long-term rehabilitation that includes preventive care for people with spinal cord injury is key to promoting health. There is evidence that secondary health conditions (SHCs) are prevalent complications across the continuum of care for people with spinal cord injury, leading to recurrent hospitalization and poor quality of life. In order to develop a context-based prevention model of care and strategies in South Africa, there is a need to understand the lived experiences of people with spinal cord injury (SCI).Aim To describe people with spinal cord injury’s experiences of secondary health conditions and the impact these have on their wellbeing.Methods A qualitative descriptive design using semi-structured interviews was adopted. Purposive sampling was used to collect data from 17 participants with SCI who attend outpatient medical care at a tertiary rehabilitation hospital in Gauteng, South Africa. Primary data were collected from August 2018-July 2019. All interviews were transcribed verbatim and analysed using a thematic analysis approach.Results People with spinal cord injury experience a range of secondary health conditions, of which pain, bowel and bladder issues were the most common. The presence of SHCs had an impact on the psychological, physical and social wellbeing of the participants.Conclusion There is a need for prevention interventions (health education and screening) for SHCs throughout the continuum of care and at all levels of prevention. Further research on factors influencing the prevention and management of SHCs is needed.


2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Nor Hanim Mohamad Hanapi ◽  
Ehsan Syukri Zainin ◽  
Mohd Harith Abdul Aziz ◽  
Daryani Darus

2021 ◽  
Author(s):  
Dima Touhami ◽  
Mirjam Brach ◽  
Stefan Essig ◽  
Elias Ronca ◽  
Isabelle Debecker ◽  
...  

Abstract Background. Inter-professional collaboration between general practitioners (GPs) and spinal cord injury (SCI) specialists is needed to improve the health outcomes of persons with SCI. The objective of this study is to understand the differences in long-term care provision by GPs and SCI-specialists, by examining (1) the first contact of care for SCI health problems, (2) the morbidity profile and use of health-care services in relation to first contact, and (3) the factors associated with the choice of first contact.Methods. In this cross-sectional study based on data derived from the Swiss Spinal Cord Injury Cohort Study Community Survey 2017, the main outcome measure was the reported first contact for SCI-specific care. This information was analysed using the chi-square test and logistic regression analysis of groups based on patient characteristics, use of health-care services and secondary health conditions assessed using the Spinal Cord Injury Secondary Conditions Scale (SCI-SCS). Results. Out of 1294 respondents, 1095 reported their first contact for SCI-specific care; 56% indicated SCI-specialists and 44% specified GPs. The mean ± standard deviation of the total SCI-SCS was significantly lower in persons who initially consulted GPs (13.1±7.7) than SCI-specialists (14.6±7.3). On average, participants who first contacted a GP reported higher number of GP consultations (5.1±5.2 vs. 3.9±7.2), planned visits to ambulatory clinics (3.7±7.3 vs. 3.6±6.7) and hospital admissions (GP, 1.9±1.7 vs. 1.5±1.3), but lower number of hospital days (22.8±43.2 vs. 31.0±42.8). The likelihood to contact a GP first was significantly higher in persons ≥75 years old (OR= 4.78, 95%-CI= 1.99–11.50), Italian speakers (OR= 5.11, 95%-CI= 2.47–10.54), had incomplete lesions (OR 2.51, 95%-CI 1.78–3.54) or diabetes mellitus (OR= 1.81, 95%-CI= 1.03–3.18), but lower for those situated closer to SCI centers (OR= 0.69, 95%-CI= 0.51–0.93) or experiencing bowel dysfunction (OR= 0.71, 95%-CI= 0.52–0.98).Conclusion. The choice of first contact for SCI-specific care may be partly explained by the complementary roles of GPs and SCI specialists, but the reasons for variation are still unclear. Developing a transparent shared-care model between GPs and SCI specialists, with defined roles and responsibilities, may improve the management of secondary health conditions.


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