Secondary health conditions and their impact on the wellbeing of people with spinal cord injury, South Africa: Patients perspective.

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.

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

PLoS ONE ◽

10.1371/journal.pone.0252280 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252280

Author(s):

Sonti Pilusa ◽

Hellen Myezwa ◽

Joanne Potterton

Keyword(s):

South Africa ◽

Health Care ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Environmental Factors ◽

Health Workers ◽

Health Conditions ◽

Factors Influencing ◽

Cord Injury ◽

The Impact

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.

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Inconsistencies with screening for traumatic brain injury in spinal cord injury across the continuum of care

Journal of Spinal Cord Medicine ◽

10.1080/10790268.2017.1357105 ◽

2017 ◽

Vol 42 (1) ◽

pp. 51-56 ◽

Cited By ~ 3

Author(s):

Seema Sikka ◽

Angela Vrooman ◽

Librada Callender ◽

David Salisbury ◽

Monica Bennett ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Brain Injury ◽

Continuum Of Care ◽

Cord Injury ◽

The Continuum

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Client Perspectives on Reclaiming Participation After a Traumatic Spinal Cord Injury in South Africa

Physical Therapy ◽

10.2522/ptj.20150258 ◽

2016 ◽

Vol 96 (9) ◽

pp. 1372-1380 ◽

Cited By ~ 3

Author(s):

Conran Joseph ◽

Kerstin Wahman ◽

Julie Phillips ◽

Lena Nilsson Wikmar

Keyword(s):

South Africa ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Physical Therapists ◽

Community Dwelling ◽

Traumatic Spinal Cord Injury ◽

Cord Injury ◽

Semistructured Interviews ◽

Insight Into ◽

The Continuum

AbstractBackgroundThe development of rehabilitation services promoting participation in people living with a traumatic spinal cord injury (TSCI) is of major concern for physical therapists. What the client sees as effective participation, barriers, and facilitators might be different due to their particular context. This study was conducted to gain insight into the experiences of attaining an important outcome in a developing context.ObjectiveThe aim of this study was to explore the experiences of reclaiming participation in community-dwelling people with TSCI in South Africa.DesignThis was an explorative, qualitative study with inductive content analysis.MethodsIndividual semistructured interviews were conducted with 17 adults living with a TSCI in order to explore their experience of participation. The verbatim transcripts were analyzed, and the end result was an overall theme that included 4 emerging categories.ResultsThe theme “participation possibility” denotes the eventual involvement in life situations. Within this theme, there were 4 categories that emerged as a representation of essential aspects along the continuum of reclaiming participation: (1) dealing with the new self, (2) a journey dominated by obstacles, (3) the catalyst of participation, and (4) becoming an agent. Dealing with and recognizing these intervening conditions seem critical for clients to reconstruct the meaning that is necessary for a broader conception of participation.LimitationsThe transferability of these findings to dissimilar contexts may be limited.ConclusionClient perspectives on reclaiming participation after injury affirm the notion of eventual participation, with each person finding strategies to succeed. In order to help clients reclaim participation, health professionals should develop contextually sensitive programs that include peer mentoring and reduce the influence of hindering factors.

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Characteristics of activity-based therapy interventions for people living with spinal cord injury or disease across the continuum of care: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2020-040014 ◽

2020 ◽

Vol 10 (7) ◽

pp. e040014

Author(s):

Anita Kaiser ◽

Katherine Chan ◽

Maureen Pakosh ◽

Kristin E Musselman

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Systematic Reviews ◽

Scoping Review ◽

Continuum Of Care ◽

Manuscript Submission ◽

Cochrane Central Register ◽

Scoping Reviews ◽

Cord Injury ◽

The Continuum

IntroductionIndividuals living with spinal cord injury and disease (SCI/D) experience sensory and motor impairments below their neurological level of injury. Activity-based therapies (ABT) are interventions that provide activation of the neuromuscular system below the level of lesion with the goal of retraining the nervous system to recover a specific motor task. ABT can lead to increased function and improved quality of life; however, research and clinical settings currently lack tools to track participation in ABT. As a first step towards developing such a tool, a scoping review will be conducted with the objective of identifying the characteristics of ABT that individuals with SCI/D participate in across the continuum of care.Methods and analysisThe review will follow the Joanna Briggs Institute scoping review framework. Studies that involve at least two sessions of ABT for individuals with SCI/D aged ≥16 years will be included. Seven databases were searched from their inception to 4 March 2020: Medline, Embase, Emcare, Cumulative Index to Nursing and Allied Health Literature, APA PsycINFO, Physiotherapy Evidence Database, Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials. The search will be rerun in November 2020 prior to manuscript submission. Screening of titles and abstracts will be followed by a review of full texts to identify articles meeting inclusion criteria. Stakeholders will be consulted for the creation of the data extraction table. The Downs and Black Checklist or the Mixed Methods Appraisal Tool will be used to assess article quality. Results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.Ethics and disseminationEthical approval is not required for this scoping review. Study findings will be shared with key stakeholder groups through academic, clinical and public venues.

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