Interventions to Improve Employment Outcomes for People With Spinal Cord Injuries: a Scoping Review Protocol Using the Donabedian Model

2021 ◽  
Author(s):  
Ntsikelelo Pefile ◽  
Joyce Diphale Mothabeng ◽  
Saloshni Naidoo
Keyword(s):  
Spinal Cord ◽  
Scoping Review ◽  
Spinal Cord Injuries ◽  
Community Integration ◽  
Employment Outcomes ◽  
Rehabilitation Professionals ◽  
Search Terms ◽  
Cord Injury ◽  
Donabedian Model

Abstract Background Unemployment among persons with spinal cord injury (PWSCI) is high and often leads to poverty (including their families). Modifiable and unmodifiable factors that influence employment among PWSCI are known and are addressed throughout the rehabilitation process. The overall aim of rehabilitation of PWSCI is quality of life and community integration (including employment). Interventions that seek to improve employment outcomes among PWSCI are well documented. However, no integrated reviews clearly describe the resources utilised, interventions utilised, duration of interventions and the outcomes (and tools used) to improve employment outcomes among PWSCI. Policymakers and rehabilitation professionals require this information to develop models or strategies to improve employment outcomes for PWSCI. This review aims to map evidence on interventions and approaches that aim to enhance the employment of PWSCI. Methodology This review will map evidence on interventions that improve employment outcomes among PWSCI, using the Arksey and O'Malley framework and the Donabedian model as the guiding lens. The first stage includes the development of the research question and will be reviewed throughout the review process. The PCC framework will be utilised to determine the inclusion and exclusion criteria and develop the search terms. Peer-reviewed primary studies will be identified using the Boolean search terms on PubMed, MEDLINE, Ebscohost, Google Scholar, CINAHL, Cochrane databases. Two independent reviewers will identify primary studies and charting data, and one reviewer will act as a supervisor and arbitrator. Data charting tool will be utilised to gather the required information from the selected studies. Nvivo software version 25 will be used to develop themes for summarising and reporting the data. The quality of the courses selected will be evaluated using the Mixed Methods Appraisal Tool (MMAT). DiscussionData from the selected studies will be discussed in relation to the research questions and the Donabedian model. Information gathered from this scoping review will enable policymakers, rehabilitation professionals and other stakeholders to use this as a foundation in an attempt to develop strategies or models that seek to improve employment outcomes among PWSCI. Moreover, a gap in current practice will be identified, and further research needed in the field will be described.

Critical Appraisal of Paralyzed Veterans of America Guidelines in Spinal Cord Injury: An International Collaborative Study Using the Appraisal of Guidelines for Research and Evaluation II Instrument (AGREE II)

2021 ◽  
Author(s):  
Ning Liang ◽  
Sizhan Wu ◽  
Simon Roberts ◽  
Navnit Makaram ◽  
James Reeves Mbori Ngwayi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Clinical Guidelines ◽  
Spinal Cord Injuries ◽  
Intraclass Correlation ◽  
Collaborative Study ◽  
Stakeholder Involvement ◽  
Correlation Coefficients ◽  
Agree Ii ◽  
Cord Injury

ABSTRACT Introduction Spinal cord injuries (SCI) in military personnel, veterans, and others require an evidence-based, multidisciplinary approach to their care. This appraisal used the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument to evaluate the methodological quality of clinical guidelines for the management of SCI published by the Paralyzed Veterans of America (PVA) organization. Materials and Methods We searched clinical guidelines on SCI published by PVA until December 2019. Four appraisers across three international centers independently evaluated the quality of eligible clinical guidelines using AGREE II. Mean AGREE II scores for each domain were calculated. In higher quality domains, scores for individual items were analyzed. Results A total of 12 guidelines published by PVA on SCI were assessed. Mean scores for all six domains were as follows: Scope and Purpose (78.8%), Stakeholder Involvement (63.7%), Rigor of Development (68.4%), Clarity of Presentation (80.1%), Applicability (53.0%), and Editorial Independence (28.5%). The mean score for the overall quality of all PVA guidelines was 71.9% (95% CI: 69.7–74.1). No guideline was assessed as “not recommended” by any appraiser. Overall quality was significantly associated with year of publication (rs = 0.754, P = 0.0046). Overall agreement among appraisers was excellent (intraclass correlation coefficients for each guideline ranged from 0.96 to 0.99). Conclusions PVA guidelines for the management of SCI demonstrated acceptable or good quality across most domains. We recommend the use of PVA guidelines for the assessment and treatment of SCI and related disorders. The quality of PVA guidelines for the management of SCI have improved over time.

Physical Activity, Quality of Life, and Functional Autonomy of Adults With Spinal Cord Injuries

2013 ◽  
Vol 30 (4) ◽  
pp. 317-337 ◽  
Author(s):  
Camilla Yuri Kawanishi ◽  
Márcia Greguol
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Functional Independence ◽  
Cord Injury ◽  
Functional Autonomy ◽  
Using Data

This study aimed to perform a systematic review of studies that address the influence of physical activity on the quality of life and functional independence of adult individuals with spinal cord injury. The review was performed using data obtained from the MEDLINE, CINAHL, SciELO, LILACS, SPORTDiscus, Web of Science, Academic Search Premier, and PEDro databases using the following keywords: quality of life; functional independence; autonomy; independence; physical activity; activities of daily living; physical exercise; tetraplegia; paraplegia; spinal cord injury; physical disabilities; and wheelchair. Eleven studies met the inclusion criteria. Although there was a lack of consensus among the selected studies, the majority of them presented a strong correlation between physical activity and variables of quality of life and/or functional independence. Thus, physical activity appears to have an important influence on social relationships, functional independence, psychological factors, and physical aspects, which can enhance quality of life and independence in the performance of daily activities.

scholarly journals Meaning of Staring and the Starer–Staree Relationship Related to Men Living With Acquired Spinal Cord Injuries

2016 ◽  
Vol 12 (2) ◽  
pp. 283-291 ◽  
Author(s):  
Rebecca Renwick ◽  
Karen Yoshida ◽  
Elizabeth Eacrett ◽  
Natalie Rose
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Secondary Analysis ◽  
Community Dwelling ◽  
Negative Consequences ◽  
Public Places ◽  
The Public ◽  
Adult Men ◽  
Cord Injury

When in public places, many individuals with physical disabilities experience staring. Although staring is typically seen as uncomplicated and something to be “ignored,” it has consequences for the person being stared and the staree. Few studies have focused on staring experienced by men following spinal cord injury (SCI). Accordingly, this study explored how adult men with SCI give meaning to the staring from others, the consequences for them, and their responses to the staring and to the starer. Principles of modified grounded theory methods were used to conduct a secondary analysis of interview data for 30 male participants from a larger study of community-dwelling individuals with SCI. Themes revealed through analysis related to context-dependent meanings of staring, negative consequences of staring for some men, and positive opportunities for self-growth and interaction with the public. These findings contribute to a more complex understanding of staring and the relationship between the starer and staree in various social circumstances which can support people living with differences in their public interactions, and improve their quality of life.

scholarly journals (A313) Role of Physiatrists in Post Disaster Scenarios - Lessons Learned from Pakistan, China and Haiti Earthquakes

2011 ◽  
Vol 26 (S1) ◽  
pp. s105-s105
Author(s):  
F.A. Rathore ◽  
C. O'connell ◽  
J. Li
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Community Integration ◽  
Functional Restoration ◽  
Lessons Learned ◽  
Spinal Trauma ◽  
Trauma Patients ◽  
Cord Injury ◽  
Post Disaster

IntroductionPhysical Medicine and Rehabilitation is a goal oriented and patient centered specialty which focuses on functional restoration and quality of life of persons with disability. The patterns of injuries among survivors of recent disasters have, range from mild (single limb fracture) to catastrophic (spinal cord injury, amputation, traumatic brain injury). Historically physiatrists have not participated the acute disaster management phase or in the emergent post disaster rehabilitation planning. This task is usually relegated to the trauma, orthopedic and general surgeons.MethodologyAuthors had firsthand experience in the acute and emergent care and rehabilitation of trauma patients after Pakistan, China and Haiti earthquakes. An electronic literature search (English, 1965–2010, Key words: trauma, rehabilitation, disability, spinal cord injury, amputation, disaster, nerve injury) was carried out. Experience sharing through committees, online forum, and communications were conducted with physiatry colleagues internationally.ResultsIn these three recent earthquakes, Physiatrists provided direct patient care, including guidance in the evacuation of survivors with pre-existing disabilities, transport of persons with spinal trauma, treatment of wounds, fractures, pain, spinal trauma patients and persons with amputations. Physiatrists devised appropriate plans for conservative management of fractures. Education of local staff and coordination of rehabilitation was initiated. Monitoring, prevention and treatment of secondary complications including prolonged immobility, pressure ulcers, chronic pain, urinary, bowel and respiratory dysfunction was performed. Physiatrists helped in patient counseling and family education.ConclusionPhysiatrists by virtue of their training and skills are in a better position to manage the disabilities, including direction of rehabilitation and community integration, prevention of complications, and education and training of health workers and teams. Timely rehabilitation interventions for Spinal cord injuries and lower limb amputations following the Pakistan, China and Haiti earthquakes resulted in reduction in morbidity and mortality among those with catastrophic injuries.

scholarly journals P.188 Neurotrauma in Indigenous populations of Canada: challenges and future directions: A Scoping Review

2021 ◽  
Vol 48 (s3) ◽  
pp. S74-S74
Author(s):  
Z Salaheen ◽  
A Moghaddamjou ◽  
MG Fehlings
Keyword(s):  
Spinal Cord ◽  
Rural Communities ◽  
Indigenous Peoples ◽  
Scoping Review ◽  
Brain Injuries ◽  
Spinal Cord Injuries ◽  
Healthcare Services ◽  
Indigenous Populations ◽  
Mesh Terms ◽  
Cord Injury

Background: Neurotrauma accounts for over 24 000 hospitalizations annually in Canada. Among those affected, Indigenous peoples are disproportionately impacted. The goal of this scoping review is to identify factors underlying these disparities. Methods: A scoping review was conducted to collect papers pertaining to neurotrauma in Indigenous populations of Canada. Using MEDLINE, 676 articles were screened with MeSH terms including ‘Indigenous’, ‘spinal cord injuries’, ‘brain injuries, traumatic’ and ‘Canada’ as of April 2021. Results: Studies report over twice the incidence of traumatic brain injury and traumatic spinal cord injury in Indigenous populations compared to non-Indigenous populations. The burden of neurotrauma is attributable to infrastructure disparities in rural communities and reserves, elevated rates of substance use and violence, and inequities in treatment and rehabilitation following injury. These issues are deeply rooted in the trauma endured by Indigenous peoples through the course of Canadian history, owing to government policies that severely impacted their socioeconomic conditions, culture, and access to healthcare services. Conclusions: Systems-level interventions guided by Indigenous community members will help to address the disparities that Indigenous peoples face in the care and rehabilitation of neurotrauma. This study will inform further research of culturally appropriate approaches to reduce neurotrauma burden among Indigenous peoples.

Neuroprotection for Spinal Cord Injury

2017 ◽  
Author(s):  
Christopher S. Ahuja ◽  
Michael Fehlings
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Current Evidence ◽  
Mechanical Trauma ◽  
Secondary Injury ◽  
Loss Of Function ◽  
Cord Injury ◽  
Death And Loss

Traumatic spinal cord injuries (SCI) often have a devastating impact on quality of life for patients and their families. Neuroprotection for spinal cord injury is aimed at improving functional outcomes by limiting secondary injury processes that occur within the first minutes, hours, and days following the primary injury. The primary mechanical trauma initiates a secondary injury cascade where ischemia, inflammatory cell infiltration, and cytotoxic changes in the microenvironment cause further cell death and loss of function. Time-sensitive neuroprotective measures targeting these secondary insults have emerged as key therapeutic strategies. This chapter summarizes current evidence-based neuroprotective treatments, such as blood pressure augmentation, early surgical decompression, and intravenous methylprednisolone, as well as important emerging interventions, including therapeutic hypothermia, sodium channel blockade using riluzole, and the anti-inflammatory actions of minocycline. The chapter concludes by summarizing the current guidelines that all practitioners should be well-versed in prior to providing care for patients with SCI.

scholarly journals Usability of the Participation and Quality of Life (PAR-QoL) Outcomes Toolkit Website for Spinal Cord Injury

2020 ◽  
Vol 26 (1) ◽  
pp. 64-77 ◽  
Author(s):  
Maude Beaudoin ◽  
Krista L. Best ◽  
François Routhier ◽  
Lynda Atack ◽  
Sander L. Hitzig ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Online Survey ◽  
Community Integration ◽  
Ease Of Use ◽  
Perceived Usefulness ◽  
Perceived Ease Of Use ◽  
Cord Injury

Background: Quality of life (QoL) is an important parameter to monitor during rehabilitation; however, accurate assessment is challenging. Among individuals with spinal cord injury (SCI), assessing QoL is further challenged due to complex sequelae, such as secondary health conditions and factors related to community integration. A Participation and Quality of Life (PAR-QoL) toolkit was created to aid clinicians and researchers in the selection of QoL outcomes tools specific to SCI. Objectives: The aim of this study was to evaluate the use and usability of the PAR-QoL toolkit. Methods: A cross-sectional study was conducted using an online survey from December 2013 to November 2016. Google Analytics were collected from April 2012 to April 2018. Survey sections addressed “use” (behavioral practices and actual use) and “usability” (perceived ease of use and perceived usefulness). Any person who visited the PAR-QoL website was invited to complete the survey. Summary statistics and percent concordances were calculated to describe results from the survey and Google Analytics. Results: The PAR-QoL website had 188,577 users. The five most visited webpages were outcome tools, with bounce rates ranging from 77% to 90%. Of the 46 survey respondents, 67% were not current users of the PAR-QoL website, and 87% intended to use the resources in the future. Conclusion: Uptake of the PAR-QoL website is currently limited. Usability of the PAR-QoL website may be improved by modifying navigation, removing the “less useful” components, ensuring regular updates of content and resources, and promoting the website.

Sign in / Sign up

Export Citation Format

Share Document