Secondary health conditions in people with spinal cord injury in South Africa: Prevalence and associated factors

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

10.21203/rs.2.16532/v1 ◽

2019 ◽

Author(s):

SONTI PILUSA ◽

Myezwa Hellen ◽

Potterton Joanne

Keyword(s):

South Africa ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Continuum Of Care ◽

Health Conditions ◽

Primary Data ◽

Structured Interviews ◽

Cord Injury ◽

The Impact ◽

The Continuum

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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