‘We’re all on the same journey; some are just a bit further down the road than others’: a qualitative study exploring peer mentors’ experiences in Active Rehabilitation camps for individuals with acquired brain injury

Purpose This study aimed to explore how peer mentors experience their role and practice in Active Rehabilitation camps for individuals with acquired brain injury. Methods Sixteen peer mentors with acquired brain injury were interviewed, and the data were analysed using Systematic text condensation. Self-determination theory was used to interpret the results. Results Six themes were constructed: “Altruistic motives drive peer mentors” engagement”, “What does it mean to be a peer mentor?”, “Peer mentors question their qualifications”, “Camp is tough—Nothing can compare”, “Being a peer mentor—A part of one’s rehabilitation process”, and “Closeness and trust—A bubble of understanding”. The peer mentors reported personal benefits, such as increased knowledge about brain injury, self-esteem, motivation, physical activity, community participation, and social networks. They perceived that mutual understanding among peer mentors and mentees created a safe camp atmosphere, which led to positive experiences. Conclusion The peer mentors benefitted from their role and described it as part of their rehabilitation journey. We recommend that peer mentors receive training before entering this position, feedback on their performance, and camp schedules that accommodate time for rest and informal meetings between mentees and peer mentors.publishedVersio

The experience of low back pain in people with incomplete spinal cord injury in the USA, UK and Greece

Engineering and Physical Sciences Research Council's (EPSRC

Perceived effectiveness and mechanisms of community peer-based programmes for spinal cord injuries: A systematic review of qualitative findings

STUDY DESIGN: Systematic review and meta-synthesis of qualitative findings. OBJECTIVES: To establish the perceived effectiveness and mechanisms of community peer-based programmes based on narratives of consumers with spinal cord injury (SCI). METHODS: Scopus, Academic Search Complete, CINAHL, Health Source, Medline, PsycARTICLES, PsychINFO, SPORTSDiscus and ProQuest were searched for articles published in English between January 1990 and December 2015. Qualitative studies referring to community peer-based interventions were included if most cases had a SCI. The results section of included studies was extracted and entered in NVivo. Data were inductively coded and analysed according to the three phases of Thematic Synthesis. RESULTS: The search yielded 1402 unique records, out of which 126 were scrutinised in full. Four studies were appraised based on eight criteria and were finally included in the analysis. Three analytical themes emerged: (1) a unique learning environment created by the right mixture of learning resources, learning processes and a can-do attitude; (2) peer mentors-a unique learning resource with high level of relatedness that eases and empowers participants; and (3) an intervention that responds to important unmet needs and unrealised potential. CONCLUSIONS: Community peer-based programmes for people with SCI provide individualised training in important life areas, using a variety of learning resources and a plethora of learning processes. The high level of perceived effectiveness suggests that this type of intervention is an important tool of health systems post discharge from initial rehabilitation. Community organisations should be supported with evaluating their programmes through quality research.Spinal Cord advance online publication, 15 November 2016; doi:10.1038/sc.2016.147

Acute management of traumatic spinal cord injury in a Greek and a Swedish region: a prospective, population-based study

Study design: Prospective, population-based study. This paper is part of the Stockholm Thessaloniki Acute Traumatic Spinal Cord Injury Study (STATSCIS).andlt;br /andgt;Objectives: To characterize patient populations and to compare acute management after traumatic spinal cord injury (TSCI).andlt;br /andgt;Settings: The Greater Thessaloniki region in Greece and the Greater Stockholm region in Sweden.andlt;br /andgt;Methods: Inception cohorts with acute TSCI that were hospitalized during the study period, that is September 2006 to October 2007, were identified. Overall, 81 out of 87 cases consented to inclusion in Thessaloniki and 47 out of 49 in Stockholm. Data from Thessaloniki were collected through physical examinations, medical record reviews and communication with TSCI cases and medical teams. Data from Stockholm were retrieved from the Nordic Spinal Cord Injury Registry.andlt;br /andgt;Results: There were no significant differences between study groups with regard to core clinical characteristics. In contrast, there were significant differences in (1) transfer logistics from the scene of trauma to a tertiary-level hospital (number of intermediate admissions, modes of transportation and duration of transfer) and (2) acute key therapeutic interventions, that is, the use of mechanical ventilation (49% in Thessaloniki versus 20% in Stockholm), and performance of tracheostomy (36% in Thessaloniki versus 15% in Stockholm); spinal surgery was performed significantly more often and earlier in Stockholm than in Thessaloniki.andlt;br /andgt;Conclusions: Despite largely similar core clinical characteristics, Stockholm and Thessaloniki cases underwent significantly different acute management, most probably to be attributed to adaptations to the differing regional approaches of care one following a systematic approach of SCI care and the other not. Spinal Cord (2010) 48, 477-482; doi: andlt;highlightandgt;10.1038andlt;/highlightandgt;/andlt;highlightandgt;scandlt;/highlightandgt;.andlt;highlightandgt;2009.160andlt;/highlightandgt;; published online 22 December 2009</p

Incidence and epidemiology of spinal cord injury within a closed American population: the United States military (2000–2009)

The objective of this study was to characterize the incidence of spinal cord injury (SCI) within the population of the United States military from 2000–2009. This investigation also sought to define potential risk factors for the development of SCI

Active rehabilitation - a community peer-based approach for persons with spinal cord injury: International utilisation of key elements

INTRODUCTION: Active Rehabilitation (AR) is a community peer-based approach that started in Sweden in 1976. As a key component of the approach, AR training camps provide intensive, goal-oriented, intentional, group-based, customised training and peer-support opportunities in a community environment for individuals with spinal cord injury. STUDY DESIGN: Prospective cross-sectional study. OBJECTIVES: To describe the profile of the organisations that use components of the AR approach, and to explore the characteristics and the international variations of the approach. SETTING: Twenty-two organisations from 21 countries from Europe, Asia and Africa reported using components of the AR approach during the past 10 years. METHODS: An electronic survey was developed and distributed through a personalised email. Sampling involved a prospective identification of organisations that met the inclusion criteria and snowball strategies. RESULTS: While there were many collaborating links between the organisations, RG Active Rehabilitation from Sweden and Motivation Charitable Trust from the United Kingdom were identified as key supporting organisations. The 10 key elements of the AR approach were found to be used uniformly across the participating organisations. Small variations were associated with variations in country income and key supporting organisation. CONCLUSIONS: This is the first study to describe the key elements and international variations of the AR approach. This will provide the basis for further studies exploring the effectiveness of the approach, it will likely facilitate international collaboration on research and operational aspects and it could potentially support higher integration in the health-care system and long-term funding of these programmes

Absence of Oligoclonal IgG Bands and Anti-Achr Antibodies in the Cerebrospinal Fluid of Patients with Myasthenia Gravis

Myasthenia gravis (MG) is a neuromuscular disorder in which antibodies are directed against the nicotinic acetylcholine receptor (AChR) at the neuromuscular junction. Some investigators describe the existence of oligoclonal IgG bands and anti-AChR antibodies in the cerebrospinal fluid (CSF) of MG patients while other refuse it. This study was performed in 15 patients with clinical and electrophysiological diagnosis of MG. Oligoclonal IgG bands (OCB) and antibodies to the AChR from human skeletal muscle were determined in the serum and the CSF of the above MG patients. The last one was done in order to investigate any possible central nervous system (CNS) involvement. It was found that all the MG patients who had a high titre of anti- AChR antibodies in the serum (mean titre 29.2±24.3 nM, range 1.8 to 62 nM) did not present OCB and anti-AChR antibodies in their CSF. On the same time, in a group of 10 patients with a definite multiple sclerosis it was found that eight of them presented OCB in their CSF while the results were negative in another group of 10 patients without evidence of CNS disease. The last two groups served as control groups. Our findings are in accordance with the concept that MG is a pure neuromuscular disorder. </jats:p

Structured, time-limited peer mentorship activity programmes for individuals with acquired brain or spinal cord injuries: a mixed methods systematic review of characteristics and outcomes

To determine the characteristics and outcomes of structured, time-limited peer mentorship activity programmes for individuals with acquired brain or spinal cord injury. A mixed methods systematic review with an advanced convergent qualitative meta-integration synthesis design was adopted. Seven databases were searched, with two reviewers independently screening, selecting, and extracting data and evaluating the methodological quality of the included studies. The review included ten original studies: five qualitative, four quantitative, and one mixed methods. The peer mentorship programmes were conducted in Europe, Oceania, the United States, and Africa, lasting from two days to 2.5 weeks. The programmes had diverse focuses, but all addressed mentees’ independence, health, or quality of life in some way. None was based on a theoretical framework. Programme participation positively impacted cognition, emotions, independence, and social life. The safe and supportive environments the mentees and peer mentors created facilitated the outcomes. The evidence of programme participation on life satisfaction and community participation was inconclusive. Despite their short duration, structured, time-limited peer mentorship activity programmes can strengthen community rehabilitation of individuals with acquired brain or spinal cord injury. It is recommended that peer mentorship programmes are grounded on a theoretical framework. Structured, time-limited peer mentorship activity programmes impact mentees’ thoughts and emotions, social lives, and independence in daily lives.Being able to challenge oneself in a safe and supportive environment created by mentees and peer mentors is essential for achieving positive outcomes.Peer mentorship programme organisers should establish clearly defined programme aims and base their rationale on how to reach these aims on relevant theoretical frameworks. Structured, time-limited peer mentorship activity programmes impact mentees’ thoughts and emotions, social lives, and independence in daily lives. Being able to challenge oneself in a safe and supportive environment created by mentees and peer mentors is essential for achieving positive outcomes. Peer mentorship programme organisers should establish clearly defined programme aims and base their rationale on how to reach these aims on relevant theoretical frameworks.</p