Community participation for individuals with spinal cord injury living in Queensland, Australia

Study design: Sequential mixed method design. Objectives: Determine factors associated with community participation for individuals with spinal cord injury (SCI). Setting: Queensland, Australia. Methods: Phase I consisted of a quantitative telephone survey of 270 people who had sustained a SCI within the past 50 years. To verify and interpret survey findings, Phase II involved a qualitative investigation. One focus group, one dyadic and one in-depth interview were conducted with a separate sample of eight people who had sustained a SCI within the past 50 years. Results: In Phase I, employment, paid or unpaid, was the strongest independent factor associated with community participation, whereas time since injury, completeness of injury, secondary conditions and functional independence were also independently associated. In Phase II, participants expressed that survey findings were consistent with their lived experiences. They explained that overall, they needed a strong reason to participate so that benefits outweigh the effort required to participate. Once out in the community, they recognised that other opportunities for participation arise. Conclusion: Rehabilitation services need to support individuals with SCI to find meaningful employment and to engage in activities that provide them with a strong reason to participate.No Full Tex

Changes in health-related quality of life among older adults aging with long-term spinal cord injury

Study design: Cross-sectional and longitudinal. Objectives: To (i) describe health-related quality of life (HRQoL) and changes over 6 years in older adults aging with long-term spinal cord injury (SCI) and (ii) investigate how changes in HRQoL are associated with age, gender, and injury characteristics. Setting: Community in southern Sweden. Methods: From the initial 123 participants (years 2011–2012) in the Swedish Aging with Spinal Cord Injury Study (SASCIS), 77 individuals (32% women, C1-L3, AIS A–D, median age 66 years, median time since injury 31 years, 30% complete injuries) were assessed 6 years later. HRQoL was rated with the Spinal Cord Injury Quality of Life Questionnaire (SCI QL-23). Associations were investigated using multivariable linear regression analyses. Results: The median rating of global QoL (scale range 0–100) was relatively high at both assessments (67 and 83, respectively). There was a large variability in all HRQoL-domains and no significant changes over 6 years. As compared to an AIS D injury, a tetraplegia AIS A–C injury and tetraplegia and paraplegia AIS A–C injuries were associated with positive change in depressive symptoms and global QoL, respectively. Conclusions: Older adults aging with long-term SCI show large variations in all HRQoL-domains and have the potential to maintain a high and stable level of HRQoL over time. Persons with AIS D injuries may need increased attention to mitigate negative changes in depressive symptoms and global QoL. Further studies are needed to identify modifiable factors associated with changes in HRQoL in older adults aging with long-term SCI

Associations between time since onset of injury and participation in Dutch people with long-term spinal cord injury

Study design Multicentre cross-sectional study. Objectives To describe relationships between time since injury (TSI) and participation in individuals with tetraplegia and paraplegia. Setting Community sample from the Netherlands Methods Individuals (N= 265) aged 28-65 years, living with spinal cord injury (SCI) for >= 10 years, age at injury between 18-35 years and using a wheelchair for everyday mobility in three TSI strata: 10-19, 20-29, and >= 30 years post-injury. The Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) was used, which consists of three scales: Frequency (including subscales for Productive, Leisure, and Social activities), Restrictions, and Satisfaction. Linear regression analyses were used to study the effect of TSI on participation, and to adjust for personal and lesion characteristics, for individuals with tetraplegia and paraplegia separately. Results Mean age was 48.4 years, with a mean TSI of 24 years. About 73.6% were male, 40.4% had tetraplegia and 81.9% had a motor complete injury. In individuals with tetraplegia (N= 107), longer TSI was independently associated with lower scores on the Frequency scale (p = 0.025) and the subscale frequency of Leisure activities (p = 0.004). In individuals with paraplegia (N= 158), longer TSI was independently associated with lower scores on the subscale frequency of Productive activities (p = 0.006). TSI was not associated with participation Restrictions and Satisfaction with participation. Conclusions Longer TSI is associated with a reduced frequency of participation in individuals with long-term SCI. Interestingly, this negative association is not accompanied by a similar association in the person's experience of participation