Availability and need of home adaptations for personal mobility among individuals with spinal cord injury

Abstract

<p><b>Objective</b>: To identify the availability and unmet need of home adaptations (HAs) among the Swiss population with spinal cord injury (SCI).</p> <p><b>Design</b>: Cross-sectional study.</p> <p><b>Setting</b>: Swiss Spinal Cord Injury Community Survey 2012.</p> <p><b>Participants</b>: Individuals aged 16 or older with chronic SCI living in Switzerland.</p> <p><b>Interventions</b>: Not applicable.</p> <p><b>Outcome measures</b>: The availability of ten HAs (self-report) was analyzed by sex, age, living situation, indoor mobility, SCI severity, SCI etiology and time since SCI. The unmet need (self-report of not having a HA but needing it) of HAs was analyzed by financial hardship.</p> <p><b>Results</b>: Among the 482 study participants (mean age 55.2 years, standard deviation 15.0 years, 71.6% males), 85.1% had at least one HA. The most frequent HA was a wheelchair accessible shower (62.7%). Availability of HAs markedly varied with indoor mobility (e.g. 38.4% of participants using a wheelchair had a stair lift compared to 17.4% of those walking) and with SCI severity (e.g. 54.8% of those with complete paraplegia had a wheelchair accessible kitchen worktop compared to 26.0% of those with incomplete paraplegia). Unmet need was highest for adjustable kitchen worktops (78.7% of those with a need) and adjustable kitchen cabinets (75.7%) and lowest for wheelchair accessible showers (9.4%) and grab bars next to the toilet (8.5%). No significant differences in unmet need were found when stratifying for financial hardship.</p> <p><b>Conclusion</b>: Availability of HAs is dependent on indoor mobility and SCI severity. There is a considerable degree of unmet need for selected HAs, which couldn't be explained by financial hardship.</p