Study design: Hospital-based incidence study. Objectives: To assess the incidence of traumatic spinal cord injuries (TSCIs) and TSCI incidence trends in relation to cause, age, gender, level and completeness of injury. Setting: Spinal Cord Injury Centre of Western Denmark. Methods: We reviewed medical records of TSCI patients admitted between 1 January 1990 and 31 December 2012. Proportions, incidence rates and incidence rate ratios were calculated for five time periods; 1990-94, 1995-99, 2000-04, 2005-09 and 2010-12, and were stratified on age, gender, cause, level and completeness of TSCI. TSCI incidence was calculated as the number of new cases divided by person-years at risk. Results: Included were 691 patients (males 81.9%). Within the study period, median age at time of injury rose from 29.0 to 47.5 years. The overall annual TSCI incidence during the study period 1990-94 to 2010-12 was 10.2 per million person-years at risk and varied from 8.3 to 11.8. The proportion of transport-related injuries fell from 56.9% in the first to 36.8% in the most recent time period. Fall-related injuries rose from 11.1 to 35.5%. The proportion of incomplete tetraplegia increased from 32.0% in the first to 40.5% in the last time period. Conclusions: The overall TSCI incidence is low and remained stable from 1990 to 2012. The proportion of transport-related injuries fell, while age at time of injury and proportion of fall-related injuries and proportion with incomplete tetraplegia all increased.
Survival after TSCI in Denmark did not change considerably from 1990 to 2014, and there seemed to be no gender difference. Mortality was highest among patients above 60 years of age at injury.
The psychosocial effects of web-based information have yet to be tested for patients joining a fast-track total hip arthroplasty programme. This study compared and evaluated the psychosocial impact of standard total hip arthroplasty programme, with and without supplementation with a web-based information platform (E-total hip arthroplasty programme). Totally, 299 patients were enrolled in an un-controlled, before-and-after study, 117 in the S-total hip arthroplasty programme group and 182 in the E-total hip arthroplasty programme group. Psychosocial outcomes before and during admission and then 3 months post-surgery were evaluated, with analyses conducted between and within groups. All outcomes improved significantly from pre-admission to 3 months post-surgery, with no between-group differences. In all, 112 of the 182 E-total hip arthroplasty programme patients accessed the learning platform. A subgroup analysis showed no significant differences between users and non-users, either at baseline or in terms of outcome. This study found no positive psychosocial effect between groups, but a significant effect within groups.
During rehabilitation, professionals and patients experience difficulties addressing complex issues. In a hermeneutical approach we examine how the ICF model can capture the complexity of the rehabilitation process using secondary deductive content analysis of transcripts from a previous interview study in line with COREQ. When focusing on interactions, the ICF model captures the complexity of individuals’ issues in a convincing way. Three themes were identified: ‘The influence body function, activity, participation and environment have on an individual’s ability to handle daily tasks of personal importance’, ‘The influence the environment in combination with body function, activity, and personal factors have on an individual’s ability to maintain their social roles’, and ‘The influence personal factors and body functions have on an individual’s confidence in participating in activities they like’. The findings show that the ICF model could provide a useful tool to facilitate communication regarding individuals’ complex issues that are often neglected.
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