Background: The development of secondary health conditions (SHCs) after spinal cord injury (SCI) is common and can affect an individual’s emotional well-being, and his or her health-related quality of life (QOL). Little is known about relationships between performing health-benefiting behaviours and the presence (or absence) of SHCs and QOL, particularly in South Africa.Objectives: This research study was conducted in order to determine the associations between health behaviour, SHCs and QOL in people with SCI (PWSCI).Method: This cross-sectional study included 36 PWSCI discharged from a private rehabilitation facility in Pretoria, South Africa. The PWSCI completed questionnaires pertaining to lifestyle, independence, presence of SHCs, social support and QOL. Data were analysed using descriptive and inferential statistics such as correlation tests and chi-square test of independence (x2) using the SPSS v25. Moderate, moderately high and high correlations are reported (Pearson r ≥ 0.4). Results were significant if p  0.05.Results: Participation in health-benefiting behaviour was associated with increased QOL (r = 0.457, p  0.01) and increased social support from family and friends (r = 0.425, p  0.01), which was associated with increased QOL (r = 0.671, p  0.001). Not participating in specific neuromusculoskeletal health behaviours was found to be associated with the overall presence of SHCs (r = -0.426, p  0.01).Conclusions: Participating in health-benefiting behaviour can reduce the development of SHCs and subsequently increase QOL in PWSCI. Health professionals must focus on minimising the development of SHCs by providing specific education on good health-benefiting behaviour.

This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

BackgroundSuccessful discharge from rehabilitation for patients with spinal cord injury (PWSCI) relies on a smooth transition home. Assessing readiness for hospital discharge (RHD) is important in reducing secondary health conditions and improving satisfaction and function. Perception of PWSCI on RHD may be different from their physiotherapists, leading to difficulties.ObjectiveTo compare the perceptions of PWSCI and physiotherapists with regard to RHD.MethodA comparative cross-sectional study included 50 PWSCI and their physiotherapists in Tshwane. They completed the Readiness for Hospital Discharge Scale (RHDS) and their responses to the subscales were compared. Data were analysed using descriptive and inferential statistics. Relationships between variables of interest and the general perception of RHD were determined using Pearson’s chi-square test. An independent samples t-test was used to analyse the difference in RHDS scores (including subscale scores) between PWSCI and physiotherapists. Results were significant if p < 0.05.ResultsThe total score of the RHDS was not significantly different (t = 1.31, df = 98, p = 0.19). Patients had higher perceptions in coping ability and expected support subscales (t = 3.15, df = 85.97, p = 0.002 and t = 4.23, df = 98, p = 0.0001, respectively). Physiotherapists had higher perceptions in the knowledge subscale regarding what to do and not do at home (t = -2.05, df = 82.08, p = 0.044) and follow-up sessions (t = 2.625, df = 85.28, p = 0.010).ConclusionThere was no difference in perception of readiness to go home, although physiotherapists gave lower scores for emotional readiness and ability to handle demands at home and higher scores for knowledge.Clinical implicationsThe use of the RHDS in the spinal cord rehabilitation units will better align the goals of rehabilitation and discharge planning to improve overall satisfaction with care and discharge outcomes. All members of a multidisciplinary team can achieve consensus and comparisons can be made on their patient’s perceived RHD.

IntroductionApproximately 80% of people with spinal cord injury experience clinically significant chronic pain. Pain (whether musculoskeletal or neuropathic) is consistently rated as one of the most difficult problems to manage and negatively affects the individual’s physical, psychological and social functioning and increases the risk of pain medication misuse and poor mental health. The aim of this study is to therefore determine the presence of pain and its impact on functioning and disability as well as to develop a framework for self-management of pain for South African manual wheelchair users with spinal cord injury.Methods and analysisCommunity-dwelling participants with spinal cord injury will be invited to participate in this three-phase study. Phase 1 will use a quantitative, correlational design to determine factors related to pain such as pectoralis minor length, scapular dyskinesis, wheelchair functioning, physical quality of life, community reintegration and pain medication misuse. Demographic determinants of pain such as age, gender, type of occupation, completeness of injury and neurological level of injury will also be investigated. Participants with pain identified in phase 1 will be invited to partake in a qualitative descriptive and contextually designed phase 2 to explore their lived experience of pain through in-depth interviews. The results of phases 1 and 2 will then be used with the assistance from experts to develop a framework for self-management of pain using a modified Delphi study. Data analysis will include descriptive and inferential statistics (quantitative data) and thematic content analysis (qualitative data).Ethics and disseminationApproval for this study is granted by the Faculty of Health Sciences Research Ethics Committee of the University of the Pretoria (approval number 125/2018). This study is registered with the South African National Health Research Database (reference GP201806005). This study’s findings will be shared in academic conferences and published in scientific peer-reviewed journals.