Background: Secondary health conditions (SHCs) such as pain, pressure sores, sexual problems, bowel and bladder problems are prevalent throughout the lifespan of people with spinal cord injury (SCI). Studies have reported that SHCs decrease life expectancy and increase health care costs. Studies on the lived experience of SHCs are, however, limited.Objectives: To explore the experiences of SHCs amongst people with SCI in a public rehabilitation hospital in South Africa.Method: Face-to-face semi-structured interviews were conducted with people with SCI from August 2018 to July 2019. All interviews were transcribed verbatim and analysed using a content analysis approach.Results: Seventeen people with SCI were interviewed. Participants experienced a range of SHCs. The most common experienced SHC was pain (94%). The main theme that emerged from the analysis was ‘the impact of secondary health conditions on health and well-being’. The categories linked to the impact were SHCs co-occurrence and how SHCs limit function, restrict participation, affect mental health and disrupt lives.Conclusion: We found that SHCs were enormously impactful on our participants’ lives and health, as illustrated by their stories of fear, embarrassment and shame. Understanding people with SCI experiences of SHCs can enhance communication between people with SCI and health professionals and may help develop prevention strategies.Clinical implications: To enhance patient-centred care, health professionals are encouraged to actively listen to patients’ experiences of illness and the impact on health and wellbeing.
Objective People living with spinal cord injuries are at a high risk to experience preventable secondary health conditions in their lifetime, which can lead to rehospitalisation and death. Given the fact that spinal cord injury is a long term disability requiring on-going care, there is need to strengthen prevention of secondary health conditions. This study aims to establish factors influencing prevention care for secondary health conditions among people living with spinal cord injuries in a metropolitan area in order to develop a prevention model of care. Results A record review of patients living with spinal cord injuries will be conducted to identify the prevalence of secondary health conditions and associated factors. Semi-structured interviews will be conducted on patients living with spinal cord injuries, their caregivers and therapists to explore the contextual factors (personal and environmental factors) influencing the prevention of secondary health conditions. Thematic analysis will be used to identify the themes. Nominal group technique will be used to develop the prevention model of care for secondary health conditions. This study will be conducted at a tertiary and specialised rehabilitation hospital in South Africa.
Background The environment where people live, work or play can influence health and disability outcomes. People with spinal cord injury are at risk for secondary health conditions, with this increasing readmission rates and decreasing quality of life. Studies on preventative care for secondary health conditions and factors influencing the prevention of secondary health conditions are scarce in low to middle-income countries. Aim To explore environmental factors influencing the prevention of secondary health conditions in people with spinal cord injury. Setting This study was based at a public rehabilitation hospital, South Africa. Methods Explorative qualitative design was used. Semi-structured interviews were conducted with 21 therapists, 17 people with a spinal cord injury and six caregivers. The interviews were transcribed verbatim. Analysis was conducted using content analysis. Results The categories that emerged included the impact of social support, inaccessible built environment and transport system, and an inefficient health care system. Sub-categories for the inefficient health care systems were: Shortage of resources, health workers lack of knowledge on prevention of secondary health conditions and inadequate patient care approach. Conclusion Environmental factors influencing the prevention of secondary health conditions are complex and multifactorial. When developing rehabilitation and prevention programmes, environmental factors must be considered.
Background/Aims Despite outcome measures being found to be useful in stroke rehabilitation, surveys have indicated that therapists do not use them regularly. The aim of this study was to identify outcome measures commonly used in the rehabilitation of patients with stroke in South Africa and the barriers and facilitators to their use. Methods A mixed-methods study was used. A cross-sectional study using a self-administered questionnaire to establish the outcome measures used by physiotherapists was undertaken first, and then qualitative interviews of physiotherapists were carried out to establish the barriers and facilitators to the use of outcome measures used in stroke rehabilitation. Results The most commonly used impairment level outcome measure was the Modified Ashworth Scale (84%), while for activity limitation and participation restriction the Berg Balance Scale (96%) and the Stroke Impact Scale (32%) were used. The factors found to have an influence on the choice of outcome measure included time taken to complete the outcome measure, ability to integrate the outcome measure into daily practice, funds to buy the outcome measure, and the physiotherapist's knowledge of the outcome measure. Conclusions The most commonly used outcome measures are the Modified Ashworth Scale, the Berg Balance Scale and the Stroke Impact Scale. Physiotherapists mainly use outcome measures that are freely available, easy to understand, not time consuming, require less space to administer and are meaningful to patients.
Background/Aims Preventative care for people with spinal cord injury is neglected, even though secondary health conditions are prevalent among this group. There is limited information on preventative care for secondary health conditions among people with spinal cord injury. This study aimed to explore how people with spinal cord injury prevent and manage secondary health conditions. Methods A total of 17 individuals with spinal cord injury attending an outpatients clinic at a public rehabilitation hospital were interviewed face to face. All the interviews were transcribed verbatim and analysed using thematic content analysis. Results The participants used different strategies to prevent and manage secondary health conditions, such as medication, assistive devices, self-management, resilience coping strategies and therapeutic approaches. The participants found prevention of secondary health conditions ‘challenging’ and some of the strategies were ineffective. Conclusions Although many strategies are used by people with spinal cord injury to prevent and manage secondary health conditions, the experience is difficult. To minimise the occurrence and the consequence of secondary health conditions among people with spinal cord injury, health professionals must promote and support preventative care for secondary health conditions.
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