"ICF-DH conceptual approach of the complex medical and psycho-social problems encountered at home and in the community; the quality of life in persons with SCI sequels"

Abstract

Objective: Evaluation (from the ICF-DH conceptual approach) of the complex medico-psycho-social problems encountered at home, by persons with spinal cord injury (SCI) sequels. Material, Methods: 660 patients with chronic SCI were reviewed by the questionnaire technique (focused mainly on basic, instrumental activities of daily living, medical, social problems encountered after discharge from the Teaching Emergency Hospital "Bagdasar-Arseni-TEHBA, Bucharest). The feedback rate was 64,4% (425 from 660 subjects). There were 205 quadriplegics (48%), 220 paraplegics (52%). The mortality was 9% during the follow-up period, 2001-2010. Results: Most of the patients had a good accessibility to the medical services, but 33% of them had a tiny medical supervision. Main medical complications at home were: pressure sores (22%), recurrent urinary infections (52%) and incontinence (20%). After discharge 53% of the patients had continued the therapy program; 18% managed to walk independently. Only 13% of the patients managed to make minor adaptations at home and ambient. Scholar (14%) and professional reintegration (12,6%) were low. Discussion and Conclusions: The paper emphasizes the aspects of the comprehensive rehabilitation and follow-up, the progress archived by the combined efforts of our Neural-Muscular Physical Rehabilitation Medicine Clinic Division of TEHBA, RoSCoS and the National Insurance House, for managing the neurogenic bladder, for a specialized web site and an electronic National Register for SCI (pending for approval). Our society must do serious efforts to accept, to solve and to reintegrate (educationally, professionally, socially) the subjects with such severe handicap, especially in the context of the global economic crisis.