Post-discharge nursing problems of spinal cord injured patients: on which ” elds can nurses contribute to rehabilitation?

Bloemen-Vrencken, J. H. A.; Witte, Luc de

doi:10.1191/0269215503cr694oa

Cited by 15 publications

(12 citation statements)

References 15 publications

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“…After discharge, both the demanding activities of daily living (ADLs) and the reduction in structured training, could make subjects susceptible to complications associated with overuse (1). Additionally, many subjects have less guidance or peer-control in self-care (23). The higher demands of ADLs, together with reduced feedback, could make subjects less conscientious towards preventive measures, such as skin checks and bladder management.…”

Section: Complicationsmentioning

confidence: 99%

Complications following spinal cord injury: Occurrence and risk factors in a longitudinal study during and after inpatient rehabilitation

Haisma¹,

Woude²,

Stam³

et al. 2007

Acta Derm Venereol

141

121

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Objective: To assess the occurrence and risk factors for complications following spinal cord injury during and after inpatient rehabilitation. Design: Multicentre longitudinal study. Subjects: A total of 212 persons with a spinal cord injury admitted to specialized rehabilitation centres. Methods: Assessments at the start of active rehabilitation (n = 212), 3 months later (n = 143), at discharge (n = 191) and 1 year after discharge (n = 143). Results: Multi-level random coefficient analyses revealed that complications were common following spinal cord injury. Most subjects reported neurogenic and musculoskeletal pain, or had spasticity at each assessment. During the year after discharge, complications remained common: urinary tract infections and pressure sores affected 49% and 36% of the population, respectively. The degree of pain decreased, whereas the degree of spasticity increased significantly during inpatient rehabilitation. Overall, increased age, increased body mass index, traumatic lesion, tetraplegia, and complete lesion all increased the risk of complications. Conclusion: Complications are common following spinal cord injury. They need specific attention after discharge from inpatient rehabilitation and within subpopulations.

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Section: Complicationsmentioning

confidence: 99%

Complications following spinal cord injury: Occurrence and risk factors in a longitudinal study during and after inpatient rehabilitation

Haisma¹,

Woude²,

Stam³

et al. 2007

Acta Derm Venereol

141

121

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“…22 The other measures were self-developed, based on clinical experience and the results of previous research. 4,24,25 Drafts were discussed with physiatrists and nurses from different rehabilitation centres and with representatives of the patient's organisation.…”

Section: Instrumentsmentioning

confidence: 99%

Burden of support for partners of persons with spinal cord injuries

Post

Bloemen

Witte³

2005

Spinal Cord

Self Cite

111

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Study design: Cross-sectional survey. Objectives: (1) To describe the support given to persons with spinal cord injuries (SCI) by their partners, (2) to describe the perceived burden of support by partners and (3) to examine predictors of perceived burden of support. Setting: The Netherlands. Methods: All members of the Dutch patients organisation DON (N ¼ 1004) and their caregivers, if applicable, were invited. Physical disability of the person with SCI was measured using the Barthel Index (BI). A number of secondary conditions, other practical problems and psychosocial problems were recorded. Partner support was described using a list of ADLsupport, other practical support and emotional support. Burden of support was measured by a six-item measure (Cronbach's alpha 0.92), Nonparametric descriptive statistics and correlations were used. Linear regression was used to identify predictors of caregiver burden. Results: Responses were obtained from 461 persons with SCI. Of 265 couples, patient as well as partner data were available. Mean age of the partners was 49.4 years (SD 12.2) and 69.8% were women. Mean BI of the persons with SCI was12.3 (SD 4.7) on a 0-20 scale and 60.4% were seriously disabled (BIo15). Most partners provided various kinds of support. ADLsupport and other practical support were given much more often by partners of persons with serious disability, but less difference was seen regarding emotional support. Professional (paid) support was obtained by 45.3% of all couples. Perceived burden of support was high in 24.8% of partners of persons with serious disabilities against 3.9% of partners of persons with minor disabilities. Significant predictors of caregiver burden were (in order of importance) the amount of ADL support given, psychological problems of the patient, partner age, partner gender, BI score and time after injury (total explained variance 47%). Conclusion: A substantial proportion of partners of persons with SCI suffer from serious burden of support. Prevention of caregiver burnout should be part of the lifelong care for persons with SCI.

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“…13,34 If this is the case, we believe that the realization of these facilities needs to be improved. First, because patients need to adjust to life outside the rehabilitation centre, and second, because budgetary problems in health services ask for an efficient organization.…”

Section: The Association With Duration Of Rehabilitationmentioning

confidence: 99%

Physical fitness in people with a spinal cord injury: the association with complications and duration of rehabilitation

et al. 2007

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Objective: To assess the association between physical fitness and its recovery over time on the one hand, and complications and duration of phases of rehabilitation on the other. Design and setting: Prospective cohort study at eight rehabilitation centres. Subjects: People with a spinal cord injury were assessed four times: at the start of active rehabilitation (n ¼ 110), three months later (n ¼ 92), at discharge (n ¼ 137) and a year after discharge from inpatient rehabilitation (n ¼ 91). Main measures: Physical fitness was defined as aerobic capacity, determined at each occasion by the peak oxygen uptake (peak Vo 2 ; L/min) and the peak power output (peak PO; W) during a maximal exercise test. On these occasions, spasticity, musculoskeletal and neurogenic pain were determined (1 ¼ present; 0 ¼ absent). During inpatient rehabilitation, complications (urinary tract infection, pulmonary infection or pressure sore) and bed rest were registered (1 ¼ complication; 0 ¼ no complications, and 1 ¼ bed rest; 0 ¼ no bed rest). Complications and bed rest occurring during the year after discharge were registered similarly. Results: Multilevel random coefficient analyses revealed associations in multivariate models (P 0.05). The peak oxygen uptake was negatively associated with complications after discharge. The recovery of peak power output over time was negatively associated with bed rest and spasticity. Both physical fitness and its recovery were negatively associated with the duration of active rehabilitation. Conclusion: Results suggest that limiting complications, spasticity or bed rest may improve fitness. A longer duration of active rehabilitation is not associated with an increase in physical fitness.

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Post-discharge nursing problems of spinal cord injured patients: on which ” elds can nurses contribute to rehabilitation?

Abstract: SCI patients experience serious problems after discharge from clinical rehabilitation. Nurses can give input on a wide variety of these problems.

Cited by 15 publications

References 15 publications

Complications following spinal cord injury: Occurrence and risk factors in a longitudinal study during and after inpatient rehabilitation

Complications following spinal cord injury: Occurrence and risk factors in a longitudinal study during and after inpatient rehabilitation

Burden of support for partners of persons with spinal cord injuries

Physical fitness in people with a spinal cord injury: the association with complications and duration of rehabilitation

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