The Health and Life Priorities of Individuals with Spinal Cord Injury: A Systematic Review

Abstract

Determining the priorities of individuals with spinal cord injury (SCI) can assist in aligning research priorities which ultimately improve these individuals' quality of life. This systematic review examined studies that directly surveyed people with SCI to ascertain their health priorities and life domains of importance. Twenty-four studies (combined sample of 5262) that met the inclusion criteria were identified using electronic databases (Medline, EMBASE, CINAHL, PsycINFO). The questionnaire methods and domains of importance were reviewed and described. While the questionnaires varied across the studies, a consistent set of priorities emerged. Functional recovery priorities were identified for the following areas: motor function (including arm/hand function for individuals with tetraplegia and mobility for individuals with paraplegia), bowel, bladder and sexual function. In addition, health, as well as relationships emerged as important life domains. The information from this study, which identified the priorities and domains of importance by individuals with SCI, may be useful for informing healthcare and research agenda-setting activities.

Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part I: rapid review of SCI prioritisation literature

“…Two reviews met the selection criteria: one SR of quantitative studies 25 and one meta-synthesis of qualitative studies. 26 The SR of quantitative studies 25 was rated as being of low-to-moderate methodological quality; a key shortcoming of this review was lack of quality appraisal of the included studies, which may bias review findings and conclusions. The metasynthesis of qualitative studies 26 was rated as being of high methodological quality, fulfilling all quality assessment criteria (Appendix 2).…”

“…Table 2 lists the primary review findings, highlighting areas of overlap and the authors' conclusions. Table 2 shows that all of the priorities identified by Simpson et al 25 were encompassed within the themes identified by Hammell. 26 Specifically, the four 'function' themes in Simpson et al relate to concepts 1 and 2 in Hammell; themes 5 and 6 from Simpson et al relate to concepts 3 and 4 in Hammell; and the remaining concepts in Hammell are not directly relatable to any of the themes from Simpson et al Characteristics of the studies included in the two reviews (citation, number of participants, data collection method and population) are contained in Appendix 3.…”

“…Notwithstanding the important differences in study methodology between the included reviews, there was some convergence in review findings. Simpson et al 25 noted that Hammell's qualitative review 26 identified '6/10 themes directly related to physical, social and psychological areas' (p. 1554). These are not specified, but two themes from Hammell's review appear directly comparable to the priorities highlighted by Simpson: 'problems associated with an impaired body,' and 'renewed importance of relationships.'…”

“…The authors of this review conclude that this information can inform research planning by helping to align consumer and researcher priorities. 25 Hammell's 26 qualitative review of 7 studies with a combined sample of 120 participants and a focus on exploration of factors that influence Quality of Life offers 'a more nuanced understanding of the experience of Quality of Life SCI than is achievable by quantitative methods ' (p. 136). Specifically, qualitative exploration facilitates description of important concepts associated with adjustment following SCI such as self-worth, injury and loss, and development of new values and perspectives.…”

Transcutaneous Electrical Nerve Stimulation for Treating Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review

“…The high prevalence of neurogenic lower urinary tract dysfunction (NLUTD) is reflected by the wide distribution of neural control in health and depends on the underlying neurological disorder, for instance reaching about 25% in patients with Alzheimer's disease and approaching 100% in those suffering from multiple sclerosis at an advanced stage [1,2]. NLUTD substantially impairs quality of life and lower urinary tract function becomes one of the most relevant aspects in daily life of the neuro-urological patient [1,3]. Optimal treatment of storage and/or voiding symptoms is a main challenge in this population, especially because conventional treatments often fail.…”