Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 22
Filter
1.
Spinal Cord ; 60(11): 984-989, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1947284

ABSTRACT

STUDY DESIGN: A qualitative study using focus group discussion. OBJECTIVE: To explore the impacts of COVID-19 on multiple aspects of the lives of individuals living with spinal cord injury (SCI) in Nepal. SETTING: Community settings in Nepal. METHODS: A qualitative phenomenological study was conducted using two virtual focus group discussions. Fourteen individuals with SCI residing in different parts of Nepal participated. A thematic analysis approach was used to analyze and interpret the participants' responses. RESULTS: The four key themes for the impacts of COVID-19 on individuals with SCI were: (1) physical health with subthemes of (a) difficulty due to the presence of COVID-19 symptoms and (b) deterioration in secondary conditions; (2) mental health with subthemes of (c) constant fear of COVID-19 and (d) psychological distress; (3) social life with subthemes of (e) social stigma and (f) social isolation, and (4) economic problems with subthemes of (g) financial burden and (i) inadequate resources. CONCLUSIONS: The pandemic has tremendously impacted the physical, mental, social, and economic aspects of the lives of individuals with SCI. These, in turn, could impede the functioning and well-being of this population. The utilization of telehealth to provide education, psychosocial support, social awareness programs, and the provision of essential medical supplies appear necessary to maintain and improve the well-being of individuals with SCI during this pandemic. Future studies using an in-depth interview approach and psychosocial interventions are recommended.


Subject(s)
COVID-19 , Spinal Cord Injuries , Humans , Pandemics , Spinal Cord Injuries/complications , Spinal Cord Injuries/epidemiology , Spinal Cord Injuries/therapy , COVID-19/epidemiology , Nepal/epidemiology , Qualitative Research
2.
Ir Med J ; 115(4): 583, 2022 04 29.
Article in English | MEDLINE | ID: covidwho-1887627

ABSTRACT

Aim To investigate the impact of the first wave of the Covid-19 pandemic on the care of patients with newly acquired traumatic spinal cord injury (TSCI) in Ireland Methods A prospective audit of patients with newly acquired TSCI from 1st March to 30th June 2020 was undertaken. Cases were drawn from referrals received through the National Spinal Injuries Unit (NSIU) and neurosciences centres. The standard of care guidelines used were from National Health Service (NHS) England standards, the Irish Integrated Care Pathway and British Association of Spinal cord Injury Specialist (BASCIS) COVID-19 guidelines. Results Nineteen patients sustained a TSCI during the study period. Thirteen patients (68%) were treated in the NSIU, eleven of whom were subsequently repatriated to non-specialist centres. Twelve patients (63%) waited an average of 113.8 ± 33.4 days for admission to specialist in-patient rehabilitation. Nine patients (75%) had developed at least one secondary complication by the time of admission. Conclusion With the exception of waiting time for specialist in-patient rehabilitation, delivery of TSCI care during this period was similar to the care previously recorded. Shortcomings in service provision are long-standing and highlight the need for timely implementation of an integrated trauma network for Ireland.


Subject(s)
COVID-19 , Spinal Cord Injuries , Spinal Injuries , Humans , Pandemics , Spinal Cord Injuries/epidemiology , Spinal Cord Injuries/therapy , Spinal Injuries/complications , State Medicine , Subacute Care
3.
Top Spinal Cord Inj Rehabil ; 28(2): 185-195, 2022.
Article in English | MEDLINE | ID: covidwho-1786626

ABSTRACT

Background: Emerging evidence suggests that the COVID-19 pandemic has been accompanied by increased rates of depression and social isolation. However, we do not yet understand how the COVID-19 pandemic has affected the psychosocial health of people with spinal cord injury (PwSCI), a population that is already at risk of experiencing mental health conditions. Objectives: The aims of the study were to (1) examine the impact of the pandemic on the psychosocial health of PwSCI and (2) investigate the experiences of PwSCI and resources they reported needing during the peak of the pandemic. Methods: A cross-sectional survey with closed- and open-ended questions was administered to 51 PwSCI. Participants were included if they had an SCI, were 18 years or older, lived in St. Louis, Missouri, and surrounding areas, and understood English. Results: Canonical correlation showed a significant association between financial security, food insecurity, and personal assistance service use and adverse psychosocial health outcomes (p < .001). Participants reported interest in resources related to COVID-19 precautions for wheelchair users as well as home exercise programming and financial assistance with utilities. Finally, qualitative analysis revealed four major themes: (1) mental health during the pandemic, (2) financial concerns and reduced access to personal assistance services, (3) feelings of social isolation prior to the pandemic, and (4) local and national authorities' handling of the pandemic. Conclusion: PwSCI are impacted by the COVID-19 pandemic and reported a variety of resource needs. These findings may inform service providers, support systems, and organizations to better support PwSCI during times of crisis.


Subject(s)
COVID-19 , Spinal Cord Injuries , Cross-Sectional Studies , Humans , Pandemics , SARS-CoV-2 , Spinal Cord Injuries/complications , Spinal Cord Injuries/epidemiology
4.
Spinal Cord ; 60(8): 757-762, 2022 08.
Article in English | MEDLINE | ID: covidwho-1713155

ABSTRACT

BACKGROUND AND OBJECTIVE: During the COVID-19 pandemic, several aspects of life have been affected. These aspects have been impacted especially in persons with spinal cord injury (SCI). The current study explored the overall effect of the COVID-19 pandemic on quality of life (QOL) domains in persons with SCI as well as evaluated their adherence to WHO-COVID 19-preventive measures. DESIGN: A retrospective longitudinal study was conducted after asking participants to complete an online validated Arabic version of the WHOQOL-BREF questionnaires including their demographics. The WHOQOL-BREF questionnaires were completed targeting two separate occasions to represent their scores prior to and during the pandemic. Participants were asked to rate their adherence to WHO-COVID-19 preventive measures on a 10-point scale. SETTING AND PARTICIPANTS: 115 participants with complete/ incomplete SCI were recruited via social media and contacted by phone to complete the questionnaires. RESULTS: Persons with SCI had lower QOL scores during the COVID-19 period compared to their QOL during the pre-COVID-19 period; all QOL domains (Physical Health, Psychological, Social Relationships, and Environment) showed a significant decrease (P < 0.001). Regarding COVID-19 preventative measures, participants were most likely to endorse self-isolation as well as staying home measures and least likely to adhere to hand washing and social distancing measures. CONCLUSION: The robustly reduced QOL reported by individuals with SCI during the COVID-19 pandemic highlights the need for rehabilitation and mental health services, particularly administered via telehealth, to buffer the effects of the pandemic. Additionally, psychoeducation and support regarding COVID-19 preventative behaviors in this region would be critical.


Subject(s)
COVID-19 , Spinal Cord Injuries , COVID-19/epidemiology , COVID-19/prevention & control , Egypt , Humans , Longitudinal Studies , Pandemics , Quality of Life/psychology , Retrospective Studies , Spinal Cord Injuries/epidemiology , Spinal Cord Injuries/psychology , Surveys and Questionnaires
5.
Spinal Cord Ser Cases ; 8(1): 2, 2022 01 12.
Article in English | MEDLINE | ID: covidwho-1636921

ABSTRACT

STUDY DESIGN: An observational study based on an online survey to explore if the participant had experienced (1) cancellation or delay of scheduled health services (2) reduction of assistance provided by a caregiver (3) barriers to social participation and recreational activities. Three validated questionnaires to investigate well-being and symptoms of anxiety and depression were also administered. OBJECTIVES: Our main aim was to quantify the obstacles experienced by adults living with SCI in Italy during COVID-19 pandemic, to explore the presence of depression and anxiety symptoms and to quantify subjective well-being. SETTING: Outpatient clinic of a Spinal Unit in Italy. METHODS: Online survey via direct contact and by e-mail lists. RESULTS: In total, 101 individuals completed the survey. Of, 82.2% participants reported a history of deferment or cancellation of non-COVID-19 health services. The majority (56.4%) revealed that, at least seldom, they have chosen to reduce their usual everyday activities and more than one third (37.6%) affirmed that they had been forced to renounce to one or more of their occupations. Discontinuation of assistance by caregivers was uncommon. The median score of questionnaires measuring depression and anxiety symptoms do not differ significatively when compared with prior studies. The variable that explored the limitations experienced in everyday activities showed a significant correlation with the results of the questionnaires measuring well-being and symptoms of anxiety. CONCLUSIONS: We believe that our results could contribute to the discussion ongoing inside our community on how to answer to the new challenges of this pandemic period and of the post-pandemic future.


Subject(s)
COVID-19 , Spinal Cord Injuries , Adult , Humans , Pandemics , Perception , SARS-CoV-2 , Spinal Cord Injuries/epidemiology , Surveys and Questionnaires
6.
J Spinal Cord Med ; 45(5): 700-709, 2022 09.
Article in English | MEDLINE | ID: covidwho-1585457

ABSTRACT

OBJECTIVES: Assess changes in access and psychological status during the COVID-19 pandemic in people with spinal cord injury (SCI). STUDY DESIGN: Cohort telephone survey study. SETTING: South Florida SCI Model System (SF-SCIMS). PARTICIPANTS: A convenience sample of 51 individuals with traumatic SCI who had previously completed SCIMS Form II follow-up interviews. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE(S): Questionnaire administration included assessments of resilience, depressive symptoms, satisfaction with life, anxiety, pain, alcohol and substance use, COVID-19 diagnoses and symptoms, and impact of early COVID-19 community restrictions on various aspects of life. RESULTS: Of the individuals interviewed, 78% reported limited access to their regular activities, 40% to healthcare information and services, 38% to personal protective equipment (PPE), 37% to food/groceries, and 34% to medication refills. Sixteen percent of the participants had at least moderate levels of depression, and 10% had at least moderate levels of anxiety. Statistically significant increases in depressive symptoms (Patient Health Questionnaire 9; P = 0.004) and significant decreases in resilience (SCI-Quality of Life Resilience subscore; P = 0.010) were found when comparing scores on measures of psychological function at the time of the study to scores collected during the previous SCIMS Form II interview (within 2 years pre-COVID-19). CONCLUSION(S): Limitations to basic needs and face-to-face communication can exacerbate challenges in access for persons with disabilities. Our results show increased levels of psychological distress related to decreased access to goods and services in individuals with SCI due to the COVID-19 pandemic. The results of this study can help the SCI community to target strategies for enhanced access, outreach, shared information, and social support in preparation for future community health or weather emergencies.


Subject(s)
COVID-19 , Psychological Distress , Spinal Cord Injuries , COVID-19/epidemiology , Humans , Pandemics , Quality of Life , Spinal Cord Injuries/complications , Spinal Cord Injuries/epidemiology , Spinal Cord Injuries/psychology
7.
Rehabil Psychol ; 66(4): 373-379, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1555824

ABSTRACT

PURPOSE/OBJECTIVE: To provide a descriptive account of the impact of the COVID-19 pandemic on the spinal cord injury (SCI) community focused on participants' concerns about medical discrimination and medical rationing, the impact of the pandemic on access to personal care attendants and medical supplies, and the impact of the pandemic on overall and mental health. Research Method/Design: Cross sectional, observational study among community-dwelling adults with SCI. Data were collected online between May 1, 2020 and August 31, 2020 (n = 187). The online questionnaire included questions regarding medical discrimination and rationing, the impact of the pandemic on access to care and medical supplies, and the impact of the pandemic on overall and mental health. RESULTS: Individuals with SCI have experienced difficulty accessing medical supplies due to the pandemic, and approximately half of our participants (52%) perceived that discrimination through medical rationing was occurring. Furthermore, compared to the general U.S. population, our sample reported that the pandemic had a greater negative impact on their mental health and access to medical supplies. CONCLUSION/IMPLICATIONS: Our findings suggest that the COVID-19 pandemic has negatively impacted mental health and increased concerns of social isolation as well as access to medical supplies among those with SCI. Rehabilitation psychologists must advocate alongside the disability community to limit health disparities and to conduct outreach, specifically with regard to mental health issues. Future research should focus on the effects of pandemic-related fears and social isolation, as well as resilience in the context of public health care threats. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
COVID-19 , Spinal Cord Injuries , Adult , Cross-Sectional Studies , Humans , Pandemics , SARS-CoV-2 , Social Isolation , Spinal Cord Injuries/epidemiology
9.
J Spinal Cord Med ; 44(sup1): S256-S265, 2021.
Article in English | MEDLINE | ID: covidwho-1517695

ABSTRACT

BACKGROUND: The current pandemic has reduced access to safe, monitored physical activity (PA) programs for persons with spinal cord injury (SCI). The use of telerehabilitation has the potential for continuing activity engagement without risking virus exposure. The present study evaluates the feasibility and efficacy of an online group-based PA program for persons with SCI. METHODS: This preliminary pre-post study delivered an online group-based PA program to persons with SCI. The program consisted of 1-hour sessions twice weekly for six weeks. Online PA satisfaction questionnaires were assessed at post-treatment. Psychosocial subscales from the NeuroQOL-SF were assessed. RESULTS: Participants were adult females between 3 and 32 years post-injury, 1 tetraplegic and 3 paraplegics (n = 4). All participants were highly satisfied with the online instruction, overall content, and videoconferencing platform. Participants stated that the online program was beneficial for their overall physical and psychosocial wellbeing. The program resulted in improvement in anxiety and satisfaction with social roles and activities. CONCLUSION: The current pilot study demonstrates the acceptability and limited efficacy of an online PA program for those with SCI. The program resulted in improved overall perceived wellbeing and satisfaction with social roles and activities. These results have important implications for the clinical implementation of online PA programs in a hospital and community setting.


Subject(s)
COVID-19 , Spinal Cord Injuries , Adult , Exercise , Feasibility Studies , Female , Humans , Pandemics , Pilot Projects , SARS-CoV-2 , Spinal Cord Injuries/epidemiology
10.
J Spinal Cord Med ; 44(sup1): S147-S158, 2021.
Article in English | MEDLINE | ID: covidwho-1517694

ABSTRACT

CONTEXT: Dedicated implementation efforts are critical to bridging the gaps between current practices and best practices. A quality improvement collaborative (QIC), the Spinal Cord Injury Implementation and Evaluation Quality Care Consortium (SCI IEQCC), was established to meet this need, bringing together a network of clinicians and administrators to systematically improve the quality and equity of tertiary spinal cord injury or disease (SCI/D) rehabilitation care in Ontario, Canada. METHODS: Clinicians and leaders from five tertiary SCI/D rehabilitation centers and two not-for-profit SCI/D advocacy groups comprised a network dedicated to supporting implementation of the SCI-High quality indicators in prioritized domains of SCI rehabilitation and related best practices by: (1) building capacity through implementation science education of frontline clinicians; (2) providing resources and support to empower frontline clinicians to lead quality improvement efforts within their institutions; (3) promoting wider learning through a network for sharing ideas, efforts, and experiences; and (4) collecting indicator data to facilitate provincial evaluation of goal attainment. RESULTS: Network members and sites collaborated to implement best practices within six priority domains; in 18 months, significant progress has been made in emotional wellbeing, sexual health, walking, and wheeled mobility despite disruptions due to the COVID-19 pandemic. These efforts encompass heterogeneous challenges and strategies, ranging from developing clinical skills programs, to streamlining processes, to manipulating physical space. CONCLUSION: A QIC targeting SCI/D rehabilitation demonstrates promise for advancing the implementation of best practices, building implementation science capacity across multiple sites, and for promoting collaboration amongst SCI/D rehabilitation centers and organizational partners.


Subject(s)
COVID-19 , Spinal Cord Injuries , Humans , Ontario/epidemiology , Pandemics , SARS-CoV-2 , Spinal Cord Injuries/epidemiology
11.
Spinal Cord ; 59(12): 1261-1267, 2021 12.
Article in English | MEDLINE | ID: covidwho-1437670

ABSTRACT

STUDY DESIGN: Cross-sectional, observational study. OBJECTIVES: To understand how resilience, access to personal care attendants (PCAs) and medical supplies, and concerns about medical rationing, finances, and social isolation are related to overall and mental health in individuals with spinal cord injury (SCI) in the context of the COVID-19 pandemic. SETTING: Community dwelling adults (N = 187) with SCI. METHODS: Data were collected online between May 1, 2020 and August 31, 2020. Outcomes were overall and mental health, depression and anxiety symptoms, and quality of life (QoL). Predictors were resilience, access to PCAs and medical supplies, and concerns about medical rationing, finances, and social isolation. RESULTS: Incomplete injury, concern about medical rationing, medical supply disruption, and social isolation predicted a greater perceived impact of the pandemic on overall heath. Younger age, decreased resilience, and concern about medical rationing and social isolation predicted greater perceived impact of the pandemic on mental health. Decreased resilience and concern about medical rationing and finances predicted increased anxiety symptoms. Incomplete injury, believing that medical rationing was occurring, decreased resilience, and concern about finances and social isolation predicted increased depressive symptoms. Decreased resilience and concern about finances, medical rationing, and social isolation predicted lower QoL. CONCLUSIONS: The negative effects of the pandemic on the overall and mental health of individuals with SCI may be ameliorated by resilience. In future crises, it may be beneficial to screen individuals for resilience so that those with decreased resilience are offered the appropriate resources to enhance resilience and improve overall wellbeing.


Subject(s)
COVID-19 , Spinal Cord Injuries , Adult , Cross-Sectional Studies , Depression/epidemiology , Depression/etiology , Humans , Mental Health , Pandemics , Quality of Life , SARS-CoV-2 , Spinal Cord Injuries/complications , Spinal Cord Injuries/epidemiology
15.
J Clin Neurosci ; 88: 128-134, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1176834

ABSTRACT

Early COVID-19-targeted legislations reduced public activity and elective surgery such that local neurosurgical care greatly focused on emergent needs. This study examines neurosurgical trauma patients' dispositions through two neighboring trauma centers to inform resource allocation. We conducted a retrospective review of the trauma registries for two Level 1 Trauma Centers in Santa Clara County, one academic and one community center, between February 1st and April 15th, 2018-2020. Events before a quarantine, implemented on March 16th, 2020, and events from 2018 to 19 were used for reference. Encounters were characterized by injuries, services, procedures, and disposition. Categorical variables were analyzed by the χ2 test, proportions of variables by z-score test, and non-parametric variables by Fisher's exact test. A total of 1,336 traumas were identified, with 31% from the academic center and 69% from the community center. During the post-policy period, relative to matching periods in years prior, there was a decrease in number of TBI and spinal fractures (24% versus 41%, p < 0.001) and neurosurgical consults (27% versus 39%, p < 0.003), but not in number of neurosurgical admissions or procedures. There were no changes in frequency of neurosurgery consults among total traumas, patients triaged to critical care services, or patients discharged to temporary rehabilitation services. Neurosurgical services were similarly rendered between the academic and community hospitals. This study describes neurosurgical trauma management in a suburban healthcare network immediately following restrictive quarantine during a moderate COVID-19 outbreak. Our data shows that neurosurgery remains a resource-intensive subspeciality, even during restrictive periods when overall trauma volume is decreased.


Subject(s)
COVID-19 , Neurosurgery/trends , Pandemics , Quarantine , Trauma Centers/trends , Academic Medical Centers , Adult , Brain Injuries, Traumatic/epidemiology , Brain Injuries, Traumatic/surgery , California/epidemiology , Child , Community Health Centers , Female , Humans , Male , Neurosurgery/statistics & numerical data , Retrospective Studies , Spinal Cord Injuries/epidemiology , Spinal Cord Injuries/surgery , Trauma Centers/statistics & numerical data , Wounds and Injuries/surgery , Wounds and Injuries/therapy
16.
BMJ Open ; 10(11): e038204, 2020 11 05.
Article in English | MEDLINE | ID: covidwho-1148165

ABSTRACT

INTRODUCTION: Pneumonia is one of the leading complications and causes of death after a spinal cord injury (SCI). After a cervical or thoracic lesion, impairment of the respiratory muscles decreases respiratory function, which increases the risk of respiratory complications. Pneumonia substantially reduces patient's quality of life, may prolong inpatient rehabilitation time, increase healthcare costs or at worse, lead to early death. Respiratory function and coughing can be improved through various interventions after SCI, but the available evidence as to which aspect of respiratory care should be optimised is inconclusive. Furthermore, ability of respiratory function parameters to predict pneumonia risk is insufficiently established. This paper details the protocol for a large-scale, multicentre research project that aims to evaluate the ability of parameters of respiratory function to predict and understand variation in inpatient risk of pneumonia in SCI. METHODS AND ANALYSIS: RESCOM, a prospective cohort study, began recruitment in October 2016 across 10 SCI rehabilitation centres from Australia, Austria, Germany, the Netherlands and Switzerland. Inpatients with acute SCI, with complete or incomplete cervical or thoracic lesions, 18 years or older and not/no more dependent on 24-hour mechanical ventilation within the first 3 months after injury are eligible for inclusion. The target sample size is 500 participants. The primary outcome is an occurrence of pneumonia; secondary outcomes include pneumonia-related mortality and quality of life. We will use the longitudinal data for prognostic models on inpatient pneumonia risk factors. ETHICS AND DISSEMINATION: The study has been reviewed and approved by all local ethics committees of all participating centres. Study results will be disseminated to the scientific community through peer-reviewed journals and conference presentations, to the SCI community, other stakeholders and via social media, newsletters and engagement activities. TRIAL REGISTRATION DETAILS: ClinicalTrials.gov NCT02891096.


Subject(s)
Spinal Cord Injuries , Adolescent , COVID-19 , Developed Countries , Humans , Multicenter Studies as Topic , Prospective Studies , Quality of Life , SARS-CoV-2 , Spinal Cord Injuries/complications , Spinal Cord Injuries/epidemiology
19.
J Neurotrauma ; 38(9): 1242-1250, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1066222

ABSTRACT

Persons living with spinal cord injury (SCI) are potentially at risk for severe COVID-19 disease given that they often have decreased lung capacity and may lack the ability to effectively evacuate their lungs. Known risk factors for negative outcomes after COVID-19, such as obesity, diabetes, and cardiovascular disease, disproportionally affect people with SCI and raise concerns for the mortality risk among persons with SCI. A rapid systematic review of English, Spanish, Portuguese, and Chinese literature on COVID-19 and SCI was performed using the keywords "spinal cord injury" and "COVID-19." We included studies that provided information on clinical presentation, characteristics, course, and outcomes of COVID-19 disease in SCI. We excluded studies on patients who did not have an SCI before severe acute respiratory syndrome coronavirus-2 infection or did not report clinical information. We included 10 studies in total: nine studies with a total of 171 patients and a survey study of 783 healthcare professionals. Fever (74%), cough (52%), and dyspnea (33%) were the most frequently reported symptoms, and 63% showed abnormalities on X-ray imaging. In the included case series and reports (N = 31), only 1 patient required mechanical ventilation, but 3 patients died (10%). The mortality rate in a large registry study (N = 140) was 19%. Clinical presentation of COVID-19 in SCI patients was similar to the general population, and though adverse events and intensive care unit admission were low, the mortality rate was high (10-19%). No prognostic factors for severe disease or mortality could be identified. Registration (PROSPERO): CRD42020196565.


Subject(s)
COVID-19/complications , Spinal Cord Injuries/complications , COVID-19/epidemiology , COVID-19/mortality , Humans , Spinal Cord Injuries/epidemiology , Spinal Cord Injuries/mortality
SELECTION OF CITATIONS
SEARCH DETAIL