Disability and rehabilitation
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To investigate the mortality, quality of life and functional limitations of intensive care unit (ICU) patients with and without joint contractures 3.3 years after discharge from the hospital. ⋯ Joint contractures in ICU were associated with higher mortality. Patients who spent 2 weeks or more in ICU and developed joint contractures identified more difficulty with mobility 3.3 years after discharge; joint contractures may impose irreversible disability. A strategy to identify and treat joint contractures in ICU may prevent long-term functional limitations.
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To estimate the psychometric properties of the Spanish version of the Cumberland Ankle Instability Tool (CAIT-Sv). ⋯ CAIT-Sv is a reliable instrument with high criterion validity to measure the presence and severity of chronic ankle instability (CAI) in the Spanish population. Implications for Rehabilitation Chronic ankle instability is the most prevalent complication after ankle injuries. CAIT is a widely used tool for clinical detection of subjects with chronic ankle instability (CAI). In this study, CAIT-Sv has shown good phsychometric properties for using with Spanish speaking individuals.
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This article presents an in-depth, idiographic study examining the lived experience of chronic pain following spinal cord injury (SCI). Neuropathic pain (NP) occurs in a large majority of the SCI population and is particularly intractable to treatment. It can be both psychologically and physically debilitating. This study examines how the experience of NP is mediated by its meaning to the sufferer. ⋯ Chronic NP after SCI is often described as worse than the injury itself, often impacting upon the sufferers physical and psychological health. The experiences of persons with SCI-specific NP highlight the impact of pain on their physical, psychological and social health. This indicates that healthcare professionals should incorporate a biopsychosocial approach for managing pain post-SCI. Routine clinical follow-up of SCI patients with chronic NP, as well as comprehensive pain management treatment programmes, could address the three themes evidenced in the current study, by moving routine intervention with NP away from pain relief, towards pain management. Continued education for patients, friends, family members and healthcare professionals may be beneficial in promoting understanding and awareness of NP and its consequences following SCI.
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The present study aimed to identify predictors of rehabilitation outcome for patients with chronic musculoskeletal pain (CMP) and psychological problems. ⋯ No strong predictors of treatment outcome were found other than the baseline scores of the respective outcome variables. More disabled patients and patients with more pain benefitted more from the rehabilitation program. Other predictors improved the prediction models slightly. Implications for Rehabilitation It remains challenging to correctly predict the outcome of treatment from patients' baseline sociodemographic and psychological characteristics; predictors other than baseline scores of the outcome variables are only slightly associated with treatment outcome. Patients with chronic musculoskeletal pain and poor physical functioning or mental health benefit most from pain rehabilitation. Older patients benefit less from a pain rehabilitation program than younger patients in terms of physical functioning. Pain reduction during a pain rehabilitation program is greatest in patients with high pain intensity who are not at work at the start of the rehabilitation program. Coping style influences the outcome of rehabilitation of patients with chronic musculoskeletal pain.
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To examine the perspectives of persons living with traumatic spinal cord injuries (tSCI) on their access to health and support services. The specific aims were to identify the perceived gaps in access, classify the nature of the perceived gaps and compare differences in perceptions of access between urban and rural participants. ⋯ Maintaining health and well-being in people with tSCI demands access to both conventional health care and support services. Implications for Rehabilitation Access to both health and support services are important to maintaining the health and wellness of people with spinal cord injury. People with spinal cord injuries take an active role in coordinating their health, at times assuming various roles to compensate for perceived shortcomings of health care providers. Negotiating balances of power with gatekeepers in the health and insurance sectors was a key function of the coordinating role assumed by people with spinal cord injury. In order to effectively address the needs of this population, a coordinated interdisciplinary out-reach service, which includes peer support, must cross boundaries to engage sectors beyond traditional health care services, such as insurers and wellness providers.