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脊髓损伤继发健康状况与日常活动之间潜在关联的探索性分析。

An Exploratory Analysis of the Potential Association Between SCI Secondary Health Conditions and Daily Activities.

作者信息

Cobb John, Dumont Frédéric S, Leblond Jean, Park So Eyun, Noonan Vanessa K, Noreau Luc

机构信息

Vancouver General Hospital , Vancouver , Canada ; Rick Hansen Institute , Vancouver , Canada.

Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and Université Laval , Quebec City , Canada.

出版信息

Top Spinal Cord Inj Rehabil. 2014 Fall;20(4):277-88. doi: 10.1310/sci2004-277.

Abstract

BACKGROUND

Secondary health conditions (SHCs) are common following traumatic spinal cord injury (tSCI) and are believed to influence a person's ability to participate in daily activities (DAs). This association should be understood so that health care providers may target interventions with clarity and purpose to manage SHCs and facilitate DAs to maximal effect.

OBJECTIVE

To explore the association between SHCs and DAs expressed as the increased chance of not participating as much as wanted in a DA when an SHC is present.

METHODS

Community-dwelling persons with tSCI (n = 1,137) responded to the SCI Community Survey. The occurrence and frequency of 21 SHCs were determined. The extent of participation in 26 DAs was measured. The relative risk (RR) of not participating as much as wanted in a DA when a SHC is present was calculated.

RESULTS

When some SHC were present, the RR of not participating as much as wanted increased significantly (range, 15%-153%; P < .001). Certain SHCs (light-headedness/dizziness, fatigue, weight problems, constipation, shoulder problems) were associated with a greater chance of not participating in many DAs. No single SHC was associated with every DA and conversely not every DA was associated with an SHC.

CONCLUSIONS

Maximizing participation in DAs requires minimizing SHCs in every instance. Understanding the association between SHCs and DAs may facilitate targeted care resulting in less severe SHCs, greater participation in DAs, and benefits to both the individual and society.

摘要

背景

继发性健康状况(SHCs)在创伤性脊髓损伤(tSCI)后很常见,并且被认为会影响一个人参与日常活动(DAs)的能力。应该了解这种关联,以便医疗保健提供者能够明确且有目的地针对干预措施来管理SHCs,并最大程度地促进日常活动。

目的

探讨SHCs与日常活动之间的关联,表现为当存在SHC时,在日常活动中无法如期望的那样充分参与的可能性增加。

方法

社区居住的tSCI患者(n = 1137)对脊髓损伤社区调查做出回应。确定了21种SHCs的发生情况和频率。测量了参与26项日常活动的程度。计算了存在SHC时在日常活动中无法如期望的那样充分参与的相对风险(RR)。

结果

当存在某些SHC时,无法如期望的那样充分参与的RR显著增加(范围为15% - 153%;P <.001)。某些SHCs(头晕/眩晕、疲劳、体重问题、便秘、肩部问题)与无法参与许多日常活动的更大可能性相关。没有单一的SHC与每项日常活动相关,反之亦然,并非每项日常活动都与SHC相关。

结论

要最大程度地参与日常活动,需要在每种情况下尽量减少SHCs。了解SHCs与日常活动之间的关联可能有助于进行有针对性的护理,从而使SHCs不那么严重,更多地参与日常活动,并使个人和社会都受益。

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