Kern Stephen B, Hunter Louis N, Sims Ashley C, Berzins Davis, Riekena Helena, Andrews Marisa L, Alderfer Jillian K, Nelson Kelly, Kushner Reva
Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania.
Department of Physical Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania.
Top Spinal Cord Inj Rehabil. 2019 Winter;25(1):62-73. doi: 10.1310/sci2501-62.
Individuals over age 65 are projected to account for over 20% of the general population by 2030. This trend is reflected in an increase in the age of individuals sustaining traumatic spinal cord injury (SCI). Based on current evidence, there is concern regarding the needs of older individuals aging with SCI and current health care services. Research is limited regarding factors that contribute to health status and treatment outcomes associated with aging 5 or more years post SCI. The purpose of this qualitative study was to explore changing health care needs of individuals aging with SCI and their caregivers and to identify the environmental supports and barriers to achieving long-term health and treatment outcomes. This was a phenomenological study utilizing semi-structured interviews. Inclusion criteria were age greater than 60 years old and 5 years post SCI. Between October 2014 and January 2016, 41 individuals with SCI and eight caregivers participated in the semi-structured interviews. Emergent themes and quotations were noted and analyzed using established methods. Triangulation was used to establish rigor and trustworthiness. Data analysis of the interviews revealed four themes (health literacy, health services, changes with age, and environment) and 10 subthemes. Rehabilitation programs should consider the health literacy of older individuals with SCI and their caregivers. Similarly, these programs should be designed to allow them to identify and utilize resources in solving barriers to everyday participation. Further investigation is required to examine the macro-environmental influences (systems and policies) on the changing health care needs of individuals aging with SCI.
预计到2030年，65岁以上的人群将占总人口的20%以上。这一趋势反映在遭受创伤性脊髓损伤（SCI）的人群年龄有所增加。根据现有证据，人们对脊髓损伤的老年患者的需求以及当前的医疗服务表示担忧。关于脊髓损伤5年或更长时间后与衰老相关的健康状况和治疗结果的影响因素的研究有限。这项定性研究的目的是探讨脊髓损伤老年患者及其护理人员不断变化的医疗需求，并确定实现长期健康和治疗结果的环境支持因素和障碍。这是一项采用半结构化访谈的现象学研究。纳入标准为年龄大于60岁且脊髓损伤后5年。在2014年10月至2016年1月期间，41名脊髓损伤患者和8名护理人员参与了半结构化访谈。使用既定方法记录并分析了浮现的主题和引语。采用三角互证法来确保严谨性和可信度。访谈的数据分析揭示了四个主题（健康素养、医疗服务、年龄变化和环境）以及10个子主题。康复项目应考虑脊髓损伤老年患者及其护理人员的健康素养。同样，这些项目的设计应使他们能够识别并利用资源来解决日常参与的障碍。需要进一步调查以研究宏观环境影响（系统和政策）对脊髓损伤老年患者不断变化的医疗需求的作用。
