Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, IL, USA.
Spinal Cord. 2021 Oct;59(10):1061-1071. doi: 10.1038/s41393-021-00614-8. Epub 2021 Feb 9.
Qualitative descriptive study using semi-structured interviews OBJECTIVE: The purpose of this study was to examine the barriers and facilitators of weight management in individuals with spinal cord injury (SCI) from the perspective of SCI health care providers.
Veterans Health Administration and Midwest Regional SCI Care Systems.
Health care providers (n = 25) who care for individuals with SCI completed semi-structured interviews. Thematic analysis methodology was used to identify emergent themes around barriers and facilitators to weight management in SCI.
Sixteen subthemes emerged for barriers and seven subthemes emerged for facilitators for weight management in SCI. Barriers included individual-level factors (e.g., physical ability/mobility limitations, lack of interest, psychological obstacles, lack of knowledge, poor dietary strategies), socio-environmental factors (e.g., challenges with family support, lack of access to weight management resources, dependency on others, difficulties obtaining weight measurement), and organizational factors (e.g., lack of integration/inconsistent weight management support from healthcare systems, pushing calorie intake early post-injury). Facilitators included individual-level factors (e.g., motivation, education/knowledge, participation in exercise and physical activity) and socio-environmental factors (e.g., positive support network, access to/use of healthy dietary strategies, access to exercise facilities/adaptive equipment, participating in weight management with others).
Healthcare providers identified individual-level, socio-environmental, and organizational barriers and facilitators that influence weight management efforts in individuals with SCI. Future weight management resources and programs should consider addressing common barriers identified by healthcare providers, individuals with SCI, and their caregivers, and develop strategies to promote facilitators to enhance weight management in this population.
采用半结构式访谈的定性描述性研究
本研究旨在从脊髓损伤（SCI）医疗保健提供者的角度探讨 SCI 个体体重管理的障碍和促进因素。
退伍军人健康管理局和中西部地区脊髓损伤护理系统。
照顾 SCI 患者的医疗保健提供者（n=25）完成了半结构式访谈。使用主题分析方法确定 SCI 体重管理障碍和促进因素的主题。
在 SCI 体重管理的障碍方面，出现了 16 个子主题，促进因素方面出现了 7 个子主题。障碍包括个体层面的因素（例如，身体能力/移动性限制、缺乏兴趣、心理障碍、缺乏知识、不良饮食策略）、社会环境因素（例如，家庭支持的挑战、缺乏体重管理资源、依赖他人、难以获得体重测量）和组织因素（例如，医疗保健系统缺乏整合/不一致的体重管理支持，在受伤后早期推动热量摄入）。促进因素包括个体层面的因素（例如，动机、教育/知识、参与运动和身体活动）和社会环境因素（例如，积极的支持网络、获得/使用健康饮食策略、获得运动设施/适应性设备、与他人一起参与体重管理）。
医疗保健提供者确定了影响 SCI 个体体重管理努力的个体层面、社会环境和组织障碍和促进因素。未来的体重管理资源和计划应考虑解决医疗保健提供者、SCI 患者及其护理人员共同确定的常见障碍，并制定策略以促进该人群的体重管理。
