LaVela Sherri L, Burkhart Elizabeth, Jones Kayla, Pellegrini Christine
Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines, Illinois, USA.
Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
PM R. 2023 Jan;15(1):20-30. doi: 10.1002/pmrj.12709. Epub 2021 Oct 29.
Literature shows that large proportions of people with a spinal cord injury (SCI) continue to experience challenges and limitations in weight management (WM) efforts in the health care setting. Despite the need, evidence-based research on effective and practical WM practices for persons with SCI is inconsistent and not widely used by health care providers (HCPs).
The objectives were twofold: (1) to explore HCP perspectives of the extent of the problem of overweight/obesity in individuals with SCI and (2) HCPs awareness of and beliefs about availability of literature or evidence-based guidelines that discuss WM in SCI.
Qualitative study using semistructured interviews with HCPs and thematic analysis to identify themes.
PARTICIPANTS/SETTING: SCI HCPs (n = 25) from Veterans Health Administration and Midwest Regional SCI Care System.
Not applicable.
SCI HCPs (88%) emphasized the large scope of the problem of overweight and obesity in persons with SCI. HCPs noted the multiple associated negative consequences, specifically 84% highlighted the impact on chronic conditions (cardiometabolic, respiratory) and 48% discussed the impact on secondary/associated conditions (skin, bowel, bladder, musculoskeletal). HCPs noted other impacts of excess weight as greater disability in later life (28%), challenges with mobility and function (60%), self-care (24%), and equipment safety (28%). This sample of HCPs (76%) indicated being unaware of published or available information about WM efforts that work in SCI populations.
Our findings indicate that HCPs believe that overweight and obesity is a significant problem in persons with SCI but that this sample of HCPs are not aware of published work and easily accessible SCI-specific WM evidence-based guidance. This suggests the need for more education and proactive efforts to improve awareness of appropriate information within interprofessional HCPs.
文献表明，在医疗环境中，很大一部分脊髓损伤（SCI）患者在体重管理（WM）方面仍面临挑战和限制。尽管有需求，但针对SCI患者有效且实用的体重管理实践的循证研究并不一致，医疗服务提供者（HCPs）也未广泛采用。
目标有两个：（1）探讨HCPs对SCI患者超重/肥胖问题严重程度的看法；（2）HCPs对讨论SCI患者体重管理的文献或循证指南的知晓情况及看法。
采用对HCPs进行半结构化访谈的定性研究，并通过主题分析确定主题。
参与者/设置：来自退伍军人健康管理局和中西部地区脊髓损伤护理系统的脊髓损伤HCPs（n = 25）。
不适用。
脊髓损伤HCPs（88%）强调了SCI患者超重和肥胖问题的严重性。HCPs指出了多种相关的负面后果，具体而言，84%强调了对慢性疾病（心脏代谢、呼吸）的影响，48%讨论了对继发性/相关疾病（皮肤、肠道、膀胱、肌肉骨骼）的影响。HCPs指出超重的其他影响包括晚年残疾加剧（28%）、行动和功能方面的挑战（60%）、自我护理（24%）以及设备安全（28%）。该样本中的HCPs（76%）表示未意识到有关SCI人群有效体重管理措施的已发表或可获取信息。
我们的研究结果表明，HCPs认为超重和肥胖是SCI患者的一个重大问题，但该样本中的HCPs并不知晓已发表的研究，也难以获取针对SCI的、基于循证的体重管理指南。这表明需要开展更多教育和积极措施，以提高跨专业HCPs对适当信息的认识。
