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在地理范围有限的脊髓损伤个体样本中,COVID-19 大流行期间的获取限制和心理困扰程度。

Access limitations and level of psychological distress during the COVID-19 pandemic in a geographically-limited sample of individuals with spinal cord injury.

机构信息

Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida, USA.

Research Service, Miami Veterans Affairs (VA) Healthcare System, Miami, Florida, USA.

出版信息

J Spinal Cord Med. 2022 Sep;45(5):700-709. doi: 10.1080/10790268.2021.2013592. Epub 2021 Dec 22.

Abstract

OBJECTIVES

Assess changes in access and psychological status during the COVID-19 pandemic in people with spinal cord injury (SCI).

STUDY DESIGN

Cohort telephone survey study.

SETTING

South Florida SCI Model System (SF-SCIMS).

PARTICIPANTS

A convenience sample of 51 individuals with traumatic SCI who had previously completed SCIMS Form II follow-up interviews.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURE(S): Questionnaire administration included assessments of resilience, depressive symptoms, satisfaction with life, anxiety, pain, alcohol and substance use, COVID-19 diagnoses and symptoms, and impact of early COVID-19 community restrictions on various aspects of life.

RESULTS

Of the individuals interviewed, 78% reported limited access to their regular activities, 40% to healthcare information and services, 38% to personal protective equipment (PPE), 37% to food/groceries, and 34% to medication refills. Sixteen percent of the participants had at least moderate levels of depression, and 10% had at least moderate levels of anxiety. Statistically significant increases in depressive symptoms (Patient Health Questionnaire 9;  = 0.004) and significant decreases in resilience (SCI-Quality of Life Resilience subscore;  = 0.010) were found when comparing scores on measures of psychological function at the time of the study to scores collected during the previous SCIMS Form II interview (within 2 years pre-COVID-19).

CONCLUSION(S): Limitations to basic needs and face-to-face communication can exacerbate challenges in access for persons with disabilities. Our results show increased levels of psychological distress related to decreased access to goods and services in individuals with SCI due to the COVID-19 pandemic. The results of this study can help the SCI community to target strategies for enhanced access, outreach, shared information, and social support in preparation for future community health or weather emergencies.

摘要

目的

评估 COVID-19 大流行期间脊髓损伤(SCI)患者获取医疗资源和心理健康状况的变化。

研究设计

队列电话调查研究。

设置

南佛罗里达 SCI 模型系统(SF-SCIMS)。

参与者

51 名曾完成过 SCIMS 第二期随访访谈的创伤性 SCI 患者的便利样本。

干预措施

无。

主要观察指标

问卷评估包括韧性、抑郁症状、生活满意度、焦虑、疼痛、酒精和药物使用、COVID-19 诊断和症状,以及早期 COVID-19 社区限制对生活各方面的影响。

结果

在接受采访的人群中,78%的人报告活动受限,40%的人难以获得医疗信息和服务,38%的人难以获得个人防护设备(PPE),37%的人难以获得食品/杂货,34%的人难以获得药物续方。16%的参与者有至少中度的抑郁症状,10%的参与者有至少中度的焦虑症状。与之前的 SCIMS 第二期访谈(COVID-19 前 2 年内)相比,研究时心理功能测量的评分显示,抑郁症状(患者健康问卷 9;=0.004)显著增加,韧性(SCI 生活质量韧性子评分;=0.010)显著降低。

结论

基本需求和面对面交流的限制会加剧残疾人获取医疗资源的困难。我们的研究结果表明,COVID-19 大流行期间,由于获取商品和服务受限,SCI 患者的心理困扰水平增加。这项研究的结果可以帮助 SCI 社区制定策略,以增强未来社区卫生或天气紧急情况下的获取、外展、信息共享和社会支持。

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