KITE, Toronto Rehab-University Health Network, Toronto, ON, Canada.
Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
PLoS One. 2022 Jun 7;17(6):e0269660. doi: 10.1371/journal.pone.0269660. eCollection 2022.
Individuals living with chronic spinal cord injury or disease (SCI/D) are at an increased risk of falling. However, little is known about the impact of falls and fall risk in the subacute phase of SCI/D, despite this being a time when fall prevention initiatives are delivered. Hence, we explored the impact of falls and fall risk in individuals with subacute SCI/D as they transitioned from inpatient rehabilitation to community living.
This qualitative photo-elicitation study used an inductive thematic analysis. Eight individuals (7 male) undergoing inpatient rehabilitation at a Canadian tertiary rehabilitation hospital due to a new SCI/D participated. Six months following discharge, photo-elicitation interviewing was used to understand the impact of falls and fall risk. Over 7-14 days, participants completed a photo-assignment that involved taking photographs in response to questions, such as what increases/decreases your likelihood of falling? A semi-structured interview followed, in which participants described their photographs and discussed their experiences with falls, fall risk and fall prevention training.
Four themes were identified. 1) Risk factors and strategies identified through lived experience. Participants discovered their fall risk factors and fall prevention strategies through "trial and error". 2) Influences on the individual's perception of their fall risk. Prior experience with falls, including falls experienced by themselves as well as friends and family, influenced their perception of fall risk. 3) Experiencing life differently due to increased fall risk. A high fall risk reduced participation, increased negative emotions and decreased independence and quality of life. 4) Falls training in rehabilitation can be improved. Prior experiences with falls training varied; however, participants expressed a desire for comprehensive and individualized training.
Although participants' experiences with falls and fall prevention varied, falls and the risk of falling can have a significant impact on the first year of living with a SCI/D.
患有慢性脊髓损伤或疾病（SCI/D）的个体发生跌倒的风险增加。然而，尽管在 SCI/D 的亚急性期实施了预防跌倒的措施，但对于这一时期的跌倒及其风险的影响却知之甚少。因此，我们探讨了亚急性 SCI/D 个体从住院康复过渡到社区生活时跌倒及其风险的影响。
这项定性照片诱发研究采用了归纳主题分析。参与研究的 8 名个体（7 名男性）因新的 SCI/D 而在加拿大一家三级康复医院接受住院康复治疗。在出院后 6 个月，使用照片诱发访谈来了解跌倒及其风险的影响。在 7-14 天内，参与者完成了一项照片任务，包括根据问题拍摄照片，例如，哪些因素增加/减少了您跌倒的可能性？随后进行了半结构化访谈，参与者描述了他们的照片，并讨论了他们的跌倒经历、跌倒风险和跌倒预防培训的经验。
确定了四个主题。1）通过生活经验识别出的风险因素和策略。参与者通过“试错”发现了自己的跌倒风险因素和预防策略。2）对个人跌倒风险感知的影响。先前的跌倒经历，包括自己、朋友和家人经历的跌倒，影响了他们对跌倒风险的感知。3）由于跌倒风险增加而导致生活方式不同。高跌倒风险会减少参与度，增加负面情绪，并降低独立性和生活质量。4）康复中的跌倒培训可以得到改善。先前的跌倒培训经历各不相同，但参与者表示希望接受全面和个性化的培训。
尽管参与者对跌倒和预防跌倒的经验有所不同，但跌倒及其跌倒风险会对患有 SCI/D 的第一年生活产生重大影响。
