Department of Health and Rehabilitation Sciences; Division of Physiotherapy; Stellenbosch University; Cape Town.
Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Sweden.
S Afr Med J. 2023 May 5;113(5):46-53. doi: 10.7196/SAMJ.2023.v113i5.16791.
Spinal cord injuries typically result in a range of negative health outcomes and health states, which impacts overall functioning, health and well-being. It remains important to establish the prevalence (burden) of health outcomes to help with the development of optimal treatment strategies.
To determine the prevalence and treatment rates of secondary health conditions (SHCs) and mental health states in persons with long-term spinal cord injury (SCI) receiving public compared with private healthcare services in South Africa.
A cross-sectional survey included 200 community-dwelling persons with long-term SCI, 60% with paraplegia, 53% with complete injuries and 156 from the public and 44 from private healthcare sectors. The following modules of the International Spinal Cord Injury (InSCI) community survey were used: (i) demographic and injury characteristics; (ii) SHCs and treatment rates; and (iii) vitality and emotional well-being. All statistical analyses were stratified according to healthcare sector.
Pain (47% v. 57), sexual dysfunction (59% v. 41%) and muscle spasms (54% v. 43%) were the most common SHCs in both cohorts, and the period prevalence was significantly higher for sleeping problems (41% v. 25%), sexual dysfunction (59% v. 41%) and contractures (42% v. 20%) in the public compared with the private cohort. Persons with SCI in the private cohort received treatment more often for sleeping problems (100% v. 45%), autonomic dysreflexia (75% v. 27%) and pain (56% v. 33%) than their counterparts with public insurance. Negative mental health states were prevalent in both groups.
SHCs and negative mental health were common in persons with SCI in South Africa, while those with public insurance reporter a higher occurrence of sleep problems and contractures, as well as lower treatment rates. Overall, a need exists to better support persons with SCI in the long-term context to facilitate improved functioning and wellbeing.
脊髓损伤通常会导致一系列负面的健康结果和健康状况，从而影响整体功能、健康和幸福感。确定健康结果的患病率（负担）仍然很重要，有助于制定最佳治疗策略。
确定在南非，接受公共医疗服务与私人医疗服务的长期脊髓损伤（SCI）患者的继发性健康状况（SHC）和心理健康状况的患病率和治疗率。
一项横断面调查包括 200 名居住在社区的长期 SCI 患者，其中 60%为截瘫，53%为完全损伤，其中 156 名来自公共部门，44 名来自私人部门。使用了国际脊髓损伤（InSCI）社区调查的以下模块：（i）人口统计学和损伤特征；（ii）SHC 和治疗率；（iii）活力和情绪健康。所有统计分析均按医疗保健部门分层。
疼痛（47%比 57%）、性功能障碍（59%比 41%）和肌肉痉挛（54%比 43%）是两个队列中最常见的 SHC，公共组的睡眠问题（41%比 25%）、性功能障碍（59%比 41%）和挛缩（42%比 20%）的现患率显著高于私人组。私人组的 SCI 患者更常接受治疗，用于治疗睡眠问题（100%比 45%）、自主神经反射障碍（75%比 27%）和疼痛（56%比 33%）。两组均存在负面心理健康状况。
南非 SCI 患者中常见 SHC 和负面心理健康，而公共保险患者报告睡眠问题和挛缩发生率更高，治疗率更低。总体而言，需要在长期背景下更好地支持 SCI 患者，以促进功能和幸福感的提高。
