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评估一项基于社区的脊髓损伤成年人自我管理计划的试点项目。

Evaluating a pilot community-based self-management program for adults with spinal cord injury.

机构信息

Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada.

Centralized Services, SPD, Singapore.

出版信息

J Spinal Cord Med. 2024 Nov;47(6):881-892. doi: 10.1080/10790268.2023.2220510. Epub 2023 Aug 7.

Abstract

To evaluate outcomes and perceptions of participating in a pilot spinal cord injury (SCI) specific community-based self-management program. A program evaluation conducted through the review of retrospective data. An outpatient vocational rehabilitation service in Singapore. Adults with SCI who completed a self-management intervention. A self-management educational program was delivered by healthcare professionals with involvement of peer mentors. Up to six self-selected topics were covered using a multi-modal teaching approach. Retrospective data collected at baseline, post-intervention, and three-month follow-up were analyzed. Outcome measures included the University of Washington Self-Efficacy scale (UW-SES), SCI Secondary Conditions Scale (SCI-SCS), Community Integration Questionnaire (CIQ), and employment. Post-program survey findings were also reviewed. Data from fifteen participants revealed positive changes over time for the UW-SES (η² = .27), SCI-SCS (η² = .21), and CIQ (η² = .23). Self-efficacy scores increased from baseline to post-intervention with a large effect size (Hedge's = 0.89), and from baseline to follow-up with a medium effect size (Hedge's = 0.50). Participants reported overall perceived benefit and satisfaction with the program's design and relevance. They valued access to useful information, effective instructional methods, program customization, and participant empowerment and affirmation. Suggestions for program refinement included: more peer support, psycho-emotional support, and continued program adaptability and accessibility. A SCI-specific community-based self-management program was associated with short-term improvements in self-efficacy and was well-received. Further research is required to determine its effectiveness, essential program features that promote successful outcomes, and cost-effectiveness of program implementation.

摘要

评估参与试点性脊髓损伤 (SCI) 特定社区为基础的自我管理计划的结果和认知。通过回顾回顾性数据进行的方案评估。新加坡的一家门诊职业康复服务机构。完成自我管理干预的 SCI 成人。由医疗保健专业人员提供自我管理教育计划,并涉及同伴导师。使用多模式教学方法涵盖多达六个自选主题。在基线、干预后和三个月随访时收集回顾性数据。结果衡量标准包括华盛顿大学自我效能感量表 (UW-SES)、SCI 继发状况量表 (SCI-SCS)、社区融入问卷 (CIQ) 和就业情况。还审查了方案后调查的结果。来自十五名参与者的数据显示,UW-SES(η²=0.27)、SCI-SCS(η²=0.21)和 CIQ(η²=0.23)随时间呈阳性变化。自我效能感评分从基线到干预后增加,具有较大的效应量(Hedge's = 0.89),从基线到随访具有中等效应量(Hedge's = 0.50)。参与者报告对方案设计和相关性的整体感知益处和满意度。他们重视获取有用信息、有效的教学方法、方案定制以及参与者的赋权和肯定。对方案改进的建议包括:更多的同伴支持、心理情感支持以及持续的方案适应性和可及性。特定于 SCI 的社区为基础的自我管理方案与短期自我效能感的提高相关,并且受到好评。需要进一步研究来确定其有效性、促进成功结果的基本方案特征以及方案实施的成本效益。

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