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影响卢旺达道路交通骨科损伤后社会融合的因素。

Factors affecting social integration after road traffic orthopaedic injuries in Rwanda.

作者信息

Allen Ingabire J C, Stewart Aimee, Uwakunda Carine, Mugisha Didace, Sagahutu Jean Baptiste, Urimubenshi Gerard, Tumusiime David K, Bucyibaruta Georges

机构信息

Department of Surgery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.

Physiotherapy Department, University of the Witwatersrand, Johannesbourg, South Africa.

出版信息

Front Rehabil Sci. 2024 Jan 16;4:1287980. doi: 10.3389/fresc.2023.1287980. eCollection 2023.

Abstract

BACKGROUND

Road traffic injuries (RTIs) leading to long-term disability present a significant public health challenge, causing immense personal and societal consequences. Every year, 50 million people are hurt, 1.2 million die, 30% are permanently disabled, and 14% cannot return to work due to road traffic accidents. However, in many developing countries, information on the social integration of patients post-RTI remains limited. This study aimed to identify factors contributing to social integration following road traffic-related orthopedic injuries (RTOI) in Rwanda.

METHODOLOGY

A multicenter, cross-sectional study included 369 adult Road traffic orthopedic injuries (RTOI) victims from five Rwandan referral hospitals. Participants completed the IMPACT-S Questionnaire between 2 June 2022, and 31 August 2022, two years after the injury. It measured social integration in terms of activities and paricipation. We used logistic regression statistical analysis with a significance level of  < 0.05 to estimate odds ratios (OR) and 95% confidence intervals (CI). The Institutional Review Board for Health Sciences and Medicine at the University of Rwanda College of Medicine ethically authorized this study. Participants signed a written consent form before participating in the study. The data was kept private and was used only for this study.

RESULTS

The study's findings indicated that the mean age of RTOI victims was 37.5 ± 11.26 years, with a notable male predominance over females. Of the participants, 5.69% were unable to resume normal life activities. The overall mean score on the IMPACT-S scale was moderate, at 77 ± 17. Specifically, participants achieved an average score of 76 ± 16 for "activities" and a higher average of 84 ± 16 for "participation." Certain factors were associated with poor social integration compared to others, including belonging to the age group above 65 years (OR = 8.25,  = 0.02), female sex (OR = 3.26,  = 0.02), lack of rehabilitation (OR = 3.82,  = 0.01), and length of hospital stay >15 days (OR = 4.44,  = 0.02).

CONCLUSION

The majority of RTOI victims in Rwanda achieved successful reintegration into society; nevertheless, their mobility and community engagement were more significantly impacted compared to other aspects assessed by the IMPACT-S scale. The study emphasized the importance of early management, effective rehabilitation, and prompt patient discharge from the hospital in facilitating a successful return to everyday life after road traffic-related orthopedic injuries.

摘要

背景

导致长期残疾的道路交通伤害(RTIs)给公共卫生带来了重大挑战,造成了巨大的个人和社会后果。每年,有5000万人因道路交通事故受伤,120万人死亡,30%的人永久残疾,14%的人无法重返工作岗位。然而,在许多发展中国家,关于道路交通伤害后患者社会融入的信息仍然有限。本研究旨在确定卢旺达道路交通相关骨科损伤(RTOI)后促进社会融入的因素。

方法

一项多中心横断面研究纳入了来自卢旺达五家转诊医院的369名成年道路交通骨科损伤(RTOI)受害者。参与者在受伤两年后的2022年6月2日至2022年8月31日期间完成了IMPACT-S问卷。该问卷从活动和参与方面衡量社会融入情况。我们使用逻辑回归统计分析,显著性水平<0.05,以估计比值比(OR)和95%置信区间(CI)。卢旺达大学医学院健康科学与医学机构审查委员会对本研究进行了伦理授权。参与者在参与研究前签署了书面同意书。数据保密,仅用于本研究。

结果

研究结果表明,RTOI受害者的平均年龄为37.5±11.26岁,男性明显多于女性。在参与者中,5.69%的人无法恢复正常生活活动。IMPACT-S量表的总体平均得分中等,为77±17。具体而言,参与者在“活动”方面的平均得分为76±16,在“参与”方面的平均得分更高,为84±16。与其他因素相比,某些因素与社会融入不良有关,包括属于65岁以上年龄组(OR=8.25,P=0.02)、女性(OR=3.26,P=0.02)、缺乏康复(OR=3.82,P=0.01)以及住院时间>15天(OR=4.44,P=0.02)。

结论

卢旺达的大多数RTOI受害者成功重新融入了社会;然而,与IMPACT-S量表评估的其他方面相比,他们的行动能力和社区参与受到的影响更大。该研究强调了早期管理、有效康复以及患者及时出院对促进道路交通相关骨科损伤后成功回归日常生活的重要性。

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