Amiri Mohammadreza, Alavinia Mohammad, Farahani Farnoosh, Khasiyeva Natavan, Burley Meredith, Kangatharan Suban, Craven Beverley Catharine
Centre for the Business and Economics of Health, The University of Queensland, St. Lucia, QLD 4072, Australia.
KITE Research Institute, University Health Network, Toronto, ON M5G 2A2, Canada.
Healthcare (Basel). 2024 Oct 20;12(20):2089. doi: 10.3390/healthcare12202089.
Personal, social, and environmental factors may influence self-efficacy and social reintegration among people living with spinal cord injury or disease (SCI/D) in urban and rural areas. Novel data collection methods have the potential to characterize community participation (CP) in diverse settings.
The objectives were (1) to describe and compare self-reported community participation (Reintegration to Normal Living Index (RNLI) and Moorong Self-Efficacy Scale (MSES)) levels of individuals with SCI/D living in urban or rural Ontario, Canada; and (2) to determine the accuracy of an artificial intelligence (AI) optical mark recognition tool for extracting data from CP surveys conducted among participants after transitioning from inpatient rehabilitation to home and residing in the community.
We partnered with SCI Ontario staff to collect MSES and RNLI survey data from adults with motor complete (e.g., AIS A-B) and incomplete (AIS C-D) SCI/D living in urban or rural Ontario, Canada, between January and October 2022. The Rurality Index of Ontario (RIO) from the postal code determined urban or rural residency. Optical mark recognition (OMR) software was used for survey data extraction. A Research Associate validated the extracted survey responses. Descriptive statistics, correlation analysis, and non-parametric statistics were used to describe the participants, their impairments, and their reported CP levels across urban and rural settings.
Eighty-five individuals with SCI/D (mean age 53.7 years, 36.5% female) completed the survey. Most of the participants resided in major urban areas (69.4%) and had traumatic injuries (64.7%). The mean total MSES score for Ontarians with SCI/D was 87.96 (95% confidence interval [CI]: 84.45, 91.47), while the mean total RNLI score for the same individuals was 75.61 (95% CI: 71.85, 79.37). Among the MSES domains, the lowest score was observed in response to sexual satisfaction (mean: 4.012, 95% CI: 3.527, 4.497), while the lowest RNLI domain item score was associated with the ability to travel out of town (mean: 5.965, 95% CI: 5.252, 6.678). Individuals with incomplete injuries in rural areas reported lower MSES and RNLI scores than those with complete motor injuries, whereas no significant differences were found in MSES and RNLI scores among urban residents based on impairment. These findings suggest that, depending on the environmental context (e.g., rural vs. urban areas), AIS categories may influence the perception of CP among people living with SCI/D. The OMR tool had 97.4% accuracy in extracting data from the surveys.
The CP (MSES and RNLI) scores reported by individuals with SCI/D differ based on their living setting. In rural Ontario, individuals with greater functional ability reported lower CP than their counterparts living in urban settings. Although CP remains a challenge, the needs of individuals with motor incomplete SCI/D and heterogeneous levels of mobility residing in rural areas require exploration and targeted interventions. The OMR tool facilitates accurate data extraction from surveys across settings.
个人、社会和环境因素可能会影响城乡脊髓损伤或疾病（SCI/D）患者的自我效能感和社会重新融入。新型数据收集方法有可能描绘不同环境下的社区参与情况。
（1）描述和比较加拿大安大略省城乡地区SCI/D患者自我报告的社区参与情况（恢复正常生活指数（RNLI）和莫龙自我效能量表（MSES））水平；（2）确定一种人工智能（AI）光学标记识别工具从参与者从住院康复过渡到家庭并居住在社区后进行的社区参与调查中提取数据的准确性。
2022年1月至10月期间，我们与安大略省脊髓损伤协会工作人员合作，从加拿大安大略省城乡地区患有运动完全性（如AIS A - B）和不完全性（AIS C - D）SCI/D的成年人中收集MSES和RNLI调查数据。根据邮政编码的安大略省农村指数（RIO）确定城乡居住地。使用光学标记识别（OMR）软件提取调查数据。一名研究助理对提取的调查回复进行了验证。使用描述性统计、相关性分析和非参数统计来描述参与者、他们的损伤情况以及他们在城乡环境中报告的社区参与水平。
85名SCI/D患者（平均年龄53.7岁，36.5%为女性）完成了调查。大多数参与者居住在主要城市地区（69.4%），且有创伤性损伤（64.7%）。安大略省SCI/D患者的MSES总平均分是87.96（95%置信区间[CI]：84.45，91.47），而同一批人的RNLI总平均分是75.61（95% CI：71.85，79.37）。在MSES各领域中，性满意度方面得分最低（平均分：4.012，95% CI：3.527，4.497），而RNLI领域项目得分最低的与出城出行能力相关（平均分：5.965，95% CI：5.252，6.678）。农村地区不完全损伤的个体报告的MSES和RNLI得分低于完全运动损伤个体，而城市居民中基于损伤情况的MSES和RNLI得分未发现显著差异。这些发现表明，根据环境背景（如农村与城市地区），AIS类别可能会影响SCI/D患者对社区参与的认知。OMR工具从调查中提取数据的准确率为97.4%。
SCI/D患者报告的社区参与（MSES和RNLI）得分因生活环境而异。在安大略省农村地区，功能能力较强的个体报告的社区参与度低于城市地区的同龄人。尽管社区参与仍然是一项挑战，但对于农村地区运动不完全性SCI/D且行动能力各异的个体的需求仍需探索并进行针对性干预。OMR工具便于从不同环境的调查中准确提取数据。
