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探索脊髓损伤患者康复的障碍:伊朗的一项定性研究。

Exploring barriers to rehabilitation for individuals with spinal cord injury: a qualitative study in Iran.

作者信息

Nosrati Nejad Farhad, Basakha Mehdi, Charkazi Abdurrahman, Esmaeili Abdullatif

机构信息

Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

出版信息

BMC Health Serv Res. 2025 Jan 28;25(1):167. doi: 10.1186/s12913-025-12284-w.

Abstract

OBJECTIVES

Rehabilitation services are crucial for improving the quality of life and overall health of individuals with spinal cord injuries (SCIs). However, access to adequate rehabilitation remains limited in many regions, including Iran. This study aims to explore the barriers faced by individuals with SCIs in accessing appropriate rehabilitation services within Golestan province, northern of Iran.

METHODS

This study employed a qualitative approach to explore the barriers experienced by individuals with SCIs in accessing rehabilitation services. Fourteen participants were purposefully selected from the Golestan province (north of Iran) until data saturation was reached. Semi-structured interviews were conducted during the summer and fall of 2023, recorded, transcribed, and subjected to rigorous thematic analysis.

RESULTS

The study identified three primary categories of barriers: 1) Personal limiting factors, such as insufficient health literacy and inadequate home adaptations; 2) provider-related, including insufficient expertise, non-professional service delivery, inappropriate facility adaptations, limited service accessibility, and inadequate service provision; and 3) socio-supportive, encompassing companionship needs, financial constraints, insurance limitations, and bureaucratic hurdles.

CONCLUSION

The findings of this study highlight a complex interplay of patient, provider, and societal factors that impede access to rehabilitation services for individuals with spinal cord injuries in Golestan province. While provider-related challenges are prevalent, the significance of individual and socio-supportive factors cannot be overstated. To optimize rehabilitation outcomes, a holistic approach is essential, addressing not only physical impairments but also psychosocial and environmental barriers. The findings of this study underscore the complex interplay of patient, provider, and societal factors that influence access to rehabilitation services for individuals with spinal cord injuries. While provider-related challenges, such as insufficient expertise and limited service accessibility, are significant, the study emphasizes the crucial role of individual and socio-supportive factors in facilitating successful rehabilitation. Addressing these multifaceted barriers requires a holistic approach that considers not only physical impairments but also psychosocial and environmental needs.

摘要

目的

康复服务对于提高脊髓损伤(SCI)患者的生活质量和整体健康至关重要。然而,在包括伊朗在内的许多地区,获得充分康复服务的机会仍然有限。本研究旨在探讨伊朗北部戈勒斯坦省脊髓损伤患者在获得适当康复服务方面所面临的障碍。

方法

本研究采用定性方法,以探究脊髓损伤患者在获得康复服务过程中所经历的障碍。从戈勒斯坦省(伊朗北部)有目的地选取了14名参与者,直至达到数据饱和。在2023年夏秋两季进行了半结构化访谈,记录、转录并进行了严格的主题分析。

结果

该研究确定了三类主要障碍:1)个人限制因素,如健康素养不足和家庭适应性不足;2)与提供者相关的因素,包括专业知识不足、服务提供不专业、设施适应性不当、服务可及性有限和服务提供不足;3)社会支持因素,包括陪伴需求、经济限制、保险限制和官僚障碍。

结论

本研究结果凸显了患者、提供者和社会因素之间复杂的相互作用,这些因素阻碍了戈勒斯坦省脊髓损伤患者获得康复服务。虽然与提供者相关的挑战普遍存在,但个人和社会支持因素的重要性也不容小觑。为了优化康复效果,采取整体方法至关重要,不仅要解决身体损伤问题,还要解决心理社会和环境障碍。本研究结果强调了影响脊髓损伤患者获得康复服务的患者、提供者和社会因素之间的复杂相互作用。虽然与提供者相关的挑战,如专业知识不足和服务可及性有限很重要,但该研究强调了个人和社会支持因素在促进成功康复方面的关键作用。解决这些多方面的障碍需要一种整体方法,不仅要考虑身体损伤,还要考虑心理社会和环境需求。

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