Psychological and socioeconomic status, complications and quality of life in people with spinal cord injuries after discharge from hospital in Bangladesh: a cohort study

Abstract

Study design: Mixed retrospective-prospective cohort study. Objectives: To determine psychological and socioeconomic status, complications and quality of life in people with spinal cord injuries (SCI) after discharge from a hospital in Bangladesh. Setting: Bangladesh. Methods: All patients admitted in 2011 with a recent SCI to a hospital in Bangladesh were identified. Patients were interviewed by telephone in 2014 using translated versions of the SF12, the SCI Secondary Conditions Scale, the Centre for Epidemiologic Studies Depression Scale (CESDS) and the Participation Component of the WHODAS. Questions were also asked about employment, living and financial situation, and opportunities to get out of bed and out of the house. Data were stratified by ability to walk on discharge.Results: A total of 350 people were discharged with a recent SCI in 2011. By 2014, 55 had died. Of those still living, 283 were interviewed (96% follow-up rate). At the time of interview, 47% of participants were employed. One-quarter (26%) of those who were wheelchair-dependent had a pressure ulcer. The mean (s.d.) scores for the Mental and Physical Component of the SF12 were 32.0 points (5.5) and 35.8 points (3.9), respectively. The median (interquartile range) scores for the SCI Secondary Conditions Scale, CESDS and WHODAS for those who were wheelchair-dependent were 15% (10 to 19), 11 points (9 to 18) and 26 points (23 to 26), respectively. Conclusion: Many people with SCI in Bangladesh are house-bound, unemployed, living in poverty and have pressure ulcers. They experience moderate rates of depression and report limited quality of life.

Utility of the World Health Organization Disability Assessment Schedule and the World Health Organization minimal generic set of domains of functioning and health in spinal cord injury

“…It is natural that, when those with a complete motor lesion were compared with those with an incomplete lesion, a complete lesion was associated with more difficulties in getting around and self-care. In our study, inability to walk was correlated with other impairments (getting around, self-care, participation and cognition) as in previous studies, which found wheelchair-dependency (36,37) and mobility restrictions (17) to increase difficulties in other domains of participation (17,37) and to decrease quality of life (36). Also, current employment was found to be associated with other domains (mobility, self-care, and life activities) in our study population.…”

Thermodysregulation in persons with spinal cord injury: case series on use of the autonomic standards

“…This lack of protection against climate change is especially true for those persons with SCI living in underdeveloped countries. Thus, increases in global temperature may further challenge decentralized thermoregulatory mechanisms and expose the vulnerability of persons with SCI to hyperthermia and challenge survival when attempting to cope with prolonged heat exposure [42][43][44][45][46].…”

Barriers and Facilitators for Wheelchair Users in Bangladesh: A Participatory Action Research Project

“…In spite of a promising political environment for people with disabilities, research still indicates that many people with spinal cord injury (often wheelchair users) in Bangladesh rarely leave their homes, have reduced opportunities for employment, experience poverty, and have secondary conditions such as pressure ulcers (Hossain et al, 2016). Additionally, evidence demonstrates that people with spinal cord injury in Bangladesh report low total community integration and life satisfaction (Ahmed et al, 2017).…”

“…Additionally, evidence demonstrates that people with spinal cord injury in Bangladesh report low total community integration and life satisfaction (Ahmed et al, 2017). Researchers have also indicated that people with spinal cord injury, many of whom use wheelchairs, have moderate rates of depression and report limited quality of life (Hossain et al, 2016) as well as lower self-efficacy (which has been linked to depression) (Villanueva et al, 2017). In the light of this situation, there is a necessity for better identification of barriers in the hope that policy-makers and service providers may then direct their attention to facilitate effective interventions and improve the quality of life for this population (Hossain et al, 2016;Ahmed et al, 2017).…”