Relationship of patient characteristics and rehabilitation services to outcomes following spinal cord injury: The SCIRehab Project

Whiteneck, Gale G.; Gassaway, Julie; Dijkers, Marcel P.; Heinemann, Allen W.; Kreider, Scott

doi:10.1179/2045772312y.0000000057

Cited by 49 publications

(70 citation statements)

References 53 publications

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“…These outcomes and the processes of obtaining them are described in detail in the first article in this SCIRehab series. 24 The…”

Section: Outcome Datamentioning

confidence: 99%

“…All FIM data were Rasch-transformed to convert ordinal FIM scores into scores on a continuous interval scale, as described in the Whiteneck article in this series. 24 Outcome measures at the 1-year anniversary include the FIM motor score, the Physical 31 place of residence, whether the person was working or in school, presence of a PU, and re-hospitalization during the period from rehabilitation discharge to the anniversary interview.…”

Section: Outcome Datamentioning

confidence: 99%

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Relationship of nursing education and care management inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: The SCIRehab project

Bailey

Dijkers

Gassaway³

et al. 2012

The Journal of Spinal Cord Medicine

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Objective: To investigate associations of nursing bedside education and care management activities during inpatient rehabilitation with functional, participation, and quality-of-life outcomes for patients with traumatic spinal cord injury (SCI). Methods: In a prospective observational study, data were obtained by means of systematic recording of nursing activities by registered nurses (RNs), chart review and patient interview. Results: Greater patient participation in nursing activities is associated with better outcomes. More time spent by RNs in coordination with other members of the care team, consultants and specialists, along with participation in physician rounds (team process) is associated with patient report of higher life satisfaction and higher CHART mobility at the one-year injury anniversary; more time providing psychosocial support is associated with higher CHART mobility and occupation scores and with greater likelihood of working or being in school at the anniversary. More time spent providing education about specific care needs is associated with several outcomes but not as consistently as might be expected. Conclusion(s): Higher levels of patient participation in nursing care activities is associated with multiple better outcomes, and hence, nurses should promote active patient participation during all aspects of care and interactions between themselves and patients with SCI. Time spent providing psychosocial support of patients and their families should be evaluated to ensure that other necessary education or care management interventions are not minimized. Note: This is the seventh of nine articles in the SCIRehab series.

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“…These outcomes and the processes of obtaining them are described in detail in the first article in this SCIRehab series. 24 The…”

Section: Outcome Datamentioning

confidence: 99%

Section: Outcome Datamentioning

confidence: 99%

Relationship of nursing education and care management inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: The SCIRehab project

Bailey

Dijkers

Gassaway³

et al. 2012

The Journal of Spinal Cord Medicine

Self Cite

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“…In such cases, SLP would not typically be consulted. Table 1 lists patient demographic and injury characteristics for the SCIRehab primary sample of 1032 (additional details are provided in the first article in this series 19 ) and for two subsamples (with and without TBI + CCL). The SCI/TBI + CCL subsample has significantly more patients who are married but there are no significant differences by age, gender, primary language, educational level, or occupation status at the time of injury.…”

Section: Resultsmentioning

confidence: 99%

“…19 Five outcomes thought to be relevant to patients with SCI/TBI or to SLP treatment goals were selected: two measures of cognitive status -cognitive FIM score at discharge and at 1-year post-injury; two measures of societal participation -CHART 10,25,26 Social Integration and Occupation; and one measure of mood state as measured by the Patient Health Questionnaire -brief 9 question version (PHQ-9). 27 Cognitive FIM items include comprehension, expression, social interaction, problem solving, and memory.…”

Section: Outcome Datamentioning

confidence: 99%

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Relationship of speech-language pathology inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: The SCIRehab Project

Gordan

Gerber

David

et al. 2012

The Journal of Spinal Cord Medicine

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Background/objective: Describe associations of patient characteristics and speech-language pathology (SLP) interventions provided during impatient rehabilitation for spinal cord injury (SCI) to outcomes at discharge and 1-year post-injury. Methods: Speech-language pathologists at six inpatient rehabilitation centers documented details of treatment provided. Least squares regression modeling was used to predict outcomes at discharge and 1-year injury anniversary. Cognitive, participation, and mood outcomes for a subsample of patients with traumatic brain injury (TBI) and cognitive-communication limitations (CCLs) were examined. Results: SLP treatment factors explain a small amount of variation in cognitive Functional Independence Measure (FIM), participation, and mood. Variation explained by treatment factors for cognitive outcomes at the time of discharge increased when the patient group was more homogeneous (patients with TBI and CCLs). More time in SLP cognitive-communication interventions had a negative relationship, while longer length of stay was positive. The added explanatory power was not seen for similar outcomes at 1-year post-injury. Conclusion: Patients with SCI who have the greatest need for interventions to address cognitive limitations due to TBI receive the most SLP cognitive-communication treatment and show the greatest amount of improvement during rehabilitation. Their cognitive functioning remained impaired at discharge; this likely accounts for the consistent finding that more hours of SLP cognitive-communication treatment is associated with lower cognitive FIM scores at discharge. Future research on individuals with dual SCI and TBI should include more comprehensive assessment of individual differences in cognitive performance in order to better examine the complex relationships between SLP treatments and outcomes. Note: This is the fifth of nine articles in this SCIRehab series.

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Disparities in Health Care for Black Patients in Physical Medicine and Rehabilitation in the United States: A Narrative Review

Odonkor

Esparza

Flores

et al. 2020

PM&R

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Racial health disparities continue to disproportionately affect Black persons in the United States. Black individuals also have increased risk of worse outcomes associated with social determinants of health including socioeconomic factors such as income, education, and employment. This narrative review included studies originally spanning a period of approximately one decade (December 2009‐December 2019) from online databases and with subsequent updates though June 2020. The findings to date suggest pervasive inequities across common conditions and injuries in physical medicine and rehabilitation for this group compared to other racial/ethnic groups. We found health disparities across several domains for Black persons with stroke, traumatic brain injury, spinal cord injury, hip/knee osteoarthritis, and fractures, as well as cardiovascular and pulmonary disease. Although more research is needed, some contributing factors include low access to rehabilitation care, fewer referrals, lower utilization rates, perceived bias, and more self‐reliance, even after adjusting for hospital characteristics, age, disease severity, and relevant socioeconomic variables. Some studies found that Black individuals were less likely to receive care that was concordant with clinical guidelines per the reported literature. Our review highlights many gaps in the literature on racial disparities that are particularly notable in cardiac, pulmonary, and critical care rehabilitation. Clinicians, researchers, and policy makers should therefore consider race and ethnicity as important factors as we strive to optimize rehabilitation care for an increasingly diverse U.S. population.

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Relationship of patient characteristics and rehabilitation services to outcomes following spinal cord injury: The SCIRehab Project

Cited by 49 publications

References 53 publications

Relationship of nursing education and care management inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: The SCIRehab project

Relationship of nursing education and care management inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: The SCIRehab project

Relationship of speech-language pathology inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: The SCIRehab Project

Disparities in Health Care for Black Patients in Physical Medicine and Rehabilitation in the United States: A Narrative Review

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