What happens post‐lockdown for people with disability? Autonomy, quality of life, service access and health changes for people with spinal cord injury in Victoria, Australia after COVID ‐19 social distancing restrictions

Abstract

Social distancing restrictions are undoubtedly important for controlling the spread of COVID‐19 however, they are also adversely impacting population health and health service access. It is important that priority populations with a disability which may already have adverse health, access to health services, and autonomy and participation compared to those without disability, are able to receive preventative health and social care during periods of restriction. The impact of social distancing restrictions on people with disability is not uniform nor well‐understood. Research has been cross‐sectional and considered data gathered during social distancing restrictions, or longitudinal, considering data gathered during a pre‐pandemic baseline. This longitudinal study investigated the impact of lifting social distancing restrictions on priority domains for people with disability including autonomy and participation, access to health services, health issues and quality of life. People with spinal cord injury in Victoria, Australia ( n = 71) completed a survey towards the end of social‐distancing restrictions (T1) and 6‐months post social distancing restrictions (T2). Non‐parametric tests for significant differences confirmed that 6‐months post‐lifting social distancing restrictions participants experienced a significant increase in health conditions, a significant decrease in the number of inaccessible health services, and a significantly lower level of limitations across participation and autonomy, outdoor autonomy and work and education domains. QOL improved 6‐months post lifting restrictions, however not to a significant level. The adverse health experienced by people with spinal cord injury after lifting restrictions may in part result from limited health service access and reduced participation during the time of restrictions. Clear definitions of what constitutes as essential care may ensure that eligible and required care remains received during lockdown or instances when service provision is compromised. Health and social care providers should be equipped with the knowledge of priority populations so that their support can be targeted to those most in need.

The impact of the COVID-19 virus and pandemic on healthcare utilization, access, delivery, experiences, and outcomes in the spinal cord injuries/dysfunction population: A scoping review study

“…Study country and setting are listed in Table 1 . Nine studies were conducted in North American countries [ 2 , 9 , 29 – 35 ], five studies were conducted in European countries [ 17 , 36 – 40 ], three in Asian countries [ 41 – 44 ], one in Australia [ 45 ], and one in South America [ 46 ]. Four studies were conducted internationally spanning multiple countries and continents [ 47 – 50 ].…”

“…Four studies were conducted internationally spanning multiple countries and continents [ 47 – 50 ]. Eighteen studies were conducted in outpatient settings in the community [ 2 , 9 , 17 , 29 – 35 , 39 – 41 , 43 , 45 , 46 , 48 , 49 ]. three were conducted in in-patient settings [ 36 , 38 , 44 ], two were conducted in both outpatient and in-patient settings [ 47 , 50 ], and one study’s setting was not described [ 42 ].…”

“…Eight studies were qualitative, with three using interviews [ 9 , 32 , 42 ], four using surveys with open-ended questions [ 17 , 31 , 34 , 46 ], and one using focus groups [ 41 ]. Fifteen studies were quantitative, with four that were retrospective using patient chart data or health administrative databases [ 2 , 30 , 33 , 36 , 37 ], eight using survey data [ 29 , 35 , 39 , 43 , 45 , 48 – 50 ], and three using patient data (prospective chart review/clinical data, intake questionnaire and video consults) [ 38 , 40 , 44 ]. One study was mixed methods and used survey data which included open-ended and closed-ended questions [ 47 ].…”

“…Of the 22 studies that used patients/individuals level SCI/D data, 11 studies investigated findings in both TSCI and NTSCD [ 2 , 17 , 31 – 34 , 40 , 41 , 44 , 48 , 49 ], and two studies only focused on TSCI [ 35 , 36 ]. However, nine studies did not specify if participants had a TSCI or NTSCD [ 9 , 29 , 30 , 38 , 39 , 42 , 43 , 45 , 46 ]. Most studies (19/22) reported additional injury/dysfunction and/or comorbidities characteristics of participants [ 9 , 17 , 30 – 36 , 38 , 39 , 41 – 46 , 48 , 49 ].…”

“…Most studies (19/22) reported additional injury/dysfunction and/or comorbidities characteristics of participants [ 9 , 17 , 30 – 36 , 38 , 39 , 41 – 46 , 48 , 49 ]. With the exception of two studies [ 2 , 44 ], all other studies reported the breakdown of either gender or sex for participants, with no studies reporting both [ 9 , 17 , 29 – 36 , 38 – 43 , 45 , 46 , 48 , 49 ]. No studies investigated differences between sex or gender.…”