Management of sleep-disordered breathing in three spinal cord injury rehabilitation centres around the world: a mixed-methods study.
Spinal Cord
; 60(5): 414-421, 2022 05.
Article
em En
| MEDLINE
| ID: mdl-35241799
ABSTRACT
STUDY DESIGN:
Mixed-methods observational study.OBJECTIVE:
To describe the sleep-disordered breathing (SDB) management models of three spinal cord injury (SCI) rehabilitation centres that are screening, diagnosing and treating uncomplicated SDB, and to determine their common elements.SETTING:
Three specialist SCI rehabilitation centres.METHODS:
Data collection at each site included direct observations and interviews with lead clinical staff and an audit of SDB-related clinical practice in 2019. Detailed descriptions of the models of care, including process maps, were developed. A theory-based analysis of the common elements of the three care models was undertaken.RESULTS:
At each centre a multidisciplinary team, consisting of medical, allied health and/or nursing staff, provided a comprehensive SDB management service that included screening, diagnosis and treatment. Inpatients with SCI were assessed for SDB with overnight oximetry and/or polygraphy. Further assessment of patient symptoms, respiratory function, and hypercapnia supported the diagnostic process. Treatment with positive airway pressure was initiated on the ward. Having a collaborative, skilled team with strong leadership and adequate resources were the key, common enablers to providing the service.CONCLUSION:
It is feasible for multi-disciplinary SCI rehabilitation teams to independently diagnose and treat uncomplicated SDB without referral to specialist sleep services provided they are adequately resourced with equipment and skilled staff. Similar models of care could substantially improve access to SDB treatment for people with SCI. Further research is required to determine the non-inferiority of these alternatives to specialist care.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Síndromes da Apneia do Sono
/
Traumatismos da Medula Espinal
/
Reabilitação Neurológica
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Spinal Cord
Assunto da revista:
NEUROLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Austrália