Community integration after spinal cord injury rehabilitation: Predictors and causal mediators.
J Spinal Cord Med
; : 1-12, 2024 Aug 12.
Article
en En
| MEDLINE
| ID: mdl-39133061
ABSTRACT
CONTEXT/OBJECTIVE:
Community integration (CI) is a crucial rehabilitation goal after spinal cord injury (SCI). There is a pressing need to enhance our understanding of the factors associated with CI for individuals with traumatic or non-traumatic etiologies, with the latter being notably understudied. Accordingly, our research explores the associations and potential mediators influencing CI across these populations.SETTING:
Specialized neurological rehabilitation center.PARTICIPANTS:
Community-dwelling individuals who were admitted as inpatients within 3 months post-injury (n = 431, 51.9% traumatic, 48.1% non-traumatic), assessed in relation to community integration within 1-3 years after discharge. OUTCOMEMEASURE:
Community Integration Questionnaire (CIQ). Covariates American Spinal Injury Association Impairment Scale (AIS), Functional Independence Measure (FIM) and Hospital Anxiety and Depression Scale (HADS).RESULTS:
Multiple linear regression yielded age, B AIS grade, educational level (< 6 years and <12 years), time since injury to admission, length of stay, HADS-depression at discharge, total FIM at discharge and three social work interventions (support in financial, legal and transportation services) as significant predictors of total CIQ score (Adjusted R2 = 41.4). Multiple logistic regression identified age, traumatic etiology, educational level (< 6 years and <12 years), length of stay, HADS depression at discharge, total FIM at discharge and one social work intervention (transportation support) as significant predictors of good community integration, AUC (95% CI) 0.82 (0.75-0.89), Sensitivity0.76, Specificity0.73. We identified motor FIM at discharge and motor FIM efficiency as causal mediators of total CIQ.CONCLUSIONS:
We identified modifiable factors during rehabilitation-functional independence, depression, and social work interventions-that are associated with CI.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
J Spinal Cord Med
Asunto de la revista:
NEUROLOGIA
/
REABILITACAO
Año:
2024
Tipo del documento:
Article
País de afiliación:
España