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Self-care independence after spinal cord injury: patient and therapist expectations and real life performance.
Lysack, C L; Zafonte, C A; Neufeld, S W; Dijkers, M P.
Afiliación
  • Lysack CL; Institute of Gerontology and Department of Occupational Therapy, Wayne State University, Detroit, Michigan 48202, USA. c.lysack@wayne.edu
J Spinal Cord Med ; 24(4): 257-65, 2001.
Article en En | MEDLINE | ID: mdl-11944784
PURPOSE: To evaluate changes in self-care performance between rehabilitation discharge and 1 year follow-up and to compare patients' and therapists' expectations of self-care independence with actual self-care performance after discharge. METHODS: Prospective study of 55 patients with tetraplegia (21 complete and 34 incomplete) after spinal cord injury (SCI) consecutively admitted to a large urban rehabilitation hospital [injury levels: C4 (5), C5 (33), C6 (9), C7 (4), and C8 (4)]. Data were collected using structured patient interviews, occupational therapists' predictions of patients' self care, and Functional Independence Measure ratings by rehabilitation staff. RESULTS: Analysis showed that for all skills, expectations of patients (mainly African American men) were higher than therapists' predictions, and for 3 of these skills, the differences were statistically significant: eating (Z = -4.47, P < .001 ); bathing (Z = -3.67, P < .001 ); and dressing (Z = -3.16, P = .002). Occupational therapists were better predictors of patients' actual self-care performance at discharge than were patients, although both tended to overestimate patients' performance. There was no evidence that self-care capability declined between discharge and 12 months follow-up, but routine self-care performance varied widely across patient and personal circumstances. CONCLUSIONS: Differential attrition reduced the study sample to 25 SCI patients who were primarily more severely injured African American men. Results showed that these patients maintained their self-care performance 1 year after discharge, but more innovative strategies must be developed to customize self-care retraining to address the unique needs of this patient population.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Relaciones Profesional-Paciente / Autocuidado / Rol del Enfermo / Traumatismos de la Médula Espinal / Evaluación de la Discapacidad Tipo de estudio: Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Spinal Cord Med Asunto de la revista: NEUROLOGIA / REABILITACAO Año: 2001 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Relaciones Profesional-Paciente / Autocuidado / Rol del Enfermo / Traumatismos de la Médula Espinal / Evaluación de la Discapacidad Tipo de estudio: Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Spinal Cord Med Asunto de la revista: NEUROLOGIA / REABILITACAO Año: 2001 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido