ارتباط زمان شروع برنامه توانبخشی و شاخص های فردی در افراد با ضایعات نخاعی

نویسندگان
نازیلا اکبرفهیمی 1
فاطمه نصیری 2
سمانه حسین زاده 3
الهام لونی 4
مریم ترابیان 5
1 استادیار، گروه کاردرمانی، دانشگاه علوم توانبحشی و سلامت اجتماعی تهران، ایران
2 کاردرمان، گروه کاردرمانی، دانشگاه علوم توانبحشی و سلامت اجتماعی تهران، ایران
3 استادیار گروه آمار زیستی دانشگاه ایران، ایران، تهران
4 استادیار،گروه علوم بالینی، دانشگاه علوم توانبحشی و سلامت اجتماعی تهران، ایران
5 دکترا پرستاری، واحد توسعه و تحقیقات بیمارستان رفیده، دانشگاه علوم توانبحشی و سلامت اجتماعی تهران، ایران
چکیده
مقدمه: شروع هرچه سریع‌تر خدمات توانبخشی در آسیب نخاعی می‌تواند بهبود استقلال بیمار و بازگشت به جامعه را تسربع کند. در این مطالعه به بررسی نقش شاخص‏های فردی ‏(سن، جنس، تحصیلات، وضعیت تاهل و درآمد) در شروع زمان توانبخشی پرداخته‌شده‏است.

روش: مطالعه توصیفی_تحلیلی (گذشته نگر)‏ و جامعه شامل تمام بیماران دچار آسیب نخاعی که خدمات توانبخشی را دریافت می‎کنند می‏باشد. بدین منظور پرونده 100 بیمار آسیب نخاعی که در سال‏های 1395 تا 1397 برای دریافت خدمات توانبخشی به بیمارستان رفیده مراجعه‌کرده‏بودند به‌صورت دردسترس بررسی‌گردید. بیماران به مدت 21 روز این خدمات را دریافت‌کرده‌بودند. اطلاعات دموگرافیک، تغییرات استقلال عملکردی قبل و پایان 21 روز با استفاده از ابزارFIM[1] بررسی و تحلیل داده‏ها در نرم‌افزار SPSS نسخه 21 و با استفاده از آزمون‏های یو_من ویتنی، کروسکال_والیس، آزمون دقیق فیشر و ضریب همبستگی اسپیرمن انجام‌شد.

یافته‎ها: براساس نتایج، 63 درصد مرد و میانگین سن افراد 39.7 (SD=) سال، 67 درصد مجرد و تنها 5 نفر بی‌سواد بودند. 83 درصد شرکت‌کنندگان درآمد متوسط داشتند. زمان شروع توانبخشی به‌طور میانگین 92 روز بعد از حادثه بوده و سطح استقلال عملکردی به‌طور متوسط 10 واحد تغییرکرده‌بود. بین سطح درآامد و زمان شروع توانبخشی، تداوم درمان و میزان بهبود استقلال عملکردی رابطه معناداری وجودداشت؛ ولی ارتباط معنی‌داری بین زمان شروع توانبخشی با سن، جنس، وضعیت تاهل، تحصیلات، مکانیزم حادثه و سطح ضایعه وجودنداشت.

نتیجه‎گیری: براساس نتایج پژوهش، درمیان عوامل فردی، سطح درآمد با شروع برنامه‏های توابخشی ارتباط دارد و افراد با درآمد بیشتر تداوم درمان بیشتری داشتند. در نتیجه این گروه که استفاده از خدمات توانبخشی را سریع‌تر و با پیوستگی بیشتر شروع کردند، بهبود‏ی بیشتری را درسطح استقلال در انجام فعالیت‏های روزمره زندگی تجربه‌کردند.







[1] functional independence measure score
کلیدواژه‌ها
آسیب نخاعی
توانبخشی
شاخص های فردی
زمان شروع توانبخشی

عنوان مقاله English

Correlation Between Rehabilitation Program Initiation Time and Individual Indicators in Individuals with Spinal Cord Injuries

نویسندگان English

Nazila Akbarfahimi 1
fatemeh Nasiri 2
samaneh hosseinzadeh 3
Elham loni 4
maryam torabian 5
1 Occupational Therapy student, Department of Occupational Therapy, University of Social Welfare & Rehabilitation Sciences, Tehran, Iran
2 Physical Medicine and Rehabilitation Department, Rofaydeh Rehabilitation Hospital, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
3 Samaneh Hosseinzadeh, Assistant Professor, Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
4 Physical Medicine and Rehabilitation Department, Rofaydeh Rehabilitation Hospital, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
5 clinical Research Development Center, Rofeideh Rehabilitation Hospital, University of Social Welfare and Rehabilitation Sciences,Tehran, Iran
چکیده English

Introduction: Starting rehabilitation services for spinal cord injury as soon as possible improve the patient's independence and return to society. The role of individual indicators (age, sex, education, marital status, and income) at the beginning of the rehabilitation period was evaluated.

Methods: This descriptive-analytical (retrospective) study included all patients with spinal cord injury who received rehabilitation services. For this purpose, the records of 100 patients with spinal cord injury who were referred to Rofeideh Hospital for rehabilitation services between 2015 and 2017 were reviewed. These patients received these services for 21 days. Demographic information, changes in functional independence before and after 21 days using FIM (functional independence measure score) tool, checking and analyzing data in SPSS software version 21, and using U-Mann-Whitney, Kruskal-Wallis, Fisher's exact test, and Spearman's correlation coefficient were performed.

Results: In this study, 63% were male and the average age of the subjects was 39.7 (SD=14/90) years, 67% were single and only 5 were illiterate. 83% of participants had an average income. On average, the rehabilitation start time was 92 days after the onset of injury, and the level of functional independence had changed by 10 units. There was a significant relationship between the level of income and the time of rehabilitation, continuation of treatment, and improvement of functional independence, but there was no significant relationship between the time of rehabilitation and: age, sex, marital status, education, mechanism of injury, and level of injury.

Conclusion: The results of this research showed that among individual factors, income level is related to rehabilitation program initiation. On the other hand, people with higher incomes had more continuity of treatment, and as a result, they started using rehabilitation services faster and more consistently and experienced more improvement in the level of independence in performing daily life activities.

کلیدواژه‌ها English

Spinal Cord Injury
Rehabilitation
Individual Indicators
Time of Rehabilitation
1. Yip PK, Malaspina A. Spinal cord trauma and the molecular point of no return. Molecular neurodegeneration. 2012;7(1):1-10.
2. Wyndaele M, Wyndaele J-J. Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey? Spinal Cord. 2006;44(9):523-9.
3. Hasanzadeh Pashang S, Zare H, Alipor A. The efficacy of stress inculation training (SIT) on resilience, anxiety depression and stress among spinal cord injury (SCI) patients. Journal of Jahrom University of Medical Sciences. 2012;10(3):12-20.
4. Abdolahi M. The assessment of rate of utilizing rehabilitation services among spinal cord injured cases of bam earthquake. Journal of Qualitative Research in Health Sciences. 2011;10(1):1-6.
5. Babamohammadi H, Negarandeh R, Dehghan NN. Important coping strategies used by individuals with spinal cord injury: A qualitative study. 2013.
6. de Ruijter LS, de Groot S, Adriaansen JJ, Smit CA, Post MW. Associations between time since onset of injury and participation in Dutch people with long-term spinal cord injury. Spinal Cord. 2018;56(12):1134-43.
7. Guihan M, Roddick K, Cervinka T, Ray C, Sutton C, Carbone L, et al. Physical and occupational therapist rehabilitation of lower extremity fractures in veterans with spinal cord injuries and disorders. The Journal of Spinal Cord Medicine. 2021:1-9.
8. Snyman A, de Bruyn J, Buys T. Goal setting practices of occupational therapists in spinal cord injury rehabilitation in Gauteng, South Africa. Spinal Cord Series and Cases. 2021;7(1):1-6.
9. Stevenson V, Playford E, Langdon D, Thompson A. Rehabilitation of incomplete spinal cord pathology: factors affecting prognosis and outcome. Journal of neurology. 1996;243(9):644-7.
10. Pedretti LW, Early MB. Occupational therapy: Practice skills for physical dysfunction: Mosby London; 2001.
11. Barclay L. Exploring the factors that influence the goal setting process for occupational therapy intervention with an individual with spinal cord injury. Australian Occupational Therapy Journal. 2002;49(1):3-13.
12. Herzer KR, Chen Y, Heinemann AW, González-Fernández M. Association between time to rehabilitation and outcomes after traumatic spinal cord injury. Archives of physical medicine and rehabilitation. 2016;97(10):1620-7. e4.
13. Scivoletto G, Morganti B, Molinari M. Early versus delayed inpatient spinal cord injury rehabilitation: an Italian study. Archives of physical medicine and rehabilitation. 2005;86(3):512-6.
14. Khazaeli K, Hoseini E, Nasir AH, Amarloui M, Ganji MK. Relationship between level of injury and quality of life in spinal cord injury (SCI) patients. Health Monitor Journal of the Iranian Institute for Health Sciences Research. 2019;18(1):45-51.
15. Rahmani Rasa A, Hosseini SA, Haghgoo H, Khankeh HR, Ray GG. Review Paper: Aspects related to Resilience in People with Spinal Cord Injury. Archives of Rehabilitation. 2017;17(4):350-9.
16. Loni E, Moein S, Bidhendi-Yarandi R, Akbarfahimi N, Layeghi F. Changes in functional independence after inpatient rehabilitation in patients with spinal cord injury: A simultaneous evaluation of prognostic factors. The Journal of Spinal Cord Medicine. 2022:1-10.
17. Bastami A, Pashaii Sabet F, Qomarverdi S, Nikbakht Nasraabadi A. Review Study of Requirements for a Model for Home-Based Rehabilitation of Traumatic Spinal Cord Injury. Iranian Journal of Nursing Research. 2017;12(2):45-9.
18. Mackintosh S. The Functional Independence Measure: Australian Physiotherapy Association; 2009.
19. Naghdi S, Ansari NN, Raji P, Shamili A, Amini M, Hasson S. Cross-cultural validation of the Persian version of the Functional Independence Measure for patients with stroke. Disability and Rehabilitation. 2016;38(3):289-98.
20. Ayyoubian M, َAbdollahi I, Amiri M. Study Cause of SCI in Client User of Rehabilitation Services. Archives of Rehabilitation. 2005;5(4):18-23.
21. Cijsouw A, Adriaansen JJ, Tepper M, Dijksta C, Van Linden S, De Groot S, et al. Associations between disability-management self-efficacy, participation and life satisfaction in people with long-standing spinal cord injury. Spinal Cord. 2017;55(1):47-51.
22. Soltani S, Moghadam MM, Amani S, Akbari S, Shiani A, Soofi M. Socioeconomic disparities in using rehabilitation services among Iranian adults with disabilities: a decomposition analysis. BMC health services research. 2022;22(1):1449.
23. Ronen J, Itzkovich M, Bluvshtein V, Thaleisnik M, Goldin D, Gelernter I, et al. Length of stay in hospital following spinal cord lesions in Israel. Spinal Cord. 2004;42(6):353-8.
24. Sumida M, Fujimoto M, Tokuhiro A, Tominaga T, Magara A, Uchida R. Early rehabilitation effect for traumatic spinal cord injury. Archives of physical medicine and rehabilitation. 2001;82(3):391-5.
25. Abdul-Sattar AB. Predictors of functional outcome in patients with traumatic spinal cord injury after inpatient rehabilitation: in Saudi Arabia. NeuroRehabilitation. 2014;35(2):341-7.
26. Tooth L, McKenna K, Geraghty T. Rehabilitation outcomes in traumatic spinal cord injury in Australia: functional status, length of stay and discharge setting. Spinal Cord. 2003;41(4):220-30.