Environmental barriers perceived by the Finnish population with spinal cord injury: a cross-sectional survey

Spinal Cord, 2024 · DOI: https://doi.org/10.1038/s41393-024-00990-x · Published: April 23, 2024

Simple Explanation

This study examines the environmental barriers (EBs) that people with spinal cord injuries (SCI) in Finland face, using the Nottwil Environmental Factors Inventory Short Form (NEFI-SF). The goal was to identify the most common barriers that hinder their participation in society. The survey asked participants about various potential barriers, such as accessibility, attitudes, climate, finances, and transport, and how much these factors made their daily life harder. The study found that climate, public access, private home access, and challenges with transport were the most frequently reported barriers. These findings can help in developing strategies to improve accessibility and reduce the impact of these barriers on the lives of people with SCI.

Study Duration

2/2019 - 7/2019

Participants

880 individuals with spinal cord injury

Evidence Level

Cross-sectional survey

Key Findings

1
Climate was the most frequently perceived environmental barrier, with 72% of respondents reporting difficulties and 44% considering it a serious barrier.
2
Public access was also a significant barrier, with 59% reporting it as a barrier and 24% as a serious one.
3
Individuals with more severe spinal cord injuries perceived more restrictions due to environmental barriers compared to those with less severe injuries (AIS D classification).

Research Summary

This study explored the environmental barriers (EBs) that hinder participation for people with spinal cord injury (SCI) in Finland, using the Nottwil Environmental Factors Inventory Short Form (NEFI-SF). The most frequently perceived EBs were climate, public access, private home access, and challenges with transport. Finances and political decisions were also reported as barriers by a significant portion of respondents. The study highlights the need for greater accessibility, equal services, and positive special treatment to reduce the impact of these modifiable EBs on the lives of people with SCI.

Practical Implications

Improved Accessibility

Enhance accessibility to public and private places to facilitate greater participation in society for individuals with SCI.

Policy Development

Inform policymakers about the key environmental barriers faced by people with SCI to create more inclusive and supportive legislation and infrastructure.

Targeted Interventions

Develop targeted interventions to address the specific barriers related to climate and transport, which were identified as significant challenges.

Study Limitations

1
The 50% response rate may introduce response bias, potentially underrepresenting younger individuals.
2
The study focuses exclusively on environmental barriers without analyzing interactions with other factors like activity and participation.
3
Skewness of responses undermines the reliability of the logistic regression models in three items, and the pseudo-R2 statistics are low, suggesting the models explained only some of the variation in reported EBs.

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