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  4. Seeking sufficient and appropriate care during the first year after spinal cord injury: a qualitative study

Seeking sufficient and appropriate care during the first year after spinal cord injury: a qualitative study

Spinal Cord, 2024 · DOI: https://doi.org/10.1038/s41393-024-00974-x · Published: March 16, 2024

Spinal Cord InjuryHealthcareRehabilitation

Simple Explanation

This study explores the challenges faced by individuals with spinal cord injuries (SCI) in accessing rehabilitation and community reintegration during the first year after their injury. The research highlights that people with SCI often experience difficulties in receiving sufficient and appropriate care, facing barriers such as shorter hospital stays and limited access to specialized services. The study also points out issues with insurance coverage and the need for better rehabilitation models to support individuals with SCI in their transition to independent living.

Study Duration
1 Year
Participants
20 individuals with newly-acquired SCI
Evidence Level
Longitudinal qualitative study

Key Findings

  • 1
    Participants experienced an average of four transitions across healthcare institutions within the first three months post-injury, indicating a fragmented care pathway.
  • 2
    Half of the participants were discharged to skilled nursing facilities (SNF), where they faced challenges such as difficulty choosing a facility and premature cessation of therapy.
  • 3
    Resource navigation proved challenging, with participants reporting barriers to communication, information access, and managing multiple concerns simultaneously.

Research Summary

This study investigates the experiences of individuals with spinal cord injury (SCI) during their first year post-injury, focusing on their navigation of rehabilitation, resources, and community reintegration. The research reveals significant challenges in attaining sufficient and appropriate rehabilitation, highlighting issues such as discharge (un)readiness, length of stay uncertainty, and difficulties in choosing skilled nursing facilities. The study concludes that innovative rehabilitation models are needed to improve the transition to independent living for individuals with SCI, emphasizing the importance of addressing systemic barriers and power imbalances in healthcare.

Practical Implications

Improve Transition Planning

Develop more comprehensive discharge planning processes that address individual readiness and long-term rehabilitation needs.

Enhance Access to Specialized Care

Increase access to SCI-specialized care and knowledgeable practitioners in community settings.

Address Insurance Barriers

Advocate for policy changes that ensure sufficient insurance coverage for rehabilitation services and reduce the influence of insurance institutions on care decisions.

Study Limitations

  • 1
    The study is limited to participants from one regional SCI rehabilitation center in the Midwestern U.S.
  • 2
    The data may not reflect the experiences of individuals with lower-level SCI.
  • 3
    The study primarily includes participants with cervical SCI, which may not be representative of all SCI populations.

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