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Selkäydinvammaisten henkilöiden terveys, toimintakyky ja kuntoutuminen Suomessa

Year: 2024
Type: dissertation
Study design: Observational Study
Abstract: Spinal cord injury (SCI) in adulthood is caused either by an accident or as a result of an illness. The effects of SCI on health and functioning can be extensive and often require multidisciplinary healthcare. The aim of this doctoral theses was to describe the health, functioning and rehabilitation of Finnish people with SCI. The study researched self-reported functioning, the incidence of both comorbidities and secondary health conditions (SHCs), and the rehabilitation process as described by people with SCI themselves. Comorbidities refer to possible common diseases not caused by SCI, while SHCs are health problems caused by SCI. Mixed methods were applied to explore these themes; At the beginning of the study, a register was created, in which all persons with SCI who met the inclusion criteria, and who had visited the SCI clinics of the University Hospitals of Helsinki, Tampere and Oulu after the 2011 regulation, were recruited, and a comprehensive survey on health, functioning and accessibility was created. A protocol was built to create the survey, which defined the questions to be selected for the survey using the core lists of the International Classification of Functioning, Disability and Health (ICF) of the World Health Organization (WHO). In elucidating the connections between SCI, functioning, comorbidities and SHCs, and background variables, e.g., simple hypothesis testing, linear regression model and negative binomial regression model were used. The rehabilitation process was researched in accordance with the qualitative research method with the help of a content analysis, in which persons with SCI were interviewed to collect the data. As expected, the results show that people who belong to the most severe disability group based on the international classification of SCI (C1-4 AIS A, B, C) have the lowest self-reported functioning, and on the other hand, people who belong to the mildest disability group (AIS D at any injury level) have the highest functioning. The time since the injury has a decreasing effect on the functioning. Those persons who have SCI due to illness have a higher functioning than those with traumatic injuries. The most common comorbidities that people with SCI in Finland suffer from are high blood pressure, back problems and high cholesterol. Compared to the Finnish population, high blood pressure and back problems are more common in the SCI population. The most common SHCs, from which more than 70% of people with a SCI suffer, are joint and muscle pain, muscle spasms, chronic pain and bowel dysfunction. Multimorbidity of comorbidities is the highest among elderly people with SCI and it is also more common in non-traumatic than in traumatic SCI. As a whole, there were found more factors that promote the rehabilitation process than hinder it. The rehabilitation process was divided into six time-advancing phases, of which, in the first, i.e., applying for and entering treatment or assessment of the need for rehabilitation, and in the fourth, i.e., the implementation of rehabilitation, more restrictive than rehabilitation-promoting factors are found. Barriers include delayed assessment of the need for treatment or rehabilitation, challenges in the diagnosis or treatment of SCI, inadequate and challenging treatment of SHCs, various shortcomings in the actions of professionals when implementing rehabilitation, and the rehabilitee’s insufficient possibilities to influence on the implementation of rehabilitation. The successful rehabilitation is based on equal communication and interaction between all stakeholders involved in the process; Good treatment and rehabilitation practices are the result of multidisciplinary teamwork, where the person with SCI is an active member of the team.
Language: English
Field: Medicine
Open Access status: green
OpenAlex ID: W7198224421
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