当前位置: X-MOL 学术Arch. Phys. Med. Rehabilit. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Environmental barriers experienced by people with spinal cord injury across 22 countries: Results from a cross-sectional survey
Archives of Physical Medicine and Rehabilitation ( IF 4.3 ) Pub Date : 2020-12-01 , DOI: 10.1016/j.apmr.2020.04.027
Jan D Reinhardt 1 , James Middleton 2 , Andrea Bökel 3 , Apichana Kovindha 4 , Athanasios Kyriakides 5 , Abderrazak Hajjioui 6 , Ken Kouda 7 , , Jolanta Kujawa 8
Affiliation  

OBJECTIVE To investigate the experience of environmental barriers by people with spinal cord injury (SCI) across 22 countries. Specific aims were to describe and compare the prevalence of environmental barriers experienced across countries, and to analyze determinants of environmental barriers at the individual and country levels. DESIGN Cross-sectional community survey Participants: 12,591 individuals living with SCI in the community participated in this study. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE(S) Nottwil Environmental Factors Inventory - Short Form (NEFI-SF). RESULTS Most barriers were experienced in relation to accessibility, climate, transportation, finances, and state services. More severe barriers were experienced in settings with lower gross domestic product (GDP), and here it refers in particular to medical supplies (gamma = -0.38, p<0.001) and finances (gamma = -0.37, p<0.001). However, in a multivariable negative binomial regression employing within-between estimation of the number of barriers experienced on the selected predictors the effect of GDP was reversed when it was adjusted for covariates. On the individual level, the number of experienced barriers decreased with better mental health, and greater self-care ability. People with low income, with paraplegia, complete lesions, and more health problems reported more barriers. On the country level, fewer barriers were reported in countries with higher average age, better mental health and greater self-care ability, and in those with a higher percentage of traumatic SCI, paraplegia and complete lesions. More barriers were reported in countries with a higher percentage of married persons, lower average household income, higher average time since injury, higher mean vitality scores, and greater income inequality. CONCLUSION(S) Study participants reported a significant number of environmental barriers, many of which are modifiable. Complementary interventions are recommended. Within and between country effects of covariates sometimes pointed in different directions, suggesting that countries with a different composition of the SCI population also differed in environmental contexts.

中文翻译:

22 个国家脊髓损伤患者经历的环境障碍:横断面调查结果

目的 调查 22 个国家的脊髓损伤 (SCI) 患者对环境障碍的体验。具体目标是描述和比较各国遇到的环境障碍的普遍性,并分析个人和国家层面环境障碍的决定因素。设计 横断面社区调查 参与者:社区中 12,591 名 SCI 患者参与了这项研究。干预 不适用。主要结果衡量标准 Nottwil 环境因素清单 - 简表 (NEFI-SF)。结果 大多数障碍都与可达性、气候、交通、财政和国家服务有关。在国内生产总值 (GDP) 较低的情况下,遇到了更严重的障碍,这里特别指的是医疗用品(gamma = -0.38,p<0.001)和财务(gamma = -0.37,p<0.001)。然而,在多变量负二项式回归中,在对选定预测变量所经历的障碍数量进行中间估计时,GDP 的影响在针对协变量进行调整时发生了逆转。在个人层面,经历障碍的数量随着心理健康状况的改善和自理能力的增强而减少。低收入、截瘫、完全病变和更多健康问题的人报告了更多障碍。在国家层面,平均年龄较高、心理健康状况较好和自我保健能力较强的国家,以及创伤性 SCI、截瘫和完全病变比例较高的国家报告的障碍较少。在已婚人口比例较高、平均家庭收入较低、自受伤后的平均时间较长、平均活力得分较高以及收入不平等程度较高的国家,报告的障碍更多。结论 研究参与者报告了大量的环境障碍,其中许多是可以修改的。建议进行补充干预。在国家内部和国家之间,协变量的影响有时指向不同的方向,这表明 SCI 人口构成不同的国家在环境背景下也不同。其中许多是可修改的。建议进行补充干预。在国家内部和国家之间,协变量的影响有时指向不同的方向,这表明 SCI 人口构成不同的国家在环境背景下也不同。其中许多是可修改的。建议进行补充干预。在国家内部和国家之间,协变量的影响有时指向不同的方向,这表明 SCI 人口构成不同的国家在环境背景下也不同。
更新日期:2020-12-01
down
wechat
bug