Environmental barriers and participation restrictions in community-dwelling individuals with spinal cord injury in Jiangsu and Sichuan Provinces of China: Results from a cross-sectional survey
| Autor: | Zizhuo Xu, Guangxu Xu, Yun Yang, Jan D. Reinhardt, Zepeng Gong, Jianan Li |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
030506 rehabilitation
business.industry Cross-sectional study Psychological intervention Outcome measures medicine.disease Social engagement 03 medical and health sciences symbols.namesake 0302 clinical medicine Environmental health symbols Medicine Neurology (clinical) Poisson regression 0305 other medical science business China Tetraplegia Spinal cord injury 030217 neurology & neurosurgery |
| Zdroj: | The journal of spinal cord medicine. |
| ISSN: | 2045-7723 |
| Popis: | Objective (1) to describe environmental barriers and participation restrictions experienced by people with spinal cord injury (SCI) from China, (2) to examine associations between lesion characteristics and participation restrictions, considering a mediating role of environmental barriers, (3) to identify those environmental barriers that have the largest influence on participation. Design Cross-sectional study. This study is part of the International Spinal Cord Injury Survey (InSCI). Setting Community, Jiangsu and Sichuan Province, China. Participants 1355 persons with SCI. Interventions Not applicable. Outcome measures Participation restrictions were measured with items from the Model Disability Survey, Environmental Barriers were measured with the Nottwil Environmental Factors Inventory-Short Form. Results Participants experienced a median of five (IQR 1-9) environmental barriers and five (IQR 0-9) participation restrictions. Environmental barriers were mainly reported in relation to climate, insufficient resources and accessibility, and participation restrictions mainly occurred in using public transportation, taking care of others, and getting to places. In an adjusted zero-inflated Poisson model, people with more severe injuries reported a greater number of environmental barriers (complete injury: IRR = 1.31, 95%CI = [1.24,1.38]) and participation restrictions (tetraplegia: IRR = 1.15, 95%CI = [1.10,1.21]; complete injury: IRR = 1.25, 95%CI = [1.18,1.31]). Moreover, environmental barriers (IRR = 1.07, 95%CI = [1.06,1.08]) were a significant predictor of participation restrictions and partially mediated the association of lesion completeness with participation restrictions. Barriers related to accessibility of public places (IRR = 1.47, 95%CI = [1.33,1.62]), accessing homes (IRR = 1.32, 95%CI = [1.21,1.44]), long distance transportation (IRR = 1.11, 95%CI = [1.04,1.20]), communication devices (IRR = 1.07, 95%CI = [1.01,1.15]) and state services (IRR = 1.10, 95%CI = [1.02,1.19]) had the greatest negative impact on participation. Conclusion Social participation of people with SCI is seriously restricted in China. Removing environmental barriers will be an important element of programs to address this problem. |
| Databáze: | OpenAIRE |
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