Association Between Health Service Systems and Pressure Injury Problems of Individuals With Chronic Spinal Cord Injury in Malaysia, Indonesia, and Thailand: A Cross-sectional Study
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Published:2024-01-19
Issue:10
Volume:103
Page:867-874
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ISSN:1537-7385
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Container-title:American Journal of Physical Medicine & Rehabilitation
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language:en
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Short-container-title:Am J Phys Med Rehabil
Author:
Kammuang-lue Pratchayapon,Pattanakuhar Sintip,Engkasan Julia Patrick,Wahyuni Luh K.,Fauzi Aishah Ahmad,Chotiyarnwong Chayaporn,Kovindha Apichana
Abstract
Objective
The aim of the study is to determine whether a health service system is an independent influencing factor of having pressure injury problems in individuals with chronic spinal cord injury living in three countries
Design
This is a cross-sectional study.
Methods
Data from the International Spinal Cord Injury Community Survey were analyzed. The pressure injury problems were assessed using the Spinal Cord Injury Secondary Condition Scales (dichotomized to “having problem” and “not having problem”). Health service systems were categorized as an inpatient-oriented spinal cord injury–specialized system and a primary care–oriented system. A directed acyclic graph was applied to create a multivariable logistic regression model to determine the independent influencing factors of pressure injury problems.
Results
Of 790 included participants, 277 (35%) had pressure injury problems. Being recruited from countries with inpatient-oriented spinal cord injury–specialized systems (model 1) and visiting rehabilitation medicine/spinal cord injury physicians at least once a year (model 2) is an independent negative correlating factor of pressure injury problems (odds ratio = 0.569 [95% confidence interval = 0.374–0.866] and 0.591 [95% confidence interval = 0.405–0.864], respectively).
Conclusions
Spinal cord injury–specialized health service systems might be a protective factor of pressure injury problems in middle-income country contexts. This result suggests the importance of having spinal cord injury–specialized services in middle-income countries to reduce the prevalence of pressure injury problems.
To Claim CME Credits
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME
CME Objectives
Upon completion of this article, the reader should be able to: (1) Identify the best strategy for managing pressure injury problems in people with spinal cord injury. (2) Describe common methods for determining health service utilization and evaluating secondary health conditions in people with spinal cord injury. (3) Discuss the advantage of having a SCI-specialized rehabilitation system in middleincome countries as a protective factor from having pressure injury problems.
Level
Advanced
Accreditation
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Publisher
Ovid Technologies (Wolters Kluwer Health)