Browsing by Author "Du Plessis, Herné"

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    Functioning and satisfaction with health services of persons living with spinal cord injuries in the Western Cape during the COVID-19 pandemic
    (Stellenbosch : Stellenbosch University, 2024-03) Du Plessis, Herné; Titus, Adnil; Joseph, Conran; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Physiotherapy.
    ENGLISH SUMMARY: Background: Spinal cord injuries (SCI) are a severely disabling condition caused by spinal damage due to trauma, disease, or degeneration. As a result, several changes in activities and participation are noted in individuals with SCI. The outbreak in the COVID-19 pandemic forced several changes within the health system to mitigate the spread of the virus, this included changes in service provision at a government-funded specialized in-patient rehabilitation centre in the Western Cape (WCRC). Given that rehabilitation is a critical component for the optimisation of functioning and good health, the complexity surrounding the decisions to limit access to primary healthcare, including rehabilitation at community level, during a pandemic are significant and should be investigated. Aim: To report on the unmet functioning needs and satisfaction with health and rehabilitation services of persons living with SCI, who have been discharged from a specialised rehabilitation centre, in the Western Cape, during the first year of the COVID-19 pandemic. Methods: A descriptive cross-sectional study was used to determine the unmet functioning needs of PWSCI, as well as their satisfaction with utilised health care services. Inclusive sampling was followed, and telephone-based survey was performed. Data on injury characteristics, demographics and socioeconomic profiles, secondary health conditions, activity limitations and participation restrictions, mental health states, and quality of life were collected using a combination of the International SCI Community Survey questionnaire and questionnaires from a previous related study. Satisfaction with health-care services was also evaluated. Data were analysed using descriptive and interferential statistics. Results: Thirty-five participants were included in the study. Sixteen (45.7%) of the individuals had SCI caused by an assault, with 57.1% having tetraplegia and 62.9% having incomplete SCI. The majority of participants (60%) were between the ages of 18 and 30, and 27 (77.1%) were men. The unemployment rate after injury was 94.3%. Spasticity (65.7%), muscular and joint pain (62.9%), and chronic pain (45.7%) were the most common secondary health conditions. The majority of participants (62.9%) reported difficulty walking, transferring from the floor (62.9%), and transferring from bed to a wheelchair (57.1%). For bowel movements, 94.3% of participants utilised suppositories, while 40% used indwelling catheters. In terms of activity and participation, the majority of participants reported difficulties standing unaided (82.9%), managing stress (54.3%), taking public transit (54.3%), and caring for others (51.4%). Happiness was the most common positive vitality and emotional well-being experience (80%), whereas fatigue was the most common negative (82.9%). Approximately 46% of participants reported that their health related QOL was satisfactory. Self-satisfaction was highest at 74.3%, and contentment with living conditions was lowest at 48.6%. Overall, health care staff were lauded for their treatment and communication skills. With 85.7% satisfaction, WCRC provided the best health care services. Conclusion: This study highlighted that there are still unmet functioning needs observed during the first year of the COVID-19 pandemic. The findings suggested that rehabilitation regimens for PWSCI should prioritise addressing the direct consequences of a SCI. It highlights the importance of expert SCI treatment, including multi-disciplinary rehabilitation initiatives, especially in times of crisis.