Browsing by Author "Lijodi, Brenda Ayuma"

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    The unmet functioning needs of persons with long term traumatic spinal cord injury in Kenya
    (Stellenbosch : Stellenbosch University, 2023-03) Lijodi, Brenda Ayuma; Joseph, Conran; Titus, Adnil; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Physiotherapy.
    ENGLISH SUMMARY: Background: Spinal Cord Injury (SCI) is damage of the spinal cord due to trauma, disease, or degeneration, leading to activity limitations and participation restrictions of the individual in the society. In Kenya, there is only one referral hospital for spinal cord injury rehabilitation After discharge, follow up in the community is rarely done. There is therefore a need to better understand the unmet functioning needs of persons with SCI in Kenya. Aim: To determine the unmet functioning needs, in terms of health status (secondary medical conditions), activity limitations, and participation restrictions, as well as the prevalence of environmental challenges of community- dwelling of persons with TSCI (PWTSCI). Methods: : A cross-sectional design was used to determine the health status and functioning of persons with SCI (PWSCI). A report of the secondary medical conditions (SMC), activity limitations, participation restrictions and environmental barriers was compiled using the International Spinal Cord Injury Community Survey (InSCI) questionnaire. The demographic information was summarized using descriptive statistics. Inferential statistics, i.e., measures of association, were done to ascertain differences in sub-groups, for example, sex, level of injury, completeness of injury, and duration of injury Results: 66 (73%) were categorically male and 24 (27%) females, with a male to female ratio of 2.8:1. The mean age at the time of injury was 32.04 years (s.d. 9.60), while most of the participants were in the 31-45 age group. Economically, 40% of the participants received a monthly income of less than 1100 Kshs (approx. 11 USD). 90% had paraplegia and 66% of participants presented with complete SCI. In terms of secondary medical conditions, the most common reported were bladder dysfunction (60%), sexual dysfunction (57%), pain (44%), and bowel dysfunction (47%). The least reported complications were injury caused by loss of sensation (3%), autonomic dysreflexia (9%), and postural hypotension (12%). The leading SMC in males was sexual dysfunction at 62% while in females, bladder dysfunction at 70%. The leading SMCs among participants with tetraplegia, paraplegia, complete and incomplete injury was bladder dysfunction. Most of the participants experienced activity limitations in toileting (76%), dressing the lower body (63%), dressing the upper body (59%), and bladder management (56%). Participation restrictions reported by most of the participants were using public transportation (90%), standing unsupported (83%), and getting to destination (76%). The leading participation restriction reported by males and females, participants with tetraplegia and paraplegia, complete and incomplete injury, was using public transportation. The prevalent environmental barriers experienced by the participants were inadequate finances (96%), inaccessibility to public places (92%) and lack of adaptive equipment for long distance transportation (90%). Inadequate finances was the most prevalent barrier experienced by both the male and female participants, participants with tetraplegia and paraplegia, and those with complete and incomplete injury. Conclusion: This study highlighted the unmet functioning needs of PWTSCI in Kenya, which will require strengthening of health services, improved access to care, and improved intersectoral collaboration between healthcare, social welfare services, transportation, and infrastructure. Rehabilitation services should also be more community oriented to increase community participation.