Article

OBJECTIVES: To quantify time from spinal cord injury to upper limb reconstructive
surgery for individuals with tetraplegia; to explore influences on
decision-making about surgery for persons with long-standing (>10y) tetraplegia;
and to determine the applicability of our previously developed conceptual
framework that described the decision-making processes for people with
tetraplegia of <5 years. DESIGN: Quantitative-qualitative mixed-methods study.
SETTING: Community based in New Zealand. PARTICIPANTS: People (N=9) living with
tetraplegia for >10 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
An audit of time frames between injury, assessment, and surgery for people with
tetraplegia was undertaken. Interviews of people with tetraplegia were analyzed
using constructivist grounded theory. RESULTS: Sixty-two percent of people with
tetraplegia assessed for surgery had upper limb reconstructive surgery. Most were
assessed within the first 3 years of spinal cord injury. Over half had surgery
within 4 years after injury; however, 20% waited >10 years. Changes in
prioritized activities, and the identification of tasks possible with surgery,
were influential in the decision-making process. Participants were aware of
surgery, but required a reoffer from health professionals before proceeding. The
influence of peers was prominent in reinforcing the improvement in prioritized
activities possible after surgery. CONCLUSIONS: Findings confirmed that the
previously developed conceptual framework for decision-making about upper limb
reconstructive surgery was applicable for people with tetraplegia of >10 years.
Similarities were seen in the influence of goals and priorities (although the
nature of these might change) and information from peers (although this influence
was greater for those injured longer). Repeat offers for surgery were required to
allow for changes in circumstances over time.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS