Abstract
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.
Keywords
List of abbreviations:
ADL (activities of daily living), IQR (interquartile range), SCI (spinal cord injury)To read this article in full you will need to make a payment
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Article info
Footnotes
Publication of this article was supported by the American Congress of Rehabilitation Medicine.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
